Maxemo EMREE 26-27
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What is the recommended first-line treatment for a bloodstream infection caused by Vancomycin-Resistant Enterococcus (VRE)?
Anonymous Quiz
7%
Vancomycin
27%
Daptomycin
60%
Linezolid
7%
Ceftaroline
Maxemo EMREE 26-27
What is the recommended first-line treatment for a bloodstream infection caused by Vancomycin-Resistant Enterococcus (VRE)?
💡 EXPLANATION:
Linezolid is the recommended first-line treatment for most serious VRE infections, including bacteremia. Daptomycin is an alternative. Vancomycin is ineffective due to resistance.
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A child with known recurrent SVT is now unresponsive, hypotensive, with cold extremities. These new findings are most likely due to which complication?
Anonymous Quiz
28%
Tachycardia-induced Cardiomyopathy
28%
Vasovagal Syncope
6%
Compensated Heart Failure
39%
Decompensated Shock
Maxemo EMREE 26-27
A child with known recurrent SVT is now unresponsive, hypotensive, with cold extremities. These new findings are most likely due to which complication?
💡 EXPLANATION:
SVT at a high rate impairs ventricular filling, causing a critical drop in cardiac output. This leads to hypotension and systemic hypoperfusion (shock), causing unresponsiveness and cold extremities.
Recall the 45M evaluated for brain death. The organ procurement organization is consulted. Which of the following is an absolute contraindication to him being a cardiac donor?
Anonymous Quiz
5%
History of hypertension
14%
Prolonged downtime (>30 min) during initial CPR
41%
Severe left ventricular dysfunction on echo
41%
Positive serology for Hepatitis C
Maxemo EMREE 26-27
Recall the 45M evaluated for brain death. The organ procurement organization is consulted. Which of the following is an absolute contraindication to him being a cardiac donor?
💡 EXPLANATION:
Severe and irreversible cardiac dysfunction (e.g., EF <30%) is an absolute contraindication for heart donation. The profound catecholamine surge during brain death can cause neurogenic stunned myocardium, requiring echocardiogram evaluation.
A 67M post-stroke has a droopy left eyelid, a constricted left pupil, and loss of pain/temperature sensation on his left face and right body. What is the most likely diagnosis?
Anonymous Quiz
25%
Medial Medullary Syndrome
58%
Lateral Medullary Syndrome
17%
Weber's Syndrome
0%
Locked-in Syndrome
Maxemo EMREE 26-27
A 67M post-stroke has a droopy left eyelid, a constricted left pupil, and loss of pain/temperature sensation on his left face and right body. What is the most likely diagnosis?
💡 EXPLANATION:
This classic presentation is known as Lateral Medullary (Wallenberg) Syndrome. The combination of ipsilateral Horner's syndrome (ptosis, miosis) and facial sensory loss with contralateral body sensory loss points to a lesion in the lateral medulla. Medial Medullary Syndrome presents with contralateral hemiparesis and ipsilateral tongue deviation. Weber's Syndrome is a midbrain stroke causing an ipsilateral CN III palsy and contralateral weakness. Locked-in Syndrome results from a pontine stroke, causing quadriplegia and mutism.
A boot-shaped heart (coeur en sabot) on chest X-ray is the classic pathognomonic finding for which congenital heart defect?
Anonymous Quiz
14%
Transposition of the Great Arteries
79%
Tetralogy of Fallot
7%
Coarctation of the Aorta
0%
Atrial Septal Defect
Maxemo EMREE 26-27
A boot-shaped heart (coeur en sabot) on chest X-ray is the classic pathognomonic finding for which congenital heart defect?
💡 EXPLANATION:
Remember the boot for PROVe: The shape comes from Pulmonary stenosis, Right ventricular hypertrophy, Overriding aorta, and a Ventricular septal defect.
A 30-year-old is brought to the ER, found unconscious with bradypnea and pinpoint pupils. What is the most appropriate initial drug to administer?
Anonymous Quiz
0%
50% Dextrose
23%
Flumazenil
46%
Naloxone
31%
Atropine
Maxemo EMREE 26-27
A 30-year-old is brought to the ER, found unconscious with bradypnea and pinpoint pupils. What is the most appropriate initial drug to administer?
💡 EXPLANATION:
The clinical triad of CNS depression (unconsciousness), respiratory depression (bradypnea), and miosis (pinpoint pupils) is the hallmark of an opioid overdose. Naloxone is a competitive opioid antagonist and the immediate, life-saving antidote. While dextrose is considered for any patient with altered mental status, the specific toxidrome makes naloxone the priority. Flumazenil reverses benzodiazepines, and atropine would address bradycardia but not the underlying cause.
The Merseburger triad (goiter, exophthalmos, tachycardia) is indicative of which condition?
Anonymous Quiz
18%
Hashimoto's thyroiditis
82%
Graves' disease
0%
Pheochromocytoma
0%
De Quervain's thyroiditis
Maxemo EMREE 26-27
The Merseburger triad (goiter, exophthalmos, tachycardia) is indicative of which condition?
💡 EXPLANATION:
Graves' disease is an autoimmune disorder causing hyperthyroidism. The Merseburger triad (Goiter, Exophthalmos, Tachycardia) represents the classic signs of the body going into overdrive.
Maxemo EMREE 26-27
What is the primary mechanism of action of Tedizolid?
💡 EXPLANATION:
Tedizolid is an oxazolidinone antibiotic. It exerts its bacteriostatic effect by binding to the 23S rRNA of the 50S ribosomal subunit, which blocks the formation of the 70S initiation complex, thereby inhibiting bacterial protein synthesis at a very early stage.
Hb Electrophoresis: HbA 58%, HbS 35%, HbA2 2%, HbF 5%. These lab values are most consistent with which diagnosis?
Anonymous Quiz
25%
Sickle cell disease (HbSS)
75%
Sickle cell trait (HbAS)
0%
Beta-thalassemia major
0%
Beta-thalassemia minor
Maxemo EMREE 26-27
Hb Electrophoresis: HbA 58%, HbS 35%, HbA2 2%, HbF 5%. These lab values are most consistent with which diagnosis?
💡 EXPLANATION:
The diagnosis is Sickle Cell Trait (HbAS). The key finding is the presence of both normal adult hemoglobin (HbA) and sickle hemoglobin (HbS), with HbA being the larger fraction (>50%). In sickle cell trait, individuals are heterozygous, carrying one normal beta-globin gene and one sickle cell gene. This results in the production of more HbA than HbS. Sickle cell disease has predominant HbS. Beta-thalassemia major has predominant HbF. Beta-thalassemia minor has elevated HbA2.
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What is the recommended first-line empiric treatment for a non-ICU patient who develops hospital-acquired pneumonia (HAP) with a low risk of MRSA?
Anonymous Quiz
0%
Ceftriaxone
33%
Piperacillin-Tazobactam
33%
Vancomycin
33%
Levofloxacin