All topics Flashcards
Mgmt after ingestion of caustic substances (burn/corrode) i.e. cleaner
Endoscopy within 24 hours, CXR if resp sxs.
Activated charcoal, corticosteroids, emetics, and acid neutralization is not recommended
Blood in urine but no rbc on microscopy
Myoglobinuria –> Rhabdomyolysis
Difference btwn heat stroke and heat exhaustion
Heat stroke: failure of thermoregulation. Rhabdomyolysis. CNS dysfunction and temps can go >104
Heat exhaustion: inadequate fluid/electrolyte replenishment. No CNS dysf(x), temps usually <104
Tinnitis, fever, hyperventilation, and anion gap metabolic acidosis after ingestion of too much of this
Aspirin
Victims of smoke inhalation (i.e. burning house) should be treated empirically for _______ poisoning to prevent cardiorespiratory arrest and neuro sxs
Cyanide
- ->hydroxycobalamin or sodium thiosulfate
- ->can give nitrites to induce methemoglobinemia
Carbon Monoxide (neuro sxs) -->100% O2 via non-rebreather
Pt with depression, comes in with anticholinergic effects (dilated pupils, intestinal ileus, tachycardia, dry mouth, urinary retenion), respiratory redepression, arrythmia/cardiotoxicity
TCA OD…antiCholinergic, Cardiotoxicity, Coma, Confusion
–>Tx: NaHCO3
Benzo toxicity/OD
CNS depression without much else. Less risk of resp depression/coma than barbiturates. Pupil size normal, respiratory rate may be normal.
–>phenytoin and alcohol OD look similar but will have +Nystagmus
Lithium toxicity
tremor, hyperreflexia, ataxia, seizures
Farmer comes in with organophosphate poisoning (all PNS type signs). Mgmt?
Atropine
Also, remove all clothes and wash body to prevent trasncutaneous absorption
Tx for acetaminophen ingestion/toxicity
Activated charcoal (for gastric decontamination) -->if high enough for liver damage, give N-acetyl cysteine
Diphenhydramine toxicity
looks like TCA OD cause strong anticholinergic effects. also have drowsiness and confusion from antihistamine effects.
–> Reverse with Physostigmine (cholinesterase inhibitor)
Ingestion leading to hypocalcemia + calcium oxalate crystals (flank pain + anion gap metabolic acidosis)
Ethylene glycol (anti-freeze)
Reversal of ethylene glycol OD (calcium oxalate stones/flank pain)
Fomepizole (or ethanol) –>inhibit alcohol DHase
NaHCO3 –>alleviate acidosis
may need hemodialysis in severe cases
Cyanosis and respiratory depression after Dapsone or Anesthesia
Methemoglobinemia –> Tx with Methylene Blue
what color will skin be in methemoglobinemia
blue (cynotic). tx with methylene blue.
unlike Carbon monoxide or cyanide poisoning
patient is having signs of opioid withdrawal. med?
Methadone!! do NOT give naloxone (this is going to make withdrawal worse)
most common cause of Mitral Regurgitation
MVP!!!!!!!!!!!! Mxyomatous degen. MS less common.
decreased globin chain synthesis vs defective globin chain synthesis
dec: thalasemmia
def: Sickle cell! defective beta-globin gene
difference btwn uncomplicated and complicated parapneumonic effusion
uncomp (sterile exudate in pleural space): pH>7.2, glucose >60, wbc <50k. Tx: ABx
comp (bacterial invasion in pleural space) Tx ABx, drain
vs Empyema = +gram stain and culture (neg in both uncomp and comp effusions)
T/F: Antipsychotics can cause unilateral bloody discharge from nipple
False. it would cause bilateral galactorhhea with amenorhhea
how do you work up abnormal nipple discharge?
Bloody or serous: MRI or US
Milky/nonbloody: blood tests
–>BUT…if there are skin changes/lumps, do MRI/US first
Endometriosis is discovered during an operative procedure. How is this treated?
Asx endometriosis = no treatment…OBSERVE
if sx, could do nsaids, OCPs, progesterone IUD
diagnostic peritoneal lavage vs exploratory laparotomy
lavage: for BLUNT abdominal trauma and hemo unstable and inconclusive FAST
ex lap: for PENETRATING trauma and hemo unstable/inconclusive FAST
Inhaled O2(+/- sumatriptan) with prophylactic verapamil
Tx of cluster headache