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Usmle 2 rapid review
usmle ck step 2
| Answer | Question |
|---|---|
| "Sawtooth" P waves | Classic ECG finding in atrial flutter. |
| Angina is new, is worsening, or occurs at rest | Definition of unstable angina. |
| ACEI | Antihypertensive for a diabetic patient with proteinuria. |
| Hypotension, distant heart sounds, and JVD | Beck's triad for cardiac tamponade. |
| β-blockers, digoxin, calcium channel blockers | Drugs that slow AV node transmission. |
| Niacin | Hypercholesterolemia treatment that → flushing and pruritus. |
| Anticoagulation, rate control, cardioversion | Treatment for atrial fibrillation. |
| Immediate cardioversion | Treatment for ventricular fibrillation. |
| Dressler's syndrome: fever, pericarditis, ↑ ESR | Autoimmune complication occurring 2–4 weeks post-MI. |
| Treat existing heart failure and replace the tricuspid valve | IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment? |
| Echocardiogram (showing thickened left ventricular wall and outflow obstruction) | Diagnostic test for hypertrophic cardiomyopathy. |
| Pulsus paradoxus (seen in cardiac tamponade) | A fall in systolic BP of > 10 mmHg with inspiration. |
| Low-voltage, diffuse ST-segment elevation | Classic ECG findings in pericarditis. |
| BP > 140/90 on three separate occasions two weeks apart | Definition of hypertension. |
| Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism | Eight surgically correctable causes of hypertension. |
| Abdominal ultrasound and CT | Evaluation of a pulsatile abdominal mass and bruit. |
| > 5.5 cm, rapidly enlarging, symptomatic, or ruptured | Indications for surgical repair of abdominal aortic aneurysm. |
| Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin | Treatment for acute coronary syndrome. |
| Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states | What is the metabolic syndrome? |
| Exercise stress treadmill with ECG | Appropriate diagnostic test? ■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate. |
| Pharmacologic stress test (e.g., dobutamine echo) | Appropriate diagnostic test? ■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina. |
| Angina, ST-segment changes on ECG, or ↓ BP | Signs of active ischemia during stress testing. |
| ST-segment elevation (depression means ischemia), flattened T waves, and Q waves | ECG findings suggesting MI. |
| Prinzmetal's angina | A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal. |
| CHF, shock, and altered mental status | Common symptoms associated with silent MIs. |
| V/Q scan | The diagnostic test for pulmonary embolism. |
| Protamine | An agent that reverses the effects of heparin. |
| PT | The coagulation parameter affected by warfarin. |
| Hypertrophic cardiomyopathy | A young patient with a family history of sudden death collapses and dies while exercising. |
| Oral surgery—amoxicillin; GI or GU procedures—ampicillin and gentamicin before and amoxicillin after | Endocarditis prophylaxis regimens. |
| Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia | The 6 P's of ischemia due to peripheral vascular disease. |
| Stasis, hypercoagulability, endothelial damage | Virchow's triad. |
| OCPs | The most common cause of hypertension in young women. |
| Excessive EtOH | The most common cause of hypertension in young men. |
| Seborrheic keratosis | "Stuck-on" appearance. |
| Psoriasis | Red plaques with silvery-white scales and sharp margins. |
| Basal cell carcinoma | The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias. |
| Impetigo | Honey-crusted lesions. |
| Cellulitis | A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity. |
| Pemphigus vulgaris | + Nikolsky's sign. |
| Bullous pemphigoid | - Nikolsky's sign. |
| Acanthosis nigricans. Check fasting blood sugar to rule out diabetes | A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck. |
| Varicella zoster | Dermatomal distribution. |
| Lichen planus | Flat-topped papules. |
| Erythema multiforme | Iris-like target lesions. |
| Contact dermatitis | A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry. |
| Pityriasis rosea | Presents with a herald patch, Christmas-tree pattern. |
| Alopecia areata (autoimmune process) | A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs. |
| Pityriasis versicolor | Pinkish, scaling, flat lesions on the chest and back. KOH prep has a "spaghetti-and-meatballs" appearance. |
| Asymmetry, border irregularity, color variation, large diameter | Four characteristics of a nevus suggestive of melanoma. |
| Actinic keratosis | Premalignant lesion from sun exposure that can → squamous cell carcinoma. |
| Lesions of 1° varicella | "Dewdrop on a rose petal." |
| Seborrheic dermatitis. Treat with antifungals | "Cradle cap." |
| Acne vulgaris | Associated with Propionibacterium acnes and changes in androgen levels. |
| Herpes simplex | A painful, recurrent vesicular eruption of mucocutaneous surfaces. |
| Lichen sclerosus | Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women. |
| Squamous cell carcinoma | Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer. |
| Hashimoto's thyroiditis | The most common cause of hypothyroidism. |
| High TSH, low T4, antimicrosomal antibodies | Lab findings in Hashimoto's thyroiditis. |
| Graves' disease | Exophthalmos, pretibial myxedema, and ↓ TSH. |
| Iatrogenic steroid administration. The second most common cause is Cushing's disease | The most common cause of Cushing's syndrome. |
| Hypoparathyroidism | A patient presents with signs of hypocalcemia, high phosphorus, and low PTH. |
| Signs and symptoms of hypercalcemia | "Stones, bones, groans, psychiatric overtones." |
| 1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia) | A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis. |
| Pheochromocytoma | A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic. |
| α-antagonists (phentolamine and phenoxybenzamine) | Should α- or β-antagonists be used first in treating pheochromocytoma? |
| Nephrogenic diabetes insipidus (DI) | A patient with a history of lithium use presents with copious amounts of dilute urine. |
| Administration of DDAVP ↓ serum osmolality and free water restriction | Treatment of central DI. |
| SIADH due to stress | A postoperative patient with significant pain presents with hyponatremia and normal volume status. |
| Metformin | An antidiabetic agent associated with lactic acidosis. |
| 1° adrenal insufficiency (Addison's disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids | A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment? |
| < 7.0 | Goal hemoglobin A1c for a patient with DM. |
| Fluids, insulin, and aggressive replacement of electrolytes (e.g., K+) | Treatment of DKA. |
| They can mask symptoms of hypoglycemia | Why are β-blockers contraindicated in diabetics? |
| Observational bias | Bias introduced into a study when a clinician is aware of the patient's treatment type. |
| Lead-time bias | Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death. |
| Confounding variable | If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a _____. |
| Sensitivity | The number of true positives divided by the number of patients with the disease is _____. |
| Out | Sensitive tests have few false negatives and are used to rule _____ a disease. |
| Highly sensitive for TB | PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific? |
| Higher prevalence | Chronic diseases such as SLE—higher prevalence or incidence? |
| Higher incidence | Epidemics such as influenza—higher prevalence or incidence? |
| Prevalence | Cross-sectional survey—incidence or prevalence? |
| Incidence and prevalence | Cohort study—incidence or prevalence? |
| Neither | Case-control study—incidence or prevalence? |
| High reliability, low validity | Describe a test that consistently gives identical results, but the results are wrong. |
| Cohort studies can be used to calculate relative risk (RR), incidence, and/or odds ratio (OR). Case-control studies can be used to calculate an OR | Difference between a cohort and a case-control study. |
| The incidence rate (IR) of a disease in exposed − the IR of a disease in unexposed | Attributable risk? |
| The IR of a disease in a population exposed to a particular factor ÷ the IR of those not exposed | Relative risk? |
| The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed | Odds ratio? |
| 1 ÷ (rate in untreated group − rate in treated group) | Number needed to treat? |
| Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer | In which patients do you initiate colorectal cancer screening early? |
| Prostate cancer is the most common cancer in men, but lung cancer causes more deaths | The most common cancer in men and the most common cause of death from cancer in men. |
| 68%, 95.5%, 99.7% | The percentage of cases within one SD of the mean? Two SDs? Three SDs? |
| Number of live births per 1000 population | Birth rate? |
| Number of live births per 1000 women 15–44 years of age | Fertility rate? |
| Number of deaths per 1000 population | Mortality rate? |
| Number of deaths from birth to 28 days per 1000 live births | Neonatal mortality? |
| Number of deaths from 28 days to one year per 1000 live births | Postnatal mortality? |
| Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality) | Infant mortality? |
| Number of deaths from 20 weeks' gestation to birth per 1000 total births | Fetal mortality? |
| Number of deaths from 20 weeks' gestation to one month of life per 1000 total births | Perinatal mortality? |
| Number of deaths during pregnancy to 90 days postpartum per 100,000 live births | Maternal mortality? |
| False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision-making capacity | True or false: Once patients sign a statement giving consent, they must continue treatment. |
| No. Parental consent is not necessary for the medical treatment of pregnant minors | A 15-year-old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed? |
| Conflict of interest | A doctor refers a patient for an MRI at a facility he/she owns. |
| The patient is a danger to self, a danger to others, or gravely disabled (unable to provide for basic needs) | Involuntary psychiatric hospitalization can be undertaken for which three reasons? |
| False. Withdrawing and withholding life are the same from an ethical standpoint | True or false: Withdrawing life-sustaining care is ethically distinct from withholding sustaining care. |
| When there is no rationale for treatment, maximal intervention is failing, a given intervention has already failed, and treatment will not achieve the goals of care | When can a physician refuse to continue treating a patient on the grounds of futility? |
| Treat immediately. Consent is implied in emergency situations | An eight-year-old child is in a serious accident. She requires emergent transfusion, but her parents are not present. |
| Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse | Conditions in which confidentiality must be overridden. |
| When treatment noncompliance represents a serious danger to public health (e.g., active TB) | Involuntary commitment or isolation for medical treatment may be undertaken for what reason? |
| Treat because the disease represents an immediate threat to the child's life. Then seek a court order | A 10-year-old child presents in status epilepticus, but her parents refuse treatment on religious grounds. |
| A patient's family cannot require that a doctor withhold information from the patient | A son asks that his mother not be told about her recently discovered cancer. |
| Emergent laparotomy to repair perforated viscus, likely stomach | Patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management? |
| Diverticulosis | The most likely cause of acute lower GI bleed in patients > 40 years old. |
| HIDA scan | Diagnostic modality used when ultrasound is equivocal for cholecystitis. |
| Acute pancreatitis | Sentinel loop on AXR. |
| Fat, female, fertile, forty, flatulent | Risk factors for cholelithiasis. |
| Murphy's sign, seen in acute cholecystitis | Inspiratory arrest during palpation of the RUQ. |
| Campylobacter | Identify key organisms causing diarrhea: ■ Most common organism |
| Clostridium difficile | Identify key organisms causing diarrhea: ■ Recent antibiotic use |
| Giardia | Identify key organisms causing diarrhea: ■ Camping |
| ETEC | Identify key organisms causing diarrhea: ■ Traveler's diarrhea |
| S. aureus | Identify key organisms causing diarrhea: ■ Church picnics/mayonnaise |
| E. coli O157:H7 | Identify key organisms causing diarrhea: ■ Uncooked hamburgers |
| Bacillus cereus | Identify key organisms causing diarrhea: ■ Fried rice |
| Salmonella | Identify key organisms causing diarrhea: ■ Poultry/eggs |
| Vibrio, HAV | Identify key organisms causing diarrhea: ■ Raw seafood |
| Isospora, Cryptosporidium, Mycobacterium avium complex (MAC) | Identify key organisms causing diarrhea: ■ AIDS |
| Yersinia | Identify key organisms causing diarrhea: ■ Pseudoappendicitis |
| Crohn's disease | A 25-year-old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias. |
| Ulcerative colitis | Inflammatory disease of the colon with ↑ risk of colon cancer. |
| Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis | Extraintestinal manifestations of IBD. |
| 5-aminosalicylic acid +/− sulfasalazine and steroids during acute exacerbations | Medical treatment for IBD. |
| Mallory-Weiss—superficial tear in the esophageal mucosa Boerhaave—full-thickness esophageal rupture | Difference between Mallory-Weiss and Boerhaave tears. |
| RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis | Charcot's triad. |
| Charcot's triad plus shock and mental status changes, with suppurative ascending cholangitis | Reynolds' pentad. |
| ↓ protein intake, lactulose, neomycin | Medical treatment for hepatic encephalopathy. |
| Establish the ABCs | First step in the management of a patient with acute GI bleed. |
| Hemolytic-uremic syndrome (HUS) due to E. coli O157:H7 | A four-year-old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause? |
| HBV immunoglobulin | Post-HBV exposure treatment. |
| TB medications (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline | Classic causes of drug-induced hepatitis. |
| Biliary tract obstruction | A 40-year-old obese female with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools. |
| Femoral hernia | Hernia with highest risk of incarceration—indirect, direct, or femoral? |
| Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids, O2, analgesia, and "tincture of time" | A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management? |
| TICS—Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia | Four causes of microcytic anemia. |
| Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer | An elderly male with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests? |
| Sulfonamides, antimalarial drugs, fava beans | Precipitants of hemolytic crisis in patients with G6PD deficiency. |
| Factor V Leiden mutation | The most common inherited cause of hypercoagulability. |
| Hereditary spherocytosis | The most common inherited hemolytic anemia. |
| Osmotic fragility test | Diagnostic test for hereditary spherocytosis. |
| Diamond-Blackfan anemia | Pure RBC aplasia. |
| Fanconi's anemia | Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, café-au-lait spots, microcephaly, and pancytopenia. |
| Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV | Medications and viruses that → aplastic anemia. |
| Both have ↑ hematocrit and RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels | How to distinguish polycythemia vera from 2° polycythemia. |
| Pentad of TTP—"FAT RN": Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neurologic abnormalities | Thrombotic thrombocytopenic purpura (TTP) pentad? |
| Anemia, thrombocytopenia, and acute renal failure | HUS triad? |
| Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs | Treatment for TTP. |
| Usually resolves spontaneously; may require IVIG and/or corticosteroids | Treatment for idiopathic thrombocytopenic purpura (ITP) in children. |
| Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hematocrit are ↓. | Which of the following are ↑ in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and hematocrit. |
| Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements | An eight-year-old boy presents with hemarthrosis and ↑ PTT with normal PT and bleeding time. Diagnosis? Treatment? |
| von Willebrand's disease; treat with desmopressin, FFP, or cryoprecipitate | A 14-year-old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or ↑ PTT, and ↑ bleeding time. Diagnosis? Treatment? |
| Monoclonal gammopathy, Bence Jones proteinuria, "punched-out" lesions on x-ray of the skull and long bones | A 60-year-old African-American male presents with bone pain. Workup for multiple myeloma might reveal? |
| Hodgkin's lymphoma | Reed-Sternberg cells |
| Non-Hodgkin's lymphoma | A 10-year-old boy presents with fever, weight loss, and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis? |
| Anemia of chronic disease | Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin. |
| Iron deficiency anemia | Microcytic anemia with ↓ serum iron, ↓ ferritin, and ↑ TIBC. |
| Chronic lymphocytic leukemia (CLL) | An 80-year-old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. Suspected diagnosis? |
| Blast crisis (fever, bone pain, splenomegaly, pancytopenia) | A late, life-threatening complication of chronic myelogenous leukemia (CML). |
| Acute myelogenous leukemia (AML) | Auer rods on blood smear. |
| M3 | AML subtype associated with DIC. |
| ↓ Ca2+ , ↑ K− , ↑ phosphate, ↑ uric acid | Electrolyte changes in tumor lysis syndrome. |
| Retinoic acid | Treatment for AML M3. |
| CML | A 50-year-old male presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Diagnosis? |
| Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenectomy | Heinz bodies? |
| Glanzmann's thrombasthenia | An autosomal-recessive disorder with a defect in the GPIIbIIIa platelet receptor and ↓ platelet aggregation. |
| Parvovirus B19 | Virus associated with aplastic anemia in patients with sickle cell anemia. |
| O2, analgesia, hydration, and, if severe, transfusion | A 25-year-old African-American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis? |
| Iron overload; use deferoxamine | A significant cause of morbidity in thalassemia patients. Treatment? |
| Infection, cancer, and autoimmune disease | The three most common causes of fever of unknown origin (FUO). |
| Fever, pharyngeal erythema, tonsillar exudate, lack of cough | Four signs and symptoms of streptococcal pharyngitis. |
| Postinfectious glomerulonephritis | A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1° infection. |
| Encapsulated organisms––pneumococcus, meningococcus, Haemophilus influenzae, Klebsiella | Asplenic patients are particularly susceptible to these organisms. |
| 105 bacteria/mL | The number of bacterial culture on a clean-catch specimen to diagnose a UTI. |
| Pregnant women. Treat this group aggressively because of potential complications | Which healthy population is susceptible to UTIs? |
| Coccidioidomycosis. Amphotericin B | A patient from California or Arizona presents with fever, malaise, cough, and night sweats. Diagnosis? Treatment? |
| 1° syphilis | Nonpainful chancre. |
| Rubella | A "blueberry muffin" rash is characteristic of what congenital infection? |
| Group B strep, E. coli, Listeria. Treat with gentamicin and ampicillin | Meningitis in neonates. Causes? Treatment? |
| Pneumococcus, meningococcus, H. influenzae. Treat with cefotaxime and vancomycin | Meningitis in infants. Causes? Treatment? |
| Check for ↑ ICP; look for papilledema | What should always be done prior to LP? |
| Bacterial meningitis | CSF findings: ■ Low glucose, PMN predominance |
| Aseptic (viral) meningitis | CSF findings: ■ Normal glucose, lymphocytic predominance |
| Subarachnoid hemorrhage (SAH) | CSF findings: ■ Numerous RBCs in serial CSF samples |
| MS | CSF findings: ■ ↑ gamma globulins |
| Cutaneous anthrax. Treat with penicillin G or ciprofloxacin | Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7–10 days. Treatment? |
| Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms | Findings in 3° syphilis. |
| Arthralgias, migratory polyarthropathies, Bell's palsy, myocarditis | Characteristics of 2° Lyme disease. |
| Mycoplasma | Cold agglutinins. |
| Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension | A 24-year-old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment? |
| ≤ 200 for PCP (with TMP); ≤ 50–100 for MAI (with clarithromycin/azithromycin) | Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV-positive patient at what CD4 count? Mycobacterium avium-intracellulare (MAI) prophylaxis? |
| Pregnancy, vesicoureteral reflux, anatomic anomalies, indwelling catheters, kidney stones | Risk factors for pyelonephritis. |
| 7–10 days | Neutropenic nadir postchemotherapy. |
| Lesion of 1° Lyme disease | Erythema migrans. |
| Fever, heart murmur, Osler's nodes, splinter hemorrhages, Janeway lesions, Roth's spots | Classic physical findings for endocarditis. |
| Parvovirus B19 | Aplastic crisis in sickle cell disease. |
| Taenia solium (cysticercosis) | Ring-enhancing brain lesion on CT with seizures |
| Actinomyces israelii | Name the organism: ■ Branching rods in oral infection. |
| Haemophilus ducreyi | Name the organism: ■ Painful chancroid. |
| Pasteurella multocida | Name the organism: ■ Dog or cat bite. |
| Sporothrix schenckii | Name the organism: ■ Gardener. |
| Toxoplasma gondii | Name the organism: ■ Pregnant women with pets. |
| Neisseria meningitidis | Name the organism: ■ Meningitis in adults. |
| Streptococcus pneumoniae | Name the organism: ■ Meningitis in elderly. |
| Klebsiella | Name the organism: ■ Alcoholic with pneumonia. |
| Klebsiella | Name the organism: ■ "Currant jelly" sputum. |
| Pseudomonas | Name the organism: ■ Infection in burn victims. |
| Pseudomonas | Name the organism: ■ Osteomyelitis from foot wound puncture. |
| Salmonella | Name the organism: ■ Osteomyelitis in a sickle cell patient. |
| Legionella pneumonia | A 55-year-old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram-negative rods. What is the diagnosis? |
| Lyme disease, Ixodes tick, doxycycline | A middle-aged man presents with acute-onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis, and how did he get it? Treatment? |
| S. aureus or S. epidermidis. | A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected? |
| All-compartment fasciotomy for suspected compartment syndrome | A patient presents with pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness. Treatment? |
| Spinal stenosis | Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips. |
| MCP and PIP joints; DIP joints are spared | Joints in the hand affected in rheumatoid arthritis. |
| Osteoarthritis | Joint pain and stiffness that worsen over the course of the day and are relieved by rest. |
| Osteogenesis imperfecta | Genetic disorder associated with multiple fractures and commonly mistaken for child abuse. |
| Suspect ankylosing spondylitis. Check HLA-B27 | Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test? |
| Reactive (Reiter's) arthritis. Associated with Campylobacter, Shigella, Salmonella, Chlamydia, and Ureaplasma | Arthritis, conjunctivitis, and urethritis in young men. Associated organisms? |
| Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid | A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment? |
| Pseudogout | Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate. |
| Polymyalgia rheumatica | An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ↑ ESR. |
| Osgood-Schlatter disease | An active 13-year-old boy has anterior knee pain. Diagnosis? |
| Distal radius (Colles' fracture) | Bone is fractured in fall on outstretched hand. |
| Avascular necrosis | Complication of scaphoid fracture. |
| Wrist drop, loss of thumb abduction | Signs suggesting radial nerve damage with humeral fracture. |
| Duchenne muscular dystrophy | A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles. |
| Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction | A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment? |
| Slipped capital femoral epiphyses. AP and frog-leg lateral view | An 11-year-old obese, African-American boy presents with sudden onset of limp. Diagnosis? Workup? |
| Multiple myeloma | The most common 1° malignant tumor of bone. |
| Cluster headache | Unilateral, severe periorbital headache with tearing and conjunctival erythema. |
| β-blockers, Ca2+ channel blockers, TCAs | Prophylactic treatment for migraine. |
| Prolactinoma. Dopamine agonists (e.g., bromocriptine) | The most common pituitary tumor. Treatment? |
| Broca's aphasia. Frontal lobe, left MCA distribution | A 55-year-old patient presents with acute "broken speech." What type of aphasia? What lobe and vascular distribution? |
| Trauma; the second most common is berry aneurysm | The most common cause of SAH. |
| Subdural hematoma—bridging veins torn | A crescent-shaped hyperdensity on CT that does not cross the midline. |
| Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation | A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment? |
| Elevated ICP, RBCs, xanthochromia | CSF findings with SAH. |
| Guillain-Barré (↑ protein in CSF with only a modest ↑ in cell count) | Albuminocytologic dissociation. |
| Normal | Cold water is flushed into a patient's ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological? |
| Lung, breast, skin (melanoma), kidney, GI tract | The most common 1° sources of metastases to the brain. |
| Absence seizures | May be seen in children who are accused of inattention in class and confused with ADHD. |
| Headache | The most frequent presentation of intracranial neoplasm. |
| Infection, febrile seizures, trauma, idiopathic | The most common cause of seizures in children (2–10 years). |
| Trauma, alcohol withdrawal, brain tumor | The most common cause of seizures in young adults (18–35 years). |
| IV benzodiazepine | First-line medication for status epilepticus. |
| Wernicke's encephalopathy due to a deficiency of thiamine | Confusion, confabulation, ophthalmoplegia, ataxia. |
| Seventy percent if the stenosis is symptomatic | What % lesion is an indication for carotid endarterectomy? |
| Alzheimer's and multi-infarct | The most common causes of dementia. |
| ALS | Combined UMN and LMN disorder. |
| Parkinson's disease | Rigidity and stiffness with resting tremor and masked facies. |
| Levodopa/carbidopa | The mainstay of Parkinson's therapy. |
| IVIG or plasmapheresis | Treatment for Guillain-Barré syndrome. |
| Huntington's disease | Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior. |
| Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe | A six-year-old girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and leptomeningeal angioma. |
| Neurofibromatosis 1 | Café-au-lait spots on skin. |
| Klüver-Bucy syndrome (amygdala) | Hyperphagia, hypersexuality, hyperorality, and hyperdocility. |
| Edrophonium | Administer to a symptomatic patient to diagnose myasthenia gravis. |
| Placental abruption and placenta previa | 1° causes of third-trimester bleeding. |
| Snowstorm on ultrasound. "Cluster-of-grapes" appearance on gross examination | Classic ultrasound and gross appearance of complete hydatidiform mole. |
| 46,XX | Chromosomal pattern of a complete mole. |
| Partial mole | Molar pregnancy containing fetal tissue. |
| Continuous, painful vaginal bleeding | Symptoms of placental abruption. |
| Self-limited, painless vaginal bleeding | Symptoms of placenta previa. |
| Never | When should a vaginal exam be performed with suspected placenta previa? |
| Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides | Antibiotics with teratogenic effects. |
| Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis | Shortest AP diameter of the pelvis. |
| Betamethasone or dexamethasone × 48 hours | Medication given to accelerate fetal lung maturity. |
| Uterine atony | The most common cause of postpartum hemorrhage. |
| Uterine massage; if that fails, give oxytocin | Treatment for postpartum hemorrhage. |
| IV penicillin or ampicillin | Typical antibiotics for group B streptococcus (GBS) prophylaxis. |
| Sheehan's syndrome (postpartum pituitary necrosis) | A patient fails to lactate after an emergency C-section with marked blood loss. |
| Inevitable abortion | Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open. |
| Threatened abortion | Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed. |
| β-hCG; the most common cause of amenorrhea is pregnancy | The first test to perform when a woman presents with amenorrhea. |
| Menometrorrhagia | Term for heavy bleeding during and between menstrual periods. |
| Asherman's syndrome | Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D |
| Weight loss and OCPs | Therapy for polycystic ovarian syndrome. |
| Clomiphene citrate | Medication used to induce ovulation. |
| Endometrial biopsy | Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding. |
| Stable, unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation | Indications for medical treatment of ectopic pregnancy. |
| OCPs, danazol, GnRH agonists | Medical options for endometriosis. |
| "Chocolate cysts," powder burns | Laparoscopic findings in endometriosis. |
| Ampulla of the oviduct | The most common location for an ectopic pregnancy. |
| Ultrasound | How to diagnose and follow a leiomyoma. |
| Regresses after menopause | Natural history of a leiomyoma. |
| Trichomonas vaginitis | A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix. |
| Oral or topical metronidazole | Treatment for bacterial vaginosis. |
| Intraductal papilloma | The most common cause of bloody nipple discharge. |
| OCP and barrier contraception | Contraceptive methods that protect against PID. |
| Endometrial or estrogen receptor– breast cancer | Unopposed estrogen is contraindicated in which cancers? |
| Consider Fitz-Hugh–Curtis syndrome | A patient presents with recent PID with RUQ pain. |
| Paget's disease | Breast malignancy presenting as itching, burning, and erosion of the nipple. |
| CA-125 and transvaginal ultrasound | Annual screening for women with a strong family history of ovarian cancer. |
| Kegel exercises, estrogen, pessaries for stress incontinence | A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options? |
| Anticholinergics (oxybutynin) or β-adrenergics (metaproterenol) for urge incontinence. | A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options? |
| ↑ serum FSH | Lab values suggestive of menopause. |
| Endometriosis | The most common cause of female infertility. |
| Colposcopy and endocervical curettage | Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation? |
| Lobular carcinoma in situ | Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts. |
| Neuroblastoma | Nontender abdominal mass associated with elevated VMA and HVA. |
| Esophageal atresia with distal TEF (85%). Unable to pass NG tube | The most common type of tracheoesophageal fistula (TEF). Diagnosis? |
| Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity | Not contraindications to vaccination. |
| Ophthalmologic exam, CT, and MRI | Tests to rule out shaken baby syndrome. |
| CF or Hirschsprung's disease | A neonate has meconium ileus. |
| Duodenal atresia | Bilious emesis within hours after the first feeding. |
| Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy | A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management? |
| Selective IgA deficiency | The most common 1° immunodeficiency. |
| Febrile seizures (roseola infantum) | An infant has a high fever and onset of rash as fever breaks. What is he at risk for? |
| High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms | Acute-phase treatment for Kawasaki disease. |
| Phototherapy (mild) or exchange transfusion (severe) | Treatment for mild and severe unconjugated hyperbilirubinemia. |
| Reye's syndrome | Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin. |
| Suspect retinoblastoma | A child has loss of red light reflex. Diagnosis? |
| HBV, DTaP, Hib, IPV, PCV | Vaccinations at a six-month well-child visit. |
| Precocious puberty | Tanner stage 3 in a six-year-old female. |
| RSV bronchiolitis | Infection of small airways with epidemics in winter and spring. |
| Surfactant deficiency | Cause of neonatal RDS. |
| Chronic granulomatous disease | What is the immunodeficiency? ■ A boy has chronic respiratory infections. Nitroblue tetrazolium test is +. |
| Wiskott-Aldrich syndrome | What is the immunodeficiency? ■ A child has eczema, thrombocytopenia, and high levels of IgA. |
| Bruton's X-linked agammaglobulinemia | What is the immunodeficiency? ■ A four-month-old boy has life-threatening Pseudomonas infection. |
| Intussusception | A condition associated with red "currant-jelly" stools. |
| Coarctation of the aorta | A congenital heart disease that cause 2° hypertension. |
| Amoxicillin × 10 days | First-line treatment for otitis media. |
| Parainfluenza virus type 1 | The most common pathogen causing croup. |
| Kwashiorkor (protein malnutrition) | A homeless child is small for his age and has peeling skin and a swollen belly. |
| Lesch-Nyhan syndrome (purine salvage problem with | Defect in an X-linked syndrome with mental retardation, |
| HGPRTase deficiency) | gout, self-mutilation, and choreoathetosis. |
| Patent ductus arteriosus (PDA) | A newborn female has continuous "machinery murmur." |
| SSRIs | First-line pharmacotherapy for depression. |
| MAOIs | Antidepressants associated with hypertensive crisis. |
| Patient on dopamine antagonist | Galactorrhea, impotence, menstrual dysfunction, and ↓ libido. |
| Conversion disorder | A 17-year-old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found. |
| Displacement | Name the defense mechanism: ■ A mother who is angry at her husband yells at her child. |
| Reaction formation | Name the defense mechanism: ■ A pedophile enters a monastery. |
| Isolation | Name the defense mechanism: ■ A woman calmly describes a grisly murder. |
| Regression | Name the defense mechanism: ■ A hospitalized 10-year-old begins to wet his bed. |
| Neuroleptic malignant syndrome | Life-threatening muscle rigidity, fever, and rhabdomyolysis. |
| Anorexia | Amenorrhea, bradycardia, and abnormal body image in a young female. |
| Panic disorder | A 35-year-old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy. |
| Agranulocytosis | The most serious side effect of clozapine. |
| Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms) | A 21-year-old male has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking. |
| Weight gain, type 2 DM, QT prolongation | Key side effects of atypical antipsychotics. |
| Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine | A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment? |
| Neuroleptics | Medication to avoid in patients with a history of alcohol withdrawal seizures. |
| Conduct disorder | A 13-year-old male has a history of theft, vandalism, and violence toward family pets. |
| Rett's disorder | A five-month-old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction. |
| Acute mania. Start a mood stabilizer (e.g., lithium) | A patient hasn't slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment? |
| Malingering | After a minor fender bender, a man wears a neck brace and requests permanent disability. |
| Factitious disorder (Munchausen syndrome) | A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide. |
| Substance abuse | A patient continues to use cocaine after being in jail, losing his job, and not paying child support. |
| Phencyclidine hydrochloride (PCP) intoxication | A violent patient has vertical and horizontal nystagmus. |
| Depersonalization disorder | A woman who was abused as a child frequently feels outside of or detached from her body. |
| Frotteurism (a paraphilia) | A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus. |
| Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, clozapine) | A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment? |
| Dissociative fugue | A man unexpectedly flies across the country, takes a new name, and has no memory of his prior life. |
| Stasis, endothelial injury and hypercoagulability (Virchow's triad) | Risk factors for DVT. |
| Pleural/serum protein > 0.5; pleural/serum LDH > 0.6 | Criteria for exudative effusion. |
| Think of leaky capillaries. Malignancy, TB, bacterial or viral infection, pulmonary embolism with infarct, and pancreatitis | Causes of exudative effusion. |
| Think of intact capillaries. CHF, liver or kidney disease, and protein-losing enteropathy | Causes of transudative effusion. |
| Fatigue and impending respiratory failure | Normalizing PCO2 in a patient having an asthma exacerbation may indicate? |
| Sarcoidosis | Dyspnea, lateral hilar lymphodenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia. |
| Obstructive pulmonary disease (e.g., asthma) | PFT showing ↓ FEV1/FVC. |
| Restrictive pulmonary disease | PFT showing ↑ FEV1/FVC. |
| Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help | Honeycomb pattern on CXR. Diagnosis? Treatment? |
| Radiation | Treatment for SVC syndrome. |
| Inhaled β-agonists and inhaled corticosteroids | Treatment for mild, persistent asthma. |
| Hypoxia and hypocarbia | Acid-base disorder in pulmonary embolism. |
| Squamous cell carcinoma | Non–small cell lung cancer (NSCLC) associated with hypercalcemia. |
| Small cell lung cancer (SCLC) | Lung cancer associated with SIADH. |
| SCLC | Lung cancer highly related to cigarette exposure. |
| Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful | A tall white male presents with acute shortness of breath. Diagnosis? Treatment? |
| Immediate needle thoracostomy | Treatment of tension pneumothorax. |
| Age > 45–50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins | Characteristics favoring carcinoma in an isolated pulmonary nodule. |
| ARDS | Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure. |
| Mycobacterium tuberculosis | ↑ risk of what infection with silicosis? |
| Right-to-left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch | Causes of hypoxemia. |
| Cardiomegaly, prominent pulmonary vessels, Kerley B lines, "bat's-wing" appearance of hilar shadows, and perivascular and peribronchial cuffing | Classic CXR findings for pulmonary edema. |
| Type I (distal) RTA | Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis. |
| Type II (proximal) RTA | RTA associated with abnormal HCO3 − and rickets. |
| Type IV (distal) RTA | RTA associated with aldosterone defect. |
| Hypernatremia | "Doughy skin." |
| Cirrhosis, CHF, nephritic syndrome | Differential of hypervolemic hyponatremia. |
| Hypocalcemia | Chvostek's and Trousseau's signs. |
| Malignancy and hyperparathyroidism | The most common causes of hypercalcemia. |
| Hypokalemia | T-wave flattening and U waves. |
| Hyperkalemia | Peaked T waves and widened QRS. |
| IV hydration and loop diuretics (furosemide) | First-line treatment for moderate hypercalcemia. |
| Prerenal | Type of ARF in a patient with FeNa < 1%. |
| Nephrolithiasis | A 49-year-old male presents with acute-onset flank pain and hematuria. |
| Calcium oxalate | The most common type of nephrolithiasis. |
| Cerebral berry aneurysms (AD PCKD) | A 20-year-old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly? |
| Nephritic syndrome | Hematuria, hypertension, and oliguria. |
| Nephrotic syndrome | Proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria, edema. |
| Membranous glomerulonephritis | The most common form of nephritic syndrome. |
| IgA nephropathy (Berger's disease) | The most common form of glomerulonephritis. |
| Alport's syndrome | Glomerulonephritis with deafness. |
| Wegener's granulomatosis and Goodpasture's syndrome | Glomerulonephritis with hemoptysis. |
| Glomerulonephritis/nephritic syndrome | Presence of red cell casts in urine sediment. |
| Allergic interstitial nephritis | Eosinophils in urine sediment. |
| Nephrotic syndrome | Waxy casts in urine sediment and Maltese crosses (seen with lipiduria). |
| Uremic syndrome seen in patients with renal failure | Drowsiness, asterixis, nausea, and a pericardial friction rub. |
| Wait, surgical resection, radiation and/or androgen suppression | A 55-year-old man is diagnosed with prostate cancer. Treatment options? |
| DI | Low urine specific gravity in the presence of high serum osmolality. |
| Fluid restriction, demeclocycline | Treatment of SIADH? |
| Renal cell carcinoma (RCC) | Hematuria, flank pain, and palpable flank mass. |
| Choriocarcinoma | Testicular cancer associated with β-hCG, AFP. |
| Seminoma—a type of germ cell tumor | The most common type of testicular cancer. |
| Transitional cell carcinoma | The most common histology of bladder cancer. |
| Central pontine myelinolysis | Complication of overly rapid correction of hyponatremia. |
| Anion gap acidosis and 1° respiratory alkalosis due to central respiratory stimulation | Salicylate ingestion → in what type of acid-base disorder? |
| Respiratory alkalosis | Acid-base disturbance commonly seen in pregnant women. |
| DM, SLE, and amyloidosis | Three systemic diseases → nephrotic syndrome. |
| RCC or other erythropoietin-producing tumor; evaluate with CT scan | Elevated erythropoietin level, elevated hematocrit, and normal O2 saturation suggest? |
| Likely BPH. Options include no treatment, terazosin, finasteride, or surgical intervention (TURP) | A 55-year-old man presents with irritative and obstructive urinary symptoms. Treatment options? |
| Antipsychotics (neuroleptic malignant syndrome) | Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms. |
| Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies | Side effects of corticosteroids. |
| Benzodiazepines | Treatment for DTs. |
| N-acetylcysteine | Treatment for acetaminophen overdose. |
| Naloxone | Treatment for opioid overdose. |
| Flumazenil | Treatment for benzodiazepine overdose. |
| Dantrolene or bromocriptine | Treatment for neuroleptic malignant syndrome. |
| Nitroprusside | Treatment for malignant hypertension. |
| Rate control, rhythm conversion, and anticoagulation | Treatment of AF. |
| Rate control with carotid massasge or other vagal stimulation | Treatment of supraventricular tachycardia (SVT). |
| INH, penicillamine, hydralazine, procainamide | Causes of drug-induced SLE. |
| B12 deficiency | Macrocytic, megaloblastic anemia with neurologic symptoms. |
| Folate deficiency | Macrocytic, megaloblastic anemia without neurologic symptoms. |
| Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant | A burn patient presents with cherry-red flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment? |
| Bladder rupture or urethral injury | Blood in the urethral meatus or high-riding prostate. |
| Retrograde cystourethrogram | Test to rule out urethral injury. |
| Widened mediastinum (> 8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus | Radiographic evidence of aortic disruption or dissection. |
| Free air under the diaphragm, extravasation of contrast, severe bowl distention, space-occupying lesion (CT), mesenteric occlusion (angiography) | Radiographic indications for surgery in patients with acute abdomen. |
| Pseudomonas | The most common organism in burn-related infections. |
| Parkland formula | Method of calculating fluid repletion in burn patients. |
| 50 cc/hour | Acceptable urine output in a trauma patient. |
| 30 cc/hour | Acceptable urine output in a stable patient. |
| Third-degree heart block | Cannon "a" waves. |
| Hypotension and bradycardia | Signs of neurogenic shock. |
| Hypertension, bradycardia, and abnormal respirations | Signs of ↑ ICP (Cushing's triad). |
| Hypovolemic shock | ↓ CO, ↓ pulmonary capillary wedge pressure (PCWP), ↑ peripheral vascular resistance (PVR). |
| Cardiogenic shock | ↓ CO, ↑ PCWP, ↑ PVR. |
| Septic or anaphylactic shock | ↑ CO, ↓ PCWP, ↓ PVR. |
| Fluids and antibiotics | Treatment of septic shock. |
| Identify cause; pressors (e.g., dobutamine) | Treatment of cardiogenic shock. |
| Identify cause; fluid and blood repletion | Treatment of hypovolemic shock. |
| Diphenhydramine or epinephrine 1:1000 | Treatment of anaphylactic shock. |
| Continuous positive airway pressure | Supportive treatment for ARDS. |
| A patient with chest trauma who was previously stable suddenly dies | Signs of air embolism. |
| AP chest, AP/lateral C-spine, AP pelvis | Trauma series. |
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