Difference between revisions of "Kaji Review Questions (Main)"

 
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'''[[User:Akaji|Amy Kaji MD PhD]], faculty at [http://www.emedharbor.edu/ 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.'''  
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[[File:kaji-review.jpg|thumbnail]]
 +
==Background==
 +
[[User:Akaji|Amy Kaji MD PhD]], faculty at [http://www.emedharbor.edu/ Harbor-UCLA], has created an extraordinary set of Emergency Medicine review questions.  Originally appearing on the wiki, the questions were not interactive and functioned poorly with the [[WikEM:Mobile_Apps|mobile apps]].  Since then, the 700+ questions with hundreds of full text articles, videos and images are now available as an [http://www.amazon.com/Kaji-Review-Emergency-Medicine-Clinical-ebook/dp/B00UIEN7IK/ref=sr_1_1?ie=UTF8&qid=1426081773&sr=8-1&keywords=kaji+review ebook]. If your residency program would like a copy of the book for all of the residents please contact us at [mailto:info@wikem.org info@wikem.org]The book is available for [https://www.amazon.com/gp/product/B00NWRMV9G/ku/ref=sr_ku_lm?ie=UTF8&qid=1426094862 free to all Amazon kindle unlimited members].
  
'''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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==Book Description==
 +
[http://www.amazon.com/Kaji-Review-Emergency-Medicine-Clinical-ebook/dp/B00UIEN7IK/ref=sr_1_1?ie=UTF8&qid=1426081773&sr=8-1&keywords=kaji+review The Kaji Review] is an evidence based clinical question book for students, residents, and attending physicians in Emergency Medicine. The book covers core content, life long learning readings, and advanced clinical care topics to advance bedside knowledge, evidence based medicine, and daily clinical practice. There are over 700 questions and hundreds of full text articles, videos, and images.
  
{| class="prettytable"
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==Free Preview==
!wikitext!!rendering!!comments
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The first two chapters of the book are available for [http://d1smiij77mksjh.cloudfront.net/wp-content/uploads/2015/03/The-Kaji-Review-Free-Preview.pdf free preview]
|-
 
|valign="top"|
 
<pre>
 
{Question
 
|type="()"}
 
+ The correct answer.
 
|| Feedback for correct answer.
 
- Distractor.
 
|| Feedback for distractor.
 
- Distractor.
 
|| Feedback for distractor.
 
- Distractor.
 
|| Feedback for distractor.
 
</pre>
 
|valign="top"|
 
{|width=250|
 
|
 
<quiz display=simple>
 
{Question
 
|type="()"}
 
+ The correct answer.
 
|| Feedback for correct answer.
 
- Distractor.
 
|| Feedback for distractor.
 
- Distractor.
 
|| Feedback for distractor.
 
- Distractor.
 
|| Feedback for distractor.
 
</quiz>
 
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|valign="top"|
 
* Feedback is text which is initially hidden, and then shown to the user when they submit the quiz for correction. Feedback typically serves the purposes of encouragement, explanation, congratulation and commiseration.
 
* Feedback is set with all types by using a double vertical line '''||''' immediately after a response.
 
* The pipes beginning the ''feedback'' section must be on a new line.
 
* Unlike some other quiz systems, '''all''' feedback items are displayed on correction. With other quiz systems, the norm is to display the feedback only for those items which were selected by the user.
 
* To try out the feedback effect, choose a response and click the correction button. The feedback will then appear.
 
|}
 
  
  
[http://docs.google.com/document/d/1aGKiJ30rzjzTvvj6GPj5kO8bb6hWHfBuGWd-BlT_QdU/edit?usp=sharing Set 1]  ||
 
[http://docs.google.com/document/d/1zHZ7ZuGgmIg1O-otSG3lMMO3X66jciXbBiINDykErx4/edit?usp=sharing Set 2] ||
 
[http://docs.google.com/document/d/1Ot60Qmtu5t131_lCgOCnZl69GrAml1Cnss8F6E_5QIo/edit?usp=sharing Set 3] ||
 
[http://docs.google.com/document/d/1JV9DfzhKpQS47zx97n9kfjzLZjiWB6rfDUqBNh76Rcs/edit?usp=sharing Set 4]  || 
 
[http://docs.google.com/document/d/1YbwfukqaBVIAKFZue34F_I0W-3QrPsXEf5vrqQEG5kg/edit?usp=sharing Set 5]  || 
 
[http://docs.google.com/document/d/10WQ7m774KO6AppbYn1jGoCTT9fuowb1QXaUidQMowyU/edit?usp=sharing Set 6]  ||
 
[http://docs.google.com/document/d/1uwtnXOnl4O__wfD8RB5uKQ6eTovqmXPV3ZnDptczOHQ/edit?usp=sharing Set 7]  ||
 
[http://docs.google.com/document/d/1sAephvRyF3oGt96g-RRwUs6wUJYBCADudzghqwbWD3Q/edit?usp=sharing Set 8]  ||
 
[http://docs.google.com/document/d/1FxKE5lbcmS93Zl6SL7xkNXd-yPk33-SwXZo2TbUuNDA/edit?usp=sharing Set 9]
 
  
<quiz display=simple>
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[[Category:WikEM]] [[Category:Board Review]]
{How many minutes of apnea can a normal, healthy adult tolerate before oxygen desaturation to less than 90% occurs after administration of 100% oxygen for 3 minutes of normal, tidal volume breathing (preoxygenation)?
 
|type="()"}
 
 
 
-1 minute
 
-3 minutes
 
-5 minutes
 
+8 minutes
 
||This time to desaturation is considerably less in children, obese adults, pregnant women, and in patients with significant comorbidities, and if the patient does not inspire 100% oxygen
 
-10 minutes
 
 
 
{Regarding testicular torsion (TT), which of the following statements is true
 
|type="()"}
 
+TT is the 3rd most common cause of a malpractice lawsuit in adolescent males 12-17 years old.
 
|| Unfortunately, the literature confirms that it is NOT possible to consistently and accurately differentiate TT from EO and other scrotal pathologic abnormality by physical examination alone. One of the major tripwires is the belief that the presence of a cremasteric reflex essentially rules out a TT. The cremasteric reflex can be absent in up to 30% of males with normal testicles, and persistence of the cremasteric reflex was reported in 40% of patients with TT. Several experts have taken a strong stance that a testis should not be presumed necrotic and unsalvageable if less than 48 hours have elapsed since the onset of symptoms. Unfortunately, color Doppler ultrasound has failed to establish the diagnosis of TT in up to 24% of patients. The most important finding on ultrasound seems to be the identification of the torsion knot in the spermatic cord.  ?<ref>Mellick LB. Torsion of the testicle – it is time to stop tossing the dice. Ped Emerg Care 2012; 28:80-86.</ref>
 
-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.
 
 
 
{If time is insufficient for a full 3 minute preoxygenation phase, how many vital capacity breaths using high-flow oxygen can achieve oxygen saturations and apnea times that match or exceed those obtained with traditional preoxygenation?
 
|type="()"}
 
-3
 
-5
 
-6
 
+8
 
||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=
 
<references />
 
[[Category:EBQ]][[Category:Board Review]]
 

Latest revision as of 17:29, 11 March 2015

Kaji-review.jpg

Background

Amy Kaji MD PhD, faculty at Harbor-UCLA, has created an extraordinary set of Emergency Medicine review questions. Originally appearing on the wiki, the questions were not interactive and functioned poorly with the mobile apps. Since then, the 700+ questions with hundreds of full text articles, videos and images are now available as an ebook. If your residency program would like a copy of the book for all of the residents please contact us at info@wikem.org. The book is available for free to all Amazon kindle unlimited members.

Book Description

The Kaji Review is an evidence based clinical question book for students, residents, and attending physicians in Emergency Medicine. The book covers core content, life long learning readings, and advanced clinical care topics to advance bedside knowledge, evidence based medicine, and daily clinical practice. There are over 700 questions and hundreds of full text articles, videos, and images.

Free Preview

The first two chapters of the book are available for free preview