Things I Have To Remember

Front 1

dosage chlorpromazine (thorazine) for intractable hiccups?

Back 1

Initial oral dose is 25 mg three times daily for up to seven to ten days. The dose can be titrated up to 50 mg four times daily for improved control. Intravenous administration may be more effective, although the drug must be infused in 500 to 1000 mL saline with the patient in the supine position to prevent hypotension.

Front 2

Dosage: metoclopramide for intractable hiccups

Back 2

10 mg three or four times daily for up to 7 to 10 days

Front 3

Side effect of metoclopramide

Back 3

tardive dyskinesia

Front 4

Side effects of chlorpromazine

Back 4

Potential side effects with short-term usage include dystonic reactions and drowsiness. Long-term therapy increases the risk of tardive dyskinesia. Chlorpromazine is contraindicated in elderly patients with dementia.

Front 5

physical maneuvers to stop hiccup

Back 5

interrupting normal respiratory function (eg, breath holding, Valsalva maneuver) or nasopharyngeal/uvula stimulation (eg, sipping cold water, gargling with water)

Front 6

a disorder of diminished motivation

Back 6

abulia

Front 7

components of the CAM ICU

Back 7

acute onset or fluctuating course; inattention; disorganized thinking; altered LOC

Front 8

requirements to diagnose delirium using CAM ICU method

Back 8

1+2 and either 3 or 4

Front 9

4 questions for disorganized thinking

Back 9

will a stone float on water; are there fish in the sea; does 1 pound weigh more than 2 pounds; can you use a hammer to pound a nail?

Front 10

slow regular breathing: diagnosis

Back 10

drugs or hypothyroidism

Front 11

components of brainstem testing in comatose

Back 11

pupil size, pupillary light reflex, corneal, Doll's eye reflex; cough and gag; cold calorics

Front 12

reason for sneaking from the side to test corneal reflex

Back 12

If the patient blinks because they see you, you have tested CN II and VII. If they blink because they hear you, you have tested CN VIII (Acoustic) and VII.

Front 13

cranial nerves involved in oculocephalic or Doll's eye reflex

Back 13

CN VIII communicates to both CN III and VI in the pons to produce horizontal eye movement

Front 14

Fever by IDSA criteria

Back 14

38.3 or 101

Front 15

7 important non infectious causes of fever in the icu

Back 15

Drug fever, pancreatitis, acalculous cholecystitis, thyroid storm, adrenal insufficiency, transfusion reaction, post op fever (plus dvt)

Front 16

Important causes of fever in the icu

Back 16

IV Cath related infection, surgical site infection, cholangitis, endocarditis, c diff, si.usitis, pna, uti

Front 17

When to treat fever with empiric antibiotics

Back 17

Clinical condition deteriorating or in shock or neutropenic, with VAD, nee fever >102

Front 18

Causes of post-op fever: pathophysio

Back 18

due to tissue trauma with cytokine release, circulating bacterial endotoxins from endogenous gut flora

Front 19

4 predominant infectious causes of postoperative fever

Back 19

Surgical site infection, pneumonia, urinary tract infection, and intravascular catheter infection

Front 20

most common noninfectious cause of postoperative fever

Back 20

medication reaction; antimicrobial agents or heparin are the drugs most frequently implicated; other causes include pancreatitis, DVT, transfusion, gout

Front 21

management of post-op fever

Back 21

remove all unnecessary treatments (meds, NGT, IV cath, Foley)Acetaminophen no routine / empiric antibiotics unless hemodynamically unstable - and d/c after 2d if no source identified

Front 22

criteria to safelyobserve patients without giving Abx in post-op neurosurg fever

Back 22

<39.4ºC (102.9ºF)CSF WBC <7,500/µLCSF glucose >10 mg/dLdelirium, seizure, or surgical site inflammation

Front 23

verapamil dose for rate control in Afib

Back 23

240 to 480 mg daily in 3 to 4 divided doses; extended release: Usual maintenance dose range: 180 to 480 mg once daily

Front 24

verapamil dose for PSVT prophylaxis

Back 24

Immediate release: 240 to 480 mg daily in 3 to 4 divided doses

Front 25

TCD mean velocity accepted as representing prob significant degree of arterial narrowing

Back 25

100-120 cm/s mean velocity

Front 26

increase in TCD implies

Back 26

hyperaemia or vasospasm

Front 27

what is the Lindegaard ratio?

Back 27

ratio between mean velocity in MCA and mean velocity in cervical ICA, if 3 or more then the high intracranial velocity likely to be due to vasospasm

Front 28

Labs to request for ISTH DIC scoring?

Back 28

Platelets, D-dimer, PT, Fibrinogen

Front 29

common causes of thrombocytopenia in the hospitalized patient

Back 29

drugs, HIT, liver disease, multi-organ failure, DIC sepsis`

Less common: TTPHUS, lymphoma, leukemia, APAS, PNH, nutrient deficiency (B12, folate, copper)

Front 30

asymptoamtic patient with thrombocytopenia, differentials?

Back 30

immune thrombocytopenia (ITP), occult liver disease, HIV infection, myelodysplastic syndromes

Front 31

drugs commonly associated with thrombocytopenia

Back 31

heparin

beta lactam Abx, vancomycin, piperacillin, sulfonamides, bactrim, linezolid, levofloxacin?phenytoin, VPA, CMZ, haldol?

ibuprofen?, naproxen?, acetaminophen?

simvastatin?, furosemide?

ranitidine?

Front 32

What is the ABCDE bundle?

Back 32

Awakening and Breathing trials (AB) their coordination (C), choosing the right sedative when indicated (C), delirium monitoring and management (D) and early mobility (E)

Front 33

the big 5 trials of interventional management of stroke in 2015

Back 33

better results compared to IV tPA alone with intracranial ICA or MCA occlusions up to 6 hours of onset

MR CLEAN SWIFT PRIME EXTEND IA ESCAP and REVASCAT

Front 34

esmolol for Afib in RVR - how to dose

Back 34

load 0.5mg/kg x 1 min then 50 ug/kg/min x 4 mins; ual effective dose 50-200 ug/kg/min; 25 might be adequate

Front 35

diltiazem for Afib in RVR - how to dose

Back 35

0.25 mg/kg actual body weight over 2 minutes (average adult dose: 20 mg); ACLS guideline recommends 15-20 mg

Front 36

DDx for sinus tach

Back 36

4 big differentials: PE MI Sepsis Dehydration

Always treat: PainFeverAnxiety

anemia

Zebras: Hyperthyroidism Malignant hyperthermia

Front 37

max value of CHADS/ CHADSVASC?

Back 37

6 and 9

Front 38

CHADS2 score components

Back 38

prior strokeand transient ischemic attack, congestive heart failure anddysfunction, hypertension, age of 75 years or older, and diabetesmellitus (score range, 0-6)

Front 39

CHADSVASC score components

Back 39

increases the point value from 1 to 2 for age of 75 years andolder and adds elements for female sex, vascular disease,and age of 65 through 74 years (score range, 0-9)

Front 40

when is OAC recommended for stroke prevention in CHADS/CHADSVASC?

Back 40

(CHADS2 score ≥2 under the2011 guideline2 and CHA2DS2-VASc score ≥2 under the 2014guideline1)

Front 41

Themost common choices used for IV induction, probably in order of frequency, are

Back 41

Propofol, Thiopental, Etomidate, and Ketamine.

Front 42

neuromuscular blocking agents

Back 42

succinylcholine (a depolarizing relaxer) or vecuronium (or any of the other -oniums or -uriums, which are all nondepolarizing relaxers).

Front 43

steps in intubating

Back 43

preoxygenate, anesthetize, loss of lash reflex, neuromuscular blocking agent (relax), twitch, intubate

Front 44

mechanism via which neurocardiogenic injury causes T-wave inversions

Back 44

catecholamine-mediated stunning of the myocardium, causing global repolarization abnormalities