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EM r 2020 > 2/15 > Flashcards

2/15 Flashcards

1
Q

Inferior orbital wall frx associated with

A

Paralysis of vertical gaze
Infraorbital anesthesia
Diplopia

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2
Q

S wave has a little chair on EKG called and cause

A

Epsilon wave

Sudden death

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3
Q

Iron deficiency anemia lab test results should be

A

Generally low

Transferrin, RDW, and TIBC is high

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4
Q

Achilles rupture manage

A

Splint ankle in slight plantarflexion

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5
Q

Bupivacaine toxicity tx

A

Intralipid

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6
Q

Chest pain and SOB after working in farm silo dx

A

Nitrogen dioxide pneumonitis

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7
Q

ST depressions in anterior leads dx

A

STEMI posteriorly

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8
Q

Hypotensive bradycardia on Dig tx

A

Dig antibody

Transcutaneous icing and atropine don’t work for dig

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9
Q

Positive fast on unstable Pt next step

A

OR

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10
Q

When to stop T1DM insulin pump

A

Keotacidosis

Assume it isn’t working and start insulin drip

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11
Q

Basal ganglia hypodensities ass with

A

CO poisoning

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12
Q

Nurse aids reduction movement

A

Elbow at 90 the. Supinate and flex

Or pronate at 90 degrees

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13
Q

Common perineal nerve supplies skin

A

Anterior shin

Top of foot

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14
Q

Radiation exposure good predictor of prognosis

A

Absolute lymphocyte count

Lower worse

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15
Q

Draining thoracentesis location

A

Two interapaces below full precussion

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16
Q

DIC labs

A

high INR
Low hgb and plt and fibrinogen
High ddimer

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17
Q

Pyeloneohritis

A

Cipro, augmentin, trim-sulfa

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18
Q

Gray pseudo membrane on gums dx

A

Necrotizing ulcerative gingivitis

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19
Q

Anaphylaxis epinephrine conc and peds dose

A

1mg/ml

0.01mg/kg

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20
Q

Depression medication adjusted presents with hypertension, tachycardia, fever, muscle rigidity dx and tx

A

Serotonin syndrome
Benzos and cypriheotadine
Hydration, cooling

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21
Q

Migraine meds increased now facial droop, miotic pupil, ST depressions, slurred speech, and burning sensation drug

A

Dihydroergotamine

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22
Q

Pulm wedge pressure only elevated in pulmonary edema from

A

Cardiac

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23
Q

Factor viii replacement in setting of bleeding dose

A

1U/kg increase circulating factor viii by 2%

Life threatening bleed need 100 % =50U/kg

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24
Q

Electroshock with normal EKG and negative UA next step

A

Discharge

UA negative for myoglobin rules out rhabdo - only get CK If positive

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25
Q

Main risk factor for endometriosis after birth

A

C-section

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26
Q

Guillian -barre vs transverse myelitis

A

Transverse myelitis has a distinct cut off level of symptoms

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27
Q

Sepsis with headache and AMS
Leg bruising, low plt, elevated INR, schistocytes
Dx

A

DIC

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28
Q

Waterhouse-Friderichsen define

A

Complication of meningitis

Hemorrhages of adrenal glands causing adrenal failure

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29
Q

SBT if WBC is above

A

100wbc/mcl

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30
Q

Pediatrics cervical spine location most common

A

C2-C3

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31
Q

PID tx

A

One time cefteiaxone and
Doxy 100ng bid for 14D
Azithro 1g one a week for two weeks

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32
Q

Verapamil is contraindicated one age and why

A

12mo or younger

Profound hypotension, cardiovascular collapse

33
Q

Fever, tachycardia, HTN, extreme rigidity overdose on and dx

A

Antiemetic (metoclopramide and promethazine)
CNS stimulants

Neoroleptic malignant syndrome

34
Q

Child knee pain and refusing to walk after trampoline next step

A

X-ray

Tibial frx

35
Q

Dental injury to Denton and enamel next step

A

Cover with calcium hydroxide paste

36
Q

Preg mom in MCV ok initial exam next step

A

Cardiotoco monitor

37
Q

Cellulitis with hx dialysis and recent admission abx

A 
Amoxicillin and doxycycline 
Bc concern for MRSA 
Also could pick 
Amox and minocycline 
Trim-sulfa
Clinda
38
Q

Wilderness bite

Elapidae species is

A

Coral snake

System symptoms

39
Q

Crotalidae species

A

Pit viper, local symptoms

40
Q

Centruroides species

A

Scorpion

41
Q

Swallows lye at intubation next step

A

Scope

42
Q 
Hx COPD presents with wheezing, leg swelling, third heart sound,  a fib, 
Hypotensive 
Gave fluids and worsen BP and arrested 
Cause?
See on US prior to fluids
A

Pulmonary hypertension

D sign

43
Q

Vaginal discharge 9 year old
Infection
Tx?

A

Amoxicillin

Staph, strep,

44
Q

Most common presentation of adult ASD

A

Afib

45
Q

Peritoneal dialysis infection
Not systemic
Tx

A

Intraperitineal abx

46
Q

Chest tube without respiratory fluctuations or decrease drainage problem

A

Blocked up

47
Q

Elevated INR with bleeding that has resolved tx

A

Oral vit K, and hold next dose

48
Q

Concern for cavernous sinus thrombosis how to test

A

MRI

49
Q

When fetus most prone to CNS issue with radiation.

A

Weeks 2-8

50
Q

Intussecption imaging

A

US

51
Q

P

Epistaxis after packing management

A

Follow up in 48hrs to remove

52
Q

Dextromethorphan can cause

A

Serotonin syndrome

53
Q

BMS vs serotonin syndrome

A

Serotonin syndrome has tremors and increased reflexes

54
Q

LLQ abd, vomiting constipation, UA leuks but nothing else, white count and a lactate dx

A

Diverticulitis

Can irritate bladder

55
Q

Toxic alcohol electrolyte abnl

A

HypoCa

56
Q

D10 to what age group

A

<1yo

57
Q

Low sodium + seizure
Receive 3% saline
Next step

A

0.9% saline infusion

58
Q

Intracranial brain bleed management

A

Head of bed 30

Neurosurge consult not really helpful

59
Q

Stroke symptoms after diving tx

A

Arterial has embolism

Hyperbaric chamber

60
Q

Salter-Harris

A 
1 is in it 
2 above 
3 below
4 through it
5 erasure of growth plate
61
Q

Peds ingestion
Confused, vomiting, transaminitis
Drug

A

ASA

62
Q

Mandated reporting of in most states

A

Child and elderly abuse

Not epilepsy

63
Q

Asa toxicity metabolic status

A

Respiratory alkalosis and metabolic acidosis

64
Q

Paracentesis in obeses

A

Spinal needle

65
Q

Asthma in pregnancy

A

Meds are safe

66
Q

Most common atypical presentation of ACS in old ppl

A

Sob

67
Q

Need to increase adensosine if Pt on

A

MNethylxanthines

Theophylline

68
Q

Painfual rash with oral lesions
Dx and exam finding
Hx of cold sore

A

Steven-Johnson
Positive Nikolsky sign
Infectious causes are herpes and mycoplasma pneumonia

69
Q

Facial swelling with frontal bone hole

Dx

A

Sinusitis

Hole from abscess osteomyelitis

70
Q

Toddler with no displace frx tibia next step

A

Ankle boot

Better than splint with less side effects

71
Q

Toxic ingestion with episodes of coma/reap depression and agitation is

A

GBH

72
Q

Iron ingestion best predictors of severity

A

Serum iron concentration

73
Q

Meth and cocaine managmenet if tachycardia

A

Wide complex treat with sodium bicarbonate

74
Q

Most specific exam find of acute otitis media

A

Bulging disc

75
Q

X-ray position for retropharyngeal abscess

A

On inspiration with neck extension

76
Q

Kid with prior sinusitis now with AMS and sepsis dx and test

A

Brain abscess

Ring enhancing lesion CT

77
Q

Hodgkin lymphoma presentation

A

Painless cervical lymphadenopathy

As well as b symptoms

78
Q

Drunk colleague with concern for Pt harm next step

A

Report to states physician health program

EM r 2020 (8 decks)

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