Family Medicine EOR Exam Questions With 100% Correct Answers

Family Medicine EOR Exam Questions With 100% Correct Answers URGENT CARE: Respiratory arrest has a multitude of causes including pulmonary, cardiac, neurologic, toxic/metabolic, etc. Name some. - answerCOPD, asthma, foreign objects, angioedema, DKA, cancer etc. Abnormal breath sounds: ____is an airway obstruction. ____ suggests obstruction above the vocal cords and ___ suggests obstruction below the vocal cords. ____suggests obstruction below the level of the trachea. ____suggests presence of interalveolar fluid (PNA), pulmonary fibrosis. - answerStridor, inspiratory stridor, expiratory stridor; Wheezing; crackles & rales _____of respiratory arrest includes ACS, acute heart failure, arrhythmia, pericardial tamponade, PE, PNA, COPD, asthma, angioedema, anaphylaxis, CO poisoning, trauma. - answerDifferential Diagnosis D/D for ____ includes DKA, hypoglycemia, UTI, sepsis, drug overdose, stroke, and seizure. - answerdeteriorating mental status or unconscious patient D/D for ____ includes appendicitis, pancreatitis, PID, obstruction, AAA, perforated viscous, diverticulitis, mesenteric ischemia, or infarction. - answeracute abdomen What is the treatment for allergic reaction? immediate & subsequent? - answerepi 1:1000 IM q 10 min 0.5mg; antihistamine (H1 & H2), steroids, bronchodilators What is the rule of 9's in burn management? - answer9 head, 9 left arm, 9 right arm, 18 anterior torso, 18 posterior torso, 1 genitals What is the Parkland formula in burn management? - answer4 cc LR per % body burned per kg body weight --- insert 2 large bore IV's into unburned skin Placenta previa presents with ____. - answerpainless vaginal bleeding. Placenta abruption presents with ____. RF: maternal HTN, smoking, cocaine, multiples, PROM, inherited thrombophilia. Labs: decreased fibrinogen, decreased platelets - answerpainful vaginal bleeding. ____is a surgical emergency. RF: previous c/s, prior uterine surgery, hyperstimulation w oxytocin, trauma, parity >4. - answerUterine rupture ____ is bleeding from umbilical cord resulting in loss of fetal blood. - answerVasa previa With a black widow bite, what can be used for muscle spasms & rigidity? What about antivenom? - answerdiazepam, calcium gluconate, robaxin; use antivenom judiciously Which pit viper snake has the most potent vemom: rattlesnake, cottonmouth, or copperhead? - answerrattlesnake What do you apply to a jellyfish sting? - answeracetic acid or vinegar What's the classic triad of foreign body aspiration? - answergeneralized wheezing, cough, diminished breath sounds Explain the Salter-Harris classification of growth plate injuries? - answerI - Straight II - Above III - Lower IV - Through V - Ram ____ is injury to a ligament. Graded I-III (complete). - answerSprain ____ = a. pain at medial malleolus/distal fibula/inability to walk b. pain at midfoot/5th metatarsal c. pain at navicular bone/inability to bear weight for 4 steps - answerOttawa ankle rules ____ = tearing of muscle or tendon fibers caused by excessive stretch during vigorous activity. Graded I-IV (complete). - answerStrain ST Elevations in II, III, aVF - answerInferior MI; right coronary artery ST Elevations in I, aVL, V4, V5, V6 - answerlateral wall MI, left circumflex artery ST Elevations in V1, V2, V3, V4, V5 - answerAnterioseptal MI, left anterior descending artery ST Elevations in V1, V2 - answerposterior wall MI, posterior descending artery No nitroglycerin in which type of MI? - answerinferior wall MI bc of possible hypotension What are the pre hospital treatments for ACS? - answerMONA; morphine, oxygen, nitroglycerin (0.4mg SL x3 prn), aspirin (325mg) What two meds should be given to all ACS patients that do not have contraindications? - answerBB - unless brady or severe COPD - then do NDCCB (verapamil/diltiazem) ACEi - if cough, use ARB How long should Plavix/Clopidogrel be used for bare metal or drug eluting stents? - answerbare metal - 30d-12m drug eluting - >/=12mon What meds should a patient go home with after ACS? - answerNitroglycerin BB ACEi ASA/Clopidogrel anticoagulant (up to 8days for LMWH) aldosterone agonist statin LIFESTYLE CHANGES Cardiac Markers: _____is detectable within 1-2 hours after acute MI. Duration <1 day. Low specificity. - answerMyoglobin Cardiac Markers: _____is the test of choice and appears 2-6 hours after MI and stays elevated for 5-10 days. - answerTroponin Cardiac Markers: _____appears 3-6 hours after MI and stays elevated for 2-4 days. Specific to heart muscle. - answerCreatine Kinase Mb Timeline: Reperfusion should take place before ___hours of symptom onset. Door to needle time for fibrinolysis is ____min. Door to balloon time for PCI is ___min. - answer12 hours; 30 minutes; 90 minutes If a patient has nondiagnostic changes in ST segment or T wave, consider what? - answerserial cardiac markers -- repeat EKGs All patients should be on _____treatment for the 1st year after MI, then ____ indefinitely. - answerdual antiplatelet for 1st year; then ASA indefinitely ____ develops in 10-20% of anterior MI's; ST elevation present 4-8 weeks post MI & pulging scar is diagnostic. - answerLV aneurysm In what patients should a "silent MI" be a concern? - answerelderly, women, DM ST elevation progresses to ____ which is a sign of dead muscle. - answerQ waves Hypertensive urgency is a bp > ____. While closely monitoring, use clonidine, nifedipine, captopril, or labetalol. - answerbp>220/110 Hypertensive ____ is severe elevation with evidence of rapidly progressive end organ damage -- encephalopathy, nephropathy, pulmonary edema etc. Decrease 10-20% in 1st hour, 5-10% over next 23 hours to target <160/100. Use IV meds. - answerhypertensive emergency In acute phase of ____, bp is only lowered to <185/110 (if reperfusion candidate) or <220/120 (if non reperfusion candidate). - answerischemic stroke PE: a negative ____ test rules out PE. What is the gold standard for PE dx? - answerd dimer test; angiography PERC score criteria (HADCLOTS) used to rule out need for further imagin w PE. - answerH - hormone/estrogen use A - age>50 D - dvt/pe hx C - cough up blood L - leg swelling disparity O - O2 sat<95 T - tachy > 100 S - surgery/recent trauma The ___ criteria = clinical signs of PE, PE #1 on d/d, HR>100 bpm, immobilization in last 3days/dx last 4 week, hemoptysis, hx of cancer, previous DVT/PE. - answerWells criteria Tension pneumothorax is treated w ____ at 2nd intercostal space, mid-clavicular line. - answerneedle decompression & chest tube; hypotension, tracheal deviation, elevated jugular venous pressure How is an open PTX treated? - answer3 sided occlusive dressing for flutter valve effect & chest tube INGESTED HARMFUL SUBSTANCES CHART - answerINGESTED HARMFUL SUBSTANCE CHART