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35 Cards in this Set
- Front
- Back
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Differential dg of acute testicular pain
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Torsion
Epididymitis Kidney stone Incarcerated hernia Trauma Renal colic |
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most common cause of testicular pain in kids?
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torsion of appendix testis
basically a skin tag on testis gradual onset of pain blue dot sign |
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what does blue dot sign show?
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it is for torsion of appendix testis in kid
it is a blue dot on the testi where a piece of skin has torsed and is now ischemic. This is where the pain would be |
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pt with sudden onset of testicular pain, no fever, abdominal pain with n/v. Would you expect this pain to be unilateral or bilateral?
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Unilateral
testicular torsion |
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when is the onset of torsion most common?
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during sleep (kids will wake up in pain, maybe with just n/v and abdominal pain)
can also follow trauma/activity |
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Torsion vs epididymitis:
onset? |
torsion: sudden
Ep: gradual |
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Torsion vs epididymitis:
fever? |
Torsion: unlikely
ep: common (infection) |
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Torsion vs epididymitis:
abd pain and n/v |
torsion: common
ep: less likely |
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Torsion vs epididymitis:
Prehn sign |
torsion: no change
ep: relief with elevation |
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Torsion vs epididymitis:
Cremasteric reflex |
torsion: absent
epi: intact |
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at what time frame does detorsing a testicle give you 100% salvage rate
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within 3 hours of onset of sx
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what type of burn does the following describe?
no blister, due to sun |
1st degree
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what type of burn does the following describe?
epidermis and superficial epidermis burned |
2nd degree: superficial partial thickness
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what type of burn does the following describe?
blistering painful, heals in 2-3 wks |
2nd degree: superficial partial thickness
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what type of burn does the following describe?
extends into deep dermis |
2nd degree: deep partial thickness
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what type of burn does the following describe?
pale white or yellow, does not blanch, not painful |
2nd degree: deep partial thickness
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what type of burn does the following describe?
skin is charred, painless, leathery |
full thickness 3rd degree
burns through all of dermis |
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Give the rule of 9s for adults
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9% head
9% R arm 9% L arm 18% Chest 18 % R leg 18% L leg 1% Genitals |
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Give the rule of 9s for kids
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18% head
9% R arm 9% L arm 36% Chest 14% R leg 14% L leg |
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major problem with CO poisoning?
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neuropsychologic sequele
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pt with bad CO poisoning from house fire what else should you worry about
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Cyanide poisoning
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Parkland formula?
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4mL x Weight in Kg x % burned surface area
give half over 8 hrs 2nd half over 16 hrs |
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Which is worse, hyper or hypo kalemia?
why |
Hyper
ventricular arrythmias |
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Causes of hyperK?
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Renal dysfunction
ACEi K admin acidosis rhabdomyolysis spironolactone |
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EKG changes with hyperkalemia (2)
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Peaked T waves
QRS widening |
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Tx for peaked T waves due to hyper K?
(3 main ways, not actually treatment...) |
Stabilize cardiac membrane
Intracellular K shift Removal of K from body |
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what can be used to Stabilize cardiac membranes in hyperkalemia?
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Calcium gluconate
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what can be used for Intracellular K shift in hyper K
(3) |
Dextrose + insulin
Na Bicarb Albuterol Neb |
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what can be used to remove K from the body in hyperkalemia?
(3) |
furosemide
Kayexalate dialysis |
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there are numerous treatments for hyperK in pts with peaked T waves. What are they? (7)
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Calcium gluconate
Dextrose + insulin Na Bicarb Albuterol Neb furosemide Kayexalate dialysis |
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AMS + Fever + hyperthyroid=
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Thyroid Storm
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what 2 things are necessary for thyroid storm
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AMS
Fever >104 (and hyperthyroid obs) |
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Treatment for thyroid storm?
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Supportive: O2, lower temp, fluids
B-Blockers Glucocorticoids PTU and methimazole Inhibition of new hormone production (Lugol solution PO) |
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What is sepsis?
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SIRS caused by infection
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define SIRS
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2 or more of the following
Temp <36 or >38 HR >90 RR>20 or pCO2 <32 WBC <4 or >12 or >10% bands |
