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40 Cards in this Set

  • Front
  • Back
L MCA stroke results in?
face and arm weakness>leg and aphasia if left is dominant (80%)
Crossed deficits with stroke implies what vessel involvement?
vertebral nd basilar: ipsilateral CN w contralateral motor.
Management of suspected stroke?
O2, withould thrombolytics until CT is done. Elevated bed to decrease ICP. workup clotting abnormalities and neurosurg consult if evacuation needed
Management of TIA?
aspirin and admit for workup of etiology
at what GCS score is endotrach performed?
<9
treatment of status epilepticus?
IV lorazepam, then phenytoin, then pheno and intubate, then propofol, EEG and neuro consult.
Isoniazid tox may present how and how to reverse?
seizure and status epi; tx with 5g pyridoxine
Seizures; who to admit?
those in status, first timers with secondary cause
seizures; who to discharge?
first timers with no secondary cuase, normal MS, or those with known but subtherapeutic drug levels.
Brief history for those in trauma?
AMPLE: allergies meds, PMH, last meal, events before trauma
Fluid replacement should be what in trauma pts?
3x EBL;
GCS score is out of how many points?
3-15; eye opening motor response verbal response...
EVM:456
GCS eye opening to pain, how many pts?
2
GCS motor response withdrawing to pain points?
4; 5 is localizing to pain
GCS inappropriate verbal respone?
3; 2 is incomprehensible
Grade 1, 2, and 3 concussions are?
1) <15 mins, 2 >15 mins symptoms, and grade 3 any LOC
Most common mechanism of spinal cord injury?
vehicular trauma, assault
most common site of c spine fracture?
C2
most common site of c spine dislocation?
C5-C6 nd C6-7
most common c spine injuries in children/eldery? teenagers and adults?
C1-3 upper, while teens C6-T1
How are c spine injuries classified? which is unstable?
flexion, extension, and axial load injuries. Extension and axial load burst fractures are extremely unstable
loss of bulbocavernosis reflex suggests?
complete cored injury
Childresn with neuro deficits but normal initial imaging should undergo what?
MRI, they may have SCIWORA due to laxity of their spinal ligaments and bones.
Which pts are considered low prob of spinal injury and thus do not require xrays?
NEXUS SCORE <5: cervical tenderness, focal neuro, alertness, no intox, no other distracting pain
What should be given to pts with spinal cord injureis?
steroids within 3 hrs
Mechanism of blunt aortic injury?
falling from > 3 stories or deceleration injuries at >30 mPH
When does flail chest occur? Why is it deadly?
3 adjacent ribs with fractures in 2+ places; punding causes pulmonary contusion which affects respiration.
What can CXR detect after blunt trauma to chest?
blunt aortic injury, pulm contusion, hemothorax, pneumothorax, rib fractures
What is used to screen for blunt myocardial injury?
EKG: abnormalities; or CT angio in stable pts.
What is Kehr's sign?
pain in shoulder that is not associated with acual shoulder pain; means spleen or liver laceration and blood irritating diaphram.
Indications for laparotomy after abdominal trauma?
unstable vitals, positive FAST, positive DPL, postiive CT, free air gross blood, retained stuff etc
Fluid requirement for burns?
FOUR ml/mg x TBSA percent FOUR FLUIDS FOR BURNS; half in first 8 hrs rest in next 16 hrs
criteria for transfer to burn center?
thrid degree, >10% TBSA, chem electrical inhilation burns.
first second and thrid degree sprins?
streching, partial and complete ligament tears
When to admit for lower extremity emergency?
if potential for compartment syndrome and fat embolism
Pt with pain radiating down both legs and bowel bladder dysfunction should get:
MRI to r/o cauda equina syndrome
end result of compartment syndrome?
volkmann's ischemic contractures; muscle contractures
most sensitive sign for compartment syndrome?
pain with passive stretching of muscle; then sensory loss pulselessness nad pallor are LATE findings
how to measure compartment pressures?
stryker STIC device. elevated is > 10 , admit; > 30 fasciotomy is indicated
angioedema from ACEI; how to treat?
FFP to replace enzyme that breaks down bradykinin; otehrwise discontinuing will lead to resolution in 24-48 hrs.