SAEM M4 COMPREHENSIVE EXAM UPDATED QUESTIONS
AND ANSWERS GRADED A+
✔✔2 most common bacteria - ✔✔-strep pneumo
-n menigitis
✔✔listeria - ✔✔-over 50
-under 3 mo
-immunocomproised
-pregnany
✔✔most commmon cause of encephalitis - ✔✔virus
✔✔when suspect encephalitis - ✔✔-suspected CNS infxn with ams or FND
✔✔triad meningitis - ✔✔-fever
-neck stiffness
-ams
✔✔common sx meningitis - ✔✔seizure
✔✔kernig - ✔✔flexing the hip and extending knee to elicit pain in back and legs
✔✔brudzinski - ✔✔passive flexion of neck causes flexion oh hip
✔✔when ct before lp 5 - ✔✔-new seizures
-immnocomrpsed
-ams
-fnd
-papilledema
✔✔try and do ____and ______ b4 abx - ✔✔-lp
-blood cultures
✔✔CSF of bacterial meniningits
-glucose
-protein
-wbc
-percent neutrophils
-opening pressure - ✔✔-under 40
-over 200
-wbc over 1000
-80% or more
-increased
,✔✔encephalitis csf - ✔✔-inc wbc with llymhpcoccytic predominace
-inc rbc
✔✔why blood in csf 3 - ✔✔-edema
-hemorrhage
-necrosis
✔✔empiric abx under 1 mo-3mo - ✔✔-amp and cefotaxime
✔✔empiric abx over 3 mo-adult under 50 - ✔✔-dexxamaethasone (maybe fore abx)
-cefotaxime/ceftriazone
-and vanco
✔✔adult over 50 - ✔✔-dexxamaethasone (maybe fore abx)
-cefotaxime/ceftriazone
-and vanco
-and ampicillin
✔✔tx hsv encephalitis - ✔✔acyclovir
✔✔tx other bugs that cause enhceplaitis - ✔✔just supporive care
✔✔why steroid - ✔✔tarted before or concurrently with the first dose of antibiotics may
decrease mortality and neurologic sequelae for some subsets of patients with bacterial
meningitis.
✔✔menigntiis triad prevlanece - ✔✔only there under 50% of time
✔✔order of tx and tests - ✔✔Empiric antibiotics should not be delayed while waiting for
a CT scan prior to an LP if meningitis is a likely diagnosis. When a CT scan is
necessary, draw blood cultures and administer steroids and appropriate antibiotics
before the LP.
✔✔CSF results if inconclusive - ✔✔tx empriicall anyway,csf often doesnt yeild classic
results
✔✔types of seizures - ✔✔simple v. complex
focal. veneralized
focal with secondary generalizaton
✔✔most seizures last - ✔✔1-2min
✔✔clues its seizure - ✔✔-tongue trauma
, -urinary or bowel incontenince
✔✔todds paralysis - ✔✔fnd post seiure
✔✔what 4 sx raise suspicion for what 3 causes of seizures - ✔✔-
tachy/diaphoresis/tremors/anixety
-withdrawal
-drug use
-hypoglycemia
✔✔3 when do epileptics ahve breathru seizures - ✔✔-med noncomplaince
-sleep deprivation
-emotional or physical stress
✔✔causes of seizure - ✔✔GAINCUCOHMW
-low glucose
-anatomic
-infection
-low or high Na
-low calcuim
-uremia
-cocaine
-low o2
-hepatic fail
-low mag
-withdrawal
✔✔new onset first time seizure what tests - ✔✔-chemistry panel
-pregnacy test
✔✔people with epilepsy test - ✔✔get level of their drug
✔✔when get CT - ✔✔new onset seizure
-chance in seizure pattern
-more seizures latlet
-trauma
-new neuro defitic
-anyone in status
✔✔when dc a seizure patient what need - ✔✔mri as outpatient
✔✔when get continuous eeg - ✔✔in status
✔✔alcohol withdraw sx - ✔✔-anxiety
-tremors
AND ANSWERS GRADED A+
✔✔2 most common bacteria - ✔✔-strep pneumo
-n menigitis
✔✔listeria - ✔✔-over 50
-under 3 mo
-immunocomproised
-pregnany
✔✔most commmon cause of encephalitis - ✔✔virus
✔✔when suspect encephalitis - ✔✔-suspected CNS infxn with ams or FND
✔✔triad meningitis - ✔✔-fever
-neck stiffness
-ams
✔✔common sx meningitis - ✔✔seizure
✔✔kernig - ✔✔flexing the hip and extending knee to elicit pain in back and legs
✔✔brudzinski - ✔✔passive flexion of neck causes flexion oh hip
✔✔when ct before lp 5 - ✔✔-new seizures
-immnocomrpsed
-ams
-fnd
-papilledema
✔✔try and do ____and ______ b4 abx - ✔✔-lp
-blood cultures
✔✔CSF of bacterial meniningits
-glucose
-protein
-wbc
-percent neutrophils
-opening pressure - ✔✔-under 40
-over 200
-wbc over 1000
-80% or more
-increased
,✔✔encephalitis csf - ✔✔-inc wbc with llymhpcoccytic predominace
-inc rbc
✔✔why blood in csf 3 - ✔✔-edema
-hemorrhage
-necrosis
✔✔empiric abx under 1 mo-3mo - ✔✔-amp and cefotaxime
✔✔empiric abx over 3 mo-adult under 50 - ✔✔-dexxamaethasone (maybe fore abx)
-cefotaxime/ceftriazone
-and vanco
✔✔adult over 50 - ✔✔-dexxamaethasone (maybe fore abx)
-cefotaxime/ceftriazone
-and vanco
-and ampicillin
✔✔tx hsv encephalitis - ✔✔acyclovir
✔✔tx other bugs that cause enhceplaitis - ✔✔just supporive care
✔✔why steroid - ✔✔tarted before or concurrently with the first dose of antibiotics may
decrease mortality and neurologic sequelae for some subsets of patients with bacterial
meningitis.
✔✔menigntiis triad prevlanece - ✔✔only there under 50% of time
✔✔order of tx and tests - ✔✔Empiric antibiotics should not be delayed while waiting for
a CT scan prior to an LP if meningitis is a likely diagnosis. When a CT scan is
necessary, draw blood cultures and administer steroids and appropriate antibiotics
before the LP.
✔✔CSF results if inconclusive - ✔✔tx empriicall anyway,csf often doesnt yeild classic
results
✔✔types of seizures - ✔✔simple v. complex
focal. veneralized
focal with secondary generalizaton
✔✔most seizures last - ✔✔1-2min
✔✔clues its seizure - ✔✔-tongue trauma
, -urinary or bowel incontenince
✔✔todds paralysis - ✔✔fnd post seiure
✔✔what 4 sx raise suspicion for what 3 causes of seizures - ✔✔-
tachy/diaphoresis/tremors/anixety
-withdrawal
-drug use
-hypoglycemia
✔✔3 when do epileptics ahve breathru seizures - ✔✔-med noncomplaince
-sleep deprivation
-emotional or physical stress
✔✔causes of seizure - ✔✔GAINCUCOHMW
-low glucose
-anatomic
-infection
-low or high Na
-low calcuim
-uremia
-cocaine
-low o2
-hepatic fail
-low mag
-withdrawal
✔✔new onset first time seizure what tests - ✔✔-chemistry panel
-pregnacy test
✔✔people with epilepsy test - ✔✔get level of their drug
✔✔when get CT - ✔✔new onset seizure
-chance in seizure pattern
-more seizures latlet
-trauma
-new neuro defitic
-anyone in status
✔✔when dc a seizure patient what need - ✔✔mri as outpatient
✔✔when get continuous eeg - ✔✔in status
✔✔alcohol withdraw sx - ✔✔-anxiety
-tremors
