ITE MOCK EXAM QUESTIONS & ANSWERS
Drug tox assoc with hyperthermia - Answers -salicylate toxicity
Hyperpnea, GI irritation, tinnitus - Answers -salicylate toxicity
Acid-base disorder in salicylate toxicity - Answers -1. Respiratory alkalosis (from
medullary stimulation --> hyperventilation)
2. Anion gap metabolic acidosis (increased renal bicarb excretion + lactic acidosis
Specific findings concerning for sexual abuse - Answers -- *non-midline perianal scar*
- perianal lacerations extending deep to external anal sphincter
- lacs/bruising to labia/perineum/hymen
- scar/fresh laceration on posterior fourchette
- absence of hymenal tissue
Indications for emergent laparotomy in penetrating abdominal trauma - Answers --
hemodynamic compromise
- peritoneal signs
- *evisceration*
2 most common organs injured in blunt abdominal trauma, in order - Answers -spleen,
liver
Intracerebral hemorrhage score components - Answers --GCS
-*ICH volume* (+1 for >30ml)
-intraventricular extension of hemorrhage
-infratentorial origin of hemorrhage
-age
Fascia iliaca block location - Answers -lateral third of inguinal ligament, deep to fascia
liliaca - contains both femoral and lateral femoral cutaneous nerves - gives near-
complete analgesia to femur
-episodic vertigo
-sensorineural hearing loss
-tinnitus
Dx? Tx? - Answers -dx = meniere disease (end-lymphatic hydros)
Tx = hydrochlorothiazide, low sodium diet,
Other - vasodilators (betahistine), calcium channel blockers, avoidance of
caffeine/tobacco, antihistamines (mecliczine), benzos (diazepam)
Diplopia from unilateral CN VI palsy - Answers -horizontal and binocular
,Diplopia from unilateral CN IV (trochlear) palsy - Answers -binocular, rotational diplopia
when looking down and toward nose
Greatest reduction in mortality in variceal hemorrhage in the setting of cirrhosis? -
Answers -ceftriaxone
Hematochezia, pain with defication, constipation, infant/toddler/school-age child -
Answers -anal fissure
Hemoptysis, SOB, bilateral hilar adenopathy, upper lobar reticular opacities, plaque-like
rash, injected sclera.
Dx? Labs? Tx? Side effect of tx? - Answers -dx = sarcoidosis (noncaseating
granulomas)
Lab = elevated ACE
Tx = corticosteroids (prednisone)
ADR = hyperglycemia
Rapid cessation of longstanding glucocorticoid therapy may trigger what life-threatening
condition? - Answers -adrenal crisis
Cough, lightheadedness, SOB, chest pain, choking, acute respiratory distress, farmer,
works in silo.
Dx? - Answers -dx = nitrogen dioxide pneumonitis (soli filler's disease)
Smells like bleach
Weakness in finger abduction, finger adduction, thumb opposition, wrist flexion.
Decreased sensation to ulnar aspect of forearm.
Damaged nerve? - Answers -T1 nerve root injury
-usually from arm hypertension
Electrical alternans
Dx? Tx? - Answers -dx: pericardial effusion with tamponade
Tx: normal saline bolus (preload dependent), pericardiocentesis, pericardial window
H's for reversible causes of PEA - Answers -Hypoglycemia
Hypoxia
Hydrogen ions (acidosis)
Hypo and Hyper-kalemia
Hypovolemia
Hypothermia
, T's for reversible causes of PEA - Answers -tension pneumothorax
Thrombosis (coronary)
Thrombosis (pulmonary embolism)
Tamponade (Cardiac)
Toxins
Sickle cell patient with vasooclusive crisis, abdominal pain w/ splenic infarction. Next
step? - Answers -IV pain medications
Most common site for pain in a patient with vast-occlusive crisis - Answers -upper back
Pt with spontaneous ocular hyphema (accumulation of blood/clots in anterior chamber
of eye). What risk factor increases development of complications? - Answers -- *sickle
cell disease*
- bleeding diathesis
- anticoagulant use
Tx of pertussis/whooping cough - Answers -macrolides - azithromycin (infants <1mo),
clarithromycin, erythromycin
Hypotensive trauma patient with negative FAST, negative CXR, negative pelvic X-ray. -
Answers -retroperitoneal bleed
Pt with trauma to head, brief loss of consciousness, amnesia, no focal neurologic
deficits, negative CT can. Dx? Tx? - Answers -concussion
Tx = cognitive rest for 24-28 hrs, then gradual return to non contact physical activity
Bite. Tongue fasciculations, disconjugate gaze, temperature reversal. Organism? -
Answers -scorpion (centruroides exillicauda)
Other - slurred speech, drooling, trouble swallowing
When getting antivenin, avoid long acting benzos d/t over sedation, and also avoid
morphine d/t histamine release
Bite. Papule to necrotic blister. Organism? - Answers -brown recluse spider
Bite. Local papule w/ halo, muscle fasciculations, abdominal pain, diaphoresis.
Organism? - Answers -blak widow spider
Bite. Local swelling, oozing blood from wound, coagulopathy. Organism? - Answers -pit
viper
Bite. Muscle paralysis. Organism? - Answers -eastern coral snake.
Drug tox assoc with hyperthermia - Answers -salicylate toxicity
Hyperpnea, GI irritation, tinnitus - Answers -salicylate toxicity
Acid-base disorder in salicylate toxicity - Answers -1. Respiratory alkalosis (from
medullary stimulation --> hyperventilation)
2. Anion gap metabolic acidosis (increased renal bicarb excretion + lactic acidosis
Specific findings concerning for sexual abuse - Answers -- *non-midline perianal scar*
- perianal lacerations extending deep to external anal sphincter
- lacs/bruising to labia/perineum/hymen
- scar/fresh laceration on posterior fourchette
- absence of hymenal tissue
Indications for emergent laparotomy in penetrating abdominal trauma - Answers --
hemodynamic compromise
- peritoneal signs
- *evisceration*
2 most common organs injured in blunt abdominal trauma, in order - Answers -spleen,
liver
Intracerebral hemorrhage score components - Answers --GCS
-*ICH volume* (+1 for >30ml)
-intraventricular extension of hemorrhage
-infratentorial origin of hemorrhage
-age
Fascia iliaca block location - Answers -lateral third of inguinal ligament, deep to fascia
liliaca - contains both femoral and lateral femoral cutaneous nerves - gives near-
complete analgesia to femur
-episodic vertigo
-sensorineural hearing loss
-tinnitus
Dx? Tx? - Answers -dx = meniere disease (end-lymphatic hydros)
Tx = hydrochlorothiazide, low sodium diet,
Other - vasodilators (betahistine), calcium channel blockers, avoidance of
caffeine/tobacco, antihistamines (mecliczine), benzos (diazepam)
Diplopia from unilateral CN VI palsy - Answers -horizontal and binocular
,Diplopia from unilateral CN IV (trochlear) palsy - Answers -binocular, rotational diplopia
when looking down and toward nose
Greatest reduction in mortality in variceal hemorrhage in the setting of cirrhosis? -
Answers -ceftriaxone
Hematochezia, pain with defication, constipation, infant/toddler/school-age child -
Answers -anal fissure
Hemoptysis, SOB, bilateral hilar adenopathy, upper lobar reticular opacities, plaque-like
rash, injected sclera.
Dx? Labs? Tx? Side effect of tx? - Answers -dx = sarcoidosis (noncaseating
granulomas)
Lab = elevated ACE
Tx = corticosteroids (prednisone)
ADR = hyperglycemia
Rapid cessation of longstanding glucocorticoid therapy may trigger what life-threatening
condition? - Answers -adrenal crisis
Cough, lightheadedness, SOB, chest pain, choking, acute respiratory distress, farmer,
works in silo.
Dx? - Answers -dx = nitrogen dioxide pneumonitis (soli filler's disease)
Smells like bleach
Weakness in finger abduction, finger adduction, thumb opposition, wrist flexion.
Decreased sensation to ulnar aspect of forearm.
Damaged nerve? - Answers -T1 nerve root injury
-usually from arm hypertension
Electrical alternans
Dx? Tx? - Answers -dx: pericardial effusion with tamponade
Tx: normal saline bolus (preload dependent), pericardiocentesis, pericardial window
H's for reversible causes of PEA - Answers -Hypoglycemia
Hypoxia
Hydrogen ions (acidosis)
Hypo and Hyper-kalemia
Hypovolemia
Hypothermia
, T's for reversible causes of PEA - Answers -tension pneumothorax
Thrombosis (coronary)
Thrombosis (pulmonary embolism)
Tamponade (Cardiac)
Toxins
Sickle cell patient with vasooclusive crisis, abdominal pain w/ splenic infarction. Next
step? - Answers -IV pain medications
Most common site for pain in a patient with vast-occlusive crisis - Answers -upper back
Pt with spontaneous ocular hyphema (accumulation of blood/clots in anterior chamber
of eye). What risk factor increases development of complications? - Answers -- *sickle
cell disease*
- bleeding diathesis
- anticoagulant use
Tx of pertussis/whooping cough - Answers -macrolides - azithromycin (infants <1mo),
clarithromycin, erythromycin
Hypotensive trauma patient with negative FAST, negative CXR, negative pelvic X-ray. -
Answers -retroperitoneal bleed
Pt with trauma to head, brief loss of consciousness, amnesia, no focal neurologic
deficits, negative CT can. Dx? Tx? - Answers -concussion
Tx = cognitive rest for 24-28 hrs, then gradual return to non contact physical activity
Bite. Tongue fasciculations, disconjugate gaze, temperature reversal. Organism? -
Answers -scorpion (centruroides exillicauda)
Other - slurred speech, drooling, trouble swallowing
When getting antivenin, avoid long acting benzos d/t over sedation, and also avoid
morphine d/t histamine release
Bite. Papule to necrotic blister. Organism? - Answers -brown recluse spider
Bite. Local papule w/ halo, muscle fasciculations, abdominal pain, diaphoresis.
Organism? - Answers -blak widow spider
Bite. Local swelling, oozing blood from wound, coagulopathy. Organism? - Answers -pit
viper
Bite. Muscle paralysis. Organism? - Answers -eastern coral snake.
