2014 Exam - Questions.docx

2014 EXAM WRITTEN List the elements of the Ranson Criteria for pancreatitis on admission (specific values) Management considerations in traumatic hyphema and globe rupture Xray features of SCFE Describe the Young and Burgess classification of pelvic fractures Diagnosis and management of PI...

2014 EXAM WRITTEN List the elements of the Ranson Criteria for pancreatitis on admission (specific values) Management considerations in traumatic hyphema and globe rupture Xray features of SCFE Describe the Young and Burgess classification of pelvic fractures Diagnosis and management of PID Different classifications of HTN in pregnancy Describe how to do retrograde cystogram Describe the stages of syphilis and treatment of secondary syphilis List elements of offline medical control Pregnant pt exposed to varicella – how to manage? List 5 inhalants that are pulmonary irritants Other than pancreatitis, what are 5 causes of increased lipase Given picture of boney pelvis and label 10 points 5 characteristics of a simple febrile seizure 5 reasons to LP before CT List 17 causes of urinary retention (given a table with different broad categories (ie. neurologic, urethral, ureteric, other…) List SIRS criteria 10 Causes of ST-elevation Given a 12-lead EKG and asked to give a diagnosis (Posterior MI) Tylenol toxicity Q– define predictors of death or transplantation (King’s College criteria) Given 2x2 and calculate ARR, RRR; define alpha, beta; how to reduce affect of chance Triage Q – SAVE, SALT and given scenarios where have to label as green, yellow, red or black Intussussception – diagnosis, xray features, management List all elements of the PERC rule; what does a negative PERC rule mean? ORAL 1.  An obese pt in their 60's with story consistent with COPD exacerbation.  In respiratory failure, intolerant of BiPap, needs to be intubated but you cannot so you describe how to perform a cric. 2.  An older male pt who is having epigastric pain and you diagnose him with an inferior STEMI.  While you are treating him and arranging for PCI, he becomes bradycardic and hypotensive and you must manage him using ACLS.  They ask what the mechanism of his bradycardia is. 3.  During a sedation you notice a colleague stealing fentanyl instead of giving it to pt.  The pt wakes up in a lot of pain.  You then notice your colleague intoxicated seeing pt's.  What is your approach to the pt that didn't receive the analgesia they were expecting, the intoxicated physician who is still seeing pt's, and all of the other pt's that doctor has seen that night. 4.  Male in his 20's who has been generally unwell, weak for 2 weeks.  Now has a cough and a fever and petechiae.  WBC's are 185.  They ask you for a differential and a final diagnosis.  I think it was leukemia/blast crisis with a concurrent pneumonia from the immunosuppression.  5.  Lady in her 50's with epigastric/RUQ pain who is otherwise well.  They ask for a differential.  Labs come back consistent with biliary obstruction, and she then becomes hemodynamically unstable.  They ask for a diagnosis (ascending cholangitis).  You call GI for ERCP and the consultant says I can see this in the morning.  What is your response? 6.  Infant in SVT that is stable that does not respond to vagal maneuvers or adenosine 6 and 12 that then becomes hemodynamically unstable and responds to electrical cardioversion. 7.  Neonate that presents febrile and in shock that is also hypoglycemic.  Initial approach to resuscitation.  You correct glucose, give fluid, Abx, start pressors, still hypotensive.  I think they were pushing for hydrocortisone.  No other cause of shock apparent. 8.  Homeless man found unconscious and hypothermic in a snowbank, requires active internal rewarming, then has a VF cardiac arrest. 9.  Elderly major trauma pt that  presents comatose, hypoxic, hypotensive.  Has hemothorax and pelvic fracture.  Needs intubation, chest tube, blood, TXA, anticoagulation reversed, etc. 10.  Girl in her 20's with Type 1 DM who presents in shock with fever and DKA.  She is unconscious.  Upon intubation she has a temporary PEA cardiac arrest and they ask you about possible causes (acidosis, resp decompensation, hyperkalemia, etc).  You treat her with hyperventilation, fluids, HCO3, shift her K on spec, give Abx, start insulin.  She initially presented with abdo pain as well, a CT showed a perf'd appendix.  11.  5 year old with severe asthma that you treat but needs intubation.  You describe this and they ask you about vent settings. 12.  Drug overdose that was likely calcium channel blocker.  You take them through the management of a hemodynamically unstable calcium channel blocker overdose.  They ask you how insulin works in this situation.