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48 Cards in this Set

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overall Strategy: write down the following so you find it quickly
Differential Diagnosis:
Allergies:
Counseling:
Then, follow this order for each case:
1) ABC's: stable or not?
2) PE: focused unless pt has a general complaint
3) Labs/ Rad
4) Triage/Meds
5) Counsel/Follow-up appt
General Orders:everyone
CBC/CMP/TSH
General Orders: Females:
β-HCG
General Orders: Infection:
CXR/UA/ Cultures/Tylenol
General Orders: Cardiac:
EKG / CXR/Echo /Cardiac enzymes
General Orders: Pulmonary:
ABG/EKG/CXR
General Orders: GI:
Guaiac
General Orders:
Renal
UA
General Orders:Heme:
Guaiac/PT / PTT /Type and match
general orders Ob-Gyn:
β-HCG / Pap/ Prolactin/ ABO, Rh
Cellulitis
Clindamycin + Ciprofloxacin
Prostatitis
Ciprofloxacin + Ampicillin + Gentamycin
Urosepsis:
Ciprofloxacin + Ceftriaxone
Diverticulitis
Metronidazol + Ciprofloxacin
Appendicitis
Metronidazole + Cefazolin
Septic Arthritis:
Azithromycin + Ceftriaxone
perforated ulcer
Metronidazole + Ampicillin + Gentamycin
Cholecystitis:
Cefuroxime
Sickle Cell:
Azithtomycin + Cefuroxime
Community-Aquired Pneumonia
Azithromycin + Ceftriaxone
Bacterial Meningitis
Vancomycin + Ceftriaxone
Bacterial Endocarditis
Vancomycin+ Gentamycin
Pelvic Inflammatory Disease
Doxycyclin + Cefoxitin
Febrile Neutropenia
Ceftazidime
Emergency Room:
1) Pulse ox/ Oxygen
2) IV access/NSS (0.9%NaCl)
3) Vitals/Continuous (BP /Cardiac)
Ward Admission:
''NAD HIC"
1) NPO/Foley/Urine outputs
2) Activity
3) Discomfort Meds: Mepiridine/ Phenergan
4) Home meds
5) Interval PE/Hx
6) Consults
ICU Admission:
1) Prophylaxis: Pantoprazole/ Pneumatic compression stockings
2) Interval PE/Hx
3) Send to ward -> then home
Discharge:
1) D/C IV access, D/C all tubes
2) D/C IVF
3) Change all meds to PO
4) Diet: disease-specific
5) Follow-up appt: 2wk unless specified
Counseling (at the 5min warning):
'X-RATED SEX"
X: safe seX
Rx: medication compliance/side effects
Alcohol: limit intake
Tobacco: cessation
Exercise: program
Directives: advance
Seat belt: when driving
Eat: diet
X: no illegal drugs
Preventative Medicine:
21 y / o:
Cholesterol/Pap smear
Preventative Medicine: 40 y/o:
Glucose/Mammogram/Prostate exam
Preventative Medicine: 50 y/ o:
Colonoscopy
Preventative Medicine: 65 y/o:
TSH/Female Pelvic exam
ALZHEIMER'S:
Labs: (4)
Tests:
Labs: TSH, Vit B12, Folate, UA
Tests: Head CT
ALZHEIMER'S:
(tx Alzheimer's)
(tx delusions
(tx anxiety)
(tx depression)
(tx insomnia)
Donepezil (tx Alzheimer's)
• Olanzapine (tx delusions)
• Buspirone (tx anxiety)
• Fluoxetine (tx depression)
• Triazolam (tx insomnia)
ALZHEIMER'S:
Location:
Counsel:
Follow-up:
Location: Office
Counsel: No driving, Advance directives
Follow-up: 2mo
BACTERIAL MENINGITIS:
Labs:
CSF:
Tests:
BACTERIAL MENINGITIS:
Labs: Blood C&S, UA/C&S, PT / PTT
CSF: Cells/Glucose/Protein/C&S + fungal/Gram/Meningococcal Ag
Tests: EKG, LP
BACTERIAL MENINGITIS:
Rx
Contact Prophylaxis
Consult:
Location:
Rx Acetaminophen (rectal), Dexamethasone -> Vancomycin/Ceftriaxone
Contact Prophylaxis: Rifampin or Ciprofloxacin
Consult: ID
Location: Ward (isolation)
SUBARACHNOID HEMORRHAGE
Labs:
Tests:
"worst HA of my life"
Labs: ESR, PT / PTT
Tests: EKG, Head CT (no contrast), Angiography (cerebral arteries)
SUBARACHNOID HEMORRHAGE Rx: tx pain, prevent vasospasm, prevent seizures, if HTN
Ketorolac (tx pain), Nimodipine (prevent vasospasm), Phenytoin (prevent seizures), Labetalol (if HTN)
SUBARACHNOID HEMORRHAGE: Consult, Location and management
Consult: Neurosurgery, Location: ICU (Neurochecks q1hr)
TRANSIENT ISCHEMIC ATTACK: Labs and Tests
Labs: PT / PTT, Lipid profile, Tests: EKG /Echo, CXR, Head CT (no contrast), Carotid Doppler
TRANSIENT ISCHEMIC ATTACK: Rx, Consult and when is an endarterectomy done?, Location
Rx: ASA, Pneumatic compression stockings, Consult: Vascular Surgery (for carotid endarterectomy if 70-99% stenosis), Location: Ward
ALCOHOL WITHDRAWAL: Labs and Tests:
Labs: ABG, EtOH/Urine tox, Blood C&S/UA, Mg/Phos /Glucometer, PT / PTT, Tests: EKG, CXR, Head CT
ALCOHOL WITHDRAWAL:
Rx:
Location:
Rx: NG tube suction, Thiamine -> Dextrose 50%, Folate, Lorazepam
Location: ICU
DEPRESSION: Labs, Tests, Rx
Labs: TSH, Vit B12, Folate, Tests: EKG, Rx: Fluoxetine, Suicide contract
DEPRESSION:
Consult
Location:
Follow-up:
Consult Psychiatry
Location: Office
Follow-up: 6wk