Revision as of 02:19, 1 October 2013

Amy Kaji MD PhD, faculty at Harbor-UCLA, has created an extraordinary set of Emergency Medicine review questions. These questions will live on WikEM with eventual incorporation into articles and CME modules. Please help format the questions for wiki quiz format.

Copy a question from the below documents and recreate it here with the wiki quiz markup. Then delete the question from the google document so that future users do not replicate the question.

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 |type="()"}
 + The correct answer.
 || Feedback for correct answer.
 - Distractor.
 || Feedback for distractor.
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Set 1 || Set 2 || Set 3 || Set 4 || Set 5 || Set 6 || Set 7 || Set 8 || Set 9

Sources

Authors:

@@ Line 82: / Line 82: @@
 ||Administration of eight vital capacity breaths with high-flow O2 can match or exceed oxygen saturations and apnea times obtained with traditional preoxygenation. <ref>Baraka A, et.al. Preoxygenation: Comparison of maximal breathing and tidal volume techniques. Anesthesiology 91;612,1999</ref>
 -10
+{Airway question – All of the following statements are TRUE about succinylcholine EXCEPT:}
+-It is rapidly active, and it typically produces intubating conditions within 60 seconds of rapid intravenous bolus administration.
+-Its clinical duration of action is 6 to 10 minutes, and full recovery of normal neuromuscular function occurs within 15 minutes.
+-It is a negative chronotrope in children less than 10 years of age, and sinus bradycardia may ensue after administration.
+-Succinylcholine remains the agent of choice for RSI in acute burn, trauma, stroke, spinal cord injury, and intra-abdominal sepsis patients if intubation occurs less than 5 days after the onset of the condition.
++It binds competitively to Ach receptors, preventing access to Ach and preventing muscular activity.
+||Answer – <ref>E. Rosen, p.13-14.</ref> Succinylcholine, a depolarizing agent exerts its effects by binding noncompetitively with Ach receptors on the motor end plate and causing sustained depolariziation of the myocyte. Succinylcholine has been associated with severe fatal, hyperkalemia in specific clinical cirumstances:
+Burns>10% BSA >5 days until healed;
+Crush injury> 5 days until healed;
+Denervation (stroke, spinal cord injury) > 5 days – 6 months;
+Neuromuscular disease (ALS and MS) –indefinitely;
+and intraabdominal sepsis > 5 days until resolution.
+However, it remains the drug of choice if intubation occurs less than 5 days after the onset of the condition (usually the case for us), since the vulnerability to succinylcholine-induced hyperkalemia does not begin until at least 5 days after the inciting injury or burn. If doubt exists about the time of onset, then a competitive, nondepolarizing agent (vecuronium, rocuronium) should be used.
 </quiz>
 =Sources=
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	1 minute
	3 minutes
	5 minutes
	8 minutes
	10 minutes

	TT is the 3rd most common cause of a malpractice lawsuit in adolescent males 12-17 years old.
	In the hands of an experienced emergency physician, it is possible to consistently and accurately differentiate TT from epididymoorchitis (EO) by physical examination alone.
	The presence of a cremasteric reflex essentially rules out TT.
	TT that present after 6 hours are not salvageable and no longer need to be evaluated in an emergent manner.
	Color Doppler ultrasound is a consistently reliable tool for confirming the diagnosis of testicular torsion.

	It is rapidly active, and it typically produces intubating conditions within 60 seconds of rapid intravenous bolus administration.
	Its clinical duration of action is 6 to 10 minutes, and full recovery of normal neuromuscular function occurs within 15 minutes.
	It is a negative chronotrope in children less than 10 years of age, and sinus bradycardia may ensue after administration.
	Succinylcholine remains the agent of choice for RSI in acute burn, trauma, stroke, spinal cord injury, and intra-abdominal sepsis patients if intubation occurs less than 5 days after the onset of the condition.
	It binds competitively to Ach receptors, preventing access to Ach and preventing muscular activity.

Kaji Review Questions (Main): Difference between revisions

Revision as of 02:19, 1 October 2013

Sources