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Clinical Judgement Scenarios

• Worth 38-42% of the exam

• 4-7

Clinical judgement questions test your ability to:

• Choose the NEXT BEST step, NOT just the correct one

• Understanding the pathophysiology of the conditions, while looking at the patient's history and risk factors

Spinal Cord Injuries

2 categories

1. Complete SCI=Transection

2. Incomplete SCI

Basic Anatomy of the spine

• Vertebrae (Bones)

Strokes

• Ischemic Stroke

• TIA

• Hemorrhagic Stroke

Ischemic Stroke

• Due to a blood clot or a blockage in a vessel in the brain

Shock

• Hypoperfusion

• Biproduct of hypoperfusion=Lactic Acid

EVERY ONE OF THESE COLLAPSED LUNGS WILL PRESENT W/ ABSENT OR DIMINISHED LS ON THE AFFECTED SIDE

Collapsed Lungs

Why do you think you did not pass?

• I did not fully understand what they were asking me

• I did not know my signs/symptoms

• I struggled with knowing my prioritizations & order of operations

• I did not understand the medical terminology

• I was being asked about topics I have never seen and did not know

Collapsed Lungs (Each one of these will present with absent or diminished LS on affected side)

Pneumothorax (Simple or Closed) =Blunt Trauma

Open Pneumothorax=Sucking Chest Wound =Penetrating Trauma

Tension Pneumothorax

Hemothorax

Patho-A collapsed lung, when air escapes from that floppy lung and accumulates in the pleural space

Bundle Branch Block

• RBBB

• LBBB

• QRS >.12 sec

• Must be identified in Leads V1 & V6

WiLLiaM (LBBB)

Neonatal Apnea

Primary Apnea

• They are NOT breathing on delivery, but after o2 or PPV, they start breathing on their own

Secondary Apnea

• The neonate continues to not breathe despite PPV and stimulation

Neonatal Bradycardia

P-wave

• Atrial Depolarization

QRS complex

• ventricular Depolarization

T-wave

• ventricular repolarization