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16 Cards in this Set
- Front
- Back
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Thought Outline In ER
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Assess ABC's. Make Diagnosis.
Severity of Illness. Stage of Illness. Evaluate Treatment. Making diagnosis comes from taking all info from the interiview and physical exam, understanding mechanism of the disease, assessing risk factors, and complications of this process. Use all this to decide next step. |
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Pharyngitis Symptoms and ABC
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Symptoms such as stridorus breathing, air hunger, toxic apperance, and drooling with inability to swallow indicate dangerous situations
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Important DDx of Pharyngitis
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Most common GABetaS. Also rule out HIV and Infectious mononucleolis. Common other causes are viral. Peritonsillar abcess, epglottis, Ludwig Angina and retropharyngeal abcess. These last ones much be ruled out to prevent airway complications.
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Centor Criteria for Streptococcal Pharyngitis
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+1 for exudate
+1 for swollen anterior lymph nodes. +1 fever by history. +1 abscence of cough. +1 Age less than 5 +4 Treat antibiotics. 2-3+ +RAT treat, -RAT no antibiotics. 0-1 no antibiotics. |
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Treatment of GAS Pharyngitis
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10 day course of Penicillin V 500mg.
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Diagnostic Steps in MI
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Cardiac monitor. Establish IV access. ECG. Chest X-Ray (rule out other causes of chest pain and confirm pulmonary edema). Cardiac Enzymes.
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Immediate Therapies in MI
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Oxygen. Nitroglycerin. IV beta blockers, LWMH. Antiplatelet agents.
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Treatments with Proven Benifit for MI
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Asprin. PCI. Thombolytics. Beta blockers. ACEI. Cholesterol lowering drugs.
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Causes of Atrial Fibrillation
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Cardio: Hypertension, rheumatic heart disease, and cardiomyopathy.
Lung: PE, COPD, Pulmonary Hypertension. Systemic Disease: Diabetes and thyroid Holidaty heart. Idopathic |
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Managment of A. Fib
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If patient is unstable begin cardioverision. If patient is stable evaluate if this first time a. fib or PAF. If first time and less than 48 hrs perform early cardioversion and assess for anticoagulation. If first time and longer than 4 hours. Give coumidin and convert in 3 weeks or TEE and heparin. Coumdin can be give 4 weeks after to prevent future clots
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Cardioversion and Anti-arrythmics
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Only 20 to 30% of patients remain in NSR with out antiarrythmic. With antiarrythmic therapy 40% with remain in NSR for a year
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Need for Anticoagulant after A. fib
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If no risk factors than Asprin can be given. If high risk factor present then coumadin is given. If more than one moderate risk factor than coumadin is given. One moderate comoudin or asprin can be given.
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Moderate Clotting Risk Factors and A. Fib
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>75. Hypertenstion. Heart failure. LV ejection <35. DM.
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High Risk factors and A. Fib
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Previous Stroke. TIA. Mitral Stenosis. Prosthetic heart valve.
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Diltiazem
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Is a CCB that is a rythmn control drug that can be used for the initial managment for a. fib with rapid ventricular response
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Antiarrythmics and A. Fib
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Block AV node conduction to slow ventricular response. Digoxin. Diltiazem. Verapamil. Amiodarone.
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