11/5/21 Flashcards
In addition to a third generation cephalosporin and vancomycin, which additional empiric antibiotic should be considered in adult patients over 50 years of age who are suspected of having bacterial meningitis?
Ampicillin
Following the diagnosis of pertussis, should close contacts be treated?
Due to the high communicability and potential for severe disease in young children, the CDC recommends initiating antibiotics for all close contacts, regardless of age or vaccination status, preferably within three weeks of diagnosis.
What is a dependent pocket of pus seen in the anterior chamber called?
Hypopyon.
Most mallet finger injuries are treated with
- volar splinting of the DIP joint in extension x six weeks
- Refer to a hand surgeon for follow-up
Most mallet finger injuries are treated with
- volar splinting of the DIP joint in extension x six weeks
- Refer to a hand surgeon for follow-up
A Boutonniere finger deformity
Caused by rupture of the central slip
characteristic DIP joint extension and proximal interphalangeal joint flexion
What can be used to treat hemodynamically stable torsades de pointes that is refractory to magnesium?
Transvenous overdrive pacing.
What are some relative contraindications to implementation of therapeutic hypothermia after ventricular fibrillation arrest and return of spontaneous circulation?
Relative contraindications include severe cardiogenic shock, life-threatening dysrhythmias, and uncontrolled bleeding.
How many patients with spontaneous esophageal rupture report no history of emesis?
25%
esophageal perforation contrasted CT
A water soluble contrast agent (ex diatrizoate meglumine) is preferred due to less mediastinal soiling and interferes less with visualization on endoscopy than barium contrast.
What is ciliary flush?
Conjunctival injection that is greatest around the limbus. This is seen in cases of iritis.
HCM Murmur
PE will show harsh crescendo-decrescendo systolic murmur that increases in intensity with Valsalva maneuver and decreases with squatting
hypertrophic cardiomyopathy (HCM) EKG
deep, narrow Q waves in the lateral and inferior leads with tall R waves in V1-V2 and large amplitude QRS complexes
What class of analgesic medications is contraindicated in the treatment of a patient with a traumatic hyphema?
Non-steroidal anti-inflammatory medications.
Reasons for ↑ protein on Lumbar Puncture
bacterial or TB meningitis, SAH, traumatic tap, MS, Guillain-Barré
Reasons for ↑ protein on Lumbar Puncture
bacterial or TB meningitis, SAH, traumatic tap, MS, Guillain-Barré
High Altitude Pulmonary Edema (HAPE) Rx
Treatment is immediate descent (most effective), supplemental oxygen
Most life-threatening high altitude illness
_______ is the only recognized reliable IO line finding on CBC
Hemoglobin
What is the mainstay of treatment for hypertrophic cardiomyopathy?
Long-term beta-blocker therapy.
_______ tags are given to patients without spontaneous respirations after one attempt to reposition the airway fails.
Black tags
______ tags are given to anyone that is able to walk away from the incident site and they are considered the walking wounded.
Green tags
______ tags are given to patients that have a respiratory rate less than 30 breaths/minute, a radial pulse or capillary refill less than 2 seconds, and are able to follow commands
Yellow tags
If they are breathing greater than 30 breaths/minute, they are assigned a _________ tag
red tag
What are the only two treatments rendered during START triage protocol?
Airway repositioning and direct pressure for hemorrhage control.
Disaster Triage- START
Black: deceased or expectant
Red: immediate
Yellow: delayed
Green: minor
In patients with evidence of hemodynamic compromise and cardiac contusion, what medication may be used to improve cardiac output?
Dobutamine.
How much air should be used to hyperinflate the tracheostomy cuff?
Up to 50 mL of air, but bleeding can be controlled with 10 to 35 mL depending on the size of the cuff.
Steps to control massive hemorrhage from a cuffed tracheostomy
1- Hyperinflate the tracheostomy cuff
2- Secure Airway with ET tube
3- Remove trach tube
4- Digitally compress innominate artery
What is the mechanism of action of fomepizole?
It inhibits alcohol dehydrogenase.
What is the gold standard for diagnosis of placental abruption?
Tococardiography.
