Somewhere, something incredible is waiting to be known.-Sharon Begley
Now onto this week’s podcast
A 2-year-old boy is brought to the emergency department by his pregnant mother with complaints of hematemesis and bloody diarrhea and an episode of shaking that looked like a seizure. The patient has no past medical history; immunizations are up-to-date. His vital signs are BP 68/32 mm Hg, HR 170 beats per minute, RR 30 breaths per minute, temperature is 36.8°C, and oxygen saturation is 96% on room air. On physical exam, the child appears pale and lethargic. HEENT exam is normal with moist mucosa. His abdomen is nondistended but tender on palpation with active bowel sounds. His skin is cool and clammy. Laboratory results are as follows:
|Chloride||99 mEq/L||Stool guaiac||Neg|
|CO2||16 mg/dL||Serum tox screen||Neg|
|Glucose||280 mg/dL||aPTT, PT w/INR||Normal|
Which of the following arterial blood gases is most consistent with the patient’s diagnosis?
A. pH 7.23, pCO2 47, HCO320
B. pH 7.33, pCO2 32, HCO314
C. pH 7.43, pCO2 40, HCO324
D. pH 7.52, pCO2 28, HCO324
E. pH 7.55, pCO2 33, HCO334
Where is the uterine fundus palpable at 36 weeks gestation?
A. At the umbilicus
B. At the xiphoid process
C. Between the pubic symphysis and umbilicus
D. Between the umbilicus and xiphoid process
A 3-week-old boy presents with two days of nonbilious projectile vomiting. Examination reveals a mass in the infant’s right upper quadrant. On a barium upper GI series report, the radiologist states a “string sign” is present. Which of the following is this infant at greatest risk of developing?
The ultrasound clip above is from an 18-year-old woman with her LMP six weeks ago. Which of the following is associated with this condition?
A. Double decidual sac
B. Fetal heart activity is never identified
C. Relative maternal bradycardia
D. The presence of a gestational and yolk sac on ultrasound
What ultrasound finding is consistent with pulmonary edema?
A. A lines
B. Absence of lung sliding
C. B lines
D. Presence of lung sliding
A 47-year-old previously healthy man is transferred to your facility in Arizona with acute respiratory distress syndrome and cardiogenic shock. Two days ago, symptoms began with muscle aches, fever, chills, cough, nausea, vomiting, and diaphoresis. Two weeks earlier he was camping in an old, unkempt cabin in the San Rafael Valley, AZ. His two friends who stayed with him eventually began to show similar symptoms. Which of the following tests will confirm the suspected diagnosis?
A. Cardiac biopsy
B. DNA probe for arthroconidia
C. Hantavirus ELISA (IgM)
D. Leptospira spp. serology (IgM)
A 16-year-old woman arrives to the ED via EMS after she collapsed at a Rave party. Her vital signs are 105.2°F, HR 160 RR 22, and BP 180/100. She is confused, agitated, combative, diaphoretic and has mydriasis. Her reflexes are 4/4 and clonus is noted. Her extremities demonstrate rigidity. Which of the following is the most likely diagnosis?
A. Malignant Hyperthermia
B. Neuroleptic malignant syndrome
C. Serotonin Syndrome
That wraps up Episode 32. Don’t forget to follow us on Twitter at @Roshcast and @RoshReview. We can also be reached by email at firstname.lastname@example.org. Please send over any feedback, corrections, or suggestions. You can also help us pick questions by identifying ones you would like us to review. To do so, write “Roshcast” in the submit feedback box as you go through the question bank. And finally, if you have a minute, make sure to rate us and leave comments on iTunes to help spread the word about Roshcast.
Until next time,
Jeff and Nachi
The post Podcast Ep 32: Iron Overdose, Fundal Height, Serotonin Syndrome, & More appeared first on RoshReview.com.