EM COMAT/COMBANK - Questions With Right
Solutions
Cases of DKA or hyperosmolar hyperglycemic nonketotic coma
should be treated generally how? Correct Answer - isotonic
saline fluid admin--> insulin tx--> correction of electrolyte
abnormalities
*preferred* imaging modality for PE
Describe how it works Correct Answer - CT angiogram
-contrast bolus is administered and the scan is timed so that it
occurs when the contrast is opacifying the pulmonary arteries
-the idea is to looking for filling defects within the pulmonary
arterial system that would correspond to PE
Most *accurate* imaging modality for PE
Describe how it works and why it is not used in the acute setting
Correct Answer - *pulmonary angiogram*
-rarely performed bc it is time consuming, very costly & invasive
-requires sedating the pt. in the IR lab, obtaining venous access w a
needle (usu. the femoral vein), & advancing a microcatheter through
the femoral, external iliac, and common iliac veins, into the IVC,
through the R. atrium and into the pul. arteries
-contrast is then injected thru the catheter and under live
fluoroscopy, the I-radiologist assess for filling defects in the pul.
arterial system, which would be consistent with a PE
, pic shows pul angio. red arrow depicts multiple filling defects with
no contrast flowing distal to them. these are consistent w/ multiple
emboli
The gold standard/choice for the dx of nephrolithiasis?
When is this not used? and what instead is used? Correct Answer
- *spiral CT w/o contrast*
*abdominal US* in pt. that should avoid radiation such as *children*
& *pregnant*
Conservative/outpatient management for nephrolithiasis includes
Correct Answer - -adequate fluid intake
-pain control
-a urine filter (pt.s should be instructed to strain their urine for
several days to recover the stone once it passes). it is helpful in
detecting the type of stone so proper treatment can be administered
and recurrences can be prevented.
How do patients with pancreatitis present? Correct Answer - -
with acute severe epigastric pain that is sudden in onset and
*radiating to the back*
-pain is classically relieved by sitting up or bending forward
-nausea, vomitting, & anorexia are also reported in about 90% of
pt.s
what is the T wave findings in MI? Correct Answer - peaked T
waves (hyperacute T waves are an early finding)
procedure which obtains pleural effusions Correct Answer -
thoracentesis
Solutions
Cases of DKA or hyperosmolar hyperglycemic nonketotic coma
should be treated generally how? Correct Answer - isotonic
saline fluid admin--> insulin tx--> correction of electrolyte
abnormalities
*preferred* imaging modality for PE
Describe how it works Correct Answer - CT angiogram
-contrast bolus is administered and the scan is timed so that it
occurs when the contrast is opacifying the pulmonary arteries
-the idea is to looking for filling defects within the pulmonary
arterial system that would correspond to PE
Most *accurate* imaging modality for PE
Describe how it works and why it is not used in the acute setting
Correct Answer - *pulmonary angiogram*
-rarely performed bc it is time consuming, very costly & invasive
-requires sedating the pt. in the IR lab, obtaining venous access w a
needle (usu. the femoral vein), & advancing a microcatheter through
the femoral, external iliac, and common iliac veins, into the IVC,
through the R. atrium and into the pul. arteries
-contrast is then injected thru the catheter and under live
fluoroscopy, the I-radiologist assess for filling defects in the pul.
arterial system, which would be consistent with a PE
, pic shows pul angio. red arrow depicts multiple filling defects with
no contrast flowing distal to them. these are consistent w/ multiple
emboli
The gold standard/choice for the dx of nephrolithiasis?
When is this not used? and what instead is used? Correct Answer
- *spiral CT w/o contrast*
*abdominal US* in pt. that should avoid radiation such as *children*
& *pregnant*
Conservative/outpatient management for nephrolithiasis includes
Correct Answer - -adequate fluid intake
-pain control
-a urine filter (pt.s should be instructed to strain their urine for
several days to recover the stone once it passes). it is helpful in
detecting the type of stone so proper treatment can be administered
and recurrences can be prevented.
How do patients with pancreatitis present? Correct Answer - -
with acute severe epigastric pain that is sudden in onset and
*radiating to the back*
-pain is classically relieved by sitting up or bending forward
-nausea, vomitting, & anorexia are also reported in about 90% of
pt.s
what is the T wave findings in MI? Correct Answer - peaked T
waves (hyperacute T waves are an early finding)
procedure which obtains pleural effusions Correct Answer -
thoracentesis
