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
31%
Tachycardia-induced Cardiomyopathy
31%
Vasovagal Syncope
6%
Compensated Heart Failure
31%
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
10%
Prolonged downtime (>30 min) during initial CPR
45%
Severe left ventricular dysfunction on echo
40%
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
38%
Medial Medullary Syndrome
63%
Lateral Medullary Syndrome
0%
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
13%
Transposition of the Great Arteries
88%
Tetralogy of Fallot
0%
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
11%
Flumazenil
44%
Naloxone
44%
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
0%
Hashimoto's thyroiditis
100%
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.
What is the primary mechanism of action of Tedizolid?
Anonymous Quiz
0%
Causes rapid depolarization of the bacterial cell membrane
0%
Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins
0%
Binds to the 50S ribosomal subunit, preventing formation of the initiation complex
0%
Binds to the 50S ribosomal subunit, inhibiting the translocation step
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.