Combank EM- Questions With Valid Solutions
Emergency Medical Treatment & Active Labor Act (EMTALA)
Correct Answer - requires medicare-participating hospitals w/
EDs to screen for and treat ALL patients with *emergency* medical
conditions in a NON-discriminatory manner
- only applies to ED, NOT outpatient settings... [can refuse unruly
pts]
- drs have ethical obligation to tx pts w/ immediate, life-threatening
conditions, irrespective of ability to pay, insurance status, race,
ethnicity, or any other factor
are doctors required to treat patients who are verbally abusive with
a URI in ED? Correct Answer - NO - does NOT extend to NON-
urgent conditions or non-urgent situations
what is the typical initial management for salicylate toxicity?
Correct Answer - IV sodium bicarbonate
- if no improvement --> hemodialysis required!
signs of salicylate toxicity? Correct Answer - dizziness,
vomiting, ***TINNITUS***, hearing loss, sweating, fever, confusion,
burning in the mouth and throat, convulsions, and coma
how soon must you give activated charcoal to be effective tx for
salicylate toxicity? Correct Answer - within 2 hours of acute
salicylate ingestion
what does acetazolamide do to urine? Correct Answer -
alkalinizes urine
,Intussusception treatment Correct Answer - prompt reduction
--> air or water soluble contrast ENEMA
Intussusception Correct Answer - telescoping of the intestines
--> severe, episodic, cramping GI pain
- target sign on abdominal US
3 major genetic assoc w/ pheochromocytoma? Correct Answer -
1) RET mutations --> MEN 2A + 2B
2) NF-1
3) VHL syndrome
von Hippel-Lindau disease Correct Answer - 40% RCC. 75%
simple renal cysts.
***Hemangioblastomas CNS.
***Retinal angiomas.
Pancreatic cysts. Pancreatic neoplasms.
50-80% Pheochromocytomas (multiple, bilateral, extraadrenal).
Horner syndrome triad Correct Answer - 1) ptosis
2) miosis (pupil constriction)
3) anhidrosis (lack of sweating)
IPSILATERAL findings
ex - R ICA stroke --> R ipsilateral Horner syndrome
Methanol toxicity Correct Answer - - CNS depression
- tachypnea
- **optic disk hyperemia
- **retinal edema
- **pupil dilation
, - ***increased AG metabolic acidosis + elevated serum osmolality
gap**
what is methanol found in? Correct Answer - - windshield
washer fluid
- antifreeze
- **homade alcohol
methanol = HIGHLY toxic, toxic effects seen within as little as 10 mL
consumption
formic acid production (hepatic conversion of methanol --> FA) -->
inhibits mitochondrial cyt. c oxidase --> cellular hypoxia + metabolic
acidosis
tx for methanol toxicity? Correct Answer - Fomepizole
- decreased methanol metabolism via competitive inhibition of
alcohol dehydrogenase
**if fomepizole NOT available --> can use EtOH, dialysis
what does ETHYLENE GLYCOL toxicity (metabolic acidosis -
MUDPILES) typically present with that methanol toxicity does NOT?
Correct Answer - **renal damage** -->
- nephrolithiasis (calcium oxalate crystals)
- hypocalcemia
- muscle spasms
- hyperreflexia
- QT prolongation
- nystagmus
what is a common lab finding in a pt presenting w/ UPPER GI
bleeding (coffee ground hematemesis + melena)? Correct Answer
- increased BUN/Cr ratio
Emergency Medical Treatment & Active Labor Act (EMTALA)
Correct Answer - requires medicare-participating hospitals w/
EDs to screen for and treat ALL patients with *emergency* medical
conditions in a NON-discriminatory manner
- only applies to ED, NOT outpatient settings... [can refuse unruly
pts]
- drs have ethical obligation to tx pts w/ immediate, life-threatening
conditions, irrespective of ability to pay, insurance status, race,
ethnicity, or any other factor
are doctors required to treat patients who are verbally abusive with
a URI in ED? Correct Answer - NO - does NOT extend to NON-
urgent conditions or non-urgent situations
what is the typical initial management for salicylate toxicity?
Correct Answer - IV sodium bicarbonate
- if no improvement --> hemodialysis required!
signs of salicylate toxicity? Correct Answer - dizziness,
vomiting, ***TINNITUS***, hearing loss, sweating, fever, confusion,
burning in the mouth and throat, convulsions, and coma
how soon must you give activated charcoal to be effective tx for
salicylate toxicity? Correct Answer - within 2 hours of acute
salicylate ingestion
what does acetazolamide do to urine? Correct Answer -
alkalinizes urine
,Intussusception treatment Correct Answer - prompt reduction
--> air or water soluble contrast ENEMA
Intussusception Correct Answer - telescoping of the intestines
--> severe, episodic, cramping GI pain
- target sign on abdominal US
3 major genetic assoc w/ pheochromocytoma? Correct Answer -
1) RET mutations --> MEN 2A + 2B
2) NF-1
3) VHL syndrome
von Hippel-Lindau disease Correct Answer - 40% RCC. 75%
simple renal cysts.
***Hemangioblastomas CNS.
***Retinal angiomas.
Pancreatic cysts. Pancreatic neoplasms.
50-80% Pheochromocytomas (multiple, bilateral, extraadrenal).
Horner syndrome triad Correct Answer - 1) ptosis
2) miosis (pupil constriction)
3) anhidrosis (lack of sweating)
IPSILATERAL findings
ex - R ICA stroke --> R ipsilateral Horner syndrome
Methanol toxicity Correct Answer - - CNS depression
- tachypnea
- **optic disk hyperemia
- **retinal edema
- **pupil dilation
, - ***increased AG metabolic acidosis + elevated serum osmolality
gap**
what is methanol found in? Correct Answer - - windshield
washer fluid
- antifreeze
- **homade alcohol
methanol = HIGHLY toxic, toxic effects seen within as little as 10 mL
consumption
formic acid production (hepatic conversion of methanol --> FA) -->
inhibits mitochondrial cyt. c oxidase --> cellular hypoxia + metabolic
acidosis
tx for methanol toxicity? Correct Answer - Fomepizole
- decreased methanol metabolism via competitive inhibition of
alcohol dehydrogenase
**if fomepizole NOT available --> can use EtOH, dialysis
what does ETHYLENE GLYCOL toxicity (metabolic acidosis -
MUDPILES) typically present with that methanol toxicity does NOT?
Correct Answer - **renal damage** -->
- nephrolithiasis (calcium oxalate crystals)
- hypocalcemia
- muscle spasms
- hyperreflexia
- QT prolongation
- nystagmus
what is a common lab finding in a pt presenting w/ UPPER GI
bleeding (coffee ground hematemesis + melena)? Correct Answer
- increased BUN/Cr ratio
