If you fell down yesterday, stand up today.–H. G. Wells
Now onto this week’s podcast
A 33-year-old woman presents to the ED with agitation and severe respiratory distress. She has been taking a significant amount of “pain medication” for low back pain, according to her son. The patient is screaming about her “ears ringing.” Vital signs are BP 100/60 mm Hg, HR 140 beats per minute, RR 35 breaths per minute, and T 100.1°F. Which of the following complications is she at risk of developing?
A. Hemodynamically significant lower gastrointestinal bleeding
B. Increased intracranial pressure
C. Noncardiogenic pulmonary edema
D. Urinary retention requiring catheterization
Which of the following is associated with carbon monoxide poisoning?
A. Bilateral basal ganglia hypodensities
B. Elevated pH
C. Low PO2
D. Odor of bitter almonds
A 62-year-old woman presents to the emergency department with dizziness. She describes the events as a spinning sensation that is worse with position changes. The dizziness is associated with hearing loss as well as tinnitus and vomiting. She notes it started three days ago and that she has had multiple episodes all lasting less than a day since that time. On physical examination, horizontal nystagmus is present as is decreased hearing on the left. The remainder of the ear and neurologic examination is within normal limits. A head CT and brain MRI are performed and are negative. Which of the following is the most likely diagnosis?
A. Acoustic neuroma
C. Meniere disease
D. Vestibular neuritis
A 28-year old woman presents with several painful ulcers she has developed in the vaginal area. Examination reveals multiple 0.5 cm to 1.5 cm oval ulcers with sharply defined borders and a yellowish-white membrane. She denies recent sexual activity. Except for recurring aphthous ulcers of her mouth, her past history is unremarkable. At this time, which of the following is the most likely diagnosis?
A. Behcet syndrome
B. Herpes simplex
C. Reactive arthritis
A 65-year-old man on peritoneal dialysis presents because his dialysis effluent is cloudy. You send it for culture and Gram staining, which returns with a preliminary result of gram-positive cocci in clusters. Vital signs are BP 125/70 mm Hg, HR 80 bpm, RR 14/min, and T 98.5°F. Other than abdominal ascites, the physical exam is unremarkable. Which of the following is the most appropriate management for this condition?
A. Inpatient management with antibiotics and temporary hemodialysis
B. Inpatient management with IV antibiotics
C. Outpatient management with intraperitoneal antibiotics
D. Outpatient management with oral antibiotics
Which of the following historical features is most consistent with infantile spasms?
A. Occur in clusters lasting a few minutes at a time
B. Occur more frequently during sleep
C. Onset between 12 and 18 months of age
D. Precipitated by loud noises or handling
That wraps up RoshCast Episode 47! Be sure to also check out the rest of the Rosh Review Blog for questions from prior episodes, related images and tables, and bonus teaching points. There are also tons of other great free resources to help prepare you for the boards and the wards. Don’t forget to follow us on twitter @RoshCast. And you can always email us at RoshCast@RoshReview.com with any feedback, corrections, or suggestions.
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Megha and Nachi
The post Podcast Ep 47: Salicylate Toxicity, Carbon Monoxide Poisoning, & More appeared first on RoshReview.com.