Reach for it. Push yourself as far as you can.-Christa McAuliffe
This week, we’ll be doing a couple of diarrhea questions to link up with the last EM Clerkship episode, in addition to a few randomly generated questions. Don’t forget that we are still running a trauma ring tone contest. Listen closely for a ring tone in an upcoming episode and e-mail us at firstname.lastname@example.org or tweet to us at @Roshcast the exact time of the ring tone to win a prize, which will certainly come in handy as we get closer to the in-training exam. Let’s get started with a review from recent posts on the Rosh Review Blog.
Now onto this week’s podcast
A 2-year-old girl presents after a witnessed seizure. The parents state that she has not been to daycare in two days, as she has bloody diarrhea and a fever. Her vitals on presentation are T 103.1°F, HR 167/min, BP 73/43 mm Hg, RR 48/min, and oxygen saturation 96%. Currently, the patient has a normal neurologic exam and minimal abdominal tenderness. There are no rashes. Labs show a WBC of 19,000, and urinalysis reveals an elevated specific gravity. Which of the following is the most appropriate next step in management?
A. Acetaminophen for fever and follow-up with primary care provider
B. Blood and stool cultures, IV antibiotics, and admission
C. Neurology consultation and admission
D. Oral antibiotics and follow-up with primary care provider
An 82-year-old nursing-home resident is sent to the emergency department with lower abdominal pain and bloody diarrhea. He has a history of vascular dementia, hypertension, and hyperlipidemia. On examination he is afebrile, and a nasogastric aspirate is negative for evidence of bleeding. Which of the following is the most likely cause of this patient’s bleeding?
B. Diverticular bleeding
C. Ischemic colitis
D. Peptic ulcer disease
Which of the following is considered a risk factor for suicide?
A. Female sex
B. First-trimester pregnancy
C. First year of marriage
D. Recent incarceration
Which of the following scenarios is most appropriate to safely discharge home a 2-year-old who has swallowed a coin?
A. The child is not drooling
B. The child is tolerating oral sips and the parents are reliable
C. The coin is in the stomach
D. The coin is oriented in the sagittal plane at the level of the clavicular heads
A 35-year-old-man with a history of occasional bloody diarrhea and abdominal pain presents with acute onset severe abdominal pain. Vital signs are significant for a temperature of 39°C, heart rate 140/min, and blood pressure 82/55 mm Hg. On physical exam, his abdomen is distended and tympanic. Which of the following diagnostic studies is indicated first at this time?
A. Abdominal radiograph
B. Barium enema
C. CT scan of the abdomen pelvis with IV contrast
A 45-year-old woman complains of two days of fluctuating diplopia and dysphagia. Her exam reveals a left cranial nerve VI palsy, ptosis, and proximal muscle weakness in her extremities. What is the pathophysiology of her disease?
A. Antibodies to the acetylcholine receptor at the neuromuscular junction
B. Inhibition of acetylcholine release at the synapse
C. Mutation of superoxide dismutase causing cell death
D. Reduced number of dopamine receptors in the midbrain
That wraps up Episode 35. Don’t forget to follow us on Twitter @Roshcast and @RoshReview. We can also be reached by email at email@example.com and are open to any feedback, corrections, or suggestions. You can 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 35: Shigellosis, Ischemic Colitis, Suicide, & More appeared first on RoshReview.com.