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224 Cards in this Set
- Front
- Back
Sx's of thyrotoxicosis
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tachycardia, congestive heart failure, wide pulse pressure, tremor, thyrotoxic stare, thyromegaly, nervousness, weight loss, and palpitations
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In thyroid storm, which drugs do you give and in what order?
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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. |
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4 common hypothryroid lab findings (not TSH or T4)
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mild normochromic, normocytic anemia, hyperglycemia, resp acidosis f/ hypoventilating, hypercholesteremia
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Big four metabolic effects of adrenal insufficiency?
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Hyponatremia
Hyperkalemia Hypoglycemia Hypercalcemia |
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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 |
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What BMP test can differentiate DKA from HHNC (formerly HONKS)?
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Bicarb is <10 in DKA and >15 in HHNC
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DKA pts are severely lacking these three substances, although lab tests will not show any deficit?
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K+, Mg, Phosphorus
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How is fluid deficit corrected in HHNC?
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Half of the fluid deficit should be replaced over the first 8 hours, and the remainder over the ensuing 24 hours
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Alcoholic comes in with hypoglycemia...why isn't glucagon an effective tx?
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Glucagon is ineffective in patients without adequate glycogen stores, as would be expected in alcoholics.
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Four ocular findings in hypertension?
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-arterio-venous nicking
-linear (flame-shaped) hemorrhages -hard exudates -optic disk edema |
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What antihypertensives can give the pt a lupus-like syndrome?
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hydralazine and procainamide
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6 big risk factors for Pregnancy Induced Hypertension
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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 |
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Initial tx for presumed AAA?
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combination of a beta-blocker and a vasodilator (i.e. esmolol and nitroprusside)
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Three contraindications to LP?
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Increased ICP, coagulopathy/thrombocytopenia, cellulitis
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4 parts of the FAST Scan?
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Subxiphoid view
RUQ view--Morrison's pouch LUQ view--Subphrenic/Splenorenal Pelvic view--Pouch of Douglas |
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5H's of PEA?
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Hypovolemia
Hypoxia Hydrogen Ions (acidosis) Hypothermia Hyperkalemia |
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5Ts of PEA?
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Tablets (Drug OD)
Tamponade (cardiac) Tension pneumo Thrombosis (PE) Thrombosis! (ACS) |
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Best chance of successful resuscitation with what rhythm?
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Vfib
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What's pulsus paradoxus and when do you find it
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Systolic drop in BP of 10 mmHg, seen in severe asthma exacerbation
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Early asthma attack shows what metabolic disturbance? Late in the attack?
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Early: Resp Alkalosis
Late: Resp Acidosis-->Metabolic acidosis (mms tire, pt "normalizes" then goes acidotic) |
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2 high risk cancers for PE?
3 Low risk? |
High: Colon / Ovarian
Low: Esophageal, ovarian, leukemia |
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Short PR interval on EKG, think:
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WPW (or other cause of early repol)
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Long PR interval on EKG, think:
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1st degree AV block
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Wide QRS on EKG, think:
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Slowed ventricular conduction velocity...often RBBB or LBBB
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P-wave greater than 2.5mm tall on EKG, think:
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Rt atrial abnormality
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"M" shaped p-wave on EKG, think:
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Lt atrial abnormality
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Way to diagnose LVH on EKG?
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Sum of V1 or V2 + V5 or V6 = 35mm or greater
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R-wave 20 in any inf lead on EKG, think:
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LV Strain (LV wall is depoling from outside to in, instead of inside to out)
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Peaked T-waves on EKG, think:
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Hyperkalemia
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T-waves shapped like a wide, shallow "V" on EKG, think:
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ischemia
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Narrow, but irregular rhythm QRS complexes on EKG, think:
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Afib
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Sawtooth pattern and rate >150 on EKG, think:
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Aflutter
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Delta wave on EKG, think:
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WPW
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Precordial leads are?
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V1-V6 (Start at RUS border and curve down around the heart)
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Inf leads are? Artery supplying this region?
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II, III, AvF
RCA |
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Septal leads are? Artery supplying this region?
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V1, V2
RCA |
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Anterior leads are? Artery supplying this region?
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V2, V3, V4
LAD |
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Lateral leads are? Artery supplying this region?
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V5, V6
LAD or Circumflex (diff anatomical variants exist) |
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High lateral leads are? Artery supplying this region?
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I, AvL
Left circumflex |
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How does GCS guide intubation?
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Rule of thumb: GCS <8, you intubate
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Best intubation sedative for trauma?
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Etomidate (short acting)
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Which useful sedative should NOT be used for trauma intubation and why?
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Ketamine (increases ICP)
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Trauma pt's BP is 190/110 with HR of 50? Dx & Tx?
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CUSHING'S REFLEX (increased ICP)
1. Elevate bed 2. Hyperventilate 3) Mannitol 4) Prophylactic dilantin (in case of sz) |
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Blown pupil in context of trauma. What happened?
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CNIII compression from transtentorial herniation 2/2 increased ICP
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"Trauma series" includes what?
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CXR, Pelvic film, C-spine
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Neurogenic shock: first two drugs?
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1) Atropine to counter unopposed vagal tone
2) Dopamine (pressorsare indicated if #1 is not sufficient) |
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Pneumonic for cardiac monitor leads?
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White is right, smoke (black) over fire (red)
(note: the green lead goes under white on the rt side) |
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List 6 causes of emergent CV CP and tx of each?
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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 |
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What cardiac disease gets emergent thrombolytics or PCI?
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STEMI or new LBBB; Goal is thrombolytics within 30mins and PCI within 90 mins
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NSTEMI diagnosed...how long do you have to give thrombolytics?
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TRICK! Thrombolytics contraindicated in NSTEMI and unstable angina due to bleeding risk.
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What is PCI and whats it used for?
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Percutaneous Coronary Intervention...aka angioplasty in the culprit artery. Unlike plavix, this is useful in NSTEMIs and unstable angina (as well as STEMIs).
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Three pathophys causes of CHF?
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1) Diminished myocardial contractility
2) Valve disease 3) Increased afterload |
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50% of CHF exacerbations are caused by?
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Myocardial ischemia
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What lab test can dx CHF?
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BNP > 500pg/mL (ventricle with high filling pressures releases BNP, BNP <100 rules out CHF)
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Three CXR findings in CHF?
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1) Heart > 50% of thoracic width
2) Cephalization of pulmonary vessels 3) Fluffy alveolar infiltrates d/t increased hydrostatic pressure in alveoli |
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What CHF pt's do NOT get supplemental O2 via BIPAP or CPAP?
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Agonal respirations or AMS
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Which B-Blocker do you give to an acute CHF presentation?
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TRICK! B-blockers reduce contractility, so you only give them in CHRONIC CHF where the heart mm has adapted.
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Does nitroglycerin reduce preload, afterload, or contractility?
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Preload and afterload
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What common drug is known for causing a wide QRS arrhythmia?
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Overdose of TCAs
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No P-wave infront of QRS w/regular R--R interval on EKG, think:
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SV-Tach
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You see a fast QRS arrhythmia but can tell what it is...next step?
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Give adenosine to slow it down. Its either ST, SVT, or Aflutter
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Pneumonic for Afib causes?
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P--PE, pneumonia, pericarditis
I--Ischemia R--Rh heat disease A--Alcohol T--Thyrotoxicosis E--Endocrine or Enlarged atria S--Sepsis, stress (fever) |
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Symptomatic bradycardia, treat with?
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ATROPINE (later a pacemaker)
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Treat STABLE unknown wide complex tachycardia with?
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Amiodarone (choice #2 is procainamide)
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Where do 90% of dissections occur?
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Ascending aorta
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Diagnostic test of choice for suspected unstable dissectiong aorta?
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TEE
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Sudden syncope without prodrome, think:
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Arrhythmia
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What's Brugada syndrome?
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RBBB with ST elevation in V1-3 (prone to developing Vtach)
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Chronic dyspnea is almost certainly d/t one of these four causes?
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Asthma
COPD CHF Interstitial Lung Disease |
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A-a gradient formula?
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150-[pO2 + (pCO2 / 0.8)]
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Asthma sx's are produced by these three changes induced by inflammatory mediators?
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1. Bronchoconstriction
2. Mucus hypersecretion 3. Airway edema |
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What IV meds are indicated in life threatening asthma exacerbation?
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Terbutaline or epi SQ (avoid if hx of ischemic heart disease)...remember B-agonists and steroids are still the mainstays of tx
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Pneumonia tx for age < 60 otherwise healthy?
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Doxy 14days or Levoflox 14days or Z-pack
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Pneumonia tx for age > 60 or with co-morbidities?
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Augumentin 14days or levoflox 14days
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Pneumonia tx for inpatient community acquired pneumonia?
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3rd gen cephalosporin + macrolide (i.e Ceftriaxone + Zpack)
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Pneumonia tx for Inpatient community acquired pneumonia?
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3rd gen cephalosporin + macrolide (i.e Ceftriaxone + Zpack)
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Pneumonia tx for aspiration pneumonia?
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Cefoxitin or Clinda +aminoglycoside
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Pneumonia tx for neutropenic or nosocomial pneumonia?
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Zosyn (anti-pseudomonal) and Levoflox
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Pneumonia tx for HIV pt with low titers?
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Prednisone before Abx, them Bactrim
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Tx small stable pneumothorax with?
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3-4 L/min Oxygen (it speeds up the reabsorption 4-fold)
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In pneumothorax trachea deviates to ________side?
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Contralateral
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When are D-dimers useful in terms of PE?
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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)
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Epigastric pain suggests pathology in?
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stomach to duodenum + bilary tree and pancreas
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Periumbilical pain suggests pathology in?
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Distal duodenum to transverse colon
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Suprapubic pain suggests pathology in?
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Distal transverse colon, rectum, urogeintal tract
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Parietal pain suggests pathology in?
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the peritoneum (or visceral pathology has progressed to the point that its irritating the peritoneum)
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Sudden pain awaken pt from sleep, think:
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ruptured viscus or vascular event
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Abd pain worsens with coughing, think?
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peritonitis
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Diff dx: Epigastric pain
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pancreatitis
biliary colic choledocholithiasis cholecystitis PUD gastritis hepatitis |
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Diff dx: periumbilical pain
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Appy (early), enteritis, IBD
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Diff dx: Suprapubic pain
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Appy (late)
diverticulitis (though usually LLQ) UTI PID Ectopic pregnancy teste torsion |
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What common complaint often occurs in patients with DKA and patient with hypercalcemia?
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Non-specific abdominal pain
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No urobilinogen on UA suggests?
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Complete common bile duct obstruction
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Key UA finding in DKA?
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ketones!
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PUD acute tx?
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"GI cocktail": Maalox, Donnatal, & viscous lidocaine (NO h2 blockers)
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Best pain relief for tube squeezing on hard object pain (ie biliary colic or nephrolithiasis)?
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Toradol (ketorolac)-->DON'T use if PUD or AAA suspected, cause its an NSAID
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Rovsing's sign?
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RLQ pain on palpation of LLQ
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Psoas sign?
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pain when lifting thigh against resistance
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Obturator sign?
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pain with flexion of hip/knee with internal rotation.
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Describe the pain of biliary colic?
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IT NOT COLICKY!!! Constant epigastic or RUQ pain for 30mins-6hrs. Also N/V & worse with fatty meals
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Murphy's sign?
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Press RUQ and ask pt to breathe in. Positive when breath is arrested d/t pain
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What does coffe ground emesis tell us about a GI bleed?
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Its partially digested blood, so the bleed has likely slowed or stopped.
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Top three causes of UGI bleeds?
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PUD, gastritis, varices
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Top three causes of LGI bleeds?
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Diverticulosis, IBD, Hemorrhoids (CA is 4th at 9%)
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How low will the Hb be in a massive acute GI hemorrhage?
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We expect it to be low, but can actually be NORMAL if 2-3 hrs have passed and hemodilution has kicked in
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Whats octreotide used for?
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Slows bleedsing (give prophylactically to alcoholics with UGI bleed, even if you haven't confirmed the varices yet)
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SIRS criteria?
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1. Temp too high or too low
2. HR >90 3. RR >20 (or PCO2 <32) 4. WBC <4, >12, or 10% bands |
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SIRS vs Sepsis vs Sever Sepsis vs Septic Shock?
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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 |
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Why is lactate a useful lab test in sepsis?
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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
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What tests are run one the four CSF tubes in an LP?
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1) Cell count + differential
2) Gram stain, culture 3) Glucose + protein 4) Repeat cell count |
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What's erysipelas and who gets it?
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Strep pyogenes skin infection involving the lymph system; common in children and older adults; usually on the legs (but can be on the face)
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When does HIV seroconversion occur?
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3-8 wks after exposure
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Physcial signs on an HIV pt with CD4 count <500?
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-lymphadenopathy
-oral candidiasis -ITP -hairy leukoplakia |
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Diseases CAUSED by HIV antiretroviral tx?
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Kidney stones and pancreatitis
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HIV pt with LDH>220 and SOB...dx?
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PCP pneumonia
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What's ALC and why is it useful?
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ALC (abs lymphocyte count)= WBCs x % lymphocytes...value <200 predicts a CD4 count <200
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Tx for CMV retinitis in HIV?
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IV gancyclovir
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When in life do people get kidney stones?
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30s-50s
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What race gets the most kidney stones?
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Whites
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Four likely areas a kidney stone will form?
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Renal calyx,
uretopelvic junction, pelvic brim, uretovesicular junction |
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Peritonitis pts body position is _______, while kidney stones body position is _______?
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Absolutely still
Writhing in pain |
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Stone sx's with urine pH >7.6 suggests?
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Urea-splitting organisms (proteus) as the cause
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Above what creatinine should pt's not receive IV contrast?
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2 mg/dL
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Conceptually a urinary obstruction with infection is similar to __________?
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An abscess! Consult urology to drain it (percutaneous nephrostomy or tubes)
|
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Most people experience testicular torsion at what age?
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Puberty (note: 10x more likely with undescended testes)
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When do you run the risk of losing the teste in testicular torsion?
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>6 hrs
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2 key findings in testicular torsion phys exam?
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One teste higher than other
No cremasteric reflex |
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What's Prehn's sign?
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Relief of teste pain with elevation of the testicle (usually a sign of orchitis rather than torsion)
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How do you fix teste torsion?
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540 degree rotation (1.5 twists) laterally (like opening a book)
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Define Balanoposthitis?
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Inflammation of glans penis AND the foreskin
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Define Phimosis?
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Can't retract foreskin, may cause urinary retention
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Define Paraphimosis?
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Foreskin stuck backward, so you can move it distally over the glans (EMERGENCY!)
|
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What disease is a risk factor for balanoposthitis?
|
Diabetes (in fact it may be the 1st presenting sign of DM)
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Tx for phimosis?
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Triamcinolone for 6-8 wks (a topical steroid)
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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 |
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Define pre-eclampsia?
|
HTN & proteinuria in a pregnant pt more than 20 wks gestation
|
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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 |
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Name 2 CBC findings that suggest HELLP syndrome?
|
1) Schistocytes on smear
2) Platelets <150 |
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Tx for pre-eclampsia?
|
-O2
-Left lat decub position -Foley to measure UOP -Hydralazine/labetalol for BP control -MgSulfate for sz prophylaxis -DELIVERY! |
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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 |
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Dark nitrazine paper on pelvic exam means?
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Rupture of amniotic membranes.
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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
|
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What extremely common adult complaints (x2) are highly suggestive of serious pathology in children?
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Headaches and backaches
|
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Top 3 bacterial pathogens age 0-1month?
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GBS, E.Coli, Listeria monocytogenes
|
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Irritability and bulging fontanelle in an infant, think:
|
Meningitis!
|
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Sick febrile child with petechiae or purpura, think:
|
Meningococcemia
|
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Barking cough, inspiratory stridor, and fever, think:
|
Croup
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Bronchiolitis in kids age 2-6 months is a major risk factor for?
|
Developing asthma
|
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Name the viral URI pathogens for fall, winter, and spring?
|
Fall: Parainfluenza
Winter: RSV Spring: Influenza |
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Narrow part of the airway for adults? For kids?
|
Adults: vocal cords
Kids: Crocoid cartilage |
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Infants less than 4 months breathe how?
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Obligate nose breathers
|
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Location of pathology with inspiratory stridor?
|
Sub-glottic/glottic obstruction above the larynx
|
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Location of pathology for Nasal flaring, dysphonia, hoarseness?
|
Upper airway obstruction...also look for supraclavicular or subcostal retractions when breathing
|
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Location of pathology for Expiratory stridor
|
Obstruction below the larynx in bronchi or lower trachea...also look for INTERcostal retractions when breathing
|
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What do you think when an infant is grunting?
|
severe respiratory distress
|
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Xray finding: Thumbprint sign?
|
Epiglotittis
|
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Xray finding: Steeple sign?
|
Croup
|
|
Xray finding: Wide retropharyngeal space?
|
Retropharyngeal abscess
|
|
Tx croup with (x3)?
|
Humidified H2O, Dexamethasone, Racemic epinephrine (nebulized)
|
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Most volvulus occurs when?
|
1st month of life
|
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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
|
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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?
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Osborn J wave;wide positive deflection at end of QRS complex (QRS looks like lower-case "h")
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First step in shock tx?
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O2 (even before fluids)
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Pt in schock with low BP is given 2L fluid but BP is still low...next step?
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pressors
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Neurogenic shock tx?
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IVF, Steroids, pressors, immobilizations...NOT BLOOD, you gotta be careful not to fluid overload these guys
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Phalen's sign?
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CTS sx's after wrist flexion for 2mins
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Tinel's sign?
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CTS sx's after tapping on the wrist
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Greenstick fracture def?
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Incomplete angled fracture of the long bones (more common in kids)
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Most common fracture i the foot (scientific name), mechanism?
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Calcaneous (heel bone) from compression from jumping down far heights
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Jones fracture def?
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5th metatarsal tuberosity fracture
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Name Ottawa ankle rules and their utlity?
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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 |
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Define felon?
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Swollen distal finger, feels tight and warm d/t compartment syndrome from atraumatic injury-->tx w/ I&D
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Clinical exam sign suggesting that hypothermia is mod or severe?
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Absence of shivering
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90% of fatal anyphylaxis is due to ?
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penicillin
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What are lightening burns like?
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Non-existent...lightening rarely leaves burns. Note: High voltage electricity burns on the other hand manifest with DEEP BURNS
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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 |
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What is the CHESS mnemonic and what is it for?
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Guides you in identifying high-risk syncope.
C-->CHF H-->Hct < 30 (Hb < 10) E--> EKG changes S--> SBP<90 S--> SOB |
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5 subtle things you MUST look for on a syncope EKG (VT/VF are obvious:)
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1. Ischemia
2. Brugada 3. WPW 4. QT prolongation 5. Hypertrophic cardiomyopathy |
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2 big risk factors for aortic dissection? and 3 rare but real risk factors.
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1. Long term HTN
2. Connective tissue disorder (marfans) --- 3. Bicuspid aortic valve 4. Pregnancy 5. Coarctation |
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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) |
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What are the EKG findings in V1-V6 in a right sided or Posterior STEMI?
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ST depressions! (don't think its just an NSTEMI--have to prove it with Rt sided EKG or posterior EKG)
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What 4 EKG findings should make prompt you to get a Rt Sided EKG?
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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 |
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What are the causes of pancreatitis (hint: clever mnemonic)
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Gall stones
Ethanol Trauma Steroids Mumps Autoimmune Scorpion venom Hyperlipidemia, hypothermia, hyperparathyroidism ERCP Drugs (valproic acid, azathioprine) |
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What are the four types of renal casts and what diseases are associated with each (hint: one is non-specific)
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1. Hyaline cast: Non-specific
2. RBC cast: Glomerulonephritis 3. WBC Cast: Pylonephritis; Interstitial nephritis 4. Brown Granular Cast: ATN |
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Formula for Cuffed ETT in Peds?
Formula for Uncuffed ETT in Peds? |
Cuffed : (age / 4) + 3.5
Uncuffed : (age / 4) + 4.0 |