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Flashcards in still Deck (26):
1

right-mainstem intubation results in ____________ on cxr

opacification of the left lung secondary to unilateral lack of ventilation.

2

pathology in hemithorax appears as __________, rather than air density (not a pneumothorax) on cxr

hyperdensity

3

Regarding the epidemiology of asthma in the United States, which of the following is true?
-Incidence is comparable for Caucasians and African-Americans
-Etiology is thought to be genetic, not environmental
-Prevalence increased in the 1980's, and then decreased in the 1990's
-More common in males than females in adult and pediatric populations

-Prevalence increased in the 1980's, and then decreased in the 1990's

4

Pulsus paradoxus is defined as ?

a fall in systolic blood pressure of greater than 10mm Hg upon inspiration

5

Which of the following is correct regarding the use of corticosteroids in acute asthma exacerbation?
-Beneficial effects occur within the first hour of administration.
-Intravenous steroids are superior to the oral route
-Tapering is needed with all corticosteroid regimens
-Inhaled steroids should be avoided

-Inhaled steroids should be avoided

6

Which of the following is true regarding the treatment of acute asthma exacerbation in the Emergency Department?

-Anticholinergics by inhalation may be beneficial
-Intravenous albuterol may be indicated
-Heliox should only be used in the intubated patient.
-Intramuscular terbutaline is preferred over intravenous

Anticholinergics by inhalation may be beneficia

7

___________, is a well-recognized occurrence in PNA and should be sought out to ensure appropriate antibiotic coverage.

Co-infection with multiple bacteria, such as Chlamydia and S. pneumoniae

8

Which of the following patients is the most likely to develop S. pneumoniae pneumonia?
-65 year old woman with no past medical history
-59 year old woman who is a cigarette smoker.
-61 year old man with hypertension
-64 year old man with type 2 diabetes

-64 year old man with type 2 diabetes

9

Varicella zoster virus (VZV), the etiologic agent of chicken pox, more commonly presents as__________ in adults, especially smokers or pregnant women

pneumonia

10

Ventricular fibrillation is primarily treated with defibrillation. If three successive shocks and epinephrine have been given, the next line agent would be ?

an antiarrhythmic, such as lidocaine or amiodarone.

11

45 year old male presents to the emergency department with CP. While you are talking to him he becomes unresponsive. The monitor shows ventricular tachycardia. The correct sequence of treatment is:
A. amiodarone
B. intubation
C. central venous access
D. epinephrine
E. immediate defibrillation up to three times

immediate defibrillation up to three times

Unstable VT is treated by a series of three stacked shocks, before medications. Early defibrillation is the key to successful resuscitation

12

optimal dosing of drugs administered endotracheally has not been established, but __________ the IV route is generally accepted

2-2 1/2 times

13

Epinephrine remains the adrenergic drug of choice in the ACLS guidelines- recommended ________ dose. Doses >1 milligram are not recommended and may be harmful.

the administration of 1 milligram IV or IO of a 1:10,000 solution every 3 to 5 minutes

14

asystole treatment of choice is

epinephrine or vasopressin and atropine

15

complete AV block

tno relationship between the P waves (atrial beats) and the ventricular beats.

The latter arises from different foci, thus the QRS complex is wide (impulse is not conducted through the normal pathways) and the rate is often slow at < 50/minutes.

16

Complete heart block is common in the setting of ischemia and also in the peri-infarct period. The treatment for complete AV block in this setting is usually ____________.

permanent pacing

17

An 82 year old man presents from the nursing home with fever, cough, nausea, vomiting and diarrhea. His vitals signs are T 102, P 65, BP 100/50, RR 24, and SpO2 92%. The most likely causative organism is:

Legionella -atypical pathogen commonly causing pneumonia. It is often found in the elderly or others with co-morbid illnesses. It is classically associated with GI symptoms and relative bradycardia.

18

Klebsiella is not a common cause of community-acquired pneumonia. It generally occurs in the elderly, smokers, alcoholics, and those with other co-morbidities. It is classically associated with a bulging fissure on chest X-ray and ____________

currant jelly sputum.

19

_________ is the most common cause of community- acquired pneumonia. Viral is the second most common cause.

Streptococcus pneumoniae

44 year old male presents with fever, cough and shortness of breath. He is a nonsmoker. He has a lobar infiltrate on CXR.

20

A 25 year old female presents with fever, productive cough, and shortness of breath. Physical exam reveals T101, RR 24 and SpO2 of 94%. Her left tympanic membrane is inflamed and there are TM bullae. The chest X-ray reveals a large right middle lobe pneumonia. The organism most commonly associated with this type of presentation is

Mycoplasma pneumoniae is a common cause of pneumonia in young adults. It is classically associated with bullous myringitis.

21

Regarding the role of malignancy in the diagnosis of pulmonary embolism (PE)

25% of PE patients without identifiable risk factors are diagnosed with cancer within 2 years

esophageal and laryngeal cancer, leukemia and lymphoma have a low incidence of PE

ovarian or colon cancers are at higher risk for developing PE- 30% of patients who die of ovarian cancer have PE.

22

Chemotherapy _______ the risk of developing PE.

increases

23

Pulseless electrical activity in Emergency Department cardiac arrest victims is associated with ______ in 33%

PE

24

pneumonia caused by Klebsiella pneumoniae complications

Abscess formation, empyema and bacteremia are frequent complications, and the mortality rate is high

25

____ causes more deaths worldwide than any other infectious agent.

TB

26

T/F ?
Cytomegalovirus does not usually cause pneumonia in immunocompetent adults

true