Rapid Review

Question 1

Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability and extrapyramidal symptoms.

Answer 1

Antipsychotics, anti-emetics, withdrawal of Parkinson’s medications (NMS)

Question 2

Side Effects of Corticosteroids

Answer 2

acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies,diabetes, hyperglycemia, suppression of HPA

Question 3

Treatment for DTs

Answer 3

benzodiazepines

Question 4

Treatment for Acetaminophen OD

Answer 4

N- acetylcysteine

Question 5

Treatment for Opioid OD

Answer 5

Naloxone

Question 6

Treatment for Benzo OD

Answer 6

Flumazenil (monitor for withdrawal and seizures)

Question 7

Treatment for NMS and MH

Answer 7

Dantrolene

Question 8

Treatement for Malignant HTN

Answer 8

Nitroprusside

Question 9

Treatment of AF

Answer 9

rate control, rhythm conversion, anticoagulation

Question 10

Treatment of SVT

Answer 10

If stable, rate control with carotid massage or other vagal stimulation; if unsuccessful consider adenosine. If unstable, cardiovert (synchronized).

Question 11

Causes of drug induced SLE

Answer 11

INH, penicillamine, hydralazine, procainamide, chlorpromazine, methyldopa, quinidine

Question 12

Macrocytic, megalobalstic anemia with neurologic symptoms…

Answer 12

Vitamin B12 deficiency

Question 13

Macrocytic, megaloblastic anemia without neurologic symptoms…

Answer 13

Folate deficiency

Question 14

Burn patient presents with cherry-red, flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?

Answer 14

Treat CO poisoning with 100% O2 or with hyperbaric O2 if poisoning is severe or patient is pregnant.

Question 15

Blood in urethral meatus or high riding prostate

Answer 15

bladder rupture or urethral injury

Question 16

Test to rule out urethral injury

Answer 16

retrograde cystourethrogram

Question 17

Radiographic evidence of aortic disruption or dissection

Answer 17

widened mediastinum (>8cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of the left main bronchus

Question 18

Radiographic indications for surgery in patients with acute abdomen

Answer 18

Free air under the diaphrgam, extravasation of contrast, severe bowel distension, space occupying lesion (CT), mesenteric occlusion (angiography)

Question 19

Most common organisim in burn related infections

Answer 19

Pseudomonas

Question 20

Method of calculating fluid repletion in burn patients

Answer 20

Parkland formula

24 hour fluids = 4 x kg x %BSA

First half given over the first 8 hours, the remainder given over the next 16 hours.

Question 21

Acceptable urine output in a trauma patient

Answer 21

50 cc/hr

Question 22

Acceptable urine outpatient in a stable patient

Answer 22

30 cc/hr

Question 23

Signs of neurogenic shock

Answer 23

hypotension and bradycardia

Question 24

Signs of increased ICP

Answer 24

Cushing’s Triad: hypertension, bradycardia, abnormal respirations

Question 25

decreased CO, decreased PCWP, increased PVR

Answer 25

hypovolemic shock

Question 26

decreased CO, increased PCWP, increased PVR

Answer 26

cardiogenic or obstructive shock

Question 27

increased CO, decreased PCWP, decreased PVR

Answer 27

distributive (septic or anaphylactic) shock

Question 28

Treatment of septic shock

Answer 28

fluids and antibiotics

Question 29

Treatment of cardiogenic shock

Answer 29

Identify cause, inotrope (dobutamine)

Question 30

Treatment of hypovolemic shock

Answer 30

Identify cause, fluid and blood repletion

Question 31

Treatment of anaphylactic shock

Answer 31

Epi 1:1000 and diphenhydramine

Question 32

Supportive treatment for ARDS

Answer 32

Low tidal volume ventilation

Question 33

Signs of air embolism

Answer 33

Patient with chest trauma who was previously stable suddenly dies.

Question 34

Signs of cardiac tamponade

Answer 34

distended neck veins, hypotension, diminished heart sounds (Beck's Triad) pulsus paradoxus, electrical alternans

Question 35

Absent breath sounds, dullness to percussion, shock, flat neck veins

Answer 35

massive hemothorax

Question 36

Absent breath sounds, tracheal deviation, shock, distended neck veins

Answer 36

tension pneumothorax

Question 37

Treatment for blunt or penetrating abdominal trauma in a hemodynamically unstable patient

Answer 37

Exploratory laparotomy

Question 38

Increased ICP in alcoholics or the elderly following head trauma. Can be acute or chronic. Crescent shaped lesion on CT.

Answer 38

Subdural hematoma

Question 39

Head trauma with immediate LOC followed by a lucid interval and then rapid deterioration. Convex shaped lesion on CT.

Answer 39

epidural hematoma

Question 40

Best next step in patient with recent neck surgery, expanding neck mass/deviated trachea, and airway compromise (noisy breathing).

Answer 40

wound exploration/evacuation of hematoma