A false positive guaiac may be caused by the presence of ___ - answer✔Methylene blue
GI pathogens that cause bloody diarrhea (4) - answer✔Campylobacter
E Coli O157
Yersinia
Salmonella
Clostridium perfringens - answer✔Gas gangrene
Late onset non-bloody diarrhea (from spores in dirt)
Yersinia enterocolitica - answer✔Usually transmitted from pet feces (e.g., puppies),
contaminated milk, or pork. Outbreaks are common in day-care centers.
Sx can mimic Crohn's or appendicitis - bloody diarrhea, vomiting, cramping RLQ
Campylobacter jejuni - answer✔#1 cause of watery or bloody diarrhea in US
Usually from travel, PPI, undercooked meat, dairy
Fever, abdominal cramp, bloody diarrhea
Similar to EIEC infection
E coli - answer✔ETEC: watery diarrhea
EHEC (O157): bloody diarrhea without fever
EIEC: watery > bloody diarrhea
Bloody diarrhea with thumb-print sign - answer✔Any sign of bowel ischemia (ischemic bowel
>> IBD, volvulus, diverticulitis)
#1 cause of upper and lower GI bleed in adults - answer✔Upper: PUD
Lower: diverticulosis
Majority of diverticulosis bleeding is from __ colon - answer✔R side
Indication for surgical removal of ingested foreign body - answer✔Object hasn't moved distally
in 24 hour observation
Symptomatic
Sharp object or batteries
CXR findings in aspiration of object - answer✔Hyperinflated opposite lung
Atelectasis of affected lung
A 22 year old running back is struck from behind by a 300-pound lineman. The blow occurs
below the knee as his foot is firmly planted and two other lineman are holding his upper body.
He presents to the emergency department with gross anterior dislocation of the tibia on the
femur. His foot is cool and palee, and dorsalis pedis and posterior tibial pulses are not detected
by Doppler ultrasound. What is the most appropriate management for this patient? -
answer✔Immediate reduction (neurovascular compromise) with ortho consult without x-rays
Burn rule of 9s - answer✔Head 9%
Each arm 9%
Chest 9%
Abdomen 9%
Each anterior leg 9%
Each posterior leg 9%
Upper back 9%
Lower back 9%
Genitals 1%
A 42 year old male with end stage liver disease due to chronic hepatitis C infection arrives to the
emergency department in stable condition after an unsuccessful suicide attempt by bilateral wrist
laceration. He reports no history of depression or psychiatric disorder. Aside from his liver
disease, for which he takes interferon alpha and ribavirin, he reports that he is in good health and
takes no other medications. Which of the following factors increased this patient's risk of new-
onset suicidal ideation? - answer✔Depression and/ or suicidal ideation are commonly reported
side effects of interferon alpha therapy
Which of the following psychiatric disorders is associated with the greatest increased risk of
committing suicide?
Panic
PTSD
Schizophrenia
Depression - answer✔Panic disorder
Silent suicide - answer✔slowly killing oneself by nonviolent means; starvation/noncompliance
with essential tx
Populations with increased suicide risk - answer✔Old caucasian people
Young native american or alaskan natives
PUD vs gastritis - answer✔PUD: unrelenting pain for weeks, not better with antacids
Liver abscess management - answer✔-drainage (not necessarily immediate in ED)
-IV antibiotics
-look for R effusion and elevation of hemidiaphragm on CXR
Proparacaine is a ____ anesthetic (type) - answer✔ester
Nonspecific signs in both preseptal and orbital cellulitis - answer✔Fever
Leukocytosis
(only orbital has EOM pain or VA impairment)
Horner's syndrome symptoms - answer✔Ptosis, miosis, anhydrosis
Hyperemia of skin
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