Ultrasounds Of The Block
Welcome to SIU's EM Residency "Ultrasounds of the Block" curriculum (formerly known as "Ultrasound of the Month"). First instituted as a friendly competition to spark increased volume of bedside studies, it has now become a melee of ultrasound fun. As part of an asynchronous curriculum in emergency ultrasound, all ultrasounds performed at our clinical sites are reviewed for quality assurance by ultrasound director. Each block a few images/clips are selected because of an interesting finding, a high quality image showing great anatomy, or because they carry an important teaching point. These “Ultrasounds of the Block” are then displayed online with clinical vignettes and questions to test residents and their knowledge. The competition aspect of the curriculum is that residents gain points by performing any selected "Ultrasounds of the Block" and for answering monthly questions correctly. Each year a winner is announced based on overall points and surprised with trophy gifts to cherish and gloat about for the many years to come.
Past "Ultrasounds of the Block" can be viewed by clicking here. This blocks "Ultrasounds of the Block" can be viewed below.
Ultrasounds Of The Block (B11)
Question 1:
The following ultrasound exam is performed on a patient in respiratory distress. They have a history of COPD and heart failure and present tachycardic, hypoxia, and is slightly hypertensive. After placing the patient on oxygen, what is your next step in treatment? m(10pts)
a) Nebulized albuterol
b) Steroids
c) Nitroglycerin
d) Tube thorocostomy
Courtesy of SI & FV
a) Nebulized albuterol
b) Steroids
c) Nitroglycerin
d) Tube thorocostomy
Courtesy of SI & FV
Question 2
The following ultrasound is performed on a patient with respiratory distress. Doing which of the following would best optimize this image? (10pts)
a) Rotate probe 90 degrees, decrease depth, change exam setting to cardiac EM
b) Rotate probe 180 degrees decrease depth, change exam setting to abdominal
c) Do note rotate probe, decrease depth, change exam setting to lung
d) Rotate probe 180 degrees, decrease depth, change exam setting to lung
Courtesy of MW
a) Rotate probe 90 degrees, decrease depth, change exam setting to cardiac EM
b) Rotate probe 180 degrees decrease depth, change exam setting to abdominal
c) Do note rotate probe, decrease depth, change exam setting to lung
d) Rotate probe 180 degrees, decrease depth, change exam setting to lung
Courtesy of MW
Question 3:
The following ultrasound is performed on a patient with chest pain who is altered and hypotensive. You are greater than 2 hours transport time to a STEMI facility. What is your next step in management? (10pts)
a) Alteplase15mg IV over 1-2min; then 50mg IV over 30min; then 35mg over 60min
b) Alteplase15mg IV over 1-2min; then 0.75mg/kg IV over 30min; then 0.5mg/kg over 60min
c) Alteplase 100mg IV over 2 hours
d) Alteplase 50mg IV over 2mins followed by 50mg IV after 15min
Courtesy of JE
a) Alteplase15mg IV over 1-2min; then 50mg IV over 30min; then 35mg over 60min
b) Alteplase15mg IV over 1-2min; then 0.75mg/kg IV over 30min; then 0.5mg/kg over 60min
c) Alteplase 100mg IV over 2 hours
d) Alteplase 50mg IV over 2mins followed by 50mg IV after 15min
Courtesy of JE
Question 4:
The following ultrasound is performed on a patient just prior to them going into cardiac arrest. You are greater than 2 hours transport time to a STEMI facility. What is your next step in management? (10pts)
a) Alteplase15mg IV over 1-2min; then 50mg IV over 30min; then 35mg over 60min
b) Alteplase15mg IV over 1-2min; then 0.75mg/kg IV over 30min; then 0.5mg/kg over 60min
c) Alteplase 100mg IV over 2 hours
d) Alteplase 50mg IV over 2mins followed by 50mg IV after 15min
Courtesy of MW
a) Alteplase15mg IV over 1-2min; then 50mg IV over 30min; then 35mg over 60min
b) Alteplase15mg IV over 1-2min; then 0.75mg/kg IV over 30min; then 0.5mg/kg over 60min
c) Alteplase 100mg IV over 2 hours
d) Alteplase 50mg IV over 2mins followed by 50mg IV after 15min
Courtesy of MW
Question 5:
The following ultrasound is performed on a patient with abdominal pain? Provide a vignette for this patient's presentation (10pts)
Courtesy of LN & FV
Courtesy of LN & FV