Emergency Medicine (COMAT) Exam Study Guide Solutions

Emergency Medicine (COMAT) Exam Study Guide Solutions TIMI score - ANSWER-a prognostic tool for patients with unstabe angina or NSTEMI Categorizes patient's risk of death and ischemic events & helps clinicians with therapeutic decision-making. A point of one for each of the following: 1) apsirin use in the last seven days 2) ST changes of at least 0.5 mm on EKG 3) Elevated serum cardiac biomarkers 4) Age greater than 65 5) known CAD (coronary stenosis greater than or equal to equal to 50%) 6) At least two angina episodes within the last 24 hours Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 2/26 7) At least three risk factors for CAD such as: HTN, DM, current cigarette smoker, family hx of premature CAD (CAD in male first-degree relative or father less than 55, or female first-degree relative or mother less than 65) most common complication associated with giving pediatric patients succinylcholine - ANSWER-Rhabdomyolysis with associated hyperkalemia Tx - copious IV Fluid hydration Contraindications to succinylcholine - ANSWER-burns, crush injuries, renal failure, immobilization for 48 hours, narrow angle glaucoma & malignant hyperthermia. What cases is hyperkalemia a huge concern? - ANSWER-Severe burns, crush injuries, & renal failure. Glasgow Coma Scale - ANSWER- What to do with a patient with a GCS of 8? - ANSWER-Intubation Thoracic injuries secondary to blunt chest - ANSWER-The plain CXR remains the standard initial diagnostic remains the standard initial diagnostic study for the evaluation of chest trauma in a hemodynamically stable patient. Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 3/26 CXR in blunt trauma patients are usually taken in the supine position initially until unstable spinal fractures have been ruled out. Then, it is important to get a PA view to appropriately evaluate for small hemothorax, pneumothorax o diaphragm injury. What is first line in supraventricular tachycardia? - ANSWER-Vagal maneuvers Compartment syndrome - ANSWER-Associated with five P's - pain, paraesthesia, pallor, pulselessness, & poikilothermia Critical level = Btwn 10 mmHg & 35 mmHg Poor outcomes = 30 mmHg Fasciotomy is the definitive treatment Normal compartment pressure - ANSWER-10 mmHg Interstitial cystitis - ANSWER-also known as bladder pain syndrome Is a chronic condition diagnosed in patients with symptoms of dysuria, frequency, urgency with no other causes of such symptoms. Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 4/26 Tx'ment of DKA (steps) - ANSWER-1) Volume expansion with IVF (0.45% NACl or 0.9% NaCl at 250-500 ml/hour) --Bolus anywhere from 2-4 liters of fluid prior to starting IV insulin 2) Check potassium levels is checked and replace as needed 3) An insulin drip will need to be started at 0.1 unit/kg/hour --after serum glucose 4) Check serum pH level to determine if bicarbonate is needed in the fluids 5) When serum glucose is at a reasonable level 200 mg/dL), the fluids should be changed to D5 0.45% NaCl & the insulin drip is weaned. Influenza Treatment - ANSWER-Immunoprophylaxis - inactivated vaccine ---Trivalent vaccine - prepared on annual basis with