Musa's Golden Rules Step 3 Ccs

Front 1

fever

Back 1

acetaminophen

Front 2

on a statin

Back 2

LFTs, check frequently

Front 3

abnormal LFTs

Back 3

get TSH

Front 4

surgery

Back 4

NPO

Front 5

NPO

Back 5

"urine output"

Front 6

woman between 12-52

Back 6

B-hCG

Front 7

diabetic

Back 7

HbA1c, continuous Accuchecks

Front 8

long standing diabetic

Back 8

opthomology consult

Front 9

respiratory distress

Back 9

ABG

Front 10

overdose

Back 10

gastric lavage, activatyed charcoal

Front 11

suicidal

Back 11

"suicide contract", "suicide precautions"

Front 12

cannot tolerate aspirin

Back 12

clopidogrel

Front 13

post angioplasty/PTCA

Back 13

abciximab

Front 14

bleeding patient

Back 14

PT, PTT, Blood Type, Crossmatch

Front 15

pregnant

Back 15

"Blood Type and Rh", "Atypical Antibody Screen"

Front 16

excessive bleeding

Back 16

"no aspirin" upon d/c

Front 17

upper GI distress

Back 17

"head elevation" "aspiration precautions"

Front 18

asthmatic

Back 18

bedside FEV1, PEFR (use to follow treatment progress)

Front 19

d/c

Back 19

change all meds to PO, nebulizer to MDI, d/c anything no longer required, move to proper setting

Front 20

AMS

Back 20

"fingerstick glucose", IV thiamine, IV dextrose, IV naloxone, utox, blood alcohol level, NPO

Front 21

hemolysis on ddx

Back 21

reticulocyte count

Front 22

on heparin

Back 22

platelets on day 3 and day 5, frequent H&H

Front 23

on coumadin

Back 23

daily PT/INR (until therapeutic 2 consecutive days)

Front 24

teratogens (list)

Back 24

list: coumadin, isotretinoin, doxy, OCPs

get B-hCG

Front 25

on furosemide (Lasix)

Back 25

KCl (hypokalemia)

Front 26

child on gentamycin

Back 26

audiometry, BUN/Cr before and after treatment

Front 27

pain

Back 27

IV morphine

Front 28

nausea

Back 28

IV Phenergan (promethazine)

Front 29

constipation

Back 29

PO docusate (Colace)

Front 30

diarrhea

Back 30

PO loperamide (Imodium)

Front 31

insomnia

Back 31

PO temazepam (Restoril)

Front 32

ICU pt

Back 32

IV omeprazole

Front 33

complete bed rest/pre-op

Back 33

"pneumatic compression stockings"

Front 34

if fluid status is vital

Back 34

Foley catheter, "urine output"

Front 35

effusion on CXR

Back 35

decubutis CXR next

Front 36

if you intubate

Back 36

"mechanical ventilation" (otherwise they just have a tube in their mouth)

Front 37

major procedure (surgery, biopsy, centesis)

Back 37

"consent for procedure"

Front 38

fluid aspiration (paracentesis, pericardiocentesis)

Back 38

get "fluid analysis" (it is not automatic)

Front 39

high dose steroids

Back 39

baseline DEXA, IV ranitidine, calcium, vitamin D, alendronate

Front 40

DKA or HHNC

Back 40

osmolality, ketone levels (serum)

Front 41

alcoholic ketoacidosis

Back 41

dextrose (insulin not needed), IV NS, IV Thiamine

Front 42

50+yr with no colonoscopy

Back 42

rectal exam, FOBT, colonoscopy/sigmoidoscopy

Front 43

women 40+yr

Back 43

yearly breast exam and mammogram (if risk factor, start at 35)

Front 44

men 50+yr

Back 44

prostate exam, PSA (if risk factor, start at 45)

Front 45

terminal disease

Back 45

"advanced directives"

Front 46

chronic disease with possible future AMS

Back 46

"medical alert bracelet"

Front 47

diarrhea

Back 47

"ova and parasites", "white cells", "culture", c-diff antigen (if warranted)

Front 48

drug levels to check:

Back 48

lithium, theophylline

Front 49

suspected MI

Back 49

statin (and check baseline LFTs)

Front 50

suspected hemolysis

Back 50

direct Coomb's

Front 51

women 18+yrs

Back 51

pap smear (unless normal pap within 1 yr)

Front 52

pre-op

Back 52

NPO, IV access, IV NS, blood type, crossmatch, analgesia, PT, PTT, pneumatic compression stockings, Foley, urine output, CBC, and any appropriate antibiotics if necessary

Front 53

beta-blocker pt requires epinephrine (anaphylaxis)

Back 53

glucagon first

Front 54

abnormal lipid profile

Back 54

TSH

Front 55

dementias and alcoholics

Back 55

"no driving"

Front 56

suspected alzheimers

Back 56

CT head, vit B12, folate, TSH, CBC, BMP, LFT, UA.

VDRL and HIV ELISA is history suggests it

Front 57

dementia

Back 57

r/o depression

Front 58

Every pt

Back 58

MVI on discharge, folate for women of repro age

appropriate pt counsel

seatbelt, exercise, compliance

Front 59

pancreatitis

Back 59

NPO, NG suction

Front 60

diets:

-diabetic

-HTN

-IBS

-Liver failure

Back 60

upon d/c:

-diabetic diet

-low salt diet

-high fiber diet

-low protein diet

Front 61

unstable angina

Back 61

DO NOT give tPA or streptokinase!!

Front 62

large amount of secretions

Back 62

pulmonary toilet, aspiration precautions

Front 63

pt at aspiration risk (overdose, comatose)

Back 63

CXR to r/o aspiration

Front 64

STD

Back 64

-do full STD check: Gonorrhea, Chlamydia, HIV, syphillis, papsmear

Front 65

croup

Back 65

"mist tent", racemic epinephrine

Front 66

abdominal pain w/ suspected perforation

Back 66

TRIPLE antibiotics: gent, amp, metro

Front 67

microcytic anemia

Back 67

irone, ferritin, TIBC

Front 68

vaginal discharge

Back 68

KOH prep, saline (wet) prep, vaginal pH, cervical gonococcal, chlamydia culture

Front 69

vaginal candida

Back 69

fasting glucose

Front 70

5 min warning!

Back 70

RATED SEX -recreational drugs, alcohol, tobacco, exercise, diet, seatbelt, education (pt), X (safe sex)

Front 71

child abuse

Back 71

admit, consult child protective services, consult ophthalmology (retinal hemorrhages), consult psychiatrist

Front 72

menopausal

Back 72

fasting lipid profile, DEXA, FOBT, colonoscopy

Front 73

colon cancer suspected

Back 73

CEA,

Front 74

pancreatic cancer suspected

Back 74

CA 19-9

Front 75

ovarian cancer suspected

Back 75

CA 125

Front 76

jaundice newborn

Back 76

phototherapy (if pathological unconjugated bilirubinemia)

Front 77

giving child prednisone

Back 77

PPD first

Front 78

high trigs

Back 78

amylase, lipase

Front 79

kid with high lead level

Back 79

venous lead level (to confirm)

-if >70 admit, IV dimercaprol and EDTA, and also "lead abatement agency" and "lead pain assay" at d/c

Front 80

arthrocentesis

Back 80

send synovial fluid for gram stain and also Crystals, Culture, Cell count (3 C's)

Front 81

hyperthyroid with exophthalmos

Back 81

prednisone (just synthroid will worse eyes)

Front 82

cancer

Back 82

oncology consult

Front 83

rapid afib

Back 83

diltiazem or metoprolol (decrease heart rate first, then deal with converting rhythm)

Front 84

new onset afib

Back 84

TSH

Front 85

suspected fluid volume depletion

Back 85

"postural vitals"

Front 86

before colonoscopy/sigmoidoscopy

Back 86

NPO, IV fluids (if necessary), polyethylene glycol

Front 87

Mobitz II or complete heart block

Back 87

immediate "transcutaneous pacemaker", cardiology consult (to implant)

Front 88

abnormal calcium

Back 88

serum magnesium, serum phosphorous, PTH

Front 89

malignant hyperthermia or NMS

Back 89

dantrolene

Front 90

splenectomy pts

Back 90

pneumovax, influenza vaccine, hemophilus vaccine

Front 91

if giving INH

Back 91

pyridoxine (B6)

Front 92

if giving pyrazinamide

Back 92

baseline uric acid level

Front 93

if giving ethambutol

Back 93

ophthomology consult

Front 94

if doing thoracocentesis (lung aspirate)

Back 94

send EFFUSION as well as PERIPHERAL BLOOD SAMPLE for: LDH, protein, pH (of effusion)

Front 95

sickle cell kid

Back 95

penicillin prophylaxis continuously until 5yrs

Front 96

recent anaphylaxis

Back 96

"skin test" for allergens, consult allergist

Front 97

what else to avoid if penicillin allergic?

Back 97

cephalosporins (ceftriaxone, cefepime, etc)

-5% are also allergic to them

Front 98

symptomatic palpitations

Back 98

Holter monitor

Front 99

first time panic attacks

Back 99

utox, TSH, finger stick glucose

Front 100

renal failure pt

Back 100

nephrology consult, calcium supplement, erythropoeitin, calcium acetate (decreases phosphorous),