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503 Cards in this Set
- Front
- Back
Q001. ACEIs; Toxicity
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A001. Cough; rash; proteinuria; angioedema; taste changes; teratogenic effects
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Q002. Amantadine; Toxicity
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A002. Ataxia; livedo reticularis
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Q003. Aminoglycosides; Toxicity
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A003. Ototoxicity; nephrotoxicity - ATN
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Q004. Amiodarone; Toxicity
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A004. Pulmonary fibrosis; peripheral deposition => bluish discoloration,; arrhythmias,; hypo-/hyperthyroidism,; corneal deposition
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Q005. Amphotericin; Toxicity
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A005. Fever/chills; nephrotoxicity; bone marrow suppression; anemia
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Q006. Antipsychotics; Toxicity
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A006. Sedation; acute dystonic reaction; akathisia; parkinsonism; tardive dyskinesia; neuroleptic malignant syndrome
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Q007. Azoles (e.g., fluconazole); Toxicity
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A007. Inhibition of P-450 enzymes
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Q008. AZT; Toxicity
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A008. Thrombocytopenia; megaloblastic anemia
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Q009. β-blockers; Toxicity
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A009. Asthma exacerbation; masking of hypoglycemia; impotence
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Q010. Benzodiazepines; Toxicity
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A010. Sedation; dependence; respiratory depression
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Q011. Bile acid resins; Toxicity
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A011. GI upset; malabsorption of vitamins; and medications
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Q012. Calcium channel blockers; Toxicity
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A012. Peripheral edema; constipation; cardiac depression
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Q013. Carbamazepine; Toxicity
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A013. Induction of P-450 enzymes; agranulocytosis; aplastic anemia
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Q014. Chloramphenicol; Toxicity
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A014. Gray baby syndrome; aplastic anemia
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Q015. Cisplatin; Toxicity
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A015. Nephrotoxicity; acoustic nerve damage
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Q016. Clonidine; Toxicity
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A016. Dry mouth; severe rebound headache; hypertension
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Q017. Clozapine
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A017. Agranulocytosis
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Q018. Corticosteroids; Toxicity
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A018. Mania (acute) immunosuppression; bone mineral loss; thinning of skin; easy bruising; myopathy (chronic); cataracts
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Q019. Cyclophosphamide; Toxicity
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A019. Myelosuppression; hemorrhagic cystitis
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Q020. Digoxin -; Toxicity
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A020. GI disturbance; yellow-green visual changes; arrhythmias - junctional tachycardia or SVT,; varying amounts of AV node blocks
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Q021. Doxorubicin -; Toxicity
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A021. Cardiotoxicity; (dilated cardiomyopathy)
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Q022. Ethyl alcohol -; Toxicity
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A022. Renal dysfunction
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Q023. Fluoroquinolones; Toxicity
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A023. Cartilage damage in children Achilles tendon rupture
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Q024. Furosemide; Toxicity
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A024. Ototoxicity; hypokalemia; nephritis
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Q025. Gemfibrozil; Toxicity
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A025. Myositis; reversible ↑ in LFTs
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Q026. Halothane; Toxicity
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A026. Hepatotoxicity; malignant hyperthermia
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Q027. HCTZ; Toxicity
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A027. Hypokalemia; hyperuricemia; hyperglycemia
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Q028. HMG-CoA reductase inhibitors; Toxicity
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A028. Myositis; reversible ↑ in LFTs
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Q029. Hydralazine; Toxicity
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A029. Drug-induced SLE
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Q030. Hydroxychloroquine; Toxicity
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A030. Retinopathy
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Q031. INH -; Toxicity
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A031. Peripheral neuropathy - prevent with vitamin B6; hepatotoxicity; inhibition of P-450 enzymes; seizures with overdose
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Q032. MAOIs -; Toxicity
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A032. Hypertensive tyramine reaction; serotonin syndrome - with meperidine
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Q033. Methanol; Toxicity
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A033. Blindness
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Q034. Methotrexate; Toxicity
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A034. Hepatic fibrosis; pneumonitis; anemia
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Q035. Methyldopa; Toxicity
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A035. Pos. Coombs’ test; drug-induced SLE
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Q036. Metronidazole; Toxicity
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A036. Disulfiram reaction; vestibular dysfunction; metallic taste
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Q037. Niacin; Toxicity
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A037. Cutaneous flushing
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Q038. Nitroglycerin; Toxicity
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A038. Hypotension; tachycardia; headache; tolerance
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Q039. Penicillin/β-lactams ; Toxicity
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A039. Hypersensitivity reactions
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Q040. Penicillamine; Toxicity
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A040. Drug-induced SLE
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Q041. Phenytoin; Toxicity
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A041. Nystagmus; diplopia; ataxia; gingival hyperplasia; hirsutism
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Q042. Prazosin -; Toxicity
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A042. First-dose hypotension
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Q043. Procainamide; Toxicity
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A043. Drug-induced SLE
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Q044. Propylthiouracil; Toxicity
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A044. Agranulocytosis
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Q045. Quinidine; Toxicity
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A045. Cinchonism -; (headache, tinnitus); thrombocytopenia; arrhythmias - torsades de pointes
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Q046. Reserpine; Toxicity
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A046. Depression
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Q047. Rifampin; Toxicity
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A047. Induction of P-450 enzymes; orange-red body secretions
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Q048. Salicylates; Toxicity
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A048. Fever; hyperventilation with; respiratory alkalosis; and metabolic acidosis; dehydration; diaphoresis; hemorrhagic gastritis
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Q049. SSRIs; Toxicity
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A049. Anxiety; sexual dysfunction
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Q050. Succinylcholine; Toxicity
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A050. Malignant hyperthermia
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Q051. Tetracyclines; Toxicity
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A051. Tooth discoloration; photosensitivity; Fanconi’s syndrome
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Q052. TCAs; Toxicity
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A052. Sedation; coma; anticholinergic effects; seizures; wide QRS; in severe cases - prolonged QT => torsade
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Q053. Valproic acid; Toxicity
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A053. Teratogenicity => neural tube defects
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Q054. Vancomycin; Toxicity
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A054. Nephrotoxicity; ototoxicity; “red man syndrome” - histamine release, not an allergy
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Q055. Vinblastine; Toxicity
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A055. Severe myelosuppression
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Q056. Vincristine; Toxicity
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A056. Peripheral neuropathy
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Q057. Acetaminophen; What is the Antidote
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A057. N-acetylcysteine
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Q058. Acid/alkali ingestion; What is the Antidote
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A058. Upper endoscopy to evaluate for stricture
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Q059. Anticholinesterases,; organophosphates; What is the Antidote
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A059. Atropine; pralidoxime
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Q060. Antimuscarinic/; anticholinergic agents; What is the Antidote
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A060. Physostigmine
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Q061. Arsenic, mercury, gold; What is the Antidote
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A061. Succimer; dimercaprol
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Q062. β-blockers; What is the Antidote
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A062. Glucagon
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Q063. Barbiturates (phenobarbital); What is the Antidote
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A063. Urine alkalinization (bicarb); dialysis; activated charcoal
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Q064. Benzodiazepines; What is the Antidote
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A064. Flumazenil
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Q065. Black widow bite -; What is the Antidote
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A065. Calcium gluconate
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Q066. Carbon monoxide -; What is the Antidote
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A066. 100% O2; hyperbaric O2
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Q067. Copper, arsenic, lead, gold -; What is the Antidote
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A067. Penicillamine
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Q068. Cyanide -; What is the Antidote
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A068. Nitrite; sodium thiosulfate
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Q069. Digitalis -; What is the Antidote
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A069. Stop digitalis,; normalize K+,; lidocaine (for torsades), anti-digitalis Fab
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Q070. Heparin -; What is the Antidote
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A070. Protamine sulfate
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Q071. Iron salts -; What is the Antidote
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A071. Deferoxamine
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Q072. Lead -; What is the Antidote
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A072. Succimer; CaEDTA; dimercaprol
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Q073. Methanol, ethylene glycol (antifreeze); What is the Antidote
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A073. EtOH; fomepizole; dialysis
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Q074. Methemoglobin; What is the Antidote
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A074. Methylene blue
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Q075. Opioids; What is the Antidote
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A075. Naloxone
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Q076. Phencyclidine hydrochloride (PCP); What is the Antidote
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A076. NG suction
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Q077. Salicylates -; What is the Antidote
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A077. Urine alkalinization; dialysis; activated charcoal
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Q078. TCAs; What is the Antidote
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A078. Na bicarb - QRS prolongation; diazepam or lorazepam for Seizures; cardiac monitor for; arrhythmias
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Q079. Theophylline; What is the Antidote
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A079. Activated charcoal
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Q080. tPA, streptokinase; What is the Antidote
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A080. Aminocaproic acid
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Q081. Warfarin; What is the Antidote
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A081. Vitamin K, FFP
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Q082. Cardiac Life Support; What are the Basic Principles
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A082. Check if responsive; call for help; Patient on firm, flat surface ABCs; Airway open?; Breathing?; CPR; IV meds before intubate; CPR if alone - 2 breaths, check pulse - carotid or femoral, 15 compressions; CPR if have help - 2 breaths, 5 compressions
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Q083. Burns; Hx/PE
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A083. 2nd leading cause of death in kids; don't underestimate degree of nonvisible deep destruction- esp. with electrical burns thorough airway & lung exam; respiratory burn - patient may need early intubation before edema sets in
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Q084. Burns; Dx; Rule of 9's
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A084. ABCs; aware of possible – shock, inhalation injury, CO poisoning; evaluate % of BSA involved rule of 9's; BSA (Body Surface Area); head = 18%; front = 18%; back = 18%; each arm = 9%; each leg = 18%
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Q085. Burns; Categories
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A085. 1st degree - epidermis involved, area painful, no blisters, capillary refill intact; 2nd degree - epidermis & superficial dermis, area painful, blisters; 3rd degree - epidermis & dermis, area painless, white & charred
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Q086. Burns; Tx
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A086. Treatment supportive; freq. dressing changes; rehydrate; topical silver sulfadiazine and mafenide; circumferential burns - at risk for compartment syn, need early escharotomy; early skin graft - prevent contractures; fluid req. - in 1st 24 hrs. - BSA x wt(kg) x 4cc, give 1/2 in 1st 8 hrs, 1/4 in next 8 hrs, 1/4 in last 8 hrs; 1st choice - lactate ringers; 2nd choice - NS (0.9%); hydrate enough to maintain urine output at least 1cc/kg/hr
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Q087. Burns; Complications
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A087. Shock; superinfection - esp. Pseudomonas
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Q088. CO Poisoning; What is it
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A088. Hypoxemic poisoning syn causes; car exhaust; smoke inhalation; barbeque in poor ventilation; old appliances
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Q089. CO Poisoning; HX/PE
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A089. Cherry-red skin; confusion; headaches; if severe – coma, seizures chronic low-level exposure; flu-like Sxs; suspect smoke inhalation in - singed nose hairs; facial burns; hoarseness; wheezing; carbonaceous sputum
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Q090. CO Poisoning; Dx
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A090. ABG; normal serum carboxyHb level - < 5% in nonsmokers, < 10% in smokers; laryngoscopy; bronchoscopy; EKG - elderly; history of cardiac dis.
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Q091. CO Poisoning; Tx
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A091. 100 O2 hyperbaric O2:; pregnant; neuro Sxs; severely ↑ carboxyHb; smoke inhalation - may need early intubation (before edema sets in)
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Q092. Aortic Disruption; What is it
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A092. Rapid deceleration injury most common causes; high speed MVAs; fall from great heights; ejection from vehicles complete; rapidly fatal; usually have contained hematoma within adventitia; laceration usually at lig. arteriosum
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Q093. Aortic Disruption; Dx
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A093. CXR immediately; wide mediastinum; loss of aortic knob; pleural cap; trachea deviation to right; left main stem bronchus depressed; aortography - gold standard; transesoph echo before OR; always suspect if sternal fractures or 1st & 2nd rib fractures
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Q094. Aortic Disruption; Tx
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A094. OR emergently
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Q095. Aortic Dissection; What is it; Risk Factors
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A095. Surging of blood through tear in aortic intima; seperation of intima & media => false lumen; Stanford type A: ascending aorta; type B: - desc. thoracic aorta (distal to lt. subclavian) risk factors:; HTN; trauma; coarctation of aorta; syphilis; pregnancy; Ehlers-Danlos; Marfan's
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Q096. Aortic Dissection; Hx/PE
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A096. Acute onset; severe tearing chest pain radiates to back => syncope, stroke, MI; asymm or decreased periph pulses; paraplegia; shock - as worsens; type A - aortic regurgitation with diastolic murmur
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Q097. Aortic Dissection; Dx
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A097. CXR; CT with IV contrast; transesoph echo or; MRI/MRA or; angiography - gold standard; EKG
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Q098. Aortic Dissection; Tx
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A098. Stabilize HBP or low HBP; IV nitrates; B blockers; goal - systolic < 120, HR < 70; type A - emergent surgery; type B - med management
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Q099. Aortic Dissection; Complications
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A099. MI; CHF; cardiac tamponade; postop hemorrhage; future dissection; future aneurysm; death
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Q100. Postop Fever; What is it Caused By; (What are the 6 W's)
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A100. Wind - atelectasis, pneumonia; Water - UTI; Wound - abscess; Walk- DVT; Wonderdrug - drug reaction; Wire - catheter
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Q101. Postop Fever; How to Decrease Risk
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A101. Incentive spirometry; short-term foley use; early ambulation; DVT prophylaxis; pre- & post-op ABx; fevers before POD3: probably not infectious unless Clostridium or B-hemolytic strep
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Q102. Acute Abdomen; What is it
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A102. Abdom Sxs so severe; surgery should be considered; primary Sx - acute abdom pain
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Q103. Acute Abdomen; Hx/PE
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A103. OPQRST: Onset, Precip factors, Quality, Radiation, Sxs, Temporal quality; Treatment modalities; full GYN Hx; LMP; STD Sxs; pelvic exam; pregnancy test - rule out PID, ectopic pregnancy,; ovarian torsion
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Q104. Acute Abdomen; Character of Pain
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A104. Sharp - parietal (peritoneal); dull, diffuse - visceral (organ); perforation - sudden onset of diffuse, severe pain; obstruction - acute onset of colicky; inflammation - gradual onset over 10-12 hrs, constant, ill- defined
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Q105. Acute Abdomen; Dx
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A105. Assess stability; emergent surgery & exploratory lap - peritoneal signs, impending shock, shock; if stable – PE, pelvic exam (women), CBC with diff, electrolytes, LFTs, amylase, lipase, urine B-hCG, UA, KUB, US; no contrast studies - if suspect complete LBO
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Q106. Acute Abdomen; Tx
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A106. Hemodynamically unstable - emergent exploratory lap; stable - expectant management; vitals; NPO; NG tube; IV fluids; serial abdom exams; serial labs; type & cross; Foley - monitor urine output; monitor fluid status
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Q107. Appendicitis; What is it
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A107. Always consider in patient with acute abdomen; MC - teens & 20's; causes - no. 1 - lumen obstructed by lymphoid tissue hyperplasia; no. 2 – fecalith, foreign body, tumor (carcinoid), parasite; obstruction => overdistention, increased pressure, ischemia & necrosis
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Q108. Appendicitis; Hx/PE
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A108. Dull, vague pain orig. at umbilicus, lasts 1-12 hrs. pain then followed by n/v, anorexia, ("hamburger sign"); may have mild fever; sharper pain => RLQ at McBurney's point, psoas sign, obturator sign, rovsing's sign; if perforated - pain decreased, peritoneal sigs will dev. atypical – elderly, kids, pregnant, retrocecal appendices
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Q109. Appendicitis; Dx
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A109. Clinical - if classic signs & Sxs, mild leukocytosis & left shift; UA - a few RBCs or WBCs; KUB – fecalith, loss of psoas shadow; US - rule out gyn abnorm; abdom CT - rule out abscesses
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Q110. Appendicitis; Tx
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A110. strong suspicion - immed open or lap appendectomy; 15-20% false pos. acceptable; if no appendicitis found - complete exploration of abdo; before surgery – NPO, IV fluids, ABx for anaerobes - 24 hrs. if perforation - cont. ABx until afebrile & WBC count normalizes, close wound by delayed primary closure on POD5; if abscess - broad-spectrum ABx, abscess percutaneously drained, elective appendectomy 6-8 wks
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Q111. Appendicitis; Complications
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A111. Risk of perforation & mortality increased with amt of time have appendicitis; (at 48 hrs - 75% risk)
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Q112. Acute Management of Trauma Patient; "ABCDE"; What is "A"
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A112. Airway - airway patency & adeq ventilation; take precedence over other Tx; conscious - nasal cannula or face mask; unconscious - chin lift or jaw thrust to reposition tongue; early intubation – apnea, decreased mental status, impending airway compromise, severe closed head injuries, failed bag mask ventilation; cricothyroidectomy - can't be intubated, signif maxillofacial trauma, keep cervical spine stable, never let this concern delay airway management
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Q113. Acute Management of Trauma Patient; "ABCDE"; What is "B"
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A113. Breathing 5 thoracic causes of immed. death must not be missed:; tension pneumothorax; cardiac tamponade; open pneumothorax; massive hemothorax; airway obstruction
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Q114. Acute Management of Trauma Patient; "ABCDE"; What is "C"
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A114. Circulation; 2 16-gauge IVs; fluid bolus of 1-2L (adults); vitals rechecked; replete fluid per fluid status; LR or NS - isotonic; replete 3:1 (fluid to blood)
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Q115. Acute Management of Trauma Patient; "ABCDE"; What is "D"
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A115. Disability; evaluate CNS dysfunction via Glasgow Coma Scale
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Q116. Acute Management of Trauma Patient; "ABCDE"; What is "E"
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A116. Extra; check temperature status; foley catheter - after rule out urethral injury; secondary survey - full exam; additional XRs - trauma series: AP chest, AP pelvis, AP/lat C-spine, T1
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Q117. Pelvic Fractures; What are they
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A117. MC after trauma such as a MVA; needs immediate attention by orthopedist; potentially life-threatening
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Q118. Pelvic Fractures; Hx/PE
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A118. ABCDE trauma survey; secondary survey - may reveal unstable pelvis; AP pelvic XR; when stable - CT; if hypotension & shock - hemorrhage likely; can be assoc with urethral injury - check for blood at urethral meatus; check high-riding, "ballotable" prostate; check for lack of prostate; retrograde urethrogram, rule out injury before Foley; serial H&H; never explore pelvic or retroperitoneal hematoma
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Q119. Pelvic Fractures; Tx
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A119. Embolize bleeding vessels; emergent external pelvic fixation; internal fixation if hemodynamically stable
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Q120. acute dystonia
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A120. involuntary muscle cont/spasm - torticollis, oculogyric crisis; Rx: anticholinergic (benztropine) or diphenhydramine; Prevent: prophylatic benztropine
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Q121. akathisia
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A121. subjective/objective restlessness; Rx: reduce neuroleptic, βblocker (propranolol), +/- benzos, anticholinergics
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Q122. dyskinesia
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A122. pseudoparkinsonism Rx:; anticholinergic (benztropine); or DA agonist (amantidine); reduce/stop neuroleptic or d/c
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Q123. tardive dyskinesia
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A123. stereotypic oral-facial movements; likely d/t DA receptor sensitization; 50% irreversible Rx:; reduce/stop neuroleptic or d/c or change drugs; giving anticholinergics or ↓neuroleptic may initially WORSEN TD
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Q124. Neuroleptic Malignant syndrome
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A124. fever; muscle rigidity; autonomic instability; clouded consciousness; ↑CPK, WBCs Rx:; stop neuroleptic; dantrolene/bromocriptine; IV fluids
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Q125. Evolution of EPS
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A125. 4 hours: acute dystonia; 4 days: akathisia; 4 weeks: akathisia; 4 months: tardive dyskinesia
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Q126. EtOH withdrawal syndrome
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A126. Mild withdrawal (6-24h from last drink): tremor, anxiety, N/V, insomnia; Major Withdrawal (10-72h): visual/auditory hallucinations, whole body tremor, vomiting, diaphoresis,↑BP; Withdrawl seizures - 6-48hrs; DTs - 2-7d, severe autonomic instability/hyperactivity (↑HR, BP), delerium, confusion, agitation, hallucinations, fever, positional nystagmus, death - mortality 15-20%
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Q127. EtOH withdrawal Rx including DTs
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A127. benzos* (DOC); haloperidol for hallucinations; clonidine, BBs for hyperadrenergic state; thiamine, folate, vitamens; replace lytes; IV fluids
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Q128. Barbituate withdrawal
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A128. anxiety; seizures; delerium; tremor; cardiac & respiratory depression; Rx: benzos
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Q129. Benzodiazepine withdrawal
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A129. rebound anxiety; seizures; tremor; instability; Rx: benzos
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Q130. Cocaine/amphetamine withdrawal
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A130. depression; hyperphagia; hypersomnolence; Rx: supportive, avoid BBs (results in excess uninhibited cardiac activation)
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Q131. Opioid withdrawal
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A131. anxiety; insomnina; flu-like symptoms*; sweating; piloerection; fever; rhinorrhea; stomach cramps; diarrhea; mydriasis; Rx: clonidine +/or buprenorphine for mod withdrawal, methadone for severe, naltrexone in pts drug-free for 7-10d
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Q132. Aortic disruption CXR
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A132. widened mediastinum; pleural cap; loss of aortic knob; deviation of trachea to R; depression of L main stem bronchus; Always suspect with R1-2#s; aortography - gold standard
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Q133. Arrhythmia Rx:; asystole
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A133. epi; atropine
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Q134. Arrhythmia Rx:; Vfib
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A134. desynchronized shock --> epi or vasopressin --> shock --> lido or amio --> shock --> procainamide or Mg
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Q135. Arrhythmia Rx:; VTach
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A135. if unstable/pulseless - desynchronized shock; if stable - lido or amio
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Q136. Arrhythmia Rx:; PEA
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A136. identify & Rx underlying; +/- epi +/or atropine
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Q137. Arrhythmia Rx:; Afib/flutter
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A137. if unstable shock at 100J; If stable, control rate (CCB, dig, BB); +/- rhythm conversion; anticoagulate
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Q138. Arrhythmia Rx:; SVT
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A138. Control rate; valsalva, carotid sinus massage, cold stimulation; adenosine (procainamide)
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Q139. Arrhythmia Rx:; bradycardia
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A139. if symptomatic consider atropine; if Mobitz II/AVB pace; Acutely, unstable - atropine/dopamine/dobutamine or transvenous pacing
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Q140. hypovolemic shock
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A140. ↓CO; ↓PCWP; ↑PVR
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Q141. cardiogenic shock
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A141. Causes:; tension PTX; cardiac tamponade; arrhythmia; structural hrt dz; MI; ↓CO; ↑PCWP; ↑PVR
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Q142. Septic shock
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A142. ↑CO; ↓PCWP; ↓PVR
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Q143. anaphylactic shock
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A143. ↑CO; ↓PCWP; ↓PVR
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Q144. Rx for malignant HTN
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A144. nitroprusside
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Q145. test to rule out urethral injury
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A145. retrograde cystourethrogram
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Q146. Radiographic indications for Sx in pts with acute abd
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A146. free air under diaphragm; extravasation of contrast; severe bowel distension; SOL; mesenteric occlusion (angiography)
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Q147. Cannon a waves
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A147. complete AVB
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Q148. signs of neurogenic shock
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A148. hypotension; bradycardia
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Q149. Cushing's triad
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A149. Signs of ↑ICP; HTN; bradycardia; abnormal respirations
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Q150. Signs of air embolism
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A150. pt with chest truma previously stable suddenly dies
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Q151. Organims/Rx of strep pharyngitis
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A151. Org: GAS, S. pneumo Rx:; Pen V; Amoxicillin; erythromycin
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Q152. Organisms causing sinusitis
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A152. S. pneumo; H. flu; M. catarrhalis; GAS; anaerobes; S. aureus
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Q153. Rx for sinusitis
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A153. 1st line – Amoxicillin (TMP-SMX if pen allergic); 2nd line - Amox/clav; 3rd line clarithromycin
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Q154. Acute OM pathogens
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A154. Viral; S. pneumo; H. flu; M. catarrhalis
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Q155. The nasopharyngeal airway can be used in which types of patients?
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A155. breathing semiconscious patients and when an oropharyngeal airway is technically challenging
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Q156. Prolonged use of a bag valve can lead to..?
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A156. Distention of the stomach increasing the chance of an aspiration event
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Q157. What are the steps of successful intubation?
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A157. 5P's Preparation, preoxygenation, pretreatment, paralysis, and placement
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Q158. How do you prepare for successful intubation?
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A158. IV access, monitors, suction, appropriate sized ET tube, and meds for rapid sequence intubation
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Q159. What pretreatment may be necessary in small children prior to intubation and why?
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A159. Atropine, to blunt the bradycardia induced by succinocholine
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Q160. What pretreatment prior to intubation may be used in adults with reactive airway disease? What about in adults where there is a concern about increased ICP?
|
A160. Reactive airway disease - lidocaine 1.5mg/kg; Pancuronium 0.01mg/kg
|
|
Q161. What sedative agent is used prior to paralysis for intubation?
|
A161. Etomidate 0.3mg/kg
|
|
Q162. volar =?
|
A162. palmar
|
|
Q163. Physical Exam of emergency ortho...?
|
A163. ROM; Palpation for subtle deformities well beyond the area of subjective pain; Neurovascular assessment
|
|
Q164. Ulnar nerve palsy causes..?
|
A164. Claw hand
|
|
Q165. Inability to extend the knee could be caused by paralysis of which nerve?
|
A165. Femoral nerve
|
|
Q166. Early treatment of ortho emergencies?
|
A166. NSAIDs; RICE (rest ice compression elevation); NPO; Reduction of long bone deformities
|
|
Q167. Don't forget to give _____ for open fractures?
|
A167. Tetanus
|
|
Q168. In children with trauma to a joint, what is important to consider on imaging?
|
A168. Comparison to the opposite extremity - difficult to tell the difference between a fracture and an epiphyseal growth plate
|
|
Q169. Compartment syndrome defined?
|
A169. When the pressure in a compartment exceeds the arterial perfusion pressure
|
|
Q170. Most reliable sign of compartment syndrome?
|
A170. Paresthesia
|
|
Q171. ARDS, neuro involvement, and thrombocytopenia post- closed fractures in leg..?
|
A171. Fat embolism
|
|
Q172. If you land directly on your shoulder, and hit hurts to reach across your body, what is the injury?
|
A172. Acromioclavicular joint separation
|
|
Q173. when does Acromioclavicular joint separation require surgery?
|
A173. type iv or higher (when the clavicle is displaced into surrounding areas)
|
|
Q174. 96% of shoulder dislocations are...?
|
A174. Anterior shoulder dislocations
|
|
Q175. how does the patient with an Anterior shoulder dislocation appear?
|
A175. holding arm in slight abduction and external rotation
|
|
Q176. What is the most common fracture in Aneterior shoulder dislocations? what nerve should be tested?
|
A176. Hill-Sachs deformity - fracture of the posterolateral aspect of the humeral head; Test the axillary nerve
|
|
Q177. Posterior dislocations are caused by...? always associated with...?
|
A177. fall on outstretched hand, convulsive seizure. Associated with Hill Sachs deformity
|
|
Q178. Most common mechanism of acute rotator cuff tear? This injury impairs which movement?
|
A178. Forced abduction. Impairs arm abduction to 30 degrees
|
|
Q179. What important structures travel with the humerus?
|
A179. The deep brachial artery and the radial nerve
|
|
Q180. Who gets supracondylar fractures? how?
|
A180. Kids < 15. Falling backwards on an outstretched hand
|
|
Q181. Posterior fat pad sign indicates?
|
A181. In adults - radial head fracture; In kids - supracondylar fracture
|
|
Q182. What is fracture of the proximal 1/3 of the ulna with radial head dislocation called?
|
A182. Monteggia fracture
|
|
Q183. What is fracture of the distal 1/3 of radius with dislocation of the distal radioulnar joint called?
|
A183. Galeazzi
|
|
Q184. Causes of carpal tunnel?
|
A184. RA, hypothyroid, DM, collagen vascular diseases
|
|
Q185. Phalen's test?
|
A185. Fully flex the wrists for 60 seconds
|
|
Q186. Tinel's sign?
|
A186. Light tapping over the median nerve produces pain or paresthesias
|
|
Q187. Most common carpal injury..?; High risk of..?
|
A187. Fracture of the scaphoid. AVN
|
|
Q188. Smith's fracture?
|
A188. Like colles, but distal fragment is displaced in the volar direction
|
|
Q189. neurogenic shock?
|
A189. state of vasomotor instability resulting from impairment of the descending sympathetic pathways in the spinal cord, or just a loss of sympathetic tone
|
|
Q190. does spinal shock signify permanent spinal cord damage?
|
A190. often times no
|
|
Q191. anterior cord syndrome results in loss of which tracts?
|
A191. spinothalamic and corticospinal tract
|
|
Q192. Central cord syndrome can be caused by? Affects?
|
A192. Hyper-extension injuries. Nerves that cross over at that level
|
|
Q193. if a penetrating spinal injury is diagnosed, begin treatment with..?
|
A193. High dose methylprednisolone
|
|
Q194. if suspecting a c-spine fracture, what xrays should be ordered?
|
A194. lateral, AP, and odontoid view
|
|
Q195. C1 burst fracture is called? Caused by...?
|
A195. Jefferson fracture. Caused by axial loading - someone falls on their head, or something falls on their head
|
|
Q196. Odontoid fractures are caused by..?
|
A196. Flexion
|
|
Q197. Hangman's fracture?
|
A197. Fracture of both pedicles of C2 - hyperextension mechanism
|
|
Q198. Stable or unstable?; atlanto-occipital dislocation; burst fracture of C5 with intact ligaments... simple wedge fracture; odontoid fracture; flexion teardrop fracture; extension teardrop fracture
|
A198. atl - unstable; burst c5 - stable; simple wedge - stable; odontoid - unstable; flexion teardrop - unstable; extension teardrop - stable
|
|
Q199. flexion teardrop fracture is associated with...?
|
A199. tearing of the posterior complex
|
|
Q200. bilateral facet dislocation...? stable?
|
A200. flexion injury; subluxation of the dislocated vertebra; very unstable
|
|
Q201. Cullen's sign? Gray-Turner's sign?
|
A201. ecchymosis of the abdomen signifies late retroperitoneal hemorrhage; Gray-Turner's: same, but of the flanks
|
|
Q202. 12% of patients with hyperthyroidism will suffer...?
|
A202. Pathologic fracture
|
|
Q203. serious associated injuries are present in up to 95% of patients with a dislocated...?
|
A203. hip
|
|
Q204. a pt with a posterior hip dislocation holds the hip how?
|
A204. flexed, adducted, and internally rotated
|
|
Q205. most common ortho injury seen in the ED?
|
A205. knee - in particular, MCL (medial collateral ligament)
|
|
Q206. 50% of patients with ACL injury have a concomitant...?
|
A206. Meniscal tear
|
|
Q207. lachman's test?
|
A207. flex the knee to 30 degrees and pull anteriorly on the tibia
|
|
Q208. donahue's unhappy triad?
|
A208. ACL, MCL, and medial meniscus tear
|
|
Q209. Injury to the ________ occurs in 50% of knee dislocations...
|
A209. popliteal artery
|
|
Q210. injury to the tibial nerve causes...?
|
A210. inability to stand on tiptoes
|
|
Q211. which ankle fracture warrants a careful radiologic examination? of what specifically?
|
A211. medial malleolar fracture; proximal shaft of the fibula (Maisoneuve fracture)
|
|
Q212. 10% of calcaneal fractures are associated with...?
|
A212. lumbar fractures
|
|
Q213. when do you call for an ortho consult?
|
A213. compartment syndrome; irreducible fractures; circulatory compromise; open fracture; anything that requires surgery
|
|
Q214. what is the most frequent complication of orotracheal intubation?
|
A214. Right main stem bronchus intubation
|
|
Q215. Patients with COPD, asthma, or CHF that are awake but cannot remain in the supine position may be intubated how...?
|
A215. Nasotracheal intubation
|
|
Q216. Most serious complication of nasotracheal intubation?
|
A216. Intracranial passage of the tube
|
|
Q217. advance airway adjuncts?
|
A217. fiberoptic intubation; retrograde intubation; combitube; laryngeal mask airway
|
|
Q218. What is the preferred surgical airway for kids? Adults?
|
A218. Kids - needle cricothyroidotomy; Adults - surgical cricothyroidotomy
|
|
Q219. if an airway will be needed for greater than 2-3 days, a surgical cricothyoidotomy should be converted to...?
|
A219. a tracheostomy
|
|
Q220. slit lamp exam consists of...?
|
A220. evaluate the integrity of the cornea, conjunctiva, and the anterior chamber; fluorescein to light up corneal defects
|
|
Q221. central retinal artery occlusion occurs in which people?
|
A221. men in their 60s
|
|
Q222. fundoscopic exam in central retinal artery occlusion?
|
A222. pale retina with cherry red fovea
|
|
Q223. what is amaurosis fugax?
|
A223. type of TIA - sudden vision loss (Shade over eye), transient, due to carotid-origin embolic shower
|
|
Q224. classic triad of optic neuritis?
|
A224. marcus gunn pupil; central vision loss; red vision desaturation
|
|
Q225. flashing lights, spider webs, or floaters that interfere with vision may be a sign of...? what meds should NOT be given?
|
A225. retinal detachment; DON'T anticoagulate
|
|
Q226. painful red eye - most often due to which things?
|
A226. conjunctivitis, corneal abrasion, or foreign body
|
|
Q227. which conjunctivitis produces copious DC?
|
A227. gonorrhea
|
|
Q228. punctuate lesions in conjunctivitis?
|
A228. viral cause
|
|
Q229. treatment of conjunctivitis?
|
A229. broad spectrum antibiotics, pain meds
|
|
Q230. soft contact wearers are especially prone to infection by.?
|
A230. pseudomonas
|
|
Q231. severe unilateral eye pain, decreased visual acuity and photophobia...?
|
A231. iritis
|
|
Q232. treatment of iritis?
|
A232. cycloplegic such as homatropine(not a mydratic)
|
|
Q233. severe unilateral HA, eye pain, N/V assoc with loss of vision....?
|
A233. narrow angle glaucoma
|
|
Q234. which drugs decrease aqueous production?
|
A234. acetazolomide and topical b blockers
|
|
Q235. which chemicals causes coag necrosis? liquefaction necrosis?
|
A235. acids; alkali
|
|
Q236. treatment of chemical burn...
|
A236. IRRIGATE
|
|
Q237. what's hyphema?
|
A237. blurred vision after blunt trauma (dull eye pain)... bleeding
|
|
Q238. basic approach to all toxicity patients in the ED?
|
A238. ABCs; Decontamination; Elimination; Antidotes
|
|
Q239. key things on physical exam for toxicity exposures....?
|
A239. Vital signs; pupils; toxidromes; autonomic signs; motor signs; mental status; skin
|
|
Q240. describe anticholinergic toxidrome?
|
A240. "mad as a hatter, dry as a bone, red as a beet, hot as a stove." Also - decreased GI motility, urinary retention, mydriasis.
|
|
Q241. describe muscarinic toxidrome?
|
A241. DUMBELLS
|
|
Q242. narcotic toxidrome?
|
A242. respiratory depression,; hypotension,; depressed sensorium, miosis
|
|
Q243. sympathomimetic toxidrome? compare with anticholinergic toxidrome?
|
A243. very similar except sympathomimetic involves diaphoresis
|
|
Q244. withdrawal toxidrome?
|
A244. agitation,; hallucination,; mydriasis,; diarrhea,; cramps,; lacrimation,; tachycardia,; insomnia,; seizures
|
|
Q245. major toxic effect of acetaminophen?
|
A245. metabolite NAPQI causes centrilobular hepatocellular damage
|
|
Q246. treatment of acetaminophen toxicity?
|
A246. 4 hour level on rumack-matthew nomogram,; activated charcoal,; N-acetyl-cysteine (to regenerate glutathione)
|
|
Q247. methanol toxicity?
|
A247. formic acid metabolite - causing a gap acidosis and direct optic nerve toxicity
|
|
Q248. treatment of ethylene glycol toxicity?
|
A248. 4MP or EtOH
|
|
Q249. which drugs can cause anticholinergic syndromes? tx?
|
A249. antihistamines, antipsychotics, TCAs... treatment - physostigmine
|
|
Q250. symptoms of calcium channel blocker toxicity? tx?
|
A250. bradycardia and hypotension; treatment - CaCl2, glucagon, epinephrine, DA
|
|
Q251. CO toxicity symptoms
|
A251. HA,; N/V,; flu-like symptoms,; CNS depression,; tachy,; hypotension
|
|
Q252. treatment of CO toxicity?
|
A252. 100% O2
|
|
Q253. GHB?
|
A253. date rape drug - euphoric and amnestic effects
|
|
Q254. refractory seizures could be caused by what toxicity?
|
A254. INH
|
|
Q255. Organophosphates can cause which toxidrome?
|
A255. muscarinic
|
|
Q256. naloxone?
|
A256. opioid antagonist
|
|
Q257. standard of care for salicylate poisoning?
|
A257. activated charcoal; also consider alkalinization of urine and blood with bicarb
|
|
Q258. benzo receptor antagonist that can rapidly reverse coma from benzo OD...? what's the problem with this drug/
|
A258. flumazenil; can lower the seizure threshold in pts with TCA OD and induce benzo withdrawal
|
|
Q259. loxosceles bites can be treated with...?
|
A259. dapsone
|
|
Q260. signs and symptoms of TCA OD?
|
A260. anticholinergic sx,; cardiac dysfunction,; intractable seizures,; and hyperthermia
|
|
Q261. treatment of TCA toxicity?
|
A261. decontamination with MDAC; Sodium bicarb administration; Benzos for seizure management; Alpha agonists for hypotension
|
|
Q262. prerenal failure due to..?
|
A262. decreased renal perfusion; (volume depletion, low CO, abnormal renal hemodynamics)
|
|
Q263. most common cause of intrinsic renal failure?
|
A263. longstanding HTN
|
|
Q264. majority of hospital-assoc episodes of ARF are caused by...?
|
A264. ATN
|
|
Q265. postrenal failure caused by?
|
A265. obstructive uropathy
|
|
Q266. FENA <1 in which condition?
|
A266. Prerenal failure
|
|
Q267. Urine Na <20 in which condition?
|
A267. Prerenal failure
|
|
Q268. treatment of prerenal failure?
|
A268. volume replacement, d/c offending meds
|
|
Q269. intrinsic RF treatment?
|
A269. monitor fluid status,; restrict protein,; correct electrolyte abnormalities
|
|
Q270. dispo for patients with ARF?
|
A270. admit
|
|
Q271. what drugs can cause ARF in pts with renal artery stenosis?
|
A271. ACE inhibitors
|
|
Q272. #1 cause of death in 1-44 year olds?
|
A272. Trauma (specifically, MVCs)
|
|
Q273. Preparation for a trauma case includes?
|
A273. History from EMTs; Prep the trauma bay; Airway box; O2 and suction; IVF and supplies
|
|
Q274. Indications for intubation?
|
A274. GCS <8; Inadequate breathing; Unable to protect airway
|
|
Q275. Chin lift is contraindicated if...?
|
A275. A C-spine injury is suspected
|
|
Q276. Radial pulse should have a BP of at least...? Femoral?
|
A276. 80 mmHg; 70
|
|
Q277. what % of ECF is plasma?
|
A277. 40181
|
|
Q278. which drug is an ineffective pressor in hypovolemic patients?
|
A278. dopamine
|
|
Q279. GCS consists of which 3 categories?
|
A279. eye opening,; verbal response,; moto response
|
|
Q280. most rapid means to lower ICP?; what other method?
|
A280. Hyperventilation; mannitol
|
|
Q281. volume of blood in an adult?
|
A281. 5 L (7% of ideal body weight)
|
|
Q282. physiologic response to acute hypovolemia?
|
A282. In order:; Tachycardia; narrowed pulse pressure (increased diastolic press); slowing of cap refill; decreased systolic pressure
|
|
Q283. raccon eyes, and battle sign?
|
A283. late findings in basilar skull fractures
|
|
Q284. assessment of C-spine in trauma?
|
A284. posterior midline - any tenderness?; focal neuro deficit?; A&O; evidence of intoxification?; any painful injury that may distract the pt?
|
|
Q285. FAST?
|
A285. quick, non-invasive method of examining the abdomen and pericardium for blood
|
|
Q286. how to check for pelvic fracture?
|
A286. press down and in on both iliac crests simultaneously
|
|
Q287. urine myoglobin can be elevated secondary to...?
|
A287. massive muscle breakdown (rhabdo)
|
|
Q288. treatment of rhabdo?
|
A288. IVF,; sodium bicarb,; and mannitol
|
|
Q289. calculate cerebral perfusion pressure?
|
A289. MAP - ICP
|
|
Q290. Cushing's reflex? sign of?
|
A290. HTN, bradycardia, hypopnea; sign of increased ICP
|
|
Q291. in traumatic head injury, what is the target MAP?
|
A291. 90mmHg
|
|
Q292. intubation considerations for elevated ICP?
|
A292. intubate early but WITHOUT ketamine
|
|
Q293. seizure prophylaxis with head bleeds?
|
A293. dilantin
|
|
Q294. how does cardiac tamponade present? findings?
|
A294. hypotension, muffled heart sounds, JVD, and pulsus paradoxus; electrical alternans on ECG; may present with pulseless electrical activity
|
|
Q295. which condition can lead to hypotension, absent breath sounds, hyperresonance, distended neck veins, and high airway pressures?
|
A295. tension pneumothorax
|
|
Q296. hypoxia occurs if an open pneumothorax is greater than?
|
A296. 2/3 trachea diameter
|
|
Q297. flail chest?
|
A297. 3 or more rib fractures in 2 or more sites with paradoxical motion of chest wall with inspiration
|
|
Q298. how to demonstrate fluid in the pericardium in tamponade?
|
A298. echocardiogram, or ED U/S
|
|
Q299. treatment of tension pneumothorax?
|
A299. angiocath in the 2nd intercostals space in the mid-clavicular line; chest tube if hemorrhagic or simple pneumothorax suspected
|
|
Q300. treatment of cardiac tamponade?
|
A300. subxyphoid pericardiocentesis
|
|
Q301. splenic injury can cause pain referred to...? eponym?
|
A301. left shoulder...Kehr's sign
|
|
Q302. which chief complaints warrant a stat EKG?
|
A302. chest pain/pressure/discomfort; SOB; hypotension; weakness/dizziness; syncope; abdominal pain especially in elderly; palpitations; N/V especially in elderly, diabetics
|
|
Q303. shortened PR interval suggests?
|
A303. alternate, abnormal conduction pathway like WPW syndrome
|
|
Q304. elongated PR interval suggests?
|
A304. some form of AV block
|
|
Q305. quick and dirty way of determining the axis of the heart?
|
A305. leads I and aVF... both up - normal; aVF down - LAD; I down - RAD; both down - RAD
|
|
Q306. DDx of U waves?
|
A306. hypokalemia; hypercalcemia; meds (digoxin, quinidine); thyrotoxicosis
|
|
Q307. Describe possible characteristics of an unstable cardiac patient?
|
A307. Pulseless; Hypotension; AMS; Ischemic chest pain; CHF
|
|
Q308. treatment basics for unstable cardiac patients?
|
A308. cardioversion (synch or un-synch) per ACLS protocol, then IV meds or other therapy
|
|
Q309. treatment of sinus tachycardia?
|
A309. treatment the UNDERLYING CAUSE
|
|
Q310. how can you tell there's paroxysmal supraventricular tachycardia? tx?
|
A310. abnormal/absent P waves; Tx: unstable --> synch cardioversion; stable --> AV node blockade via adenosis, calcium channel blockers (diltiazem, verapamil), b-blockers, manuevers
|
|
Q311. treatment of a fib?
|
A311. unstable --> synch cardioversion; stable w/ rapid vent. response --> AV blockade: calcium channel blockers, b blockers, digoxin; anticoagulation
|
|
Q312. pts with pre-excitation syndromes - be careful not to...?
|
A312. block the AV node by conventional meds
|
|
Q313. premature ventricular contractions, etiology?
|
A313. 4 H's - hypokalemia, hypomagnesemia, hypoxia, hyperthyroidism; drugs; heart disease
|
|
Q314. what is trigeminy?
|
A314. every 3rd beat is a PVC
|
|
Q315. treatment of PVCs?
|
A315. iv lidocaine or amiodarone; iv magnesium sulfate; procainamide
|
|
Q316. treatment of pulseless v tach?
|
A316. immediate UNSYCNHED cardioversion
|
|
Q317. treatment for unstable v tach?
|
A317. synchronized cardioversion, then amiodarone or lidocaine drip
|
|
Q318. treatment for stable v tach?
|
A318. medical cardioversion with lidocaine, amiodarone, adenosine, or procainamide
|
|
Q319. etiology of torsades?
|
A319. ischemic heart disease; MI; hypo-electrolyte states
|
|
Q320. treatment of stable torsades?
|
A320. electrical overdrive pacing; also consider Mg sulfate
|
|
Q321. treatment of Vfib?
|
A321. unsynchronized cardioversion,; ACLS protocols,; and correction of lytes abnormalities
|
|
Q322. pulseless electrical activity etiology?
|
A322. MATCH4ED; MI; Acidosis; Tension pneumo; Cardiac tamponade; H4- hypothermia, hyperkalemia, hypoxia, hypovolemia; Embolism (pulm); Drug OD
|
|
Q323. treatment of ventricular asystole?
|
A323. IVF, epinephrine, atropine; Transvenous pacing
|
|
Q324. for Mobitz II 2nd degree AV block, what tx? What won't work?
|
A324. transcutaneous or transvenous pacing; Admit for implantable pacemakers; Atropine won't work
|
|
Q325. treatment for 3rd degree AV block?
|
A325. immediate temporary pacemaker
|
|
Q326. you should consider a new LBBB to be _______ until proven otherwise?
|
A326. acute MI
|
|
Q327. Indications for temporary cardiac pacing?
|
A327. hemodynamically unstable bradycardia; bradycardia that fails to respond to tx; refractory tachycardia dysrhythmias; early bradyasystolic arrest
|
|
Q328. how does digoxin cause toxicity?
|
A328. blockade of the NaKATPase; increased vagal tone and increased AV nodal blockade
|
|
Q329. EKG signs of WPW?
|
A329. short PR interval; Delta wave; wide QRS; adult tachycardia
|
|
Q330. EKG signs of hypokalemia?
|
A330. more prominent U waves; flattened t waves
|
|
Q331. EKG signs of hyperkalemia?
|
A331. hyperacute T waves; wide QRS that eventually blends with the T wave to form a sine wave appearance
|
|
Q332. EKG signs of hypocalcemia?
|
A332. prolonged QT; terminal T wave inversion
|
|
Q333. EKG signs of hypercalcemia?
|
A333. shortened QT interval
|
|
Q334. associated symptoms of ACS?
|
A334. dyspnea, diaphoresis, nausea, lightheadedness, or sense of weakness
|
|
Q335. define stable angina?
|
A335. symptoms precipitated by exertion and relieved by rest or nitroglycerin
|
|
Q336. define unstable angina?
|
A336. Exertional angina of recent onset; angina of worsening character; angina at rest
|
|
Q337. describe myoglobin as a cardiac marker?
|
A337. elevated as early as one hour and peaks at 4-12 hours; nonspecific
|
|
Q338. describe CKMB as a cardiac marker?
|
A338. rises in 3-4 hours, peaks at 12-24 hours; can be elevated in skeletal muscle injury
|
|
Q339. describe troponin as a cardiac marker?
|
A339. rises in 3-6 hours, peaks 12-24 hours; most specific and sensitive
|
|
Q340. acute MI tx?
|
A340. MOAN B H; morphine; oxygen; aspirin; nitroglycerin; beta blockade; heparin
|
|
Q341. in pump failure.. which pressors for hypotension in a volume unresponsive patient..?
|
A341. sbp 80-100 - dobutamine; sbp 70-80 - dopamine; sbp <70 - levophed
|
|
Q342. pericarditis - presentation?; pain is worsened by..?
|
A342. sharp stabbing precordial or retrosternal chest pain... pain worsened by inspiration or lying flat
|
|
Q343. associated symptoms of pericarditis?
|
A343. low grade fever; dyspnea; dysphagia; tachycardia
|
|
Q344. test of choice for detection and f/u of pericarditis?
|
A344. echo
|
|
Q345. treatment for pericarditis
|
A345. NSAIDs for 1-3 weeks
|
|
Q346. aortic dissections typically occur in what group?
|
A346. uncontrolled hypertensive males ages 50-70
|
|
Q347. physical findings in aortic dissection?
|
A347. asymmetric pulses with BP differences between extremities; very hypertensive; severe distress; JVD; palpable pulsatile mass or tenderness
|
|
Q348. chest tube required for what size pneumothorax?
|
A348. >15%
|
|
Q349. Nitro's relief of cardiac vs esophageal pain?
|
A349. Cardiac w/in 5 minutes, esophageal w/in 10 minutes
|
|
Q350. life threatening etiologies of abdominal pain...?
|
A350. ruptured AAA,; perforated viscous,; intestinal obstruction,; ectopic pregnancy,; mesenteric ischemia,; appendicitis,; and MI
|
|
Q351. INITIAL TEST OF CHOICE FOR BILIARY TRACT DISEASE, AAA, ectopic, or free peritoneal fluid?
|
A351. US
|
|
Q352. Plain films can rule out which abdominal emergencies?
|
A352. Perforation or obstruction
|
|
Q353. Colicky pain usually responds to which drugs? Specifically...?
|
A353. NSAIDs,; esp IV Ketorolac
|
|
Q354. Triad of pain, hypotension, and a pulsatile abdominal mass...?
|
A354. AAA
|
|
Q355. _______ is virtually 100% sensitive in detecting AAAs?
|
A355. US
|
|
Q356. What is usually the primary inciting factor of appendicitis?
|
A356. Obstruction of the appendix usually by an appendicolith
|
|
Q357. risk factors for cholecystitis?
|
A357. fat, forty, and female
|
|
Q358. radiation of pain in acute cholecystitis?
|
A358. tip of the right scapula
|
|
Q359. most useful test if suspicious of cholecystitis?
|
A359. US of RUQ
|
|
Q360. which agents should not be used in acute gastroenteritis?
|
A360. anti-motility agents (Imodium) because it diminishes diarrheal excretion of organisms
|
|
Q361. Presentation of patients with acute hepatitis?
|
A361. Jaundice,; dark urine/light stools,; hepatomegaly,; fatigue, malaise,; RUQ pain,; N/V,; and fever
|
|
Q362. coagulation should be normalized with FFP in which condition?
|
A362. hepatitis
|
|
Q363. presentation of acute mesenteric ischemia?
|
A363. severe, poorly localized colicky abdominal pain associated with recurrent forceful bowel movements; classic - abdominal pain out of proportion to the minimal physical exam findings
|
|
Q364. Most useful test to diagnose acute mesenteric ischemia?
|
A364. Angiography
|
|
Q365. Midepigastric abdominal pain usually associated with N/V?
|
A365. Acute pancreatitis
|
|
Q366. An amylase raised _______ times the upper limit of normal is 98% specific to acute pancreatitis...
|
A366. 1.5
|
|
Q367. All patients with acute pancreatitis should be....
|
A367. admitted and made NPO
|
|
Q368. good narcotic choice for pain in acute pancreatitis
|
A368. Meperidine (better than morphine)
|
|
Q369. fever, abdominal pain, and rebound tenderness...?
|
A369. Peritonitis
|
|
Q370. Small bowel obstruction is caused by ________ more than 50% of the time...?
|
A370. postoperative adhesions
|
|
Q371. Most significant complications of small bowel obstruction?
|
A371. Strangulation and bowel infarction
|
|
Q372. etiology of bronchitis?
|
A372. viruses (influenza, adenovirus, etc.); Mycoplasma; Chlamydia; Bordetella pertussis
|
|
Q373. Virchow's triad of the pathophysiology behind PE?
|
A373. Venostasis; Hypercoagulability; Vessel wall damage/inflammation
|
|
Q374. Classic triad of PE presentation?
|
A374. Hemoptysis; Dyspnea; chest pain
|
|
Q375. EKG findings in PE?
|
A375. S1; Q3; inverted T3
|
|
Q376. golden standard for diagnosing PE?
|
A376. pulmonary angiography
|
|
Q377. ED treatment of CHF?
|
A377. diuretics; nitrates; anlgesics; intubation or CPAP if no improvement
|
|
Q378. treatment of COPD in the ED?
|
A378. ABCs monitoring; albuterol neb; glucocorticoids; MgSO4 in severe exacerbations; antibiotics (empiric broad spectrum)
|
|
Q379. ED eval of asthma?
|
A379. Monitors, O2, pulse ox; Peak expiratory flow rate; CXR - to rule out pneumonia
|
|
Q380. signs of hyperventilation syndrome?
|
A380. tachypnea, chest wall tenderness, carpopedal spasm, Chvostek's/Trousseau's sign (hypocalcemia)
|
|
Q381. this condition likely results from inflammation of CN VII as it courses through the styloid foramen?
|
A381. Bell's palsy
|
|
Q382. treatment of bell's palsy?
|
A382. acyclovir AND prednisone; eye patching to prevent keratitis and corneal ulceration
|
|
Q383. work up of CVA?
|
A383. STAT head CT - esp if < 3 hrs; standard labs; STAT Accu-check
|
|
Q384. in hemorrhagic stroke, you want to decrease SBP by no more than _____ to limit hypoperfusion...?
|
A384. 20-25%
|
|
Q385. Peripheral vertigo is caused by.?
|
A385. viral etiology (labyrinthitis); decaying or "lost" otoliths
|
|
Q386. peripheral vertigo presentation?
|
A386. acute onset; intense spinning sensation, N/V; unidirectional nystagmus that can be inhibited by fixation
|
|
Q387. work-up of peripheral vertigo?
|
A387. hallpike maneuver; epley manuevers; anti-emetics, anti-cholinergics
|
|
Q388. most seizures in the ED are due to...?
|
A388. Medical non-compliance in known seizure patients
|
|
Q389. workup of seizures in the ED...
|
A389. ABCs; IV; check glucose; head CT; anti-epileptic level; LP if any possibility of intracranial hemorrhage or meningitis
|
|
Q390. LOC occurs in ____ % of patients with SAH?
|
A390. 0.5
|
|
Q391. 75% of SAH is due to...?
|
A391. ruptured congenital arterial aneurysm
|
|
Q392. diagnostic test for SAH?
|
A392. noncontrast head CT
|
|
Q393. if there is suspicion for SAH and it's not seen on CT, ____ must be performed?
|
A393. LP
|
|
Q394. What other condition besides SAH could cause blood in the CSF?
|
A394. Herpes encephalitis
|
|
Q395. goal of ICP management is to maintain the cerebral perfusion pressure greater than ______?
|
A395. 60
|
|
Q396. A chronic headache that started out mild to moderate in severity and intermittent in nature, described as a deep, aching pain and worsened by coughing, and often maximal upon awakening...?
|
A396. intracranial tumor / mass
|
|
Q397. 85% of people experiencing malignant hypertension complain of _____?
|
A397. Headache
|
|
Q398. Temporal arteritis affects women ______ than men, and is uncommon before the age of _____? ESR is usually ____?
|
A398. Women more than men; 50; ESR 50-100
|
|
Q399. Jaw claudication is strongly suggestive of...?
|
A399. temporal arteritis
|
|
Q400. treatment of temporal arteritis?
|
A400. prednisone 60mg po, arrange a biopsy to confirm diagnosis
|
|
Q401. Often compression of ______________ can improve the pain of migraine?
|
A401. the ipsilateral superficial temporal or carotid artery
|
|
Q402. ergotamine is contraindicated in... ? Should be used w/ caution in ....?
|
A402. Pregnancy; Caution in HTN or CAD
|
|
Q403. Patients should avoid _____ while in the midst of cluster headaches?
|
A403. Alcohol
|
|
Q404. This causes headaches often in overweight women in their 30s...
|
A404. Pseudotumor Cerebri (benign intracranial HTN)
|
|
Q405. 90% of patients with Pseudotumor Cerebri have ....?
|
A405. papilledema
|
|
Q406. in Pseudotumor Cerebri, head CT will show...? LP will show...?
|
A406. CT - slit-like ventricles; LP - increased opening pressure
|
|
Q407. treatment of Pseudotumor Cerebri..?
|
A407. Acetazolamide 250 mg pid
|
|
Q408. treatment of post LP HA?
|
A408. caffeine sodium benzoate
|
|
Q409. cherry-red coloration of skin/mucous membranes, retinal hemorrhages, AMS?
|
A409. CO poisoning
|
|
Q410. sudden onset of head/eye pain, decreased visual acuity?
|
A410. Acute angle closure glaucoma
|
|
Q411. treatment of acute uncomplicated UTI?
|
A411. Bactrim for 3 days
|
|
Q412. Pyelonephritis w/ systemic sx tx?
|
A412. admit for IV antibiotics
|
|
Q413. pregnant women with UTI tx?
|
A413. macrobid for 7 days
|
|
Q414. What % of pts presenting with classic UTI sx show minimal to no bacteria on UA?
|
A414. 30-40%
|
|
Q415. Sudden onset of testicular pain in children and young men?
|
A415. Testicular torsion
|
|
Q416. most common cause of urinary retention?
|
A416. BPH
|
|
Q417. >100 ml postvoid residual urine volume is diagnostic of...?
|
A417. urinary retention
|
|
Q418. what is fournier's gangrene?
|
A418. aggressive fasciitis of the perineum in a toxic appearing pt likely with history of DM, urethral trauma, surgery, or obstruction
|
|
Q419. treatment of fournier's gangrene??
|
A419. immediate surgery - complete debridement of necrotic tissue
|
|
Q420. tender, swollen, painful epididymis and testis usually accompanied by fever?
|
A420. Epididymitis
|
|
Q421. testicular US can distinguish...?
|
A421. torsion from epididymitis
|
|
Q422. the cremasteric reflex is present in _____ but not in ___________?
|
A422. epididymitis; torsion
|
|
Q423. nonspecific infection of the glans penis is called...?
|
A423. balanitis
|
|
Q424. abnormally small opening in the foreskin?
|
A424. phimosis
|
|
Q425. abnormal painful swelling of the glans penis occurring after aggressive retraction of a phimotic foreskin?
|
A425. paraphimosis
|
|
Q426. flank/abdominal pain, does not change with position or remaining still, radiation to groin...
|
A426. stones
|
|
Q427. work up of stones?
|
A427. IVF; IV narcotics; UA - will generally show hematuria; BMP
|
|
Q428. test of choice for kidney stones?
|
A428. noncontrast CT
|
|
Q429. stone <3mm probability of passing spontaneously?
|
A429. 0.8
|
|
Q430. Indications for urology consults or admission in kidney stones...?
|
A430. Associated UTI; uncontrolled pain/emesis; extravasation of contrast; renal failure; single kidney; hydronephrosis + hydroureter; stone > 6mm
|
|
Q431. in a patient >60, first time renal colic is _________ until proven otherwise...
|
A431. AAA
|
|
Q432. of those women who experience bleeding in the first trimester, ______________ will undergo spontaneous abortion
|
A432. 40180
|
|
Q433. threatened abortion...?
|
A433. vaginal bleeding with a pre-viable fetus and closed cervix
|
|
Q434. inevitable abortion?
|
A434. vaginal bleeding with cervical dilatation
|
|
Q435. incomplete abortion
|
A435. vaginal bleeding with partial passage of products of conception and dilated cervix
|
|
Q436. complete abortion
|
A436. passage of all products of conception and closed cervix
|
|
Q437. missed abortion
|
A437. fetal demise and retention of products of conception, cervix closed
|
|
Q438. 6-8 weeks gestation with amenorrhea, spotting, and cramping lower abdominal pain....concerning for...?
|
A438. ectopic
|
|
Q439. gold standard in diagnosing an ectopic?
|
A439. US
|
|
Q440. any patient who presents with vaginal bleeding and is _____ should be given RhoGAM?
|
A440. Rh -
|
|
Q441. 2 most common pregnancy related causes of vaginal bleeding in the second trimester?
|
A441. miscarriage; hydatidiform mole
|
|
Q442. pre-eclampsia that occurs prior to 20 weeks gestation is pathognomonic for...?
|
A442. trophoblastic disease
|
|
Q443. most common presentation of placenta previa?
|
A443. late 2nd to early 3rd trimester painless bleeding
|
|
Q444. ____________- may occur in up to 1/3 of placental abruptions?
|
A444. DIC
|
|
Q445. pre-eclampsia?
|
A445. triad of HTN, edema, and proteinuria of >100 mg/dl
|
|
Q446. HELLP syndrome?
|
A446. subset of pre-eclamptic pts:; Hemolysis, Elevated Liver enzymes, and Low Platelets
|
|
Q447. In preeclampsia and eclampsia, the most important part of the CBC is...?
|
A447. the platelet count
|
|
Q448. seizure prophylaxis in pre, eclampsia?
|
A448. MgSO4
|
|
Q449. preterm labor is defined as occurring...?
|
A449. before 37 weeks gestation
|
|
Q450. Strawberry cervix?
|
A450. trichomonas
|
|
Q451. average blood loss in normal menses/
|
A451. 30-60cc
|
|
Q452. benign leiomyomas that develop in the uterus and often result in menometrorraghia?
|
A452. fibroids
|
|
Q453. dysfunctional uterine bleeding tx..?
|
A453. NSAIDs, and OCPs; rule out endometrial carcinoma
|
|
Q454. Chlamydia can cause....?
|
A454. Asymptomatic infection; Urethritis; Cervicitis; PID
|
|
Q455. PID?
|
A455. Lower abdomen. tenderness, cervical motion tenderness, and adnexal tenderness; + fever or increased WBC or ESR etc..
|
|
Q456. most common cause of infectious arthritis in young sexually active adults?
|
A456. Gonorrhea
|
|
Q457. green-gray discharge?
|
A457. trichomonas
|
|
Q458. thin-gray malodorous discharge, non sexually transmitted
|
A458. bacterial vaginosis
|
|
Q459. most common cause of pelvic pain in women not associated with infection is...?
|
A459. Rupture of an ovarian cyst
|
|
Q460. 50% of cases of ovarian torsion are caused by..?
|
A460. Benign dermoids that cause the ovary to twist
|
|
Q461. A major cause of pelvic pain, dyspareunia, and dysmenorrhea
|
A461. Endometriosis
|
|
Q462. postcoital contraception?
|
A462. norgestrel
|
|
Q463. first, second, etc degree frostbite?
|
A463. 1st - warm, hyperemic, sensate; 2nd - clear vesicles; 3rd - purple bullae; 4th - mummification
|
|
Q464. ED management of frostbite?
|
A464. treatment hypothermia; IVF; remove nonadherent wet apparel; rapid thawing thawing in 42C water bath; unroofing clear blisters; aloe vera; tetanus prophy; ibuprofen, ascorbic acid, nifedipine
|
|
Q465. How to estimate total body surface area for burns..?
|
A465. 9's; LUE - 9%,; LLE - 18%,; posterior torso - 18%,; head - 9%
|
|
Q466. burn degrees?
|
A466. 1st - superficial epidermis (no blisters, heals w/out scar); 2nd - superficial dermis (blisters, scarring in 3 wks...); 3rd - all of dermis (charred, painless, scars with contractures)
|
|
Q467. How do you determine IVF needs in a burn victim?
|
A467. If TBSA >15%.... 4ml x kg weight x tbsa% = total volume of replacement needed in first 24 hrs
|
|
Q468. don't forget _________ in frostbite, burns, and a variety of other injuries....?
|
A468. tetanus prophylaxis
|
|
Q469. hypothermia defined?
|
A469. core temp < 35 C
|
|
Q470. presentation of mild hypothermia?
|
A470. confusion, lethargy, fatigue, shivering, tachycardia, respiratory alkalosis
|
|
Q471. resuscitation in severe hypothermia should include _________ in order to treat cardiac dysrhythmias...?
|
A471. Warming until core temp > 32 C
|
|
Q472. severe dehydration, thermoregulaory failure, temp >40C, tachycardia, hypotension, confusion, rhabdo...?
|
A472. Heat stroke
|
|
Q473. treatment of heat stroke..?
|
A473. rapid cooling, monitoring, seizure prophylaxis
|
|
Q474. voltage > _____________ is considered high tension..?
|
A474. 1000 V
|
|
Q475. the _________ the resistance, the more the current and damage
|
A475. less
|
|
Q476. AC current is ___________ dangerous than DC, because?
|
A476. more; increased duration of exposure; increased likelihood of Vfib
|
|
Q477. barotrauma of ascent?
|
A477. when a diver fails to exhale when ascending, exacerbating the overexpansion of the airspaces
|
|
Q478. type 1 decompression sickness? type 2?; treatment if severe?
|
A478. 1 - joint, skin, bone problems; 2 - neuro, lung, CV problems; Hyperbaric oxygen chamber
|
|
Q479. what agent can mimic acclimatized state in the treatment of altitude sickness?
|
A479. Acetazolamide - causes a compensatory respiratory alkalosis
|
|
Q480. most infection prone bite injury?
|
A480. human bite to the hand
|
|
Q481. ___________ is implicated in 50% of infected cat bites and 30% of infected dog bites?
|
A481. Pasteurella
|
|
Q482. complications of this infection include encephalitis, Painaud's, osteolytic bone lesions, purpura, and erythema nodosum
|
A482. Bartonella
|
|
Q483. describe phases of rabies briefly?
|
A483. Incubation period - couple months; Prodrome - 1 week of localized pain, malaise, N/V; Acute neuro phase - 1 week; Coma - up to 2 weeks
|
|
Q484. Loxosceles spider bite tx?
|
A484. wound care; antibiotics if superinfected; antihistamines and analgesics; dapsone to prevent ulceration; IV steroids in viscerocutaneous loxoscelism to prevent hemolysis
|
|
Q485. sudden onset fever, centripetal rash spread, severe HA, myalgia, N/V, and abdominal pain
|
A485. Rocky mountain spotted fever
|
|
Q486. treatment of rocky mountain?
|
A486. teracycline or chloramphenicol; supportive care for shock, DIC, ARDS, CHF
|
|
Q487. complications of auricular hematoma?
|
A487. cauliflower ear, cartilage necrosis
|
|
Q488. pathogens of otitis externa?
|
A488. pseudomonas and staph
|
|
Q489. treatment of anterior bleeding epistaxis?
|
A489. pinching pressure, decongestion, silver nitrate, packing, abx to prevent sinusitis
|
|
Q490. problem with posterior bleeding epistaxis?
|
A490. pharyngeally stimulated hypoxia and stopped breathing
|
|
Q491. ____________ cures >95% of peritonsillar abscesses?
|
A491. I and D
|
|
Q492. Ludwig's angina? big concern?
|
A492. Trench mouth - dental origin infection of submandibular space due to horrible hygiene; Concern - airway compromise
|
|
Q493. duck quack cry is characteristic of...?
|
A493. Retropharyngeal deep space infection
|
|
Q494. swallowed coins appear ____________ in trachea, _____________ in esophagus?
|
A494. side on; face on
|
|
Q495. diagnosis and treatment of esophageal foreign body?
|
A495. EGD for visualization; glucagon for esophageal relaxation
|
|
Q496. epiglotitis has traditionally been associated with which infection?
|
A496. Hemophillus B
|
|
Q497. diagnosis of epiglotitis?
|
A497. loss of V-shaped dip in neck plain film (valecula sign)
|
|
Q498. if suspecting epiglotitis in kids....what next?
|
A498. call ENT or anesthesia - no IV's, oral exam, nothing that stimulates/agitates the child
|
|
Q499. croup? what type of cough?
|
A499. laryngotracheobronchitis - viral infection; seal-like barking cough
|
|
Q500. difference in presentation in kids with croup vs. epiglotitis?
|
A500. in croup, kids generally appear well
|
|
Q501. treatment of croup?
|
A501. racemic epinephrine,; humidified air,; steroids
|
|
Q502. angioedema? tx
|
A502. inflammatory autoimmune reaction, increased capillary permeability; treatment - H1 blocker, steroids, H2 blocker, epinephrine for severe cases
|
|
Q503. causes of pharyngitis?
|
A503. group A strep; Mono with lymphadenopathy, splenomegaly; adenovirus
|