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  • NIRTP 3rd Shifting 2021 - Emergency Medicine

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    Ali Serrano
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    NIRTP 3rd shifting 2021 - Emergency Medicine

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    5 views12 pages

    NIRTP 3rd Shifting 2021 - Emergency Medicine

    Uploaded by

    Ali Serrano

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 12
    This injury follows a drowning event: * O tiypoxic ischemic encephalopathy © cerebral edema O setaure O Hypoxia Apneustic breathing is a respiratory manifestation seen in pathology affecting this part of the CNS * O Thatamus O micorin © cerebellum O Pons ‘A713 ylo male was brought to the ED due to ‘a motorcycle collision accident. The neurologic exam showed him to be drowsy but can answer questions but with paradoxical respiration, and flaccid uadriparesis. Which of the following procedures will you prioritize? * © doanimmediate cervical CT © suabitize the spine © oan immediate cranial CT scan © suite arway Special consideration for the management of septic shock in children EXCEPT: * Timely érocortsonetharapy in hile © sth uidetrctory emecholaine resistant shock Initia therapeutic neon of resuscitation of spe shock ince CRT “Zaeo,rarmnal BP, nord pulses with 2 © asterenta betwen peshers! and cents Dulies warm extemties, UO >Im/Ag/he Sand normal mental stats Empiialantbotes shouldbe © administered within hours of the ‘denification of septic shock ‘gin penpheral tropic support in © chiaren who arent responsive to Fu resusotaton Massive capillary leak and burn shock happens during what time course in Burn patients: * O eays17 © oven © o-anr © rst2ane True of spinal cord injuries in children EXCEPT: * Spinal cord injury without radiographic © abnormalities (SCIWORA) is more common In adults than children, ctileren éommiig a Fi02 <4 and PEEP <5 © Awake with intact away reflexes © Leable of haning oropharyngeal secretions © onvesopressor support Colloid is usually instituted how many hours after burn injury? * © 024-48 hours © Upon resuscitation O #24 hours © 4072 hous Cardiac tamponade is a form of which type of shock? * O© Hypovolemie shock © obstructive shock © oietbutive shock © cardiogenic shock The following organs are relatively spared after abdominal trauma EXCEPT: * © Pencress © uodenum O twer O ‘kicneys Cheyne-Stokes breathing characterized by gradually increasing and decreasing tidal volume, is a respiratory pattern that can be found in neurologic diseases affecting which part of the brain: * O conex O Mistrain O pons Oo Medulla and pons Example of central airway obstruction that may result in respiratory failure EXCEPT * © Laryngomalacia O asthma © Vocal cord paraysis ° Obstructive sleep apnea Alveolar-interstitial disease EXCEPT: * © Hemosiserosis O Hyoline membrane disease © Lobar pneumonia O oystic Fibrosis For refractory traumatic intracranial hypertension the following therapy is used * O caaniectomy © Placement of le? monitor © continuous hypertonic Satine infusion © tumbar drain It reflects the adequacy of resuscitation in burn patients: * © Acie nase balance © Normal hematocrit © Normal clatting factors © Hspoatbuminemia © cesscoress O Hypertension and bradycardia © depressed level of consciousness © New-onset headache Alone rescuer in an outpatient setting who witnessed a child's sudden collapse should treat the arrest as - © cardiopulmonary arest © onthostatic hypotension © Asphyxia © Primary arhythmia A patient demonstrates eye opening to pain, utters inappropriate words and ‘abnormal flexion to painful stimuli. His Glasgow coma scale is * O eve O eva O e2vama © esvoma What isthe altitude threshold where: ines may begin to occur? * © 250m © 250m © 11000m © 150m The 3 components for determining brain death include the following EXCEPT: * © absence of brainstem reflexes O apnea © cardiopulmonary fate © reversible coma with a known cause Spinal cord injury that presents loss of urinary and rectal sphincter control, flaccid weakness , and sensory disturbances of legs. * © conus meduaris syndrome O Spinal shock O Transient quacriparesis, © central cardiesion ‘The recommended observation period for performing 2 brain death examinations after CPR or severe acute brain injury is: * © sohe O 7a O 26-900 O 1 Which of the following is the primary symptom of Acute Mountain Sickness (ams)? * O Shortness of breath O Headache © Hearing sifcuties O cognitive dysfunction The following statement about emergency transport is FALSE: Its the primary care physician's O tweens tina transport once the child in an emergency situation is stabilized Copies of pertinent medical records and © any imaging or laboratory studies should be Sent with the patient Dect physiclante-physcion © comuncaonieeertial io enue tdequete tranemiselon of patient care information Child may be wansported wa @ private © ‘eicte ifthe cline every close tothe hospital so as not to waste precious time. Example of central airway obstruction that may result in respiratory failure EXCEPT: * O vocat cord paralysis © Layngomatacia © obstructive sleep apnea © Asthma Rare in children, and when present itis sign of cic! ines and an evidence of decompensated Ckculatory shock * © rpotnsion O rerenson O cenate O strana Prevention's the most important step to recuce ne rowing pation. several hours aftr cardigpuimanary arrest, cerebral edema may occur. This isan ominous ‘sign of profound CNS damage © ented ise! reese O caret edema O resena © tne hypertension Injury that typieally volves the upper extremities toa ‘greater degree. tis from contusion and hemorrhage in the center of spinal cord * O cent crateion © Trin Ouest © sein stock © cone mc ‘Shock resiting in metabolic acidosis which causes respiratory distress: * O tee nih oberacton © kettontoh shunts O rrerensn © ‘etear tne eons In unstable SupraventricularTachyearda (SVT) urveszonsive to adenosine, thie should be performed: Symchonized cardoversion at 8. Defias 2k Detonlate 0g O° © smmeronaed cedoverson at 747g. O° fe) \Which among the following is the most important aspect inthe care of spinal cord injuries? * © Menppetsoloe 1 ey nie cours of wesment O remediate spine maging © mer erevemon © sual stcompression \What maneuver shouldbe done when performing rapid sequence intubation inorder to prevent aspiration of gastric contents? * © setee maneer © eure maneiner © ener manever O eassit china mareoer Cushing triad con be a sign o fe threatening Increase CP and should be evaluate inthe ER. Cushing triad is the combination of: © restzende nypotenson snes © saree hypertension, sered sensor. © teeryaria hypotension redyanen © ‘Twcycatia hypertension shared sensu Which of the fotowing is true for traumatic head injuries? = © oie ery tte to pater svat © Atte contt ois ltd to pation sural Eaty poet raumatic sez i ot prevented by at © Sohertecrne © cpteste ange Irreversible CNS injury hgppens when the duration of anoxia reaches: * O tnne O semi O mie O esmine Colloids usualy instituted how many hours after burn injury? * O vponrenstaton O ss72n0ue O e24neur O 248 nour It is considered as the deadliest ofthe high-altitude iloesses:* © Homsttase Pumonary Edema APE) O Hirata cerebral edeme (ACE) O cattogente Pumonary Edema © este Noa seaness (0) ‘Anine-year od intubated patient inthe PICU due to increased ICP from a intracranial mass, now on his @th hospital day, suddenly develops new onset fever, leukocytosis and lng infirates on Chest Xray. What is the most plausible diagnosis? * O sepsie Commun Aequired Pneumonia O° © ‘etcroume O° ‘Ventnor Associsted Poeun What isthe primary symptom of Acute Mountain Sickness(AMS)?* O stonres fresh © esting psp © sprite eadase O° Resting tachycardia The top 3 causes of injury mortality are the folowing EXCEPT:* O Disseterseated monty O Tatceite jie O rowing O suns Children with thisthese blood disorder should avoid travel to altitude, * © sieie tat nd Siete Cll Disease Physiologic Anemia Sieteasti Anemia O° O Fedeticney Anemia O° AS albumin infusion may be used to meinain the serum abuminlevel ata desired 2gfdL Whats tha rato ‘of aloumininfusionf the burn is 60-70% of ttl BSA? O oaminas © oamingys O osmings © oaminare This is the most common precipitating event for ‘corciac instability in infants and children. * O crerpatpaty Cena cyanosis O° O cosine ane O° Respiratory insufency Hatlmarks of extro-thorecle sway obstruction are: Ineprtory stride supastral chest wal and ‘subcostal reactions, and prolonged expeation O° subcostal ection, and protonged expiration Inoprtory etrdr suprastral chest wal and subcostal evactons, and prolonged nsption. O° subcostal retraction, and prolonged inspiration, O° ‘One of the following is seen inpatient with moderate ‘carbon moneside (HeCO) poisoning. * O Hatucnaton a staca O Metab & opt fave O Hessscne aso asones O sever ‘Te hallmark of severe traumatic brain injury: O neon O misoconia O coms O wree This topical agents useful forthe treatment of burn wounds that ae heavily colonized with multidrug resistant bacteria, * © siveten eam © pawest ag O wate atte © osssiver state Syncope must aso be distinguished with seizure because seizure has the ff features EXCEPT * © connison a common © romiaton wah pose © Aeorrementrysmptome rng © commen snort 9 thdnge TRUE of HACE or High Altitude cerebral Edema. * © Wrce ne detest of the igh tude nse. © nctance of HACE fe cormon below 4000m atu O Dezerrensnste mast etc wentrent or Hace, O Temerteonmen reasons son coseneds Most common cause of mortality and long-term morbidity in drowning * O sro O ensiny O Mrpotermia O oie epi dress nome Which ofthe folowing statements is TRUE regaring Prognotis of Drowning in children? * O iste ey aad oe uy ie a patent wih Sin aubmersion drain, eben f poor nereagi outcome. 1} O tazerieae tebe poetics erste Oo ENS outcome, Laboratory ane technologie methods ar superior to reuologl examination fr prognostication. Patient came to your clinic and patient complaints “My head is pinning” The room s whiting. tis ‘sagravated by mation, Patient hae nystagmus. What is ‘the usuel cause of this case ?* © inpate sera perison O vestbatr ore O depressive sorder O coven nero ytietion ‘The development of increased intracranial pressure after a brain injuryis usually manifests as:* O recreate ameter O° O erenson Oo Techypnes ‘This remains the mainstay agnostic tool in assessing the spine * O crecan O ma © wwasound © Phantom Headaches that occur on arising in the morning. are worse wien ying flat or accompanied by vomiting * O Ccincease isan peeeve O Amorsne © Prsnusteniacne O esuessteaiaene ‘The most halpful diagnostic feature in hypothermia: decrease n allay temperature 0 32°C levated heart rate shiver ©O00 Aooreae in rectal temperature to <24°C Patient came to your clini and patient complaints "My heads spinning” The room s whirling. tis ‘aggravated by motion, Patient has nystagmus This could be:* O vege O secur O Presieope O Uoressainese The following are signs of increase ICP with impending herniation. * O Hrrctnson O Lorerat ecus pay O reerearia O woitnerate TRUE of HACE or High Atte cerebral Edema, * O haceietne detest ot high antuce esses. © tnednc of HACE common low 000m ade O Desettonaathe most ett tester O Temesteonmanneuaton doncberesie ‘Most common cause of mortality and long-term, ‘moti in drowning * O area O ensinuy O Protea O Aoverepinon deters amdome Which ofthe folowing statements is TRUE regarding Prognosis of Drowning in children? * © oereray meaty onenr ua patient wth >Sminevomersen duration, 6c scor«? on hosptal admissions nave Nghe probably f poor nerleglceusome Oo. Co ° Laborstry an technologie methods ae superior neurolai examinaton or prognostication. Patient came to your cine and patient coment ie “My head is spinning." The room s whiting, tis caggrevated by motion. Patient has nystagmus. Whats ‘the usual cause of this ease ?* O impared cerebral pertusion O weston eorter O epee dnorder O cana aaoioi astern ‘The development of increased intracranial pressure after abraininjury is usualy manifests as:* O recpeaca O Prec O Hieron O rectneees This remains the mainstay dlagnostctoolin assessing the spine * O crsean O O vrescind O Pte raigron Headaches that accur on arising in the morning, re worse whan yng fla or accompanied by vomiting * © © merase iracranal pressure O Aririne © Brsin nesdacne O asics nsascne ‘The most helpful diagnostic feature in hypothermia is: ecrease in xl temperature to «32°C erated ear rate stivering ‘decreace neta temperature to 34°C ‘The ful outine of unresponsiveness (FOUR) score is 8 ‘modification of GCS with eye and motor response but eliminates the verbal response and adds 2 functional ‘assessments which include: * © ove! ant wnat aytincon an ese QO tee atin ©0000 © brit efensand eprtion © ‘atone og oneng no Patent came to your lnc and pation: complaint is “My heodis sinning” The rooms whiting tis aggravated by motion, Patient has ystagrus This could be :* ‘The folowing or character lngs of erion pneumethorax XCEPT:* O verign O vsequirum O Mrperreson O Preanose O Wormeedtness percussion tone Diminished rentheouncs on palatal ie ° O Fat reck sens O° ‘The following are signs of increase ICP with impending herniation. ‘Occult UI can be considered if J ofthe allowing ere present * O Poretenion © “iret ier 90, 40 her. fours fever Lateral atu play O° © recente O° <1 year le, ever of 96, ever

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