Oral Boards Overview With Updated and Correctly Answered Questions Already Graded A+ 100%

Oral Boards Overview With Updated and Correctly Answered Questions Already Graded A+ 100% Dopamine and Dobutamine rates - CORRECT ANSWER-5-20 mcg/kg/min PALS doses 1. epinephrine a. ETT b. drip c. Anaphylaxis/Severe Asthma 2. adenosine 3. atropine 4. Calcium Chloride (10%) 5. Glucose 6. Naloxone 7. Bicarbonate 8. Procainamide - CORRECT ANSWER-1. 0.01 mg/kg 1:10,000 IV a. 0.1 mg/kg 1:1000 ETT) b. 0.1 mcg/kg/min c. 0.01 mg/kg 1:1,000 max 0.5 mg 2. 0.1 mg/kg, then 0.2 mg/kg (max 6, 12 mg) 3. 0.02 mg/kg IV/IO (max 0.5 mg kids, max 1 mg adolescents) 4. 20 mg/kg IV/IO 5. 1 g/kg IV/IO 6. <5 y or ≤20 kg: 0.1 mg/kg / ≥5y or >20 kg: 2 mg IV/IO/ET 7. 1 mEq/kg per dose IV/IO 8. 15 mg/kg over 30 min Don't forget these in practically every patient - CORRECT ANSWER-EKG, treat pain + nausea, Discuss with patient/family *CP causes at ABEM General Hospital (7) - CORRECT ANSWER-ACS, PE, Dissection, Tension PTX, Pericarditis, Tamponade, Boerrhaves Dopamine and Dobutamine rates - CORRECT ANSWER-5-20 mcg/kg/min *Acute MI Treatment - CORRECT ANSWER-He MOAN Plavix to Cath a Cards fellow = Heparin (60u/kg + 12u/kg/hr) + MSO4 + O2 + ASA (plavix if ASA allergy) + Nitro (check erectile dysfx meds) +/- Plavix (300mg) + Activate cath lab + Cardiology consult *MI heparin bolus and drip dose? PE heparin bolus and drip dose? - CORRECT ANSWER-60u/kg + 12u/kg/hr = max 4,000 + 1000u/hr 80u/kg + 18u/hr = max 5,000 + 1000u/hr *PCI door to balloon goal? - CORRECT ANSWER-90 minutes, if > 2 hrs transfer give Plavix 600 mg *Pericarditis Diagnosis and Treatment - CORRECT ANSWER-friction rub + EKG + Echocardiogram // NSAIDS (naproxen) *What to do if patient has Pericarditis with effusion - CORRECT ANSWER-Admit for serial echo, if no effusion dc w/ 1 week f/u w/ naproxen *Boerrhaave's Syndrome / esophageal rupture 1. exam 2. diagnosis 3. consults 4. Antibiotics/meds - CORRECT ANSWER-1. crepitus in neck (must ask) 2. *Gastrografin Esophagram* + CT chest with contrast, CXR + neck xray 3. GI, ENT for source + CT surgery if needed 4. Imipenem/cilastatin + pepcid, NPO, *Pericardial Effusion (e.g. dialysis pt with hypotension + muffled hrt sounds). Dx and Rx? - CORRECT ANSWER-Bedside Echo // IVF (+/- dopamine) + Cardiology + CT surgery consults for pericardial window *Hypertensive Emergency presenting as headache, Actions and Treatment? - CORRECT ANSWER-Labetalol (goal 25% MAP 1-2 hrs*) + CT-H + LP (r/o SAH) *HTN Emergency in Ischemic Stroke: treat blood pressure at what point? How do you calculate MAP? - CORRECT ANSWER-Treat BP if >220/120 (with goal of 10% reduction) MAP = ⅔ DBP + ⅓ SBP *Digoxin Toxicity Findings? a. diagnosis and treatment - CORRECT ANSWER-See Yellow Halos! PVCs + Brady (regularized Afib, bigeminy/trigeminy) a. digoxin level ; CLWAP + Digibind 5 vials *Digoxin Toxicity Treatment? What electrolyte to watch for? What to avoid (3)? - CORRECT ANSWER-Digibind 5 vials over 30 minutes + Atropin PRN Treat hyperkalemia!! Avoid Calcium, Procainamide, Cardioversion/Pacing *Inferior STEMI thing to do beyond pneumonic - CORRECT ANSWER-He MOAN Plavix to Cath a Cards fellow + Right-sided EKG *Cocaine Chest Pain treatment - CORRECT ANSWER-Benzos + He MOAN * + Troponin + Cards c/s + Observation *CHF (don't BLANC!) - CORRECT ANSWER-Bipap + Lasix + Foley to monitor UOP + Aspirin + NTG (50mcg/min) + Cards c/s +/- Inotropes (dopamine/dobutamine) *Acute Infective Endocarditis 1. symptoms 2. Diagnosis 3. Treatment? - CORRECT ANSWER-1. h/o of "heart murmur" / getting abx with dental work 2. blood cx + ↑ ESR + TEE 3. Vanc + Gent *Aortic dissection (diastolic murmur) 1. Types and 2. HR and BP Goals of Treatment? back up drip prn? 3. what else? - CORRECT ANSWER-1.Stanford: A (go up to surgery), B (descending: medical) 2. Goals HR: <60, SBP <110 with ESMOLOL (labetalol). If BP >120 add: Nitroprusside 3. T+C for 10 units of blood (like AAA) *Abdominal Aortic Aneurysm (> 5 cm) present with flank/abdominal pain. 1. Exam? 2. Dx 3. Treatment for unstable vs. stable - CORRECT ANSWER-1. Rectal + ask pulsatile mass!! + if leaking: gray turners sign (retroperitoneal bleeding) 2. Bedside Ultrasound or CT if stable - if CT is ever down always go to CXR/KUB/U/S 3. Unstable/leaking: General Surgery C/S (OR+NPO+NG +foley) + Resuscitation (Crossmatch 10-15 units + FFP) If Stable: elective repair if > 5cm ; if impending rupture get HR < 80 with esmolol *1 Pulmonary embolism PERC rules (pretest prob <15%)? 2 PE Diagnosis? 3a stable PE treatment 3b unstable PE treatment (and dosages) - CORRECT ANSWER-1 Age<50, hr<100, o2 sat>94%, no h/o dvt, recent surgery, hemoptysis, OCP, leg swelling → if any + straight to CT chest 2 Low Risk: Dimer, o/w → CT chest 3a Heparin (80u/kg + 18u/hr = 5-6,000 + 1000/hr) or Enoxaparin (1mg/kg q12) 3b TPA 15mg push + 85mg over 2 hrs or Embolectomy *1 Stable SVT Treatment Steps (4) 2 What are you going to tell the patient? - CORRECT ANSWER-1a. Vagal (carotid massage, ice pack on face, valsava) → 1b. Adenosine (6/12/12) with Running rhythm strip + Defibrillator at bedside* 1c. Diltiazem/cardizem (50mg) (careful not in WPW) 1d synchronized cardioversion 50 joules