Lisa Crit Care 4/ucla

Front 1

what drug causes : Agitation, miosis, resp depression, euphoria, decreased blood pressure, low temp, constipation, urinary retention; depressed sensorium, severe: pulm edema, collapse, sz?

Back 1

Opiates/morphine

Front 2

What drug w/drawal causes - anxiety, poor school performance, rhinorrhea, insomnia, stomach cramps

Back 2

Opiates/morphine

Front 3

what drug causes Sympathomimetic: coma, Hypertensive crisis; Hi temp, cerebral hemorrahage, arrythmias, Combative, tachy, mydriasis

Back 3

amphetamine

Front 4

what drug causes - Vertical and horizontal nystagmus, ataxia, lack of coordination; combative, M. rigidity; normal pupil size; tacky, HTN, increased reflexes; miosis, flushing, sweating, Psych disturbances;
-what's tx?

Back 4

PCP:
- TX: haldol, chlorpromazine, or lorazepam

Front 5

drug causes - Sleepiness, sedation

Back 5

benzo

Front 6

what drug -- Giggling slurred speech, ataxia, death ~ asphyxia or cardiac arrythmia?

Back 6

Organic solvent abuse

Front 7

what syndrome causes - NO aldosterone -> hypoglycemia, hyperkalemia, hyponatremia ; Fatigue, V, HA, wt loss, salt wasiting; ~ candidiasis w/ autoimmune polyendocrinopathy; Hi ADH levels

Back 7

adrenal insufficiency

Front 8

what's mechanism of ARDS? and tx?

Back 8

pulm edema →increased permeability of alveolar cap membrane: reticular infiltrate; ;
- due to PNA, aspiration, smoke inhalation
TX: PEEP !!

Front 9

What does prognosis of near drowning depend on ?

Back 9

prognosis depends on: duration of asphyxia: time from submersion to when adequate respiration is restored: determines the extent of damage

Front 10

how do you acutely treat AS?

Back 10

AS → Prostaglandins to reopen the ductus arteriosis for mixing of Oxygenated and deox blood

Front 11

hi ammonia, change in mental status; due to what?
- ? dx with: low ceruloplasmin, low serum copper/ HI urine copper (hi organ copper levels); -Liver bx: hi copper

Back 11

liver failure;
-wilson's

Front 12

how do you calculate ETT size?

Back 12

(Age + 16)/ 4

Front 13

what meds can you give via ETT?

Back 13

LANE: liodcaine, atropine, narcan, epi; * Atropine given for bradycardia, not asystole

Front 14

when do you give CAlcium as treatment?

Back 14

low CA, hyperkalemia (protects heart), hypermagnesmia

Front 15

what's cause of involves Subdural hematoma; retinal hemorrages, bulging fontanelle; later HA, drowsiness

Back 15

shaken baby

Front 16

periorbital ecchymosis is a sign of what?

Back 16

Sign of neuroblastoma

Front 17

Name abuse fractures

Back 17

bucket handle fracutres: avulsed bone fractures;
-corner fractures; spiral fx in infants, Rib fractures, multiple skull fx, spinous process fx; scapula fx, sternum fx

Front 18

name accidental fractures

Back 18

non-displaced linear skull fx, clavicluar fx, spuracondylar elbo fx;
-BUCKLE fracture of distal radius ( vs bucket handle – abuse!!)

Front 19

what kind of fracture affects: - of humerus; affects vasculature of elbow; if trauma mentioned, assume neurovascular compromise
- -pallor, cyanosis, of distal ext; pain on passive ext of fingers watch for a posterior fat pad – not normal finding; but ant fat pad: normal finding

Back 19

Supracondylar fx

Front 20

11-15 yo fall on oustretched arm which is supinated w/ elbow partially extended NOT hyperexteded
~ neurovascular compromise

Back 20

Dislocation of the elbow

Front 21

fx -older kids due to direct impact w/ arm laterally rotated on impact; neurovasc compromise less likely

Back 21

Epiphyseal fracture

Front 22

Forearm is supinated, ; neurovasc compromise less likely

Back 22

Lateral condyle fx

Front 23

New elbow swelling, tenderness; TX: supinate and flex arm

Back 23

nursemaids elbow

Front 24

Needs eval for possible displacement of trachea or mediastinal structures
-Tx: shoulder immobolization

Back 24

Medial clavicular fx w/ anterior or posterior displacement

Front 25

palpable step off the R anterior shoulder joint in absence of crepitus; h/o teenager that can’t raise arm above head;
-pain over distal clavicle w/ point tenderness over superior aspect
-happens in skeletally mature teens

Back 25

AC separation

Front 26

calculate burn victim fliuds:

Back 26

Rule of 9 calculating fluids: arms – 9% each (4.5 % front/back); Legs 18% (9 front/back) each, head and neck 19%; perineum 1 %;
Palmar method: palm area : 1%
* IVF for 10 kg burn/dehydrated kid in 24 hours? If 15% burned = 15 x 10 x 4 = 600/24 hours; give ½ in first 8 hours: 300 mL in 8 hours (37.5/hour x 8 hours), then 300 over 16 hours (18.75/hour x 16)