Em - To Page 100

Front 1

CI to I&D?

Back 1

pulsatile mass, inability to cheive analgeis, rpoximity to neurovascular structures or tendon

Front 2

CI to ABG?

Back 2

bleeding diathesis, thrombolytics, peripheral vascular disese, skin abnormal

Front 3

CI to central venous access?

Back 3

coagulopathy if subclavian; it is relative CI if other sites

Front 4

CI to procedural sedation?

Back 4

ASA class II-IV (severe disease with functional limitation), meal within 4 hrs, intoxication

Front 5

what drug gives both analgesia and sedation?

Back 5

ketamine; fentanyl only mild sedation

Front 6

what drug is fast acting and gives amnesia and sedation?

Back 6

etomidate; watch for myoclonus

Front 7

side effect of fentanyl

Back 7

does not induce hypotension like others but rigid chest syndrome and facial pruritis can occur; reverse with naloxone

Front 8

midazolam side effects?

Back 8

respiratory depression, hypotension

Front 9

effects of midazolam

Back 9

amnesia, sedation.

Front 10

reversal of too much midazolam?

Back 10

versed.

Front 11

When is flumazenil contraindicated?

Back 11

polysubstance abusers, TCA users, seizure disorder, alocholics

Front 12

if naloxone fails to relieve rigid chest syndrome, what to do?

Back 12

succinylcholine and PPV

Front 13

Most common adverse events in procedural sedation?

Back 13

desat, vominiting, apnea, laryngospasm

Front 14

CI to lumbar puncture?

Back 14

cellulitis over site, increased ICP

Front 15

Normal CSF opening pressure?

Back 15

10-20mmHg, much like in the eye; >40 for pseudotumor cerebri

Front 16

When does post-LP hjeadache begin and how to treat?

Back 16

24-48 hrs after and treat with iv fluids, caffiene, antiemetics

Front 17

headache lasts > 1 week after LP, what to do?

Back 17

suspect subdural hematoma due to tearing of beigns from decreased CSF

Front 18

max dose of lidocain without epi?

Back 18

4 mg/kg, around 28 mL of 1% in a 70 kg man

Front 19

Suture removal for face?

Back 19

3-5 days

Front 20

suture removal time for extremities, torso and scalp

Back 20

7-10 days

Front 21

suture removal time for hand, back, butt, foot and joints?

Back 21

10-14 days.

Front 22

FAST scan views?

Back 22

sobxiphoid, morison's pouch/hepatorenalfossae, splenorenal space, pubic symphysis looking at retrovesicular or retrouterine pouch of douglas

Front 23

first thing to do while patient is unresponsive?

Back 23

ABC and start CPR while attaching defibrillator

Front 24

what to do if in VF or VT?

Back 24

defib, airway, IV, epie or vasopressin///consider antiarrhythmics LAMP: lido, amiodarone, mag, procainamide

Front 25

What to do if PEA?

Back 25

epi, epi, find etiology and atropine if PEA is slow

Front 26

Waht to do if asystole?

Back 26

epi or atropine, call code if doesn't work.

Front 27

What are risk factors for challenging airway?

Back 27

overbit, small mouth, short neck

Front 28

What dictates type of airway intervention if pt is failing to oxygenate?

Back 28

orotrachial if unconsciens; RSI if conscious with easy airway; LMA or fiberoptic if difficult

Front 29

type of airway intervention in unconscience patient?

Back 29

orotracheal.

Front 30

RSI steps?

Back 30

prep, proxygenate, pretreat with pancuroniam and lido to prevent lanyngospasm; iunduction with sedation,paralysis and protection w sellick maneuver, placement and confirmation with ascultation

Front 31

succinylcholine CI in?

Back 31

ppl with hyperkalemia or denervated musculature ie guillan barre or SC injury

Front 32

management of neurogenic shock?

Back 32

dopamine or atropine as pressors

Front 33

management of all shock?

Back 33

ABC, esp O2 to decrease respiratory muscle O2 consumption

Front 34

management of shock due to PE?

Back 34

HOLD FLUIDS, NE for pressors

Front 35

treatment of cardiogenic shock?

Back 35

fluids only! no Bblockers, ACI etc, NE if bp <70, correct pump via PCI

Front 36

Unilateral loss of breath sounds, chest pain. What to do?

Back 36

needle decompression; 2nd intercostal at midaxillary line

Front 37

all pts with ACS should be given?

Back 37

Mona; morphine, oxygen, nitroglycerin, aspirin

Front 38

Management of aortic dissection?

Back 38

immediate Bblocker ie esmolol or labetalol and nitroprusside to reduce BP

Front 39

What to do if suspect ischmia?

Back 39

bblock, nitro, anticoag, consult cards for cardiac cath - TIMI score

Front 40

Pt with elevated troponin. What to do?

Back 40

B-blocker, heparin, consult cards, clopidogrel if hospital without PCI capabilities.

Front 41

tachyarrythmia that is fas, narrow, and regular: how to distinguish?

Back 41

administer adenosine to slow down rate to see diagnosis

Front 42

two types of irregular rhythms?

Back 42

afib and MAT

Front 43

tx for symptomatic bradycardia?

Back 43

atropine IVP and pacemaker

Front 44

After stabilizing suspected dissection, how to diagnose?

Back 44

Chest CT angio or TEE bedside if unstable.

Front 45

Treatment of stanford type A vs B dissection?

Back 45

A- HR/BP control and surgical management;
B - pulse BP control ONLY

Front 46

Hypertensive mergency defined as?

Back 46

sudden increase in BP with acute endorgan damage aka malignant hypertensive and hypertensive crisis

Front 47

hypertensive urgency is?

Back 47

elevated BP, chronic end organ damage but WITHOUT acute end organd damage (not emergent, but urgent!)

Front 48

Goal if HTN emergency?

Back 48

reduce MAP by 20% in first 30 mins (1/3 SBP + 2/3 DBP)

Front 49

prolonged use of nitroprusside?

Back 49

cyanide toxicity.