Peer 9 - critical diff

Question 1

time frame for tracheostomy fistula to mature?

Answer 1

1 week

Question 2

first tx step with descending necrotizing mediastinitis?

Answer 2

IV broad spectrum abx then call surgery

Question 3

first intervention with airway/inhalation burns?

Answer 3

RSI

Question 4

most common symptom in cauda equina syndrome?

Answer 4

urinary retention

Question 5

what level does cauda equina typically occur?q

Answer 5

l4-l5

Question 6

tx of hemophilia A in head trauma?

Answer 6

50 units/kg factor VIII then head CT

desired factor VIII level (%) x 0.5 x patient weight kg

Question 7

first line treatment for hypertensive emergency?

Answer 7

nicardipine titrated to MAP of 20% first hour, 25% first day

Question 8

tx of unstable vtach with a pulse?

Answer 8

synchronized cardioversion

Question 9

most common cause of polymorphic VT?

Answer 9

ACS

Question 10

rash of gonococcemia?

Answer 10

pustular dusky pustules

Question 11

sx of myxedema coma?

Answer 11

bradycardia, decreased ventilation, hypotension, hypothermia

Question 12

What should be considered with STEMI EKG pattern?

Answer 12

aortic dissections

Question 13

side effect of dopamine making it poor choice for ventricular arrhythmia?

Answer 13

pro arrhythmic effect

Question 14

preferred treatment for zSTEMI patients with shock or post resuscitation?

Answer 14

PCI

Question 15

tx of GI bleeding from nonvariceal bleeding?

Answer 15

PPI and abx

Question 16

tx of GI bleeding from variceal bleeding?

Answer 16

octreotide and abx

Question 17

signs for left ventricular aneurysm on EKG?

Answer 17

ST segment elevation with q waves in ant leads

Question 18

what are the steps to treating mastoiditis?

Answer 18

oral abx with follow up

iv abx and ENT consult

surgical therapy if above doesn’t work

Question 19

Signs of flexor tenosynovitis?

Answer 19

kenaval signs

• tenderness to palpation over flexor tendon sheath
• symmetric finger swelling
• pain with passive extension
• flexed positioning of digit to minimize pain

Question 20

bacteria in flexor tenosynovitis?

Answer 20

staph, strep, gonorrhea

Question 21

most common causes of infection in transplant patients 1-6 months

Answer 21

CMV, EBV, hepatitis, herpes virus, adenovirus

Question 22

most common cause of infection in transplant patients within 1 month?

Answer 22

wound infections, abscess, catheter-related infections

Question 23

most common causes of infection in transplant patients > 6 months?

Answer 23

s pneumo, CAP

Question 24

if patient has hypokalemic episode what should you check for?

Answer 24

hyperthyroidism

Question 25

gold standard for diagnosing and treating necrotizing soft tissue infections?

Answer 25

surigcal exploration

Question 26

tx of stable WPW with a fib? tx of unstable WPW with a fib?

Answer 26

procainamide synchronized cardioversion

Question 27

gold standard for diagnosis of myocarditis?

Answer 27

cardiac MRI

Question 28

most common complication of necrotizing external otitis?

Answer 28

paralysis of seventh cranial nerve

Question 29

urgent endoscopy is indicated to remove FB when?

Answer 29

ingestion of button, long/sharp object, multiple objects, or 24 hours earlier, airway compromise, perforation

Question 30

tx for narrow complex tachy WPW?

Answer 30

adenosine

Question 31

abx tx for suspected infective endocarditis?

Answer 31

vancomycin

Question 32

most sensitive sign of acute chole?

Answer 32

sonographic murphy sign