11/5/21 Bonus Flashcards
Black tags
given to patients without spontaneous respirations after one attempt to reposition the airway fails.
What is considered “high dose” aspirin therapy for management of Kawasaki disease?
80 to 100 mg/kg/day for 14 days, followed by 3 to 5 mg/kg/day for 6 to 8 weeks for those without coronary aneurysms or indefinitely for those with coronary aneurysms.
Green tags
given to anyone that is able to walk away from the incident site and they are considered the walking wounded.
Yellow tags
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
Red tag
If they are breathing greater than 30 breaths/minute
The increased risk of acute coronary syndromes is most pronounced in younger patients with lupus erythematosus and which other rheumatologic condition?
Rheumatoid arthritis.
Which two factors determine the risk of fetal death due to abruptio placentae?
Rapidity of separation and degree of placental surface affected.
What is the dose of propofol in procedural sedation?
Initial bolus of 0.5 to 1 mg/kg titrated to effect.
Ehrlichiosis and Anaplasmosis
Vector: ticks
Febrile illness, headache, myalgia, rash, chills
Labs w/ leukopenia, thrombocytopenia, inc LFTs
Test whole blood PCR, do not delay treatment
Rx: doxycycline
What is the most common complication of a corneal ulcer?
Corneal scarring.
What bacteria has a gram stain showing gram-positive cocci in chains?
Streptococcus
Pediatric Pulsless V-Tach algorithm
1- immediately defibrillate at 2 joules/kg
2- CPR x two minutes (100-120)
3- defibrillated at 4 joules/kg
*Epinephrine 0.01 mg/kg (0.1 ml/kg of 1:10,000 concentration) q3-5 min starting with the second defibrillation.
4- CPR x two minutes
5- defibrillated at 4 joules/kg
*Amiodarone 5 mg/kg IV/IO or lidocaine 1 mg/kg IV/IO if the patient remains in pulseless ventricular tachycardia after the third attempt of defibrillation.
6- An advanced airway should be placed.
Capnocytophaga canimorsus
GNR bacteria
responsible for fulminant bacteremic illness after a dog bite
Bartonella henselae
causative agent in cat-scratch disease
clinical syndrome of regional lymphadenopathy developing about one week after a cat bite or scratch
Eikenella corrodens
gram-negative rod bacteria transmitted via human bites
Pasteurella multocida
can be found in infected dog bites and even more commonly in infected cat bites.
What are the common adverse effects seen with etomidate?
Respiratory depression, myoclonus, nausea and vomiting.
A seizing patient with hyponatremia should be treated with _________________
3% hypertonic saline 2 mL/kg over 20-30 minutes.
What medications should be used with caution in patients with vasospastic angina?
Propranolol (can exacerbate attacks) and aspirin (inhibits prostacyclin at high doses and can precipitate attacks).
Treatment is calcium channel blockers and nitrates
Cryptococcus neoformans
- HIV meningitis w/ CD4 < 100/mm3
- India ink stain of CSF (round encapsulated yeast), cryptococcal antigen (CrAg): CSF or serum
- Rx amphotericin B (fungicidal), flucytosine (fungicidal), fluconazole (fungistatic)
Disseminated Intravascular Coagulation (DIC) Labs
- thrombocytopenia
- decreased fibrinogen
- increased fibrin split products and Dimer
- increased BT, PT, and PTT
Immune thrombocytopenia
- acquired autoimmune thrombocytopenia without an identifiable cause.
- Auto-antibodies attach to platelets which signals for their removal by the reticuloendothelial system.
- sx: plts< 20,000 with normal bone marrow.
- most commonly presents in children 2 to 6 years of age and frequently develops within 3 weeks of a viral illness.
- ITP will typically resolve in 1 to 2 months.
- The chronic form, which is more common in adults and associated with SLE and HIV, can present with epistaxis, gingival bleeding, and menorrhagia
What protein is not cleaved into smaller units leading to long strings of multimers and ultimately causes thrombotic thrombocytopenic purpura?
von Willebrand factor.
moderate croup
stridor at rest with mild to moderate retractions
Treatment for moderate to severe croup requires administering dexamethasone and nebulized racemic epinephrine.
severe croup
Stridor at rest and marked retractions with agitation, lethargy, or cyanosis
Treatment for moderate to severe croup requires administering dexamethasone and nebulized racemic epinephrine.
What formula is used to calculate the minimum systolic blood pressure for a child aged 1–10 years?
Minimum SBP = 70 + (2 x age in years).
Minimum SBP = 70 + (2 x age in years).
Neonate: 100–205 bpm 1 month to 1 year: 100–190 bpm 1–2 years: 98–140 bpm 3–5 years: 80–120 bpm 6–11 years: 75–118 bpm ≥ 12 years: 60–100 bpm
