APMLE Part 2 Crozer- medicine Questions With Complete
Solutions
Do NSAIDS affect bone healing ? Correct Answers NSAIDS
and COX-2 inhibitors may inhibit bone healing via their anti-
inflammatory effects
First choice for *non-narcotic oral*? Correct Answers Ultram
(Tramadol)
First choice for non-narcotic IV? Correct Answers Torodol
(ketorolac)
First choice narcotic IV pain med? Correct Answers Demerol
For long term DVT prophylaxis, what drugs can be ordered?
why? Correct Answers - Heparin- works right away
- Coumadin- takes 3-5 days and causes an initial transient
hypercoag state
How are amides (ex lidocaine and bupivacaine) metabolized?
Correct Answers Liver
how are benzodiazepines reversed? Correct Answers
Flumazenil
How are esters (ex Novocain) metabolized Correct Answers
Plasma pseudocholinesterase
How are glucocorticoids metabolized? Correct Answers liver
and then secreted in urine
,How can you determine if a patient is an overproducer or
underexcretor? Correct Answers Take a 24 hour urinalysis
How is a DVT diagnosed clinically? Correct Answers - Pain,
heat, swelling, erythema of unilateral limb
- Positive Pratt sign- Squeezing of post calf causes pain
- Positive Homan sign- Dorsiflexing of foot causes calf pain
- PE
How is cocaine metabolized? Correct Answers Plasma
pseudocholinesterase
How is coumadin dosed? Correct Answers 5-10mg PO daily for
3-4 days then adjust for INR
How is Coumadin reversed? Correct Answers - Vitamin K
- Fresh frozen plasma
How is Lovenox reversed? Correct Answers Recombinant
factor VII
How long does it take for coumadin to become therapeutic?
Correct Answers 3-5 days
How much lengthening is required, what procedure may be
performed? Correct Answers 1mm per day (0.25mm q6h)
How to convert % of solution to mg/ml? Correct Answers move
decimal point of percentage one place to right
(ex: 1% solution has 10mg/ml)
, How to dose Heparin for peri operative DVT prophylaxis?
Correct Answers 5000 units SC 2 h prior to sx
5000 units SC q12h until the pt ambulates
How to dose lovenox for peri-operative DVT prophylaxis?
Correct Answers 30mg SC q12h for 7-10 days
If gout is suspected, what should a specimen be sent in? Correct
Answers One in formaldehyde (dissolves gouty tophi) and one
in ETOH (does not dissolve gouty tophi)
If more than 1 cm of lengthening is req, what procedure may be
performed? Correct Answers *Callus distraction* with mini-rail
fixation
If patient is at risk for malignant hyperthermia, what pre-op test
may be performed? Correct Answers CPK
- elevated in 79% of patients with malignant hyperthermia
In what age group should bupivicaine be avoided? Correct
Answers children < 12
Is there a risk with *intra-articular* injections of bupivicaine?
Correct Answers Studies show that *chondrocyte death*
following prolonged exposure to bupivicaine
Name two non-narcotic analgesics? Correct Answers Tramadol
(Ultram) and Torodol (Ketorolac)
Solutions
Do NSAIDS affect bone healing ? Correct Answers NSAIDS
and COX-2 inhibitors may inhibit bone healing via their anti-
inflammatory effects
First choice for *non-narcotic oral*? Correct Answers Ultram
(Tramadol)
First choice for non-narcotic IV? Correct Answers Torodol
(ketorolac)
First choice narcotic IV pain med? Correct Answers Demerol
For long term DVT prophylaxis, what drugs can be ordered?
why? Correct Answers - Heparin- works right away
- Coumadin- takes 3-5 days and causes an initial transient
hypercoag state
How are amides (ex lidocaine and bupivacaine) metabolized?
Correct Answers Liver
how are benzodiazepines reversed? Correct Answers
Flumazenil
How are esters (ex Novocain) metabolized Correct Answers
Plasma pseudocholinesterase
How are glucocorticoids metabolized? Correct Answers liver
and then secreted in urine
,How can you determine if a patient is an overproducer or
underexcretor? Correct Answers Take a 24 hour urinalysis
How is a DVT diagnosed clinically? Correct Answers - Pain,
heat, swelling, erythema of unilateral limb
- Positive Pratt sign- Squeezing of post calf causes pain
- Positive Homan sign- Dorsiflexing of foot causes calf pain
- PE
How is cocaine metabolized? Correct Answers Plasma
pseudocholinesterase
How is coumadin dosed? Correct Answers 5-10mg PO daily for
3-4 days then adjust for INR
How is Coumadin reversed? Correct Answers - Vitamin K
- Fresh frozen plasma
How is Lovenox reversed? Correct Answers Recombinant
factor VII
How long does it take for coumadin to become therapeutic?
Correct Answers 3-5 days
How much lengthening is required, what procedure may be
performed? Correct Answers 1mm per day (0.25mm q6h)
How to convert % of solution to mg/ml? Correct Answers move
decimal point of percentage one place to right
(ex: 1% solution has 10mg/ml)
, How to dose Heparin for peri operative DVT prophylaxis?
Correct Answers 5000 units SC 2 h prior to sx
5000 units SC q12h until the pt ambulates
How to dose lovenox for peri-operative DVT prophylaxis?
Correct Answers 30mg SC q12h for 7-10 days
If gout is suspected, what should a specimen be sent in? Correct
Answers One in formaldehyde (dissolves gouty tophi) and one
in ETOH (does not dissolve gouty tophi)
If more than 1 cm of lengthening is req, what procedure may be
performed? Correct Answers *Callus distraction* with mini-rail
fixation
If patient is at risk for malignant hyperthermia, what pre-op test
may be performed? Correct Answers CPK
- elevated in 79% of patients with malignant hyperthermia
In what age group should bupivicaine be avoided? Correct
Answers children < 12
Is there a risk with *intra-articular* injections of bupivicaine?
Correct Answers Studies show that *chondrocyte death*
following prolonged exposure to bupivicaine
Name two non-narcotic analgesics? Correct Answers Tramadol
(Ultram) and Torodol (Ketorolac)
