MCCQE 1 Verified Study Solutions With Real
Solutions
HERPETIC WHITLOW ANS Painful grouped vesicles on an erythematous base located on the
distal finger
Cause: Infection with HSV
Treatment:
Self-limiting disease
Antiviral (e.g., acyclovir) may be beneficial
ONYCHOCRYPTOSIS/ INGROWN NAILS ANS Inflammation and soft tissue hypertrophy +/−
secondary infection occurring when the
lateral edge of the nail plate impinges on the nail fold
ONYCHOCRYPTOSIS Cause:
Onychomycosis
Incorrect technique of nail cutting
Repetitive trauma
Poor foot hygiene; poorly fitting shoes ANS Treatment
Barrier placement between nail plate and nail fold
Excision of the portion of nail plate pressing on the nail fold
+/− Antibiotics
Biphasic Anaphylaxis ANS Recurrence of Sx 4 to 32 h (mean
10 h) after the initial episode.
Occurs in up to 20% of patients
and is due to the release of 2◦
mediators and the late-phase
response.
,Protracted Anaphylaxis ANS Refractory Resp distress or
hypotension despite appropriate
medical Rx.
What Saves Lives? EPI,
EPI, EPI ANS Adults: 0.3 to 0.5 mg IM
Children: 0.01 mg/kg IM
I V EPI: 0.1 mg, dilute 0.1 mL
1:1,000 in 10 mL N/S
Give 1 to 2 mL/min
All patients presenting with signs or Sx of anaphylaxis get: ANS • Measures to stop any
continuing Ag exposure
• Two large bore I Vs • Supplemental O2
• Cardiac and O2 sat monitoring
• EPI IM or I V
• Methylprednisolone 125 mg I V
• Diphenhydramine 50 mg I V + ranitidine 50 mg I V
MINOR BURNS ANS • cleaning with soap and water or dilute antiseptic solution.
Td immunization prn
topical Abx: 1%silver sulfadiazine(Dermazine) , bacitracin (Baciguent),
or bacitracin/neomycin/polymyxin B (Neosporin ointment).
Occlusive, clean dressings should be applied regularly.
Parkland Formula ANS Fluid required (ml of RL) = 4 × kg body wt × TBSA
• 1/2 given in first 8 h from time of injury, 1/2 given in next 16 h
Anticholinergic ANS Antihistamines, TCAs, phenothiazines,
, atropine
Cholinergic ANS Insecticides, nerve agents, nicotine,
pilocarpine, urecholine
Sympathomimetic ANS Cocaine, amphetamines, MDMA (ecstasy),
ephedrine, theophylline
Opiate/sedative ANS Heroin, morphine, benzodiazepines,
barbiturates, meprobamate, EtOH
Hallucinogens ANS LSD, mescaline, phencyclidine, psilocybin
CVS ANS β-Blockers, CCBs
Serotonin ANS MAOI, SSRI, meperidine, TCA, L-tryptophan
Cellular ANS CO, H2S, cyanide
TCAs ANS Amitriptyline, doxepin
Simple asphyxiants ANS CO2, inert gases
Drugs inducing metabolic acidosis
(BP usually low) ANS Ethanol, methanol, ethylene glycol, ASA,
NSAID, tylenol
Anticholinergic ''hot as a hare, dry as a bone, red as a beet, blind as a bat, and mad as a hatter''