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121 Cards in this Set
- Front
- Back
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what are the 2 primary treatments of PSVT?
cardizem narcan defibrillation cardioversion adenosine |
cardioversion and adenosine
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what is the MC dysrhythmia in kids?
psvt afib vtach vfib |
psvt
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_ is a transitional dysrhythmia between NS and A fib. Usually the rate is between 240-350 bpm.
vfib a fib a flutter psvt |
a flutter
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A pt presents with SOB, you notice a murmur, you ask the pt to squat and during that the murmur fades what is it?
Aortic stenosis HOCM pericarditis anteroseptal MI |
Hocm
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a pt with sudden, painless vision loss in which you see a cherry red spot with or without exudates/hemorrhage superior to the optic disc. what are you worried about?
central retinal vein occlusion central retinal artery occlusion |
central retinal artery occlusion
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kerley B lines =?
COPD CHF pneumonia atelectasis |
CHF
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_ vertigo has vertical nystagmus.
peripheral central |
central, less intense insidious onset, is constant and not positional
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_ vertigo is sudden in onset, positional, may or may not have hearing issues, can have horiz/vert/rotational nystagmus.
peripheral central |
peripheral
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checking the corneal reflex with a cotton wisp is testing
V1 of trigeminal for motor and VII for sensory V1 of trigeminal for sensory and VII for motor |
V1 of trigeminal for sensory and VII for motor
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With vertical nystagmus, a _ lesion in brainstem or cerebellum must be ruled out.
peripheral central |
central
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_ is distal weakness that works it way proximally, it is symmetrical, with c/o numbness & tingling to extremities.
MS MG Guillain-Barre syndrome ALS |
Guillain-Barre Syndrome
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deafness, vertigo & tinnitus =??
labrynthitis vertigo BPPV meniere's |
meniere's
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weakness of the extensor hallucis longus, decreased sensation over the lateral aspect of the calf and first web is recognized as _
L4 L5 S1 S3 |
L5
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What is the MC dysrhythmia in kids?
vtach vfib psvt sinus tach |
psvt
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If a pt has ST elevation in II, III, and AVF, what is it?
inferior MI anterior MI lateral MI posterior MI |
inferior MI
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if a pt presents with vertical nystagmus what type of vertigo is this?
peripheral central lateral |
central: a lesion in the brainstem or cerebellum must be ruled out
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V1 of the trigeminal nerve is responsible for the _ corneal reflex (with cotton wisp).
sensory motor |
sensory; the facial nerve VII is responsible for motor
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A pt presents with progressively worsening distal weakness that is working its way proximally, it is symmetric and assoc with n/t. What is it?
MS MG Guillian Barre ALS |
Guilian Barre syndrome
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A 7 y.o. comes in with a limp c/o hip and groin pain, an xray shows a widenin of the hip joint space.What is it?
SCFE legg calves perthes adrenal crisis |
legg-calves perthes
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What is the MCC of adrenal crisis?
roid OD addison's disease stopping steroids too suddenly |
stopping steroids too suddenly
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a 77 y.o. female, post fall comes in with leg shortening, is held in adduction and internal rotation. What are you thinking?
posterior hip dislocation anterior hip dislocation lateral hip dislocation |
posterior hip dislocation
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what process is MC found in 10-15 y.o. males that are usually obese, if found in a female it tends to be bilateral.
SCFE legg calves perthes hip fracture cellulitis |
SCFE: typically obese with a limp, external rotation, thigh/knee pain that is worse with activity.
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What must you be concerned about with Legg-Calve-Perthes disease?
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AVN of femoral head, >in males ages 3-10 with an antalgic gait.
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A pt presents with a high fever a rash that first presented on the hands and feet and is working its way proximally what is it and what do you treat it with?
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RMSF and Doxy
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A warm, red tender area with poorly demarcted borders that is spreading is most likely ?
erisypelas cellulitis carbuncle furuncle |
cellulitis-treat with 1st generation cephalosporins
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A 67 y.o. woman presents iwth an erythematous, shiny area of warm and tender skin on her face with a well-demarcated and indurated advancing border, what is it?
cellulitis erysipelas impetigo abscess |
erytipelas-IV antibiotics
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what is the hallmark of ethylene glycol toxicity?
Ca gluconate crystals uric acid crystals ca oxalate crystals |
ca oxalate crystals
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which psych meds can cause sudden death?
SSRI SNRI TCA |
TCAs
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_ are contraindicated in cocaine toxicity due to unopposed alpha stimulation can cause hypertension
alpha blockers beta blockers CCB's nitrates |
beta blockers
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what is the treatment of aortic aneurysm/dissection?
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labetolol 0.25mg IV. & nitroprusside 0.3=10ug/kg/min
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what is the MC organ damaged with blunt trauma?
large colon small colon liver spleen |
spleen
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what is the MC organ damaged with penetrating trauma?
large colon small colon liver spleen |
liver
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what is the most reliable symptom of compartment syndrome?
pulselessness pain poikilothermia parasthesia |
parasthesias
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what is the hallmark of ethylene glycol toxicity?
confusion hematuria ca oxalate crystals in urine unresponsiveness |
ca oxalate crystals in the urine
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t/f
charcoal is the TOC of ethylene glycol toxicity. |
false; it is of limited benefit, infusion of ethanol or fomepizole inhibit toxic pathway, dialysis if level >25
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where is IO access in kids?
proximal tibia proximal fibula distal fibula distal tibia |
kids=proximal tibia
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what is placement of choice for an IO in an adult?
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distal tibia
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sickle cell is a vasocclusive crisis, what is the treatment?
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hydration and pain control
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t/f
the TOC with TTP is platelet transfusion. |
FALSE!!! plasmaphoesis, FFP and pRBC's
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is heparin intrinsic or extrinsic
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intrinsic-VII, IX, X, XI, XII
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what factors are vitamin K dependent?
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2, 7, 9, 10
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Mad as a hatter
blind as a bat red as a beet hot as a hare dry as a bone..what is it? cholinergic OD anticholinergic OD opiate OD Sympathomimetic OD |
anticholinergic OD
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a pt presents with respiratory acidosis, constricted pinpoint pupils, what do you think it is?
sympathomimetic OD opiate OD cocaine OD asa OD |
opiate OD
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what common 3 things cause respiratory alkalosis? ABC....
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amphetamines
beta agonists cocaine |
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at what level is APAP toxic?
50mcg/ml 100mcg/ml 150mcg/ml 200mcg/ml |
150mcg/ml at this level treat with NAC 140mg/kg then 70mg/kg x17 doses
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MCC of sudden cardiac death in adults is?
vtach psvt asystole vfib |
vfib-defibrillate
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what is the tx of stable vtach?
cardioversion verapamil amiodarone cardizem |
amiodarone
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what is the tx of unstable vtach?
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cardiovert, if pulseless defibrillate
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what is the tx of choice for unstable aflutter?
defib digoxin IV cardioversion amiodarone |
synchronized cardioversion
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what is the TOC of stable aflutter?
cardioversion amiodarone digoxin diltiazem |
diltiazem
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Where do you perform a needle decompression on a pneumothorax ?
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2nd ICS mid-clavicular line
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tx of frostbite?
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active rewarming, analgesia, elevation, tetanus
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t/f
eclampsia occurs up to the time of delivery |
false; can occur up to 10 days after delivery
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a pt presents with a red, swollen and painful great toe joint. Aspirate of the joint shows negative bifringement crystals. What do you think?
gout cellulitis pseudogout |
gout-
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A pt shows with pain in the hip joint that is red, swollen and warm, joint aspirate shows positive bifringement crystals. What is it?
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pseudogout
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A 69 y.o. female presents with excertional dyspnea, angina and one episode of syncope this morning. You note a cresendo-decresendo murmur on auscultation. What type of murmur do you have?
Aortic Stenosis Aortic Regurg Mitral Stenosis Mitral Regurg |
aortic stenosis
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What is the MC location for an esophageal FB in adults? In kids?
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adults-LES
kids-cricopharyngeous muscle |
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What is the 1st and 2nd MCC of SBO's in adults?
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1st-adhesions
2nd-incarcerated hernias |
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what is the MC and frequent manifestation of gout?
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podagra
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a pregnant woman with an opened cervical os that is bleeding is considered?
missed Ab threatened Ab inevitable Ab incomplete Ab |
inevitable Ab
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an opened cervix with incomplete passage of fetal contents is ?
missed Ab threatened Ab inevitable Ab incomplete Ab |
incomplete Ab
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a pregnant woman has retained deceased fetal tissue after abortion is ?
missed Ab threatened Ab inevitable Ab incomplete Ab |
missed Ab
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what is the mainstay of treatment of a PE?
thrombolytics anticoagulants thrombic pumps |
anticoagulants
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Mi's are a result of __ vs ___.
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coronary artery plaque rupture vs vasospasm
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blood at the urethral meatus is virtually diagnostic for _ injury and demands early imaging before catheter placement.
prostatic urethral ureteral spermatic cord |
urethral
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a pt who has been at the beach all day presents c/o dizziness, nausea, H/A and diaphoresis. what do you think?
heat stroke heat exhaustion |
heat exhaustion
heat stroke would have core temp >104, altered mental status, anhydrosis, and elevated transaminases |
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what is the MC affected valve by endocarditis from IV drug use?
aortic mitral tricuspid |
tricuspid
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the inability to retract foreskin over glans (proximally) is called?
phimosis paraphimosis |
phimosis
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the inability to reduce proximal foreskin over glans (distally).
phimosis paraphimosis |
paraphimosis
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t/f
diverticulosis does not commonly cause bloody stools |
false; it does
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MC location for c-spine fracture?
C1 C3 C5 C7 |
C5
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MC site for spinal subluxation?
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C5 on C6
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MC location for compartment syndrome?
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anterior tibial
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non-bilious vomiting, forceful vomiting in kids?
gastritis esophagitis pyloric stenosis gastric outlet obstruction |
pyloric stenosis
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All of the following are appropriate treatments of ITP except ?
IVIG FFP platelet infusion Steriods (prednisone) |
not FFP
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which of the following is the most important preventative measure in the prevention of wound infection?
sterile technique wound irrigation prophylactic antibiotics |
wound irrigation
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which of the following bugs is most commonly implicated in meningitis of pt's 2mo-50y.o.?
h. flu s. pneumo n. mening. |
s. pneumo
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An HIV pt presents with a seizure what are you most concerned about?
intercranial lesion meningitis |
intercranial lesion
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A 4 y.o. presents with colicky abdominal pain and vomiting with "dark jelly like" diarrhea. What is it?
adhesions SBO intusseception appendicitis crohn's disease |
intussuception
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foamy, foul smelling vaginal d/c with a pH of >5.5 is ??
trich BV candida |
trich
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What is the formula for figuring out Anion Gap?
Na+(Ca + HCO3) Na-(Ca + HCO3) K+(Ca+HCO3) K-(Ca+HCO3) |
Na-(Ca + HCO3)
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What is the normal Anion Gap?
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< or equal to 12 to 14
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what is the tx of torsades?
adenosine cardizem magnesium digoxin |
magnesium
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what is the 1st course of action in a pt with high potassium?
insulin glucose ca gluconate kayexalate |
ca gluconate
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the MC presenting sign of an elderly women with an MI?
chest pain chest pressure dyspnea diaphoresis |
dyspnea
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aspirin toxicity would cause?
metabolic acidosis metabolic alkalosis respiratory acidosis respiratory alkolosis A & C A & D B & C A & B |
metabolic acidosis & respiratory alkalosis
A & C |
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intra-uterine pregnancies are seen on transvaginal ultrasound at what beta hcg level?
250-500 500-750 1000-1500 >6000 |
1000-1500
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if you have a pt with pelvis injuries and blood at the urethral meatus, what is the TOC before placing a foley cath?
IVP ultrasound retrograde urethrogram |
retrograde urethrogram
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The GCS on a pt that opens eyes to verbal command, localizes pain, and converses but is disorientated is?
13 14 15 12 |
12
3=opens eyes to verbal command 5=localizes pain to painful stimulus 4=disorientated but converses |
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_ cord syndrome is seen with full or partial loss of bilateral pain and temperature sensation and paraplegia. Often with flexion injuries and carries a poor prognosis.
posterior cord syndrome anterior cord syndrome central cord syndrome brown-sequard syndrome |
anterior cord syndrome
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_ cord syndrome is usually seen with hyperextension injuries. This is characterized by weakness greater in the upper extremities than the lower, and distal is worse than proximal.
posterior cord syndrome anterior cord syndrome central cord syndrome brown-sequard syndrome |
central cord syndrome
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A 70 year old male presents to the ER after a whiplash injury. He ambulates in well but has an extremely weak handshake. What is it?
posterior cord syndrome anterior cord syndrome central cord syndrome brown-sequard syndrome |
central cord syndrome
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what is the MC type of odontoid fracture?
1 2 3 4 |
type 2. Involves only the base of the dens
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hypotension, JVD, and muffled heart sounds is called _ triad.
Beck's Connor's Treet's |
Beck's
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A 19 y.o. male presents to the ER with a stab wound to the chest from a knife, he c/o dyspnea. Absent left breath sounds. What is it?
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pneumothorax
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Your pt comes to the ER with a stab wound to the left chest, dyspnea but his lungs are clear. He is hypotensive and has JVD.
What are you thinking about? |
cardiac tamponade
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A 25 y.o. female presents after a high speed MVA with dyspnea and tachycardia. There is local bruising over the right side of her chest. The CXR shows a right upper lobe consolidation. What is it?
cardiac contusion pulmonary emboli pulmonary contusion cardiac tamponade |
pulmonary contusion
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The most frequently injured sold organ associated with blunt trauma is the _.
small bowel spleen liver |
spleen
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the most frequently injured solid organ associated with penetrating trauma is the _.
small bowel large bowel liver spleen |
liver
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what is the treatment of a pneumothorax?
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tube thoracostomy
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pt presents with stroke symptoms of syncope & weakness, which artery would be involved?
basilar cerebellar cerebral |
basilar
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pt presents with stroke symptoms of HA, N & V and central dizziness. Which artery is involved?
basilar cerebellar cerebral |
cerebellar
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which artery is MC involved in the stroke process?
middle cerebral vertebrobasilar basilar cerebellar |
middle cerebral artery
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which value of the following requires further workup and treatment in the scenario of an ischemic stroke?
serum glucose >200 MAP 76 SBP 90 |
serum glucose, you want it below 150.
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what is the best class of meds to use in the tx of seizures?
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benzo's
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the loss of the ankle reflex is loss at _.
L4 L5 S1 S2 |
S1 injury
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what is the #1 cause of SAH?
trauma AVM ruptured aneurysm idiopathic |
trauma
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if a pt presents with a "horrible" worst headache of her life and the CT is negative, what is the next best thing to do?
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LP
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A 52 y.o. woman presents with a severe throbbing frontal headache, and is tender over the temporal artery. Her ESR is 57, what is the diagnosis? What is the tx?
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temporal arteritis, temporal artery biopsy is diagnostic and the tx is prednisone. If left untreated can cause vision loss.
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what is the treatment of a post LP headache? Mild and Severe.
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mild-analgesics
severe-blood patch |
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what is the MC bug involved with meningitis most of the time?
s. pneumo n. mengitidus s. aureus what is the treatment |
s. pneumo and ceftriaxone
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what is the treatment of all pt's with posterior nasal bleeding?
packing admission ENT consult lido with epi injection |
admission with EnT consult
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A 67 yo woman presents with c/o decreased strength and stability of her legs that began yesterday. Her only pertinent history besides her HTN is that she had a viral illness about a week ago that was treated with fluids and rest. Her PE shows loss of DTR's distal weakness of all 4 extrimities, legs are worse than the arms. During exam she notes decreased sensation in her feet. What does she have?
myasthenia gravis guillain-barre syndrome multiple sclerosis |
guillain-barre syndrome: watch for respiratory failure
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proximal muscle weakness that is relieved with rest but associated with ptosis and diplopia, confirmed with edrophonium test. what is it?
myasthenia gravis guillain-barre syndrome multiple sclerosis |
myasthenia gravis
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the EMS calls and describes the following pt. LOC with tonic/clonic contractions. Some circumoral cyanosis is noted, loss of bladder control is noted. What type of seizure is it?
absence grand mal partial complex partial |
grand mal-will be followed by a postictal period
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a 7 y.o. male presents, his parents state that he has been c/o a sore throat. He is in the tripod position with drool coming out of her mouth. What do you think?
peritonsillar abscess epiglottitis strep pharyngitis croup |
epiglottitis
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what "sign" will you see on a soft tissue neck of a child with epiglottitis?
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thumbprint sign
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t/f
group A, beta-hemolytic strep is associated with sequelae of RF and PSGN. Treating strep pharyngitis prevents RF but not PSGN. |
true
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A 29 y.o. male who had been treated for strep throat the previous week presents iwth progressive difficulty swallowing. PE reveals a fluctuant mass on the right side of the soft palate and deviation of the uvula to the right. What are you thinking?
peritonsillar abscess epiglottitis croup retropharyngeal abscess |
peritonsillar abscess
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what is the MC bug involved with pneumonia in a non-smoker is?
s.aureas klebsiella legionella s. pneumo mycoplasma |
s. pneumo
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A 27 y.o. pt presents with pneumonia, bullous myringitis, and a cxr that looks worse than expected. What type of pneumonia are you thinking?
s. pneumo klebsiella mycoplasma pneumonia h. flu |
mycoplasma pneumonia
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