48M arrives in the passenger seat of wifes car coughing up a large amount of blood. He is very pale appearing, his pulse becomes thready and the patient starts to become unresponsive. Wife tells you he has a history of AML and is being treated with Amphotericin B for an Aspergilloma. The patient arrives to the resuscitation room in cardiac arrest.
John Cafaro MD
Which anti-epileptic is most likely to cause hyponatremia?
C. Valproic Acid
Answer is A - Carbamazepine or Tegretol
Bonus Question: What is the first line management in Trigeminal Neuralgia?
Answer: Carbamazepine or Tegretol
A 40 year old man presents via ambulance after he was found stumbling around a park on a hot summer day. He is mumbling, not responding to questions appropriately, and very disoriented. His skin is dry and hot to touch. Rectal temperature is 106.1 F. IV access has been obtained and normal saline has been started. What is next most effective immediate treatment for cooling?
A. Rectal Acetaminophen
B. Cooling with fans and skin wetting from a spray bottle.
C. Bladder lavage.
D. Ice packs placed on axillae and groin.
E. Cardiopulmonary bypass/ ECMO.
A 30 year old mechanic presents for a right lower leg injury. He was working on his car when it fell on his right leg. Urinanalysis reveals dark urine with a dipstick positive for large mount of blood. Serum CK is 28,000 units/L. The primary treatment modality is:
A. Sodium Bicarbonate
D. Normal Saline
E. Calcium Gluconate
Answer is D - Normal Saline