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37 Cards in this Set
- Front
- Back
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HYPERventilation (to decrease ICP) |
decreases "blows-off" CO2 --> cerebral vasoCONSTRICTION! --> decreases ICP |
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CO2's effect on cerebral blood flow? |
CO2 = cerebral vasoDILATOR (increases ICP) |
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pO2 <50 or 90% O2 sat (cerebral effect) |
Increases cerebral blood flow (increases ICP) |
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Markedly elevated (1000s) AST & ALT Encephalopathy INR > 1.5 Increased PT |
Acetominophen Acute Hep B hepatitis Ischemic hepatopathy ("shock liver" 2/2 sepsis) Acute fatty liver of pregnancy HELLP
(NOT anything to do w/ alcohol abuse) |
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Very painful MONOCULAR sudden loss of vision, halos around lights UNILATERAL ROCK-HARD EYE, FRONTAL HEADACHE photophobia, redness |
Acute glaucoma |
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Acute glaucoma Tx:
AVOID WHAT? |
"MPAT" Mannitol Pilocarpine Acetazolamide Timolol
AVOID ATROPINE! (mydriatics)
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Systolic Crescendo-Decrescendo @ ULSB does NOT radiate to carotids
Increases w/ VALSALVA or STANDING |
Hypertrophic cardiomyopathy |
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Alcoholic hepatitis - lab values |
AST:ALT>2 (but NEVER in the 1000s) Increased GGT! Increased Ferritin!
Decreased Albumin & proximal m. weakness if malnourished. |
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Suspected URETHRAL INJURY (high-riding prostate = POSTERIOR urethral injury)
Dx: |
#1: Retrograde urethrogram
An immediate surgical repair is occasionally done in cases of Anterior urethral injury. |
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Anterior urethra injury |
1. Urinary diversion via suprapubic catheter while the primary injury & hematomas are allowed to heal
2. After healing, residual damage, e.g. urethral stricture is assessed & repaired |
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Blood in urethral meatus Inability to void HIGH-RIDING PROSTATE in DRE |
Posterior urethral injury
#1 step: Retrograde urethrogram (BEFORE insertion of foley catheter) |
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Thrombocytopenia (& small platelets) Eczema Recurrent bacterial infxns |
Thrombocytopenia 2/2 DECREASED PLATELET PRODUCTION
Wiskott-Aldrich syndrome |
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Metabolic Alkalosis with Urine Chloride > 20 |
Hypervolemia: - PRIMARY HYPERaldosteronism - Cushing's dz - Ectopic ACTH
Hypovolemia / Euvolemia: - Bartter & Gittelman syndromes; Current diuretics |
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Hip flexion Knee extension
Sensation to Anterior Medial Leg |
Femoral Nerve (Quads, anterior thigh muscles) --> Saphenous nerve (sensation to anteromedial leg) |
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Knee flexion Toe flexion
Plantarflexion
Sensation to lateral leg & Plantar foot |
Tibial Nerve |
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Foot eversion Sensation to Anterior lateral lower leg & last 4 toes |
Superficial Peroneal/Fibular N. |
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Foot dorsiflexion Toe extension
Sensation to small area between Big toe & 2nd toe |
Deep Peroneal/Fibular N. |
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"TIP PED" |
Tibial: Inversion, Plantarflexion
Peroneal: Eversion, Dorsiflexion |
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Streptokinase (clot-lysing enzyme) - used to treat? |
STEMI & Thrombotic strokes |
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3 days post-op Current meds include Heparin Pt develops Pulm Embolism (decreased pCO2, decreased pO2)
Next step? |
Spiral CT chest |
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Tension pneumothorax + Hemodynamically unstable (splenic laceration) -- 1st mgmt? |
Needle thoracostomy! |
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s/p Fall (signs of aortic rupture) -- transfuse what? |
IV RINGER'S LACTATE SOLUTION! or 0.9% Normal saline
(NOT typed & crossmatched RBCs! = only for low Hgb) |
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Chronic constipation since early infancy w/ firm Produces 1 string-like stool every 4 days NO stool in ampulla |
RECTAL MANOMETRY!!! absence of internal anal sphincter relaxation upon rectal distention
(Hirshsprung) |
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Blood in the urethral meatus + Pelvic fracture |
Retrograde urethrography! |
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First febrile seizure & source of infection is known (e.g. bulging tympanic membrane) |
Oral Antibiotic therapy!
(NO need to do a CT head!) |
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AIDS w/ CXR: bilateral interstitial infiltrates Silver stain of sputum: cysts & organisms Tx? |
TMP/SMX!
(dx: MAC) |
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s/p surgical repair of AAA 6 days ago tolerated clear liquid diet
+Epigastric tenderness, no guarding or rebound +Distended & tympanitic Increased amylase Thickened indurated pancreas w/ loss of surrounding soft tissue planes |
IV cephalosporin |
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Sickle cell Normal MCV but Decreased Hgb |
Folic acid (B9) |
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Acute asthma exacerbation
After bronchodilator treatments --> worsening pO2 (decreasing pO2, although pH is normalizing) |
Intubate! |
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SLE patient who has been on steroids (Prednisone) for years Binge drinking & not eating lately + onset of rhinitis, conjunctivitis, nonproductive cough --> unconscious, hypotensive, high temperature |
IVFs + CORTICOSTEROIDS!
Adrenal crisis (from abrupt withdrawal of chronic steroids + recent infection = body stress) |
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kid with increasing unilateral ear pain erythematous, bulging TM & edematous auditory canal with small amount of mucopurulent discharge EAR IS DISPLACED LATERALLY + MODERATE TENDERNESS BEHIND THE EAR |
1st step: CT of temporal bone! = MASTOIDITIS
(NOT oral amoxicillin) |
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Demented nursing home patient has urinary incontinence so urinary catheter was placed 2 weeks ago --> develops UTI with gram neg bacilli
What most likely could have prevented the pt's condition? |
Incontinence briefs INSTEAD of the catheter! |
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15-years of uncontrolled HTN, EXTREMELY elevated BP (170/102)
Greatest risk factor for which? Aortic aneurysm Glaucoma MI Subarachnoid hemorrhage |
MI! |
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Avoid complications related to subcutaneous central venous catheter in an immunocompromised hospitalized woman? |
HAND WASHING with an antibacterial soap prior to contact with the catheter
(NOT placement of a new sterile dressing at the site of access) |
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Prevent Otitis Media? |
AVOID passive smoke exposure in the home! |
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Pregnant woman on vegetarian diet and does NOT eat meat or fish. Best vitamin during pregnancy & lactation? |
VIT B12! |
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Can Ruptured Eptopic pregnancy present with CERVICAL MOTION TENDERNESS? |
Yes!
Diffuse abdominal pain Cervical motion tenderness + ADNEXAL TENDERNESS |
