Study your flashcards anywhere!

Download the official Cram app for free >

  • 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

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

85 Cards in this Set

  • Front
  • Back
True/False: Changes in pupillary response are an early sign of brain injury?
• Changes in pupillary response is a late sign of brain injury
• The correct answer is: False
After assessing the ABCs in trauma, what are the "DEFGs"?
• D: disability (neurologic status)
• E: exposure/environmental control
• F: foley/finger (rectal)
• G: gastric intubation/girl (pregnant?)
What are the Glascow Coma scores that suggest mild, moderate, and severe injury?
• mild: 3-8
• moderate: 9-12
• severe: 13-15
What is considered adequate urine output for an adult and child?
• Adult: 0.5 cc/kg/hr
• Child (> 1 y/o): 1.0 cc/kg/hr
• Child (< 1y/o): 2.0 cc/kg/hr
Foley is contraindicated if urethral transection is suspected. What are signs of urethral transection?
• blood at the meatus
• "high-riding" prostate
• perineal or scrotal hematoma
What test should be done if urethral transection is suspected?
retrograde urethrogram
How much fluid should pediatric patients receive IV bolus?
20 cc/kg
What is the treatment for asystole?
• transcutaneous pacing
• epinephrine
• atropine
What is the treatment for symptomatic bradycardia?
• atropine
• transcutaneous pacing (definitive tx)
• dopamine
• epinephrine
• isoproteronol

* dopamine & epi increase contractility
What is the treatment of V-tach (with a pulse)?
• Amiodarone
• Lidocaine
What is the treatment for patients with unstable atrial fib?
What are treatment options for rate control of A-Fib?
• Diltiazem (1st line?)
• Metoprolol
• Amiodarone
• Verapamil
• Digoxin
What are treatment options for rate and rhythm control for Wolf-Parkinson White?
• Rate control: amiodarone or procanamide
• Rhythm control: cardiovert only < 48 hrs
What is the treatment for PSVT?
• vagal maneuvers (1st intervetion in stable patients)
• Adenosine
• other options:
- Diltiazem
- Esmolol
- Metoprolol
- Propanolol
- Digoxin
What are the most common causes of V-tach?
• ischemic heart disease
• acute MI
What is the treatment for pulseless V-tach?
What is the treatment for unstable patients in V-tach who are not pulseless?
What are treatment options for hemodynamically stable patients (with normal cardiac function) in V-tach?
• Amiodarone
• Other options:
- sotalol
- procainamide
- lidocaine
What are treatment options for hemodynamically stable patients (without normal cardiac function) in V-tach?
• Amiodarone
• Lidocaine (alternative)
What are causes of PEA or asystole?
• P: PE
• A: acidosis
• T: tension PTX
• C: Cardiac Tamponade
• H(5): Hyperkalemia, hypokalemia, hypovolemia, hypothermia, hypoxia
• M: myocardial infarction
• D: drug overdose
What is the definition of shock?
inadequate delivery of oxygen on the cellular level secondary to hypoperfusion
What are causes of hypovolemic shock?
• hemorrhage (most common)
• burns
• diarrhea
• pancreatitis
• vomiting
What are characteristics of hypovolemic shock?
• peripheral vasoconstriction (to perfuse central organs)
• tachycardia
• narrowed pulse pressure
Describe the different classes of hemorrhagic shock
• Class I: up to 15% blood loss; up to 750 cc
• Class II: 15-30% blood loss; 750-1500 cc
• Class III: 30-40% blood loss; 1500-2000 cc
• Class IV: > 40% blood loss; > 2000 cc
Which form of shock produces a wide pulse-pressure, near-normal blood pressure, and tachycardia?
septic shock
Which form of shock produces distended neck veins, hypotension, and tachycardia?
cardiogenic shock
What are causes of cardiogenic shock?
• acute myocardial infarction
• air embolus
• blunt myocardial injury
• cardiac tamponade
• tension pneumothorax
Which form of shock produces vasodilation, hypotension, and bradycardia?
neurogenic shock
What causes neurogenic shock?
occurs when spinal cord injury causes loss of peripheral sympathetic tone
What is included in the "trauma series"?
• lateral c-spine
• AP chest
• AP pelvis
Which tools are used for rapid detection of intra-abdominal bleeding?
• diagnostic peritoneal lavage (DPL)
• focused abdominal sonogram for trauma (FAST)
Which pain medication is good for renal colic?
Which pain medication is good for treating pain with suspected gallbladder etiology?
What is the max dose of lidocaine?
• with Epi: 7 mg/kg
• w/out Epi: 4.5 mg/kg
What is the duration of action for Lidocaine?
2 hrs
What is the duration of action of Bupivicaine?
4 hrs
What is the max dose of Bupivicaine?
• w/ epi: 2 mg/kg
• w/out epi: 3 mg/kg
What parts of the body should not be injected with epinephrine?
• ears
• fingers
• nose
• penis
• toes
How can patients with metabolic acidosis clinically present?
• Abdominal Pain
• Nausea
• Vomiting
• Shock
• Tachypnea (Kussmaul)
What are causes of anion gap metabolic acidosis?
• Alcohol
• Methanol
• Uremia
• Paraldehyde
• INH/Iron
• Lactic Acidosis
• Ethylene Glycol/Ethanol
• Salicylates
What are causes of non-anion gap metabolic acidosis?
• Ureterostomy
• Small bowel fistulas
• Extra chloride
• Diarrhea
• Carbonic anhydrase inhibitors
• Adrenal insufficiency
• Renal tubular acidosis
• Pancreatic fistula
What is the expected change in PCO2 in acute metabolic acidosis?
PCO2 decreases by 1mm Hg for every 1 mEq/dL decrease in bicarbonate
What are causes of metabolic alkalosis?
• excessive diuresis
• excessive loss of gastric secretions (ex. vomiting)
How can patients with metabolic alkalosis clinically present?
• dehydration-type symptoms
• impaired oxygen delivery
• muscle irritability
• tachydysrhythmia
What are other differential diagnosis for patients presenting w/ metabolic alkalosis symptoms?
• dehydration
• excessive diuresis
• glucocorticoid administration
• hypercapnia
• hypokalemia
• increased intake of citrate or lactate
• loss of gastric acid
• severe hypoporteinemia
What are treatment options for metabolic alkalosis?
• IV fluids (normal saline)
• KCL (no faster than 20 mEq/h, unless serum K+ > 5.0 mEq/L
Respiratory acidosis may be a precursor to what?
respiratory arrest
How can patients with respiratory acidosis present?
• unconscious
What lab test is essential for diagnosing respiratory acidosis?
What are treatment options for respiratory acidosis?
• increase ventilation (intubation if necessary)
• treat underlying disorder
What are other disorders that need to be rule-out for patients presenting with hyperventilation?
• asthma
• ASA overdose
• fever
• hyperthyroid
• liver disease
• pulmonary embolism
How can patients in respiratory alkalosis clinically present?
• dizziness
• carpal-pedal spasm (painful flexion of the wrists, fingers, ankles, and toes)
• chest tightness/pain

* symptoms caused by cerebral and peripheral hypoperfusion
What are symptoms of hyponatremia?
• agitation
• cramps
• hallucinations
• headache
• lethargy
• seizures
What are causes of hyponatremia?
• dilutional (MCC)
• elevated protein
• hyperglycemia
• hyperlipidemia
What are treatment options for hyponatremia?
• IV fluids (NS)

• fluid restriction (in normotensive patients)

• severe hyponatremia
- hypertonic saline
- lasix
What are complications of rapid correction of hyponatremia?
• Central pontine mylelinolysis
An osmolarity increase of __ will cause thirst
What are symptoms of hypernatremia and at what osmolarity do symptoms occur?
• symptoms occur when osmolarity is > 350

• symptoms include:
- ataxia
- irritability
- lethargy
- seizures
What are causes of hypernatremia?
• excessive water loss
- vomiting/diarrhea
- diabetes insipidus
- dialysis
- diuresis

• increase sodium

• mineralcorticoid or glucocorticoid excess
What is the treatment for hypernatremia?
• NS or lactated ringer

* change to ½NS after a urine output of 0.5 ml/kg/hr is reached
What is the treatment for hypernatremia if no urine output is observed after NS or lactated ringer solution rehydration?
• ½ NS
• Lasix
What is the treatment for central diabetes insipidus?
How can patients with hypokalemia clinically present?
- cramps
- hyporeflexia
- weakness

• Cardiovascular
- dysrhythmias
- EKG changes
- hypotension or hypertension
- worsening of dig toxicity

• GI (ileus)

• Glucose intolerance

• Renal
- metabolic alkalosis
- worsening hepatic encephalopathy
What are causes of hypokalemia?
• diuretics (MCC)
• decreased intake
• increased loss
• shift into cell
What are EKG changes caused by hyperkalemia and what are serum K+ level do they occur?
• K+ > 6.5-7.5
- Peaked T waves
- Prolonged PR/ short QT

• K+ > 7.5-8.0
- QRS widens
- P waves flatten

• K+ > 8.0
- Sine wave
- V-fib
- Heart blocks
What are clinical symptoms of hyperkalemia?
• Neuromuscular symptoms
- paralysis
- weakness

• GI symptoms
- colic
- diarrhea
- vomiting
What is the MCC of hyperkalemia?
renal failure with oliguria
What is pseudohyperkalemia?
elevated K+ caused by hemolysis after blood draw
What is first line treatment for severe hyperkalemia?
calcium gluconate
How can patients with hypocalcemia clinically present?
• confusion
• cramps
• increased DTRs
• parasthesias
• seizures
• weakness
What are 2 clinical signs that can be seen in hypocalcemia?
• Chovstek sign
• Trousseau sign
What are causes of hypocalcemia?
• drugs (ex. cimetadine)
• hypoparathyroidism
• hypomagnesemia
• pancreatitis
• phosphate overload
• renal failure
• sepsis
• shock
• tetanus toxin
• Vit D deficiency
What are treatment options for hypocalcemia?
• Calcium gluconate OR Calcium Cloride (IV/PO)
• Vitamin D
What are causes of hypercalcemia?
• PTH,
• Addison’s ds
• Multiple Myeloma
• Paget’s ds
• Sarcoidosis
• Cancer
• Hyperthyroid
• Milk-alkali syndrome
• Immobilization
• Vitamin D increase
• Thiazides
What wil 1/3 of patients with hypercalcemia also develop?
How can patients with hypercalcemia present clinically?
• Stones (renal calculi)
• Bones (malign bone destruction)
• Moans (psych, lethargy, weakness, fatigue, AMS)
• Groans (abd pain, constipation, polyuria/dipsia)
What are EKG changes seen in hypercalcemia?
• Short QT
• Wide T wave
• Depressed ST
• Heart blocks
What are treatment options for hypercalcemia?
• NS
• Lasix (Furosemide)
• Calcitonin
• Hydrocortisone
What are clinical findings of hypomagnesemia?
• Anemia

- ataxia
- depression
- increased DTRs
- tetany
- vertigo

• Cardiac
- arrhythmias
- prolonged QT/PR
- worsening of digitalis

• Dysphagia
• Hypotension
• Hypothermia
What are causes of hypomagnesmia?
• alcoholism (MCC in US)
• correction of DKA
• cirrhosis
• excess GI loss
• pancreatitis
• poor nutrition
What is treatment for hypomagnesmia?
• correct volume deficit and any decreased K+, Ca++, Phosphate levels first

• Magnesium sulfate (if patient is an alcoholic in DTs)
- check DTRs q 15 mins, stop when DTRs normalize
What is a normal magnesium level?
What are clinical findings of hypermagnesemia?
• no DTRs (Mg > 3.5)
• muscle weakness ( > 4.0)
• hypotension (> 5.0)
• respiratory paralysis (> 8.0)
What are causes of hypermagnesemia?
renal failure with ingestion of antacids or lithium
What are treatment options of hypermagnesemia?
• rehydrate with NS and Lasix (in absence of renal failure)
• correct acidosis with ventilation and sodium bicarbonate
• Calcium chloride in symptomatic patients to antagonize Mg++ effects