Kaji Review Questions (Main)

Revision as of 02:41, 30 September 2013 by Ostermayer (talk | contribs)

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 past in this page with formatting according to the example below. Then delete the question from the google document so that future users do not replicate the question.


Kaji Questions 1

Kaji Questions 2

Kaji Questions 3

Kaji Questions 4

Kaji Questions 5

Kaji Questions 6

Kaji Questions 7

Kaji Questions 8

Kaji Questions 9

<quiz display=simple> {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 -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.  ?[1]

-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.


Sources

  1. Mellick LB. Torsion of the testicle – it is time to stop tossing the dice. Ped Emerg Care 2012; 28:80-86.