Quiz 132, November 5th, 2021

Welcome to the 132th FOAMed Quiz.

 

Source image: www.pixabay.com

Question 1

Another paper about therapeutic hypothermia was published just a few weeks ago.

In the CAPITAL CHILL trial, 389 comatose survivors of out-of-hospital cardiac arrest were randomised to either a target body temperature of 31 °C (moderate hypothermia) or 34 °C (mild hypothermia) for a period of 24 hours. The primary outcome was all-cause mortality or poor neurologic outcome at 180 days.

What did the authors find?

A: Patients in the moderate hypothermia group had lower all-cause mortality or poor neurologic outcome at 180 days compared to patients in the mild hypothermia group

B: Patients in the mild hypothermia group had lower all-cause mortality or poor neurologic outcome at 180 days compared to patients in the moderate hypothermia group

C: The rate or all-cause mortality or poor neurologic outcome at 180 days did not differ between the two groups

The correct answer is C

EM cases covered the trial last week.

The primary outcome occurred in 48.4% in the 31 °C group and in 45.4% in the 34 °C group.

Keep in mind there was no normothermia group.

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Question 2

Concussion symptoms can last for quite a while.

This recently published paper is about the role of digital screen time (TV, computer, phone) in the recovery of concussion.

125 patients aged 12 to 25 years were randomised to either be permitted to engage in screen time or were asked to abstain from screen time (screen time abstinent group) for 48 hours after injury.

The primary outcome was days to resolution of symptoms, defined as a total Post-Concussive Symptom Scale (PCSS) score of 3 points or lower.

What did the authors find?

A: Abstainers recovered quicker compared to screen users

B: Screen users recovered quicker compared to abstainers

C: Speed of recovery was not different between the two group

The correct answer is A.

The paper was covered on JournalFeed last week.

The screen time permitted group had a significantly longer median recovery time of 8.0 days compared with 3.5 days in the screen time abstinent group.

The screen time permitted group reported a median screen time of a whopping 630 minutes, compared with (only) 130 minutes in the screen time abstinent group.

Source image: www.pixabay.com

Question 3

The recently published CAP-IT trial is about dose of amoxicillin and duration of treatment of community acquired pneumonia (CAP) in children.

814 children requiring amoxicillin for CAP were randomized into four groups.
3 day course of amoxicillin 35 to 50 mg/kg per day
3 day course of amoxicillin 70 to 90 mg/kg per day
7 day course of amoxicillin 35 to 50 mg/kg per day
7 day course of amoxicillin 70 to 90 mg/kg per day

The primary outcome was clinically indicated antibiotic re-treatment for respiratory infection within 28 days after randomization. The non-inferiority margin was 8%.

What did the authors find?

A: 3 day course of amoxicillin was inferior compared to a 7 day course

B: The lower dose of amoxicillin was inferior compared to the higher dose of amoxicillin

C: Both a shorter duration of treatment and a lower dose of amoxicillin were non-inferior

The correct answer is C

The trial was covered on Don’t forget the Bubbles last week.

The primary outcome occurred in 12.6% with lower dose and 12.4% with higher dose and in 12.5% with 3-day treatment vs 12.5% with 7-day treatment. Both groups demonstrated noninferiority.

How long should we treat children with pneumonia for? – the results of CAP-IT

Source image: www.pixabay.com

Question 4

Which of the following is not a treatment option for cannabis hyperemesis syndrome (CHS)?

A: Hot shower

B: Haloperidol

C: Capsaicin cream

D: Morphine

The correct answer is D

PEM Cincinnati covered cannabis hyperemesis syndrome last week.

Morphine is not effective in CHS.

Source image: www.blog.clinicalmonster.com

Question 5

The syndrome we are looking for is a complication after pacemaker implantation. It is caused by manipulation of the pacemaker box at the implantation site with the result of device malfunction.

What is the name of this syndrome?

A: Stiffler’s syndrome

B: Swiffer’s syndrome

C: Twiddler’s syndrome

D: Swimmer syndrome

The correct answer is C.

Twiddler’s syndrome was covered on County EM last week. It is caused by external manipulation of the pacemaker box, leading to lead displacement.

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This quiz was written by Sophie Nieuwendijk, Denise van Vossen, Gijs de Zeeuw, Nicole van Groningen and Joep Hermans

Reviewed and edited by Rick Thissen