• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/224

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

224 Cards in this Set

  • Front
  • Back
Sx's of thyrotoxicosis
tachycardia, congestive heart failure, wide pulse pressure, tremor, thyrotoxic stare, thyromegaly, nervousness, weight loss, and palpitations
In thyroid storm, which drugs do you give and in what order?
1) PTU
2) SSKI (iodine)
3) O2, diuretics and steroids if in heart failure d/t thyrotoxicosis
Don't give iodine 1st cause PTU organifies it.
4 common hypothryroid lab findings (not TSH or T4)
mild normochromic, normocytic anemia, hyperglycemia, resp acidosis f/ hypoventilating, hypercholesteremia
Big four metabolic effects of adrenal insufficiency?
Hyponatremia
Hyperkalemia
Hypoglycemia
Hypercalcemia
Solutions (KapCH9)

What does IP=Ksp mean?
Saturated, it has reached dynamic EQ of precipitaiton and dissolution

THINK Q and Keq

Q> Keq -----soln is saturated
Q<Keq------soln is unsat
Q=Keq------equal
What BMP test can differentiate DKA from HHNC (formerly HONKS)?
Bicarb is <10 in DKA and >15 in HHNC
DKA pts are severely lacking these three substances, although lab tests will not show any deficit?
K+, Mg, Phosphorus
How is fluid deficit corrected in HHNC?
Half of the fluid deficit should be replaced over the first 8 hours, and the remainder over the ensuing 24 hours
Alcoholic comes in with hypoglycemia...why isn't glucagon an effective tx?
Glucagon is ineffective in patients without adequate glycogen stores, as would be expected in alcoholics.
Four ocular findings in hypertension?
-arterio-venous nicking
-linear (flame-shaped) hemorrhages
-hard exudates
-optic disk edema
What antihypertensives can give the pt a lupus-like syndrome?
hydralazine and procainamide
6 big risk factors for Pregnancy Induced Hypertension
1) less than 20 years old,
2) primigravidas,
3) have twin or molar pregnancies,
4) hypercholesterolemic,
5) smokers
6) positive for family history of PIH
Initial tx for presumed AAA?
combination of a beta-blocker and a vasodilator (i.e. esmolol and nitroprusside)
Three contraindications to LP?
Increased ICP, coagulopathy/thrombocytopenia, cellulitis
4 parts of the FAST Scan?
Subxiphoid view
RUQ view--Morrison's pouch
LUQ view--Subphrenic/Splenorenal
Pelvic view--Pouch of Douglas
5H's of PEA?
Hypovolemia
Hypoxia
Hydrogen Ions (acidosis)
Hypothermia
Hyperkalemia
5Ts of PEA?
Tablets (Drug OD)
Tamponade (cardiac)
Tension pneumo
Thrombosis (PE)
Thrombosis! (ACS)
Best chance of successful resuscitation with what rhythm?
Vfib
What's pulsus paradoxus and when do you find it
Systolic drop in BP of 10 mmHg, seen in severe asthma exacerbation
Early asthma attack shows what metabolic disturbance? Late in the attack?
Early: Resp Alkalosis
Late: Resp Acidosis-->Metabolic acidosis (mms tire, pt "normalizes" then goes acidotic)
2 high risk cancers for PE?

3 Low risk?
High: Colon / Ovarian
Low: Esophageal, ovarian, leukemia
Short PR interval on EKG, think:
WPW (or other cause of early repol)
Long PR interval on EKG, think:
1st degree AV block
Wide QRS on EKG, think:
Slowed ventricular conduction velocity...often RBBB or LBBB
P-wave greater than 2.5mm tall on EKG, think:
Rt atrial abnormality
"M" shaped p-wave on EKG, think:
Lt atrial abnormality
Way to diagnose LVH on EKG?
Sum of V1 or V2 + V5 or V6 = 35mm or greater
R-wave 20 in any inf lead on EKG, think:
LV Strain (LV wall is depoling from outside to in, instead of inside to out)
Peaked T-waves on EKG, think:
Hyperkalemia
T-waves shapped like a wide, shallow "V" on EKG, think:
ischemia
Narrow, but irregular rhythm QRS complexes on EKG, think:
Afib
Sawtooth pattern and rate >150 on EKG, think:
Aflutter
Delta wave on EKG, think:
WPW
Precordial leads are?
V1-V6 (Start at RUS border and curve down around the heart)
Inf leads are? Artery supplying this region?
II, III, AvF
RCA
Septal leads are? Artery supplying this region?
V1, V2
RCA
Anterior leads are? Artery supplying this region?
V2, V3, V4
LAD
Lateral leads are? Artery supplying this region?
V5, V6
LAD or Circumflex (diff anatomical variants exist)
High lateral leads are? Artery supplying this region?
I, AvL
Left circumflex
How does GCS guide intubation?
Rule of thumb: GCS <8, you intubate
Best intubation sedative for trauma?
Etomidate (short acting)
Which useful sedative should NOT be used for trauma intubation and why?
Ketamine (increases ICP)
Trauma pt's BP is 190/110 with HR of 50? Dx & Tx?
CUSHING'S REFLEX (increased ICP)
1. Elevate bed
2. Hyperventilate
3) Mannitol
4) Prophylactic dilantin (in case of sz)
Blown pupil in context of trauma. What happened?
CNIII compression from transtentorial herniation 2/2 increased ICP
"Trauma series" includes what?
CXR, Pelvic film, C-spine
Neurogenic shock: first two drugs?
1) Atropine to counter unopposed vagal tone
2) Dopamine (pressorsare indicated if #1 is not sufficient)
Pneumonic for cardiac monitor leads?
White is right, smoke (black) over fire (red)

(note: the green lead goes under white on the rt side)
List 6 causes of emergent CV CP and tx of each?
1) ACS-->MONA
2) Aortic Dissection-->Esmolol & Nitroprusside
3) Tension PTX-->Needle thoracostomy then chest tube
4) PE-->Anticoagulation
5) Esophageal tear -->Surg + broad spec Abx
6) Pericardial tamponade--> pericardiocentesis
What cardiac disease gets emergent thrombolytics or PCI?
STEMI or new LBBB; Goal is thrombolytics within 30mins and PCI within 90 mins
NSTEMI diagnosed...how long do you have to give thrombolytics?
TRICK! Thrombolytics contraindicated in NSTEMI and unstable angina due to bleeding risk.
What is PCI and whats it used for?
Percutaneous Coronary Intervention...aka angioplasty in the culprit artery. Unlike plavix, this is useful in NSTEMIs and unstable angina (as well as STEMIs).
Three pathophys causes of CHF?
1) Diminished myocardial contractility
2) Valve disease
3) Increased afterload
50% of CHF exacerbations are caused by?
Myocardial ischemia
What lab test can dx CHF?
BNP > 500pg/mL (ventricle with high filling pressures releases BNP, BNP <100 rules out CHF)
Three CXR findings in CHF?
1) Heart > 50% of thoracic width
2) Cephalization of pulmonary vessels
3) Fluffy alveolar infiltrates d/t increased hydrostatic pressure in alveoli
What CHF pt's do NOT get supplemental O2 via BIPAP or CPAP?
Agonal respirations or AMS
Which B-Blocker do you give to an acute CHF presentation?
TRICK! B-blockers reduce contractility, so you only give them in CHRONIC CHF where the heart mm has adapted.
Does nitroglycerin reduce preload, afterload, or contractility?
Preload and afterload
What common drug is known for causing a wide QRS arrhythmia?
Overdose of TCAs
No P-wave infront of QRS w/regular R--R interval on EKG, think:
SV-Tach
You see a fast QRS arrhythmia but can tell what it is...next step?
Give adenosine to slow it down. Its either ST, SVT, or Aflutter
Pneumonic for Afib causes?
P--PE, pneumonia, pericarditis
I--Ischemia
R--Rh heat disease
A--Alcohol
T--Thyrotoxicosis
E--Endocrine or Enlarged atria
S--Sepsis, stress (fever)
Symptomatic bradycardia, treat with?
ATROPINE (later a pacemaker)
Treat STABLE unknown wide complex tachycardia with?
Amiodarone (choice #2 is procainamide)
Where do 90% of dissections occur?
Ascending aorta
Diagnostic test of choice for suspected unstable dissectiong aorta?
TEE
Sudden syncope without prodrome, think:
Arrhythmia
What's Brugada syndrome?
RBBB with ST elevation in V1-3 (prone to developing Vtach)
Chronic dyspnea is almost certainly d/t one of these four causes?
Asthma
COPD
CHF
Interstitial Lung Disease
A-a gradient formula?
150-[pO2 + (pCO2 / 0.8)]
Asthma sx's are produced by these three changes induced by inflammatory mediators?
1. Bronchoconstriction
2. Mucus hypersecretion
3. Airway edema
What IV meds are indicated in life threatening asthma exacerbation?
Terbutaline or epi SQ (avoid if hx of ischemic heart disease)...remember B-agonists and steroids are still the mainstays of tx
Pneumonia tx for age < 60 otherwise healthy?
Doxy 14days or Levoflox 14days or Z-pack
Pneumonia tx for age > 60 or with co-morbidities?
Augumentin 14days or levoflox 14days
Pneumonia tx for inpatient community acquired pneumonia?
3rd gen cephalosporin + macrolide (i.e Ceftriaxone + Zpack)
Pneumonia tx for Inpatient community acquired pneumonia?
3rd gen cephalosporin + macrolide (i.e Ceftriaxone + Zpack)
Pneumonia tx for aspiration pneumonia?
Cefoxitin or Clinda +aminoglycoside
Pneumonia tx for neutropenic or nosocomial pneumonia?
Zosyn (anti-pseudomonal) and Levoflox
Pneumonia tx for HIV pt with low titers?
Prednisone before Abx, them Bactrim
Tx small stable pneumothorax with?
3-4 L/min Oxygen (it speeds up the reabsorption 4-fold)
In pneumothorax trachea deviates to ________side?
Contralateral
When are D-dimers useful in terms of PE?
Use D-dimer ONLY to rule out very low risk patients (risky way to get someone out of the ED-->be prepared to act on a positive D-dimer if you get that result)
Epigastric pain suggests pathology in?
stomach to duodenum + bilary tree and pancreas
Periumbilical pain suggests pathology in?
Distal duodenum to transverse colon
Suprapubic pain suggests pathology in?
Distal transverse colon, rectum, urogeintal tract
Parietal pain suggests pathology in?
the peritoneum (or visceral pathology has progressed to the point that its irritating the peritoneum)
Sudden pain awaken pt from sleep, think:
ruptured viscus or vascular event
Abd pain worsens with coughing, think?
peritonitis
Diff dx: Epigastric pain
pancreatitis
biliary colic
choledocholithiasis
cholecystitis
PUD
gastritis
hepatitis
Diff dx: periumbilical pain
Appy (early), enteritis, IBD
Diff dx: Suprapubic pain
Appy (late)
diverticulitis (though usually LLQ)
UTI
PID
Ectopic pregnancy
teste torsion
What common complaint often occurs in patients with DKA and patient with hypercalcemia?
Non-specific abdominal pain
No urobilinogen on UA suggests?
Complete common bile duct obstruction
Key UA finding in DKA?
ketones!
PUD acute tx?
"GI cocktail": Maalox, Donnatal, & viscous lidocaine (NO h2 blockers)
Best pain relief for tube squeezing on hard object pain (ie biliary colic or nephrolithiasis)?
Toradol (ketorolac)-->DON'T use if PUD or AAA suspected, cause its an NSAID
Rovsing's sign?
RLQ pain on palpation of LLQ
Psoas sign?
pain when lifting thigh against resistance
Obturator sign?
pain with flexion of hip/knee with internal rotation.
Describe the pain of biliary colic?
IT NOT COLICKY!!! Constant epigastic or RUQ pain for 30mins-6hrs. Also N/V & worse with fatty meals
Murphy's sign?
Press RUQ and ask pt to breathe in. Positive when breath is arrested d/t pain
What does coffe ground emesis tell us about a GI bleed?
Its partially digested blood, so the bleed has likely slowed or stopped.
Top three causes of UGI bleeds?
PUD, gastritis, varices
Top three causes of LGI bleeds?
Diverticulosis, IBD, Hemorrhoids (CA is 4th at 9%)
How low will the Hb be in a massive acute GI hemorrhage?
We expect it to be low, but can actually be NORMAL if 2-3 hrs have passed and hemodilution has kicked in
Whats octreotide used for?
Slows bleedsing (give prophylactically to alcoholics with UGI bleed, even if you haven't confirmed the varices yet)
SIRS criteria?
1. Temp too high or too low
2. HR >90
3. RR >20 (or PCO2 <32)
4. WBC <4, >12, or 10% bands
SIRS vs Sepsis vs Sever Sepsis vs Septic Shock?
SIRS plus...
+ source of infection & its sepsis
+Hypotension and its severe sepsis
+End organ damage or hypotension that doesn't respons to fluid and its septic shock
Why is lactate a useful lab test in sepsis?
Surrogate marker for end-organ perfusion. Measure lactates to see if your pt is respinding to fluids (decrease lactate means good response)...Also monitor with mental status checks, BP, UOP
What tests are run one the four CSF tubes in an LP?
1) Cell count + differential
2) Gram stain, culture
3) Glucose + protein
4) Repeat cell count
What's erysipelas and who gets it?
Strep pyogenes skin infection involving the lymph system; common in children and older adults; usually on the legs (but can be on the face)
When does HIV seroconversion occur?
3-8 wks after exposure
Physcial signs on an HIV pt with CD4 count <500?
-lymphadenopathy
-oral candidiasis
-ITP
-hairy leukoplakia
Diseases CAUSED by HIV antiretroviral tx?
Kidney stones and pancreatitis
HIV pt with LDH>220 and SOB...dx?
PCP pneumonia
What's ALC and why is it useful?
ALC (abs lymphocyte count)= WBCs x % lymphocytes...value <200 predicts a CD4 count <200
Tx for CMV retinitis in HIV?
IV gancyclovir
When in life do people get kidney stones?
30s-50s
What race gets the most kidney stones?
Whites
Four likely areas a kidney stone will form?
Renal calyx,
uretopelvic junction,
pelvic brim,
uretovesicular junction
Peritonitis pts body position is _______, while kidney stones body position is _______?
Absolutely still
Writhing in pain
Stone sx's with urine pH >7.6 suggests?
Urea-splitting organisms (proteus) as the cause
Above what creatinine should pt's not receive IV contrast?
2 mg/dL
Conceptually a urinary obstruction with infection is similar to __________?
An abscess! Consult urology to drain it (percutaneous nephrostomy or tubes)
Most people experience testicular torsion at what age?
Puberty (note: 10x more likely with undescended testes)
When do you run the risk of losing the teste in testicular torsion?
>6 hrs
2 key findings in testicular torsion phys exam?
One teste higher than other
No cremasteric reflex
What's Prehn's sign?
Relief of teste pain with elevation of the testicle (usually a sign of orchitis rather than torsion)
How do you fix teste torsion?
540 degree rotation (1.5 twists) laterally (like opening a book)
Define Balanoposthitis?
Inflammation of glans penis AND the foreskin
Define Phimosis?
Can't retract foreskin, may cause urinary retention
Define Paraphimosis?
Foreskin stuck backward, so you can move it distally over the glans (EMERGENCY!)
What disease is a risk factor for balanoposthitis?
Diabetes (in fact it may be the 1st presenting sign of DM)
Tx for phimosis?
Triamcinolone for 6-8 wks (a topical steroid)
At ___wks the uterus is at the ____?

At ___ wks its at the ___?
12 weeks, pubic symphysis
20 weeks, umbilicus

(rules of thumb for fundal height)
4 findings on US that should give you high suspicion of an ectopic?
1. Non-cystic adnexal mass
2. Fluid in the cul-de-sac
3. Extrauterine gestational sac
4. Empty uterus with B-HCG >1000
Define pre-eclampsia?
HTN & proteinuria in a pregnant pt more than 20 wks gestation
Name 7 risk fators for pre-eclampsia
1. Nulliparity
2. Age >40
3. Mult gestations
4. Gestational trophoblastic disease
5. obesity
6. Black
7. Previous preeclampsia
Name 2 CBC findings that suggest HELLP syndrome?
1) Schistocytes on smear
2) Platelets <150
Tx for pre-eclampsia?
-O2
-Left lat decub position
-Foley to measure UOP
-Hydralazine/labetalol for BP control
-MgSulfate for sz prophylaxis
-DELIVERY!
What side effects occur at what levels of MgSulfate?
Therapeutic = 5-8
Loss of DTRs = 8-12
Resp depression = 15-17
Cardiac arrest = 30-15
Dark nitrazine paper on pelvic exam means?
Rupture of amniotic membranes.
What do you do if you feel ubilical cord on bi-manual exam?
Don't remove your hand, just elevate the babies head to prevent further compression and rush to C-section
What extremely common adult complaints (x2) are highly suggestive of serious pathology in children?
Headaches and backaches
Top 3 bacterial pathogens age 0-1month?
GBS, E.Coli, Listeria monocytogenes
Irritability and bulging fontanelle in an infant, think:
Meningitis!
Sick febrile child with petechiae or purpura, think:
Meningococcemia
Barking cough, inspiratory stridor, and fever, think:
Croup
Bronchiolitis in kids age 2-6 months is a major risk factor for?
Developing asthma
Name the viral URI pathogens for fall, winter, and spring?
Fall: Parainfluenza
Winter: RSV
Spring: Influenza
Narrow part of the airway for adults? For kids?
Adults: vocal cords
Kids: Crocoid cartilage
Infants less than 4 months breathe how?
Obligate nose breathers
Location of pathology with inspiratory stridor?
Sub-glottic/glottic obstruction above the larynx
Location of pathology for Nasal flaring, dysphonia, hoarseness?
Upper airway obstruction...also look for supraclavicular or subcostal retractions when breathing
Location of pathology for Expiratory stridor
Obstruction below the larynx in bronchi or lower trachea...also look for INTERcostal retractions when breathing
What do you think when an infant is grunting?
severe respiratory distress
Xray finding: Thumbprint sign?
Epiglotittis
Xray finding: Steeple sign?
Croup
Xray finding: Wide retropharyngeal space?
Retropharyngeal abscess
Tx croup with (x3)?
Humidified H2O, Dexamethasone, Racemic epinephrine (nebulized)
Most volvulus occurs when?
1st month of life
Most intussusception occurs when?
<age 2
Peak incidence of appy is when?
10-12 yrs
What does vomitting before the onset of abdominal pain suggest?
More benign process like gastroenteritis
Intermittent abd pain and currant jelly stools, think:
Intussusception
Most NEC occurs when?
1st month of life
Xray finding: Double bubble sign?
Volvulus
ECF is composed of (x3):
ICF is composed of (x3):
ECF: Sodium, Bicarb, Cl-
ICF: K+, Phosphate, proteins
Osmolarity formula?
2 (Na) + BUN / 2.8 + Glucose / 18
2 / 4 of these clinical signs means that a kid is dehydrated
Ill appearence
Absence of tears
dry mucous membranes
delayed cap refill
In children, how do you replace fluid for hypotonic, hypertonic, and isotonic dehydration?
Hypotonic (Na<130) = 0.9NS
Hypertonic (Na>150) = D5 1/4 NS-->D5 1/2 NS
Isotonic = D5 1/2 NS
Otitis media bugs (x3)?
Hemophilus, strep, moraxella
What Abx do you use for acute otitis externa?
TRICK! Use Abx only for AOM
Besides exposure, what 3 key features of a toxic substance determine its toxicity ?
Absorption, Distribution, Elimination
Toxidrome for Opiods? Antidote?
CNS depr, miosis (pinpoint), resp depression

Naloxone, ventilation
Toxidrome for sympathomimetics (cocaine, meth)?
Antidote?
Psychomotor agitation, mydriasis, diaphoresis, tachycardia, hypertension, hyperthermia

Cooling, benzos, hydration
Toxidrome for Cholinergics (organophosphate, insecticides)?
Antidote?
Salivation, lacrimation, urination, defecation, diaphoresis, mms fasciculations, weakness

Atropine, intubate, pralidoxime
Toxidrome for Anticholinergics (atropine, scopolamine, jimson weed)?
Antidote?
AMS, mydriasis, dry/flushed skin, no poop or pee, dry mucous membrane

cooling, benzos, physostigmine if applicable
Toxidrome for: salicilates
Antidote?
AMS, resp alk, met acidosis, tinnitus, tachycardia, diaphoresis, N/V

MDAC (charcoal), alk of urine w/ K+ repletion
Toxidrome for: Hypoglycemia
Antidote?
AMS, diaphoresis, tachycardia, hypertension

Glucagon, glucose, octreotide
Toxidrome for: Serotonin Syn
Antidote?
AMS, incr mm tone, hyperreflexia, hyperthermia

Cooling, benzos, supportive
MIOTIC agents?
C: Cholinerics, clonidine
O:Opiods, Organophosphates
P:Phenothiazine
S:Sedative hypnotics
MYDRIASIS agents?
A: Antihistamines
A: Antidepressants
A: Atropine (anticholinergics)
S: Sympathomimetics
Antidote for Tylenol?
N-acetylcysteine
Antidote for cyanide?
Sodium nitrate, thiosulfate
Antidote for methanol?
Folic acid, leucovorin
Antidote for Ca channel blocker or Bblocker?
Glucagon
Antidote for Refractory hypoglycemia?
Octreotide
Antidote for heparin?
protamine
Antidote for isoniazid?
Pyroxidine
Antidote for anticoagulants?
Vitamin K
Name 3 toxic alcohols and where you find them and what they're converted to?
1) Isopropanol, rubbing alcohol, acetone
2) methanol, windsheild fluidformic acid
3) ethylene glycol, antifreeze, glycolic acid and oxalic acid
Why a rectal exam with isopropanol ingestion?
Hemorrhagic gastritis
Whats your osmol gap with toxic ETOH ingestion?
increased (more importantly you anion gap is elevated)
Tx for toxic ETOH ingestion if acidemia, eye impairment or renal damage?
Dialysis!
Chronic salicylate poisoning mimics ____?
Sepsis
Add three drops to ____to urine in salicylate poisoning and it turns ______?
Ferric chloride, purple
Whats the O2 sat in CO poisoned pts?
FALSELY normal or even high, need to get a serum lactate (>10 is danger zone)
Temp range for mild, mod, severe hypothermia?
Mild; 89.6 - 95.0
Mod: 86.0 - 89.5
Sev: < 86.0
Why are hypothermic pts often hyperglycemic?
Cold-induced DECREASE in insulin secretion (tx by rewarming, do not give insulin)
EKG finding of hypothermia?
Osborn J wave;wide positive deflection at end of QRS complex (QRS looks like lower-case "h")
First step in shock tx?
O2 (even before fluids)
Pt in schock with low BP is given 2L fluid but BP is still low...next step?
pressors
Neurogenic shock tx?
IVF, Steroids, pressors, immobilizations...NOT BLOOD, you gotta be careful not to fluid overload these guys
Phalen's sign?
CTS sx's after wrist flexion for 2mins
Tinel's sign?
CTS sx's after tapping on the wrist
Greenstick fracture def?
Incomplete angled fracture of the long bones (more common in kids)
Most common fracture i the foot (scientific name), mechanism?
Calcaneous (heel bone) from compression from jumping down far heights
Jones fracture def?
5th metatarsal tuberosity fracture
Name Ottawa ankle rules and their utlity?
Get an Xray if any of these 4 are present?
-Can't walk 4 steps after accident
-Can't walk 4 steps in ED
-Tender on medial malleolus
-Tender on lateral malleolus
Define felon?
Swollen distal finger, feels tight and warm d/t compartment syndrome from atraumatic injury-->tx w/ I&D
Clinical exam sign suggesting that hypothermia is mod or severe?
Absence of shivering
90% of fatal anyphylaxis is due to ?
penicillin
What are lightening burns like?
Non-existent...lightening rarely leaves burns. Note: High voltage electricity burns on the other hand manifest with DEEP BURNS
Bizz-Buzz Hypertensive Drugs. What do you treat HTN for each disease with?
1. Hemorrhagic Stroke
2. Pregnancy/Pre-eclampsia
3. Cocaine OD
4. Aortic Dissection
5. Pulmonary Edema
1. Nicardipine
2. Labetalol or Hydralazine
3. Benzos or Phentolamine
4. Esmolol + Nitroprusside
5. Nitroglycerin
What is the CHESS mnemonic and what is it for?
Guides you in identifying high-risk syncope.
C-->CHF
H-->Hct < 30 (Hb < 10)
E--> EKG changes
S--> SBP<90
S--> SOB
5 subtle things you MUST look for on a syncope EKG (VT/VF are obvious:)
1. Ischemia
2. Brugada
3. WPW
4. QT prolongation
5. Hypertrophic cardiomyopathy
2 big risk factors for aortic dissection? and 3 rare but real risk factors.
1. Long term HTN
2. Connective tissue disorder (marfans)
---
3. Bicuspid aortic valve
4. Pregnancy
5. Coarctation
What are the complications (very general) for the following MI locations?

1. Anterior (3)
2. Posterior (1)
3. Right-Sided (1)
4. Inferior (1)
1. Anterior -- Cardiogencic shock; Valve ruptures/CHF, BAD bradycardias
2. Posterior --High rate of missed MI's
3. Right-Sided--Hypotension
4. Inferior--Blocks (usually benign--i.e. Mobitz 1)
What are the EKG findings in V1-V6 in a right sided or Posterior STEMI?
ST depressions! (don't think its just an NSTEMI--have to prove it with Rt sided EKG or posterior EKG)
What 4 EKG findings should make prompt you to get a Rt Sided EKG?
Right sided MI is the EVIL TWIN of the more benign inferior MI. Get rt sided leads if:
1. Any inferior MI
2. ST elevation in III > II
3. ST elevation in V1 > V2
4. ST depression in V2 and not V1
What are the causes of pancreatitis (hint: clever mnemonic)
Gall stones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion venom
Hyperlipidemia, hypothermia, hyperparathyroidism
ERCP
Drugs (valproic acid, azathioprine)
What are the four types of renal casts and what diseases are associated with each (hint: one is non-specific)
1. Hyaline cast: Non-specific
2. RBC cast: Glomerulonephritis
3. WBC Cast: Pylonephritis; Interstitial nephritis
4. Brown Granular Cast: ATN
Formula for Cuffed ETT in Peds?
Formula for Uncuffed ETT in Peds?
Cuffed : (age / 4) + 3.5
Uncuffed : (age / 4) + 4.0