ER Flashcards

(201 cards)

1
Q

What is acute chest syndrome?

A

Acute chest syndrome is characterized by fever, chest pain, wheezing, cough, hypoxia, and a new lung infiltrate in at least one whole lung segment in patients with a history of sickle cell disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which of the following medications improves mortality in patients with spontaneous subarachnoid hemorrhage (thought to possibly prevent cerebral vasospasm)

A

Nimodipine

a calcium-channel blocker, has been shown to reduce the occurrence of secondary ischemia with a favorable trend toward reducing case fatality. The mechanism of this improvement is unclear, and this benefit has not been demonstrated in other calcium-channel blockers. It is appropriate to administer nimodipine 60 mg PO every 4 hours. If the patient cannot swallow, the nimodipine should be crushed and given via nasogastric tube, as there is no evidence of the efficacy of intravenous nimodipine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What BBs are indicated in heart failure management?

A

Bisoprolol, carvedilol, and metoprolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

_______ is the treatment of choice in hemodynamically stable wide complex tachydysrhythmias in WPW syndrome

A

Procainamide

Electrical cardioversion can be used if procainamide fails or in patients with hemodynamic instability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the Cushing triad of ICP?

A

bradycardia, hypertension and diminished irregular breathing (irregular breathing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the tx for ASA toxicity? What acid base disorder is it associated with?

A

sodium bicarb

metabolic acidosis and respiratory alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the MOA for the botulism toxin?

A

blocks the release of acetylcholine from the nerve terminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the tx for cocaine induced MI? What drug class should be avoided?

A

CCB

BB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the pathophysh behind an herniated disc?

A

the nucleus pulposus protrudes posterolaterally through the annulus fibrosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe a junctional rhythm

A

QRS complex is narrow (unless there is baseline QRS conduction aberrancy), and the rate is typically between 40 and 60 bpm. P waves may be negative or hidden within the QRS complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What effect will the administration of atropine have on third-degree heart block?

A

It alters conduction ratios without changing the appearance of the ventricular escape rhythm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe a first degree heart block

A

defined by normal AV conduction with a prolonged PR interval (> 200 msec). There is a 1:1 relationship between P waves and QRS complexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

head trauma (usually from a fall from significant height or MVA), MC in young adults, LOC followed by a period of lucid interval. Then HA and vomiting. What am I?

A

epidural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Epidural hematoma is a tearing of what artery?

A

middle meningeal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of a lidocaine overdose?

A

dizziness, headache, tingling, tinnitus, sedation, tremors, and seizures. Cardiovascular effects include bradycardia, heart block, and arrhythmia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the max dose of lidocaine without epi?

A

lidocaine is 3-5 mg/kg without epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the max dose of lidocaine WITH epi?

A

lidocaine 5-7 mg/kg WITH epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the Salter-Harris fx classifications?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of Salter-Harris fx is commonly missed on xrays?

A

type I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the definitive way to dx and clear a cervical spine injury?

A

cervical spine MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What information does a flexion-extension cervical spine X-ray provide?

A

joint instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a common cause of subdural hematomas?

A

tearing of bridging dural VEINS due to sudden acceleration-deceleration. WILL cross cranial suture lines

This results in accumulation of blood in the space between the dura mater and arachnoid mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the 2 major risk factors for subdural hematoma?

A

extensive atrophy of the brain (older pts)

alcohol use disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are 4 minor risk factors for subdural hematoma?

A

include age < 2 years

low cerebrospinal fluid volume

prior head trauma

anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
a crescent-shaped lesion that crosses suture lines on noncontrast CT. What dx?
subdural hematoma
26
What opioid is associated with prolonged QTc interval and torsades de pointes?
methadone
27
What medications are used to treat hypertension caused by cocaine toxicity?
bzd and phentolamine
28
What is bilateral interfacetal dislocation most likely to be associated with?
complete cord transection
29
What is the usual cause of bilateral facet dislocation? What is the technical definition?
forceful hyperflexion of the neck complete anterior dislocation of affected vertebral body more than 50% of its width
30
What is Brown-Sequard syndrome?
hemicord syndrome that typically results from unilateral penetrating trauma to the spinal cord
31
What is the best radiologic view for diagnosing a bilateral facet dislocation?
lateral view
32
What is a thoracostomy?
chest tube insertion
33
What opioid can cause mydriasis when taken at toxic doses?
meperidine
34
Why is a septal hematoma an emergency?
the problem is that the perichondrium, which supplies nutrition to the septum, is no longer in contact with the septum because of the intervening hematoma. Thus, the septal cartilage can necrose leading to a perforated septum.
35
What is the treatment for a septal hematoma?
be drained acutely and the nose packed to keep the perichondrium in contact with the septal cartilage
36
What is the appropriate rabies protocol?
human rabies immune globin and 4 doses of inactivated rabies vaccine over 14 days on days: 0 3 7 14
37
What antioxidant is depleted in an acetaminophen overdose?
glutathione is depleted which leads to cell necrosis
38
What can be administered to decrease the amount of drug absorbed if the patient presents early (within 1 hour of ingestion) after a toxic ingestion?
activated charcoal
39
What is the antidose of choice for serious iron overdose?
deferoxamine
40
What is the treatment for lead poisoning?
Edetate disodium calcium or succimer
41
What is the next best stp in the tx of shock-refractory ventriculat fibrillation?
amiodarone 300mg bolus
42
Why is amiodarone used in shock-refractory vfib and pulseless ventricular tachycardia?
drug prolongs action potentials by inactivating sodium channels
43
What medication is an acceptable alternative to amiodarone in refractory ventricular fibrillation?
lidocaine
44
What is the active toxic ingredient in antifreeze?
ethylene glycol
45
What is the antidote for ethylene glycol?
should instantly think antifreeze antidote: *fomepizole* or ethanol
46
What electrolyte disturbance will happen with antifreeze ingestion? What acid-base disorder?
hypocalcemia high anion gap metabolic acidosis
47
What is the super dangerous outcome associated with ethylene glycol toxiciation?
kidney failure (secondary to deposition of calcium oxalate crystals in the renal tubules)
48
What is a Chance fx?
are a variant of the flexion-distraction injury of the spine and occur due to forceful flexion against a restraint. Commonly seen in people who wear only LAP SEATBELTS These fractures typically occur in the thoracolumbar junction, which spans from T11–L2.
49
What are 2 risk factors for Chance fractures?
pregnant pts obesity *commonly seen in peopel who wear only lap seatbelts*
50
What intra-abdominal injuries are most commonly seen with Chance fractures?
Duodenal hematoma or perforation and pancreatic injury.
51
What is the common mechanism of injury for a proximal humerus fracture?
think older adults fall onto an outstretched and abducted arm
52
What is the MC complication of a proximal humerus fx?
adhesive capsulitis
53
What is the most commonly injured nerve in proximal humerus fractures?
axillary nerve
54
________ is indicative of a radial head fx?
posterior fat pad sign elevation of the anterior or *posterior* fat pads (or both)
55
Tenderness of the______ and a positive ____ sign indicate the injury should be treated as a radial head fracture.
lateral elbow fat pad
56
What does the Froment sign test? What is it?
a clinical test used to assess ulnar nerve dysfunction To perform the test, a patient is asked to hold a piece of paper between the thumb and index finger. A positive Froment sign is observed when the patient compensates by flexing the thumb’s interphalangeal joint, indicating weakness of the adductor pollicis due to ulnar nerve impairment.
57
Wrist drop results from damage to the _____ nerve and may point to a _______ fx
radial nerve humeral shaft fx
58
What injury is likely to be present in a child with a raised elbow fat pad?
supracondylar fx
59
describe what chlamydia would look like under a microscope
Chlamydia is a small gram-negative bacterium that is an obligate intracellular parasite as it can only replicate within a host cell.
60
What is the preferred dx test for urethritis?
NAAT: Nucleic acid amplification test
61
Name this skin finding. What dx is it associated with?
dermatitis herpetiformis celiac disease
62
Tissue transglutaminase (tTG) antibody test is positive. What dx?
celiac disease
63
What is the criteria for a stable pt with a pneumothorax?
RR < 24/min HR > 60 and < 120 bpm oxygen saturation > 90% on room air no dyspnea at rest normal blood pressure for the patient, absence of hemothorax
64
What is the most common risk factor for new-onset childhood immune thrombocytopenia?
viral infection
65
gum or nose bleed with petechiae in a child, should think of what diagnosis? What age range?
Primary immune thrombocytopenia 2-6 years old
66
What ECG finding has the highest likelihood ratio for the diagnosis of heart failure?
atrial fibrillation
67
When coding someone, immediately after defibrillation, _____ is the most important next step
chest compressions
68
What is the most likely cardiac arrest rhythm in someone who arrests in public (as opposed to at home)?
ventricular fibrillation
69
What dx?
patellar tendon rupture
70
What is the EKG finding in a PE?
S1Q3T3
71
What is the treatment for pulmonary embolism?
Hemodynamically unstable patients are treated with thrombolysis Stable patients are treated with heparin.
72
what abx for parotitis without a fever?
augmentin or clinda
73
What abx for parotitis with a fever? aka IN pt tx
ampicillin-sulbactam OR clinda OR cephalosporin + metro
74
What antibiotic is appropriate for a pediatric patient with bacterial parotitis and a severe penicillin allergy?
clinda
75
At what size should asymptomatic AAAs be corrected? Give #s for both male and female
male >5.5 cm female >5.0 cm
76
What are the 2 MC risk factors for development of placental abruption?
1. previous placental abruption 2. HTN
77
ped pt with encephalopathy and fatty degeneration of the liver. What dx? What tx? What will have happen before the symptoms started?
Reye's syndrome supportive care ASA exposure in the setting of preceding viral illness
78
what is the preferred BP agent in aortic dissection? What is the preferred imaging modality?
esmolol CTA of the aorta
79
______ is the most consistent finding in a pt with cauda equina syndrome
urinary retention with a palpable distended bladder
80
What is the abx of choice for postpartum infections after c-section?
clina PLUS gentamicin OR ampicillin-sulbactam
81
What is the Beck triad? What dx?
jugular venous distention distant heart sounds hypotension pericardial effusion with tamponade
82
What finding? What dx?
electrical alternans pericardial tamponade
83
What is the MC pt to have Prinzmetal angina?
young patients of Japanese descent may have hx of cocaine use
84
HIV pt with fever, dry cough, CXR that reveals bilateral interstitial infiltrates. What dx? What tx?
Pneumocystis jiroveci pneumonia (PJP) tx: bactrim and if severe prednisone
85
What are the s/sx of cholinergic toxicity poisoning?
think pesticides SLUDGE mnemonic: salivation, lacrimation, urination, diarrhea, gastrointestinal cramps, and emesis BRADYcardia bronchorrhea is excessive production of watery sputum
86
What eye finding is seen in clonidine toxicity?
miosis
87
oil of wintergreen contains what harmful ingredient when consumed in large doses?
salicylates
88
tinnitus, vomiting and diaphoresis strongly suggest ______ toxicity. Which causes what type of acid/base imbalance?
salicylate metabolic acidosis
89
What is a Jones fracture?
transverse fracture at the fifth metatarsal base
90
What is a Bennett fracture?
fx of first metacarpal base
91
What two bones does the base of the fifth metatarsal articulate with?
fourth metatarsal and cuboid
92
Name the facture
Jones fracture
93
pinprick sensation at the site of bite, then mild erythema and swelling, severe cramping pain in the chest and abdomen, hypertension. What dx?
black widow spider bite
94
How much fluid must accumulate in the abdomen before it is detectable by ultrasound examination?
200mL
95
What is the treatment of choice to control the s/sx of a black widow spider bite?
opioids and bzd
96
**What are the 3 components to the Cushing reflex? What does it indicate?
hypertension bradycardia diminished respiratory effort elevated ICP (or herniation)
97
What is the first line PREVENTATIVE therapy for a cluster HA?
verapamil
98
_______ nerve injury is most likely in hyperextension injury. How will it present?
T1 nerve root injury finger abduction, finger adduction, thumb opposition, and wrist flexion. It also provides sensation to the ulnar aspect of the forearm.
99
diarrhea then vomiting should think of _____ as dx
gastroenteritis
100
What are some clues to bacterial sources of gastroenteritis vs viral?
bacterial: diarrheal onset high stooling frequency high fevers > 40 C grossly bloody stools severe abdominal pain
101
What are some historical elements that indicate cardiac causes of syncope?
syncope during exertion palpitations at the time of syncope ECG findings of dysrhythmogenesis (e.g., bifascicular block, intraventricular conduction delay, QT interval abnormalities, Brugada pattern findings) family history of sudden cardiac death lack of postdrome
102
What does staph aureus look like under the microscope?
gram + cocci in clusters
103
Gram-negative diplococci, what common organism?
Neisseria gonorrhoeae
104
Gram-negative rods, What common organisms?
Escherichia coli, Shigella, Proteus, Klebsiella, Salmonella, and Yersinia
105
Gram-positive cocci in pairs, what common organism?
Streptococcus organisms
106
What variant of endocarditis is found in patients with systemic lupus erythematosus?
Libman-Sacks endocarditis, a noninfectious (sterile) thrombotic form of endocarditis.
107
What is the most common cause of acute arterial occlusion?
atrial fibrillation
108
Is Crohn's disease or UC more likely to develop malignancy?
UC is more likely to develop malignancy
109
What is the innervation of the biceps muscle?
The musculocutaneous nerve. The nerve roots for the musculocutaneous nerve are C5, C6, and C7.
110
What are the Kanavel criteria for flexor tenosynovitis?
111
What is the MC bacterial cause of AOM in children?
H influenzae (50-60%) of cases
112
What dysrhythmias can be triggered by premature ventricular contractions?
ventricular tachycardia
113
What does the T wave on an ECG correspond to?
ventricular repolarization
114
Deep symmetric T wave inversions or biphasic T waves in leads V2-V3 are seen in ______ and are highly specific for critical stenosis of the _______ artery.
Wellens syndrome left anterior descending
115
Coved ST segment elevation > 2 mm followed by a negative T wave in leads V1-3 is referred to as the ________
Brugada sign
116
a _________ infarction is characterized by horizontal ST depression with tall, broad R waves and upright T waves in leads V1-3
posterior myocardial infarction
117
Elevation in which right sided lead indicates right ventricular infarction?
V4R
118
ST elevation in aVR > V1 with horizontal ST depression in I, II and V4-6 indicates ________ artery subocclusion or occlusion.
left main coronary artery
119
What are the presenting symptoms of a BB toxicity?
bradycardia, hypotension and heart block can cause hypoglycemia
120
What are the presenting symptoms of clonidine toxicity?
lethargy, miosis and bradycardia
121
What are s/sx of a phenobarbital toxicity?
respiratory depression, hypotension and psychosis
122
What is the tx for iron poisoning?
deferoxamine
123
What is the antidote of choice for a TCA toxicity?
sodium bicarb
124
What is a Jefferson fx?
C1 fracture think football and diving into a shallow pool axial loading
125
Which views should be obtained when obtaining cervical spine X-rays in the setting of trauma?
Anteroposterior, lateral, oblique, and odontoid.
126
What is this rhythm? What is the next best step?
ventricular fibrillation immediate defibrillation
127
What is the MC cause of ventricular fibrillation?
ischemic heart disease
128
What is Brown-Sequard syndrome? What is the usually precepting factor?
hemisection of the spinal cord, most commonly occurring after a penetrating injury. It is characterized by ipsilateral motor loss and proprioception and vibratory sensation deficit, owing to damage to the corticospinal tract and dorsal columns, respectively.
129
What should you NOT due in a pt with aspirin overdose?
do NOT intubate them can make it acidosis worse
130
By what mechanism does a TCA overdose happen?
TCAs act by fast INWARD sodium channel blockade causing QRS complex widening (> 100 msec) on ECG
131
What are the hallmark EKG findings associated with TCA overdose?
WIDE QRS complexes (>100msec) dominant terminal R wave in lead aVR
132
Would find this in an EKG of _____ toxicity
TCA
133
How long after iron ingestion does the serum iron level peak?
2-6 hours after ingestion
134
Define anterior cord syndrome
which is characterized by bilateral loss of motor function and pain and temperature sensation below the level of injury
135
What are the dorsal column of the spinal cord responsible for?
vibration and proprioception
136
What is the most common complication of thoracostomy tube placement?
chest tube malposition
137
HIV antivirals are very likely to cause what type of heart condition?
dilated cardiomyopathy
138
What is the tx for non-sexual transmitted epidimyitis?
levo or ofloxacin atl: bactrim
139
What is the tx for insertive anal intercourse, obstructive uropathy or recent urologic procedure epididymitis?
ceftriazone and levo
140
What clotting factors does warfarin prevent the activation of?
II, VII, IX and X
141
What is the tx for a pt on warfarin with an INR >10?
Patients with an INR > 10 should receive oral vitamin K, holding the next warfarin dose and repeating lab tests in 24–48 hours
142
What is the tx for a pt on warfarin with their INR <10?
should lower or omit their upcoming warfarin doses and have the INR rechecked to ensure it is therapeutic.
143
What blood product may be used to reverse warfarin?
fresh frozen plasma
144
What is the reversal agent for heparin?
protamine sulfate
145
What is the reversal agent for warfarin?
four-factor prothrombin complex concentrate
146
What is the MC affected vessel in an ischemic stroke?
middle cerebral artery
147
When should hypertension be treated in the setting of an acute ischemic stroke?
If the systolic is > 220 mm Hg, the diastolic is > 110 mm Hg, or if the patient has another condition that would benefit from blood pressure control.
148
What is the appropriate management for a child under 1 year of age who aspirates a foreign body and is choking?
Hold the head lower than the feet and alternate five back blows with five chest thrusts.
149
What is the MC ankle injury?
lateral ankle sprain
150
What rhythm? Asymptomatic, HR 50 and lab work is WNL. What is the next step?
Mobitz type II second-degree atrioventricular heart block will require admission for continuous cardiac monitoring (with transcutaneous pacing pads)
151
ECG shows a consistent and unchanged PR intervals followed by a P wave that fails to conduct into a QRS interval. What type of heart block?
Mobitz type II second-degree AV blocks
152
Where is the problem located in a Mobitz type II second-degree AV block?
Mobitz type II second-degree AV block is almost always caused by a disruption in the conduction system BELOW the level of the AV node, usually in the *bundle of His* or in the *bundle branches*.
153
What is the most common objective manifestation of Lyme carditis?
AV block
154
What is the tx for mastitis?
dicloxacillin, cephalexin, or clindamycin
155
What is the pathophys process behind poststreptococcal glomerulonephritis?
immune complex deposition
156
Patients will classically present with hypertension, edema, tea-colored urine, or foamy urine. What dx?
poststreptococcal glomerulonephritis
157
What eye finding is hallmark of idopathic intracranial hypertension?
papilledema
158
What is an alternative to funduscopy when evaluating for papilledema?
ocular US
159
A 72-year-old man with a history of hypertension, emphysema, and depression presents to the emergency department after a house fire. He is awake and alert but screaming in pain due to multiple burns across his body. His exam reveals a 100 kg man with superficial burns of his entire chest, superficial partial thickness burns of his entire left arm and half of his right arm, and deep partial thickness burns of the anterior left lower extremity. Along with admission to a burn unit and wound care, using the Parkland formula, what fluid resuscitation should be started in the emergency department?
45mL of LR over the first 8 hours
160
What type of burns are excluded from the Parkland formula?
superficial burns are excluded!!
161
What are the 5 classifications of burns?
superficial, superficial partial thickness, deep partial thickness, full thickness, and fourth degree from shallowest to deepest
162
What is the monitoring required for DMARDs? Why?
need to monitor CBC due to of bone marrow suppression
163
What bone fracture is MC involved in acute compartment syndrome?
tibia
164
positive anticentromere antibody is associated with what dx?
Scleroderma
165
skin thickening and tightening, Raynauds, GERD, salt and pepper pigmentation of the skin. What dx?
scleroderma
166
What is the most reliable indication of an achilles tendon rupture?
positive thompson test lack of plantar flexion with calf squeeze
167
What does the O'Brien test test for?
glenohumeral joint tear specifically superior labral tear from anterior to posterior
168
oral bisphosphonates should be avoided in what pt population?
pts with esophageal disorders
169
What are the side effects of estrogen therapy in osteoporosis?
increased risk for breast and endometrial cancer
170
Which muscle attachment is inflamed in lateral epicondylitis?
extensor carpi radialis brevis
171
What treatment has proven mortality benefit in STEMI?
ASA
172
What dx? HR is 140, BP 78/50. What tx?
wide complex tachycardia (unstable)
173
Which pathogen should be considered in pneumonia that occurs after an influenza infection?
Methicillin-resistant Staphylococcus aureus (MRSA) or streptococcus pneumoniae.
174
Anti-D immune globulin must be administered within _____ of delivery to be effective in preventing anti-Rh antibody formation secondary to Rh-isoimmunization
72 hours
175
What is the most common cause of large bowel obstruction?
cancer
176
What is the MC type of shoulder dislocation?
anterior
177
What is the common presenting feature of an anterior shoulder dislocation?
externally rotated and slightly abducted acromion will appear prominent and shoulder will lose its normal rounded contour
178
What is the hallmark sign of central vertigo?
falling when walking
179
Describe the nystagmus associated with peripheral vertigo
unidirectional and horizontal-torsional, and auditory symptoms like tinnitus or hearing loss may be present.
180
What medications should be given acutely in an acute angle closure glaucoma situation?
A topical beta-blocker and alpha-agonist, such as timolol and apraclonidine, respectively, along with acetazolamide
181
What is the anti-HTN med of choice for hypertensive encephalopathy?
nicardipine or labetalol
182
What is the anti-HTN med of choice for an acute MI?
nitroglycerin
183
What is the anti-HTN med of choice for aortic dissection?
esmolol rapid acting BB
184
What is the anti-HTN med of choice for eclampsia?
magnesium sulfate
185
What drugs are most likely to cause SJS?
(PEC SLAPP) include penicillin, ethosuximide, carbamazepine, sulfa medications, lamotrigine, allopurinol, phenytoin, and phenobarbital
186
What non-drug is the next most common cause to cause SJS?
Mycoplasma pneumoniae infections
187
Kerley B lines on CXR, should make you think of what dx?
think pulmonary edema or heart failure
188
Westermark sign on CXR. What dx?
pulmonary embolism
189
What causes Kerley B lines on chest X-ray?
engorgement of lymphatic vessels
190
What is the FDA approved tx for scabies?
Permethrin 5% cream on day 1, then reapply in 1-2 weeks then washed off after 8 to 14 hours
191
What rhythm? What cormorbity is commonly associated with it? What is the tx?
Multifocal atrial tachycardia (MAT) irregular rhythm resulting from at least three different atrial foc decompensated chronic lung disease supportive care
192
Where are most anal fissures located?
posterior midline
193
What is the preferred medical management for an ectopic pregnany?
methotrexate
194
What virus is the MC cause of pharyngitis and tonsillitis?
rhinovirus
195
What s/sx when present should make you think of a viral (vs bacterial)
viral: cough, rhinorrhea, conjunctivitis
196
What is the most common complication from a midshaft humerus fx?
radial nerve injury think radial nerve palsy or wrist drop
197
What nerve can be damaged during shoulder dislocation and reduction?
axillary nerve
198
What is the deciding factor when choosing between different treatment options for thromboses external hemorrhoids?
Acutely thrombosed hemorrhoids present for < 48 hours in healthy patients can be treated with excision under local anesthesia using an elliptical incision symptoms present for > 48 hours, is discharge with stool softeners, sitz baths and PCP follow up
199
What neurotransmitter imbalance is responsible for acute dystonic reaction commonly seen in psych pts taking first-generation antipsychotics (haloperidol)?
dopamine receptor blockage, leading to increased cholinergic activity
200
What is the MC cause of a subarachnoid hemorrhage?
ruptured berry aneurysm in the circle of willis
201