EMERGENCY MEDICINE (COMAT)
QUIZZES WITH UPDATED ANSWERS.
TIMI score ANS - a prognostic tool for patients with unstabe angina or NSTEMI
Categorizes patient's risk of death and ischemic events & helps clinicians with therapeutic decision-
making.
A point of one for each of the following:
1) apsirin use in the last seven days
2) ST changes of at least 0.5 mm on EKG
3) Elevated serum cardiac biomarkers
4) Age greater than 65
5) known CAD (coronary stenosis greater than or equal to equal to 50%)
6) At least two angina episodes within the last 24 hours
7) At least three risk factors for CAD such as: HTN, DM, current cigarette smoker, family hx of premature
CAD (CAD in male first-degree relative or father less than 55, or female first-degree relative or mother
less than 65)
most common complication associated with giving pediatric patients succinylcholine ANS -
Rhabdomyolysis with associated hyperkalemia
Tx - copious IV Fluid hydration
Contraindications to succinylcholine ANS - burns, crush injuries, renal failure, immobilization for >48
hours, narrow angle glaucoma & malignant hyperthermia.
What cases is hyperkalemia a huge concern? ANS - Severe burns, crush injuries, & renal failure.
Glasgow Coma Scale ANS -
,What to do with a patient with a GCS of 8? ANS - Intubation
Thoracic injuries secondary to blunt chest ANS - The plain CXR remains the standard initial diagnostic
remains the standard initial diagnostic study for the evaluation of chest trauma in a hemodynamically
stable patient.
CXR in blunt trauma patients are usually taken in the supine position initially until unstable spinal
fractures have been ruled out. Then, it is important to get a PA view to appropriately evaluate for small
hemothorax, pneumothorax o diaphragm injury.
What is first line in supraventricular tachycardia? ANS - Vagal maneuvers
Compartment syndrome ANS - Associated with five P's - pain, paraesthesia, pallor, pulselessness, &
poikilothermia
Critical level = Btwn 10 mmHg & 35 mmHg
Poor outcomes = >30 mmHg
Fasciotomy is the definitive treatment
Normal compartment pressure ANS - <10 mmHg
Interstitial cystitis ANS - also known as bladder pain syndrome
Is a chronic condition diagnosed in patients with symptoms of dysuria, frequency, urgency with no other
causes of such symptoms.
Tx'ment of DKA (steps) ANS - 1) Volume expansion with IVF (0.45% NACl or 0.9% NaCl at 250-500
ml/hour)
, --Bolus anywhere from 2-4 liters of fluid prior to starting IV insulin
2) Check potassium levels is checked and replace as needed
3) An insulin drip will need to be started at 0.1 unit/kg/hour
--after serum glucose
4) Check serum pH level to determine if bicarbonate is needed in the fluids
5) When serum glucose is at a reasonable level 200 mg/dL), the fluids should be changed to D5 0.45%
NaCl & the insulin drip is weaned.
Influenza Treatment ANS - Immunoprophylaxis - inactivated vaccine
---Trivalent vaccine - prepared on annual basis with two strains of influenza A & one strain of influenza
B----
Chemoprophylaxis - influenza-specific antiviral agents
1) Anantadine
2) Rimantadine
3) Zanamivir
4) Oseltamivir
5) Peramivir
Prophylaxis & treatment of influenza type A in person >= 1 y.o. ANS - Anantadine & Rimantadine
Treatment (only) of influenza A or B in persons >= 7 y.o., who have been symptomatic for =< 2 days ANS
- Zanamivir
Treatment (only) of influenza A or B in persons >= 1 y.o., who have been symptomatic for =< 2 days ANS
- Oseltamivir
Effective treatment modality for Influenza A & Influenza B in uncomplicated influenza in patient >=
18y.o., who have been symptomatic for =< 2 days ANS - Peramivir
QUIZZES WITH UPDATED ANSWERS.
TIMI score ANS - a prognostic tool for patients with unstabe angina or NSTEMI
Categorizes patient's risk of death and ischemic events & helps clinicians with therapeutic decision-
making.
A point of one for each of the following:
1) apsirin use in the last seven days
2) ST changes of at least 0.5 mm on EKG
3) Elevated serum cardiac biomarkers
4) Age greater than 65
5) known CAD (coronary stenosis greater than or equal to equal to 50%)
6) At least two angina episodes within the last 24 hours
7) At least three risk factors for CAD such as: HTN, DM, current cigarette smoker, family hx of premature
CAD (CAD in male first-degree relative or father less than 55, or female first-degree relative or mother
less than 65)
most common complication associated with giving pediatric patients succinylcholine ANS -
Rhabdomyolysis with associated hyperkalemia
Tx - copious IV Fluid hydration
Contraindications to succinylcholine ANS - burns, crush injuries, renal failure, immobilization for >48
hours, narrow angle glaucoma & malignant hyperthermia.
What cases is hyperkalemia a huge concern? ANS - Severe burns, crush injuries, & renal failure.
Glasgow Coma Scale ANS -
,What to do with a patient with a GCS of 8? ANS - Intubation
Thoracic injuries secondary to blunt chest ANS - The plain CXR remains the standard initial diagnostic
remains the standard initial diagnostic study for the evaluation of chest trauma in a hemodynamically
stable patient.
CXR in blunt trauma patients are usually taken in the supine position initially until unstable spinal
fractures have been ruled out. Then, it is important to get a PA view to appropriately evaluate for small
hemothorax, pneumothorax o diaphragm injury.
What is first line in supraventricular tachycardia? ANS - Vagal maneuvers
Compartment syndrome ANS - Associated with five P's - pain, paraesthesia, pallor, pulselessness, &
poikilothermia
Critical level = Btwn 10 mmHg & 35 mmHg
Poor outcomes = >30 mmHg
Fasciotomy is the definitive treatment
Normal compartment pressure ANS - <10 mmHg
Interstitial cystitis ANS - also known as bladder pain syndrome
Is a chronic condition diagnosed in patients with symptoms of dysuria, frequency, urgency with no other
causes of such symptoms.
Tx'ment of DKA (steps) ANS - 1) Volume expansion with IVF (0.45% NACl or 0.9% NaCl at 250-500
ml/hour)
, --Bolus anywhere from 2-4 liters of fluid prior to starting IV insulin
2) Check potassium levels is checked and replace as needed
3) An insulin drip will need to be started at 0.1 unit/kg/hour
--after serum glucose
4) Check serum pH level to determine if bicarbonate is needed in the fluids
5) When serum glucose is at a reasonable level 200 mg/dL), the fluids should be changed to D5 0.45%
NaCl & the insulin drip is weaned.
Influenza Treatment ANS - Immunoprophylaxis - inactivated vaccine
---Trivalent vaccine - prepared on annual basis with two strains of influenza A & one strain of influenza
B----
Chemoprophylaxis - influenza-specific antiviral agents
1) Anantadine
2) Rimantadine
3) Zanamivir
4) Oseltamivir
5) Peramivir
Prophylaxis & treatment of influenza type A in person >= 1 y.o. ANS - Anantadine & Rimantadine
Treatment (only) of influenza A or B in persons >= 7 y.o., who have been symptomatic for =< 2 days ANS
- Zanamivir
Treatment (only) of influenza A or B in persons >= 1 y.o., who have been symptomatic for =< 2 days ANS
- Oseltamivir
Effective treatment modality for Influenza A & Influenza B in uncomplicated influenza in patient >=
18y.o., who have been symptomatic for =< 2 days ANS - Peramivir
