ITE 2025/2026 || QUESTIONS WITH COMPLETE
SOLUTIONS!!
Ottawa ankle/foot rules (5 total) correct answers 1. Inability to ambulate/amulation w limp
for 4 steps
2. Tenderness to the distal fibula
3. Tenderness to distal tibia
4. Tenderness at the base of the 5th metatarsal
5. Tenderness at the navicular bone
Iritis/Uveitis causes correct answers Trauma, infection, idiopathic (UC)
Iritis/Uveitis symptoms correct answers Painful red eye, photophobia, blurry vision
iritis/uveitis treatment correct answers homatropine 1-2% (cyclophelgics), 1% prednisolone
acetate
PERC rule out criteria for PE correct answers 1. Age <50
2. HR < 100
3. O2 > 95
4. No Unilateral leg swelling
5. No hemoptysis
6. No recent surgery or trauma
7. No prior PE or DVT
8. No hormone usage
*if all criteria are met then less than 2% risk of PE. If any criteria are positive cannot perc
out.
Wells Criteria correct answers 1. Clinical signs and symptoms of DVT
2. PE most likely diagnosis
3. Hr > 100
4. Immobilized for 3 days or surgery on last 4 weeks
5. Previous PE or DVT
6. Hemoptysis
7. Cancer w tx in past six months or palliative
*risk stratifies into low, moderate, and high risk
Revised Geneva Score correct answers 1. Age > 65
2. Pervious PE or DVT
3. Sx or fx in past month
4. Cancer
5. Unilateral lower limb pain
6. Hemoptysis
7. HR
8. Pain on lower limb palpation or unilateral edema
*risk stratified on above criteria
, PE fibrinolytics correct answers TPA 100 mg over 2 hrs
Streptokinase 250k U bolus then at 100kU/hr for 24 hrs
MOA of tPA (Alteplase), (tenectaplase and reteplase are not FDA cleared but tenectaplase
has highest specificity for fibrin) correct answers conversion of the zymogen (plasminogen)
to plasmin the catalytic form which breaks down fibrin to a soluble polypeptide
MOA of streptokinase correct answers binds to plasminogen causing conformational change
that opens up fibrin bindings site and increases the rate of catabolism
TAPSE correct answers Tricuspid Annular Plane Systolic Excursion
*find apical 4 chamber view Direct measurement of right ventricular function
• Measurement of vertical distance of tricuspid
lateral annulus
• TAPSE value < 16mm is indicative of dysfunction
5 most common peds mal claims correct answers 1. arrest
2. appendicitis
3. male genital problems
4. encephalopathy
5. meningitis
Workup rules for fever in infants correct answers -infants < 28 days- blood cultures, abx, cbc,
cmp, procal, ua, cxr, lp, fluids, admit
-infants > 28 days < 60 days- +/- LP
simple febrile seizure correct answers age 6 m to 5 y
no focalization
< 15 min
1 in 24 hrs
no signs of CNS infection
lidocaine dosage in wide complex tachycardia/VT correct answers 1-1.5 mg/kg IV push
every 5-10 min then another 0.5-0.75 mg/kg for a max of 3.0 mg/kg
Oral to iv opioid conversion correct answers Iv is 1/3 oral dose
Serotonin syndrome symptoms correct answers Delirium, tachycardia, hyperreflexia,
shivering, agitation, sweating, muscle spasms, coarse tremors
Seratonin syndrome culprits correct answers SSRI, snri, tramadol, maoi, tca, trazodone,
bupropion, lithium, dextromethorphan, triptans
seratonin syndrome treatment correct answers Fluids, benzos, supportive care
Gamma-hydroxybutyrate (GHB) correct answers A potent sedative, hypnotic, euphorigenic
agent that is illicitly ingested for its pleasurable effects. Quick on and off. Sometimes known
in the streets as a date rape drug
SOLUTIONS!!
Ottawa ankle/foot rules (5 total) correct answers 1. Inability to ambulate/amulation w limp
for 4 steps
2. Tenderness to the distal fibula
3. Tenderness to distal tibia
4. Tenderness at the base of the 5th metatarsal
5. Tenderness at the navicular bone
Iritis/Uveitis causes correct answers Trauma, infection, idiopathic (UC)
Iritis/Uveitis symptoms correct answers Painful red eye, photophobia, blurry vision
iritis/uveitis treatment correct answers homatropine 1-2% (cyclophelgics), 1% prednisolone
acetate
PERC rule out criteria for PE correct answers 1. Age <50
2. HR < 100
3. O2 > 95
4. No Unilateral leg swelling
5. No hemoptysis
6. No recent surgery or trauma
7. No prior PE or DVT
8. No hormone usage
*if all criteria are met then less than 2% risk of PE. If any criteria are positive cannot perc
out.
Wells Criteria correct answers 1. Clinical signs and symptoms of DVT
2. PE most likely diagnosis
3. Hr > 100
4. Immobilized for 3 days or surgery on last 4 weeks
5. Previous PE or DVT
6. Hemoptysis
7. Cancer w tx in past six months or palliative
*risk stratifies into low, moderate, and high risk
Revised Geneva Score correct answers 1. Age > 65
2. Pervious PE or DVT
3. Sx or fx in past month
4. Cancer
5. Unilateral lower limb pain
6. Hemoptysis
7. HR
8. Pain on lower limb palpation or unilateral edema
*risk stratified on above criteria
, PE fibrinolytics correct answers TPA 100 mg over 2 hrs
Streptokinase 250k U bolus then at 100kU/hr for 24 hrs
MOA of tPA (Alteplase), (tenectaplase and reteplase are not FDA cleared but tenectaplase
has highest specificity for fibrin) correct answers conversion of the zymogen (plasminogen)
to plasmin the catalytic form which breaks down fibrin to a soluble polypeptide
MOA of streptokinase correct answers binds to plasminogen causing conformational change
that opens up fibrin bindings site and increases the rate of catabolism
TAPSE correct answers Tricuspid Annular Plane Systolic Excursion
*find apical 4 chamber view Direct measurement of right ventricular function
• Measurement of vertical distance of tricuspid
lateral annulus
• TAPSE value < 16mm is indicative of dysfunction
5 most common peds mal claims correct answers 1. arrest
2. appendicitis
3. male genital problems
4. encephalopathy
5. meningitis
Workup rules for fever in infants correct answers -infants < 28 days- blood cultures, abx, cbc,
cmp, procal, ua, cxr, lp, fluids, admit
-infants > 28 days < 60 days- +/- LP
simple febrile seizure correct answers age 6 m to 5 y
no focalization
< 15 min
1 in 24 hrs
no signs of CNS infection
lidocaine dosage in wide complex tachycardia/VT correct answers 1-1.5 mg/kg IV push
every 5-10 min then another 0.5-0.75 mg/kg for a max of 3.0 mg/kg
Oral to iv opioid conversion correct answers Iv is 1/3 oral dose
Serotonin syndrome symptoms correct answers Delirium, tachycardia, hyperreflexia,
shivering, agitation, sweating, muscle spasms, coarse tremors
Seratonin syndrome culprits correct answers SSRI, snri, tramadol, maoi, tca, trazodone,
bupropion, lithium, dextromethorphan, triptans
seratonin syndrome treatment correct answers Fluids, benzos, supportive care
Gamma-hydroxybutyrate (GHB) correct answers A potent sedative, hypnotic, euphorigenic
agent that is illicitly ingested for its pleasurable effects. Quick on and off. Sometimes known
in the streets as a date rape drug
