Your adult anaphylaxis patient is suffering from hypotension that is not responding to epinephrine. Which of the following medications is capable of combating hypotension associated with anaphylaxis when epinephrine fails to improve blood pressure?

Correct Answer: C

Rationale: The correct answer is C: Hydrocortisone. When epinephrine fails to improve hypotension in anaphylaxis, corticosteroids like hydrocortisone are indicated. Corticosteroids help reduce inflammation and stabilize blood vessels, which can aid in increasing blood pressure. Cimetidine (A) is an H2 receptor antagonist used for acid reflux, not for anaphylaxis. Albuterol (B) is a bronchodilator used for respiratory symptoms in anaphylaxis. Ipratropium (D) is an anticholinergic bronchodilator and not indicated for hypotension in anaphylaxis.

Correct Answer: B

Rationale: Step 1: Chest pain that is not changed or relieved by oxygen therapy alone is a key indicator of acute myocardial infarction (MI). Step 2: In a suspected MI, the lack of improvement with oxygen therapy suggests a cardiac origin for the chest pain. Step 3: Oxygen therapy may alleviate chest pain related to respiratory issues, but not typically in cases of cardiac origin. Step 4: This lack of response to oxygen therapy indicates the need for further evaluation and treatment for a suspected MI. Summary: Choices A, C, and D are incorrect because they do not specifically address the characteristic of chest pain in relation to oxygen therapy, which is a crucial differentiating factor in identifying a potential acute MI.

Correct Answer: B

Rationale: The correct answer is B (80-110 mg/dL) as per the American Heart Association guidelines. It is considered the optimal range for glucose concentration to prevent hypoglycemia and hyperglycemia. Choice A (60-90 mg/dL) is too low and can lead to hypoglycemia. Choice C (186-202 mg/dL) and D (110-160 mg/dL) are too high and can increase the risk of hyperglycemia and complications. Staying within the recommended range helps maintain stable blood sugar levels and reduces the risk of adverse events.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): 1. Children's spinal cords are more flexible than adults', increasing risk of injury without x-ray abnormalities. 2. Pediatric spinal injuries may not show on x-ray initially, requiring further imaging. 3. This phenomenon is known as SCIWORA (spinal cord injury without radiographic abnormality). 4. In contrast, adults' spinal cords are less flexible, often leading to visible abnormalities on x-ray. Summary of Incorrect Choices: B: Hypotension in infants with TBI is usually due to other factors like hemorrhage, not cerebral edema. C: Methylprednisolone is not recommended for initial therapy in pediatric TBI due to lack of proven benefit. D: Children more commonly have diffuse axonal injury rather than focal mass lesions in TBI compared to adults.

Correct Answer: C

Rationale: In Class 2 hemorrhage, systolic blood pressure starts to decrease due to significant blood loss (15-30%). This reduction triggers compensatory mechanisms to maintain perfusion. In Class 0, there is no blood loss, so blood pressure remains stable. In Class 1, minimal blood loss occurs, causing little impact on blood pressure. In Class 3, severe blood loss leads to a rapid decrease in blood pressure, making it unlikely for systolic blood pressure to start decreasing gradually.