MCCQE 1 Study Solutions With Real Solutions

MCCQE 1 Study Solutions With Real Solutions
HERPETIC WHITLOW Painful grouped vesicles on an erythematous base
located on the distal finger
Cause: Infection with HSV
Treatment:
Self-limiting disease
Antiviral (e.g., acyclovir) may be beneficial
ONYCHOCRYPTOSIS/ INGROWN NAILS Inflammation and soft tissue
hypertrophy +/− secondary infection occurring when the
lateral edge of the nail plate impinges on the nail fold
ONYCHOCRYPTOSIS Cause:
Onychomycosis
Incorrect technique of nail cutting
Repetitive trauma
Poor foot hygiene; poorly fitting shoes Treatment
Barrier placement between nail plate and nail fold
Excision of the portion of nail plate pressing on the nail fold
+/− Antibiotics
Biphasic Anaphylaxis Recurrence of Sx 4 to 32 h (mean
10 h) after the initial episode.
Occurs in up to 20% of patients
and is due to the release of 2â—¦
mediators and the late-phase
response.
Protracted Anaphylaxis Refractory Resp distress or
hypotension despite appropriate
medical Rx.
What Saves Lives? EPI,
EPI, EPI Adults: 0.3 to 0.5 mg IM
Children: 0.01 mg/kg IM
I V EPI: 0.1 mg, dilute 0.1 mL
1:1,000 in 10 mL N/S
Give 1 to 2 mL/min
All patients presenting with signs or Sx of anaphylaxis get: • Measures to stop
any continuing Ag exposure
• Two large bore I Vs • Supplemental O2
• Cardiac and O2 sat monitoring
• EPI IM or I V
• Methylprednisolone 125 mg I V
• Diphenhydramine 50 mg I V + ranitidine 50 mg I V
MINOR BURNS • cleaning with soap and water or dilute antiseptic solution.
Td immunization prn
topical Abx: 1%silver sulfadiazine(Dermazine) , bacitracin (Baciguent),
or bacitracin/neomycin/polymyxin B (Neosporin ointment).
Occlusive, clean dressings should be applied regularly.
Parkland Formula Fluid required (ml of RL) = 4 × kg body wt × TBSA
• 1/2 given in first 8 h from time of injury, 1/2 given in next 16 h
Anticholinergic Antihistamines, TCAs, phenothiazines,
atropine
Cholinergic Insecticides, nerve agents, nicotine,
pilocarpine, urecholine
Sympathomimetic Cocaine, amphetamines, MDMA (ecstasy),
ephedrine, theophylline
Opiate/sedative Heroin, morphine, benzodiazepines,
barbiturates, meprobamate, EtOH
Hallucinogens LSD, mescaline, phencyclidine, psilocybin
CVS β-Blockers, CCBs
Serotonin MAOI, SSRI, meperidine, TCA, L-tryptophan
Cellular CO, H2S, cyanide
TCAs Amitriptyline, doxepin
Simple asphyxiants CO2, inert gases
Drugs inducing metabolic acidosis
(BP usually low) Ethanol, methanol, ethylene glycol, ASA,
NSAID, tylenol
Anticholinergic ''hot as a hare, dry as a bone, red as a beet, blind as a bat, and mad as a hatter''
• ↑ Temperature
• Possible ↑ HR
• Dry mucous membranes
• Erythematous
• Mydriasis
• Disoriented, agitated • Reaching blindly for objects
• Large ODs can lead to depressive state

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