Orders

Question 1

when to order as UNIT (at UMC)

Answer 1

limited patient availability (procedure or imaging scheduled)

Question 2

transfusions to remember

Answer 2

need to consent pts

Question 3

if home med is NF

Answer 3

give home med

Question 4

to always remember when ordering imaging

Answer 4

INCLUDE PERTINENT CLINICAL INFORMATION

Question 5

how to order CXR’s

Answer 5

PA and lateral, not portable

Question 6

CT ordering….

Answer 6

• don’t order w/ and w/o contrast

Question 7

MR ordering

Answer 7

need to fill out metal screen form

Question 8

why do you need contrast?

Answer 8

• important to evaluate vascular or vascularized structure. Find lesions, infection, or inflammation.
• lack of contrast decreases sensitivity and specificity of exam.
• GI contrast is important to define bowel lumen and differentiate bowel from other tissues, especially in the pelvis.

Question 9

contrast types that can hurt kidney

Answer 9

CT contrast (iodinated), not MR contrast (gadolinium)

Question 10

managing contrast

Answer 10

• contact rads or nephrology if GFR is less than 60.
• if allergy to iodinated contrast, need to premedicate with pred 50 mg PO at 13, 7, and 1 hour prior to exam + diphenhydramine 50mg PO on way to scanner.

Question 11

what to use to replete calcium

Answer 11

calcium carbonate (Tums)

Question 12

how to replete iron

Answer 12

• PO before repleting IV (a lot of hypersensitivity/immunologic reactions to IV iron)
• QOD (better absorption if done every other day).

Question 13

how to treat nausea from uremia

Answer 13

ondansetron

Question 14

imaging for any joint

Answer 14

always get 3 view

Question 15

first line for pseudogout flares

Answer 15

intraarticular pred

Question 16

tylenol vs. aspirin

Answer 16

In contrast to aspirin, paracetamol does not prevent blood from clotting (it is not an antiplatelet), and thus may be used in people who have concerns with blood coagulation. Additionally it does not cause gastric irritation.[77] However, paracetamol does not help reduce inflammation, while aspirin does.[78] Compared with ibuprofen—whose side effects may include diarrhea, vomiting and abdominal pain—paracetamol has fewer adverse gastrointestinal effects.

Question 17

esr threshold for OM

Answer 17

greater than 100 is highly sensitive

Question 18

drugs with penicillin cross-reactivity

Answer 18

cephalosporins

Question 19

how to manage penicillin rash in childhood

Answer 19

give drug + monitor in house + write in note “discussed with patient”

Question 20

how to test for strep pneumo

Answer 20

urine antigen for strep pneumo

Question 21

how to dose lasix

Answer 21

BID (you will diverse a lot with single dosing then activate RAAS)

Question 22

basic categories of patients

Answer 22

stable, watcher, sick

Question 23

mgmt of pt fluid overloaded w/ renal disease acutely

Answer 23

emergent dialysis

Question 24

how to manage stepping up O2 therapy in altered patient

Answer 24

CAN’T do BIPAP (could get hypercarbic), need to be tubed.