In-training exam review

Buzzwords

This page consists of high-yield word associations meant for rapid review while studying for ITE or boards

Cardiovascular

Question	Answer
Treatments for Torsades de pointes?	Magnesium, Isoproterenol, Overdrive pacing, Defibrillation
Most specific sign in acute CHF?	S3
Most common sign in myocarditis?	Tachycardia
Joules for synchronized cardioversion? (with biphasic)	Narrow regular(eg SVT): 50-100 J Narrow irregular (eg A fib): 120-200 J (50-100 J often sufficient for A flutter) Wide regular (eg Vtach): 100 J
Joules for defibrillation?	120-200 J
Joules for pediatric cardioversion and defibrillation?	Cardioversion: 0.5 J/kg, repeat with 1 J/kg if unsuccessful Defibrillation: 2 J/kg, repeat with 4 J/kg if unsuccessful
Most common cause of pacemaker failure to pace?	Oversensing
EKG findings in pericarditis?	Diffuse PR depressions and ST elevations (reversed in aVR)
Dialysis patient w/ new-onset heart failure. Pressing on fistula causes pulse to drop from 130 to 90 bpm. Dx and sign?	High-output heart failure, Branham sign
Treatment for patient with ACS with aspirin allergy?	Clopidogrel
How to distinguish early repolarization from pericarditis?	ST/T ratio < 0.25 in early repolarization
Cardiac transplant patient with bradycardia. Which drug will NOT work?	Atropine due to denervation of heart during transplantation
Bidirectional ventricular tachycardia?	Digoxin toxicity
How many blood cultures are needed to diagnose endocarditis?	3 separate sets

Endocrine

Question	Answer
What are the doses for dextrose in pediatric patients?	5ml/kg of D10 if <1yo, 2ml/kg of D25 if 1-8yo, 1ml/kg of D50 if >8yo

Environmental

Question	Answer
Which blood count is used for prognostication in acute radiation syndrome?	Absolute lymphocyte count

GI

Question	Answer
Painful bowel movements with BRB when wiping?	Anal fissure
Most common cause of small bowel obstruction?	Adhesions
Most common cause of large bowel obstruction?	Cancer
Management of thrombosed hemorrhoid?	Elliptical incision to remove clot
Risk factors for sigmoid volvulus?	Elderly, residents of long-term and psychiatric facilities, hx chronic constipation
Risk factors for cecal volvulus?	Younger patients than sigmoid volvulus (30-60 yo), pregnancy
Most common location for esophageal foreign body in children?	Cricopharyngeus muscle
Most common location for esophageal foreign body in adults?	Lower esophageal sphincter
Infant with bloody stools that are hemoccult negative after recently starting antibiotics. Which antibiotic were they prescribed?	Cefdinir
Toddler with bloody diarrhea and seizures. Diagnosis?	Shigella
Diagnostic criteria for spontaneous bacterial peritonitis?	Ascitic fluid with PMNs ≥250 (≥100 for peritoneal dialysis-associated peritonitis)

HENT

Question	Answer
Best solutions for an avulsed tooth?	Hank's solution>Milk>Saliva>Saline
Ellis classification for dental fractures?	Class I: Enamel Class II: Dentin exposed Class III: Pulp exposed Management: Dental referral, Class I file down sharp edges, Classes II/III cover with calcium hydroxide
Most common source in anterior epistaxis?	Kiesselbach plexus
Most common source in posterior epistaxis?	Sphenopalatine artery
"Woody" texture and swelling of submandibular tissues w/ tongue elevation?	Ludwig's angina
Most common organism in otitis externa?	Pseudomonas
Most common organism in otitis media?	Strep pneumo
Toddler presents with perioral electrical burns after chewing on a cable. What complication is he/she at risk for?	Delayed labial artery bleeding (5-21 days after injury)

Infectious Disease

Question	Answer
Patient with arthralgias and pustule on hand. Diagnosis?	Disseminated gonorrhea
What organism needs to be covered for prophylaxis for a puncture wound through a tennis shoe?	Pseudomonas, treat with ciprofloxacin
Prophylaxis for close contacts of patient with meningococcal meningitis?	Rifampin
Diagnosis and treatment for patient with fever and target rash in the NE United States?	Lyme disease and doxycycline

Neurology

Question	Answer
BP goal for acute ischemic stroke?	<220/120mmHg if not a tPA candidate, <185/110mmHg if giving tPA

Pediatrics

Question	Answer
Formula for low end of normal systolic blood pressure?	70 mmHg + (age in years x 2) mmHg

Toxicology

See also: Antidotes

Question	Answer
Lab findings and treatment for ethanol toxicity?	+ osmolar gap, + anion gap (if ketoacidosis), supportive care
Lab findings and treatment for methanol toxicity?	+ osmolar, + anion gap, fomepizole, folinic acid, +/- dialysis
Lab findings and treatment for ethylene glycol toxicity?	+ osmolar, + anion gap, fomepizole, thiamine, pyridoxine, +/- dialysis
Lab findings and treatment for isopropyl alcohol toxicity?	+ osmolar gap, - anion gap, supportive care
Beta blocker overdose antidotes?	Glucagon and high dose insulin
Beta blocker overdose with wide QRS?	Propranolol
Beta blocker overdose with prolonged QT?	Sotalol
Dispo for patient who presents comatose and is intubated for airway protection, then wakes up in the ED and is A&Ox4?	Discharge (GHB toxicity, short half life)
Mechanism of benzodiazepines?	Increase frequency of GABA-A channel opening
Mechanism of barbiturates?	Increase duration of GABA-A channel opening
Mnemonic for common dialyzable toxins?	BLISTMED and ISTUMBLED
Indications for hyperbaric oxygen in carbon monoxide poisoning?	CO level >25% (>15% if pregnant), loss of consciousness, severe metabolic acidosis (pH < 7.1), concern for end-organ ischemia
Ingestion that mimics tetanus and exhibits "awake" seizures in which patient is alert and oriented during tonic-clonic activity?	Strychnine

Miscellaneous

Question	Answer
If an on-scene physician arrives after EMS has initiated care, who makes the final decision, the on-scene doc or the medline physician?	The medline physician, though he/she can defer to on-scene physician