Pimp Notes vol. 1

 When the Attending goes into rapid fire pimp mode

 And you get them ALL RIGHT!

Over the last four years, I’ve started a small collection of questions that I repeatedly gotten pimped on by various attendings from many different services. We at QuickHits decided to empower the med student by starting a weekly post with a number of high yield questions along with some you-know-it-or-you-don’t type questions that you can impress some attendings with.

We hope this allows our readers to continue to build a thorough knowledge base. Give a shot at the first volume of pimp notes.

See how many you get right. Leave some comments!:

  • Highly sensitive physical exam test for mandibular trauma/fracture?
  • ST Segment elevation in right sided V4 lead is high suggestive of?
  • Most severe complication (and most common cause of death) in ITP?
  • Metabolic causes of acute confusion?
  • Pneumonia classically associated w/ bullous myringitis?
  • Diagnosis?:

click for larger view.

Case:
26 year old male presents with his elbows, wrist, and fingers locked in flexion. He started having an exacerbation of his anxiety attacks about 4 hours ago. When seen in the ED, he is hyperventilating and complaining of tingling in his fingers and inability to relax his hands.

  • Diagnosis?
  • Pathophysiology?
  • Treatment?

CONTINUE READING FOR ANSWERS

Highly sensitive physical exam test for mandibular trauma/fracture

ST Segment elevation in right sided V4 lead is high suggestive of: Right ventricular ischemia/infarction

Most severe complication in ITP: intracerebral hemorrhage

Metabolic causes of acute confusion: hypoglycemia, hypo/hypernatremia, hypercalcemia

Pneumonia classically associated w/ bullous myringitis:  Mycoplasma pneumoniae

  • common cause of pneumonia in young adults. It is classically associated with bullous myringitis.

Diagnosis of X-ray: Kienbock disease

Case:

  • Diagnoisis: tetany 2/2 hyperventilation
  • Pathophys: hyperventilation –> decreased levels of CO2 –> increased in pH –> increased albumin binding to calcium –> hypocalcemia –> constriction of blood vessels and tingling
  • Treatment = Treat underlying cause –> stop hyperventilation/anxiety attack, put on rebreather mask to increase CO2
  • Neurologic bulletin from UMass w/ case study and brief literature review 
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