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boards 9 Flashcards

1
Q

what things does activated charcoal not work for

A

lithium, iron, cyanide, hydrocarbons, alchol, alkali, acid

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2
Q

what to use whole bowel irrigation for

A

sustained release drugs, iron, lithoium, drug packers, lead - CI with ileus obstruction

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3
Q

what drugs eliminated with urine alkalizationa

A

salicylates, phenobarb, INH - goal ph 7-8, replace K+

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4
Q

what drugs do you need to use HD for

A

salicylates, lithium, methanol, isopropanolol, ehtylene glycol, phenobarb, theophylline

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5
Q

what characteristics of drugs do you use HD on

A

low protein binding, low MW, small volume of distrib, water soluble

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6
Q

antidote for acetaminophen/ arsenic/ aspirin

A

NAC, BAL DMS, alkaline diuresis HD

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7
Q

antidote for B blocker, barb

A

Glucagon, intralipids, Alkaline diruesis and HD

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8
Q

antidoite for CA channel blocker, carbamate, CO

A

calcium, glucagon gluc/ins, intralipids ATROPINE, 100% o2

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9
Q

antidote for Warfarin, cyanide, digitalis

A

FFP vit k PPCC, hydroxycobalamin, na nitritem na thosulfate, DIGIBIND fab ab

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10
Q

what cause sincreased anion gap

A

MUDPILES- methanol/metformin, uremia, DKA, paraldehyde, IronINH, Lactic acidosis, ethylene glycol salicylates

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11
Q

increased osmolar gap

A

acteone, isopropanol, methanol, ethylene glycol, mannitol, ketoacidosis, ethanol

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12
Q

anticholinergic tox are eyes dilated or constricted

A

DILATED

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13
Q

causes of antich toxidrome

A

antihistamines, atropine, TCA, antiparkinsons, jimsonweed

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14
Q

treatent of cardiac complications of anticholinergic

A

lido or amio for ventricular dysrhthhma, na bicarb for Wide complex tachy, physostigmine

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15
Q

sympathomemtic toxidrome sxs- and hows it differ from antich

A

aigtated, sz, htn, tachy, sweating, dilated pupils - different because antich IS DRY NOT WET

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16
Q

cholinergic toxidrome treatment

A

atropine tirate to killer B - bradycardia, bhornchorhea, bronchospasm , 2-pam pralidoxome

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17
Q

what are the nicotiic effects of the cholinergic toxidrome

A

muscular weakness fasciculations and resp failure

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18
Q

mechanism of cholinergic toxidrome

A

inhibit cholinesterase- increased ACH

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19
Q

tylnoel nomogram keys

A

level greater than 140 at 4- they GET 140 mg/kg NAC- prevents toxic hepatic metaboolites from forming by using a cofactor

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20
Q

cn IV palsy, nystagmus, ataxia, global confusion

A

Wenickes encephalopathy - thamine b1

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21
Q

confabulation and retrograde amnesia

A

korsakoffs

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22
Q

anion gap acidosis, inc osmolar gap, visual symptoms, hx pain thinner, wood alcohol

A

methanol- nontoxic but metabolized to formic acid- sxs delayed 12-18 hrs - seziures, visual changes

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23
Q

treatment of ethanol

A

4pm- fomepizole, dilayiss

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24
Q

antifreeze, pain, solvents, anion gap acidosis, inc osmola gap - oxalic acids precipiatet in urine to form oxalata crysteal

A

ethylene glycol- renal failure, hematuria, hyopocalcemia, treatment fomepizole - inhibits alcohol dehydregenase - excretes EtG from urine

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25
Q

rubbing alcohol, CNS depression, ketosis but NO ACIDOSIS- normal anion gap, inc osmolar gap

A

isopropyl etoh, - pulm edema, hypotension, HD

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26
Q

young woan saw gyn recently started on medication now with flushing, diaphoresis, nv headache hypotension seizures dhysrhythmias

A

antabuse disulfiram rxn - Etoh + flagyl

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27
Q

overdose that causes cutaneous bullae

A

bartibutrates, tx charcoal, alkalinzation

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28
Q

how does CO affect oxy hb curve

A

shifts to LEFT, inhbits the release of oxygen from hemoglobin

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29
Q

descent injuries in scuba

A

squeeze syndroes- barotitis media - TM rupture, blocked eustacean tube , vertigo

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30
Q

pulmonary barotrauma- uncontrolled ascent problems

A

burst lung- ptx, pneummediastinum, hemothoaix or AIR GAS EMBOLISM- sudden - LOC and seizures - air emboli- has to go into DIVE CHAMBER

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31
Q

disorders of depth

A

nitrogen narcosis- neutoxic- inc partial pressure pushes out nitrogen- euphoria, confusion, disorentation, poor judgment- treatment with controlled ascent

32
Q

disorder of ascent

A

decompression sickness- if the nitrogen doesnt com out during a slow ascent - treatmetn recompression

33
Q

types of decompression sickeness

A

type 1- BENDS- MSK, skin, lymph, BENDs- periartiuclar pain- skin marbling- nitrogen trapped

type 2- CNS decompression sickness- high CNS concentration- paresethsias, weakness, headache, diplopia - can come on hours to days after surfacing - treat with decompression chamber

34
Q

summary - ascent vs descent disease

A

ascennt- pulmonary pressuization, air embolis, decompression ilnes gradual vs Descent- squeeze syndrome, nitrogen narcosis

35
Q

treatmetn of decompression sickness

A

recompresison/barometric chamber- low threshold - cant fly after diving or it will exacerabate decomrppessions sickness

36
Q

organs injured in blast type 1 trauma

A

TM, lung, GI, CNS

37
Q

what is chilblains

A

painful inflammaotry skin lesions - chronic inttemittnt exposure to non freezing dam temp- 1–12 hours after exposure - tx rewarming

38
Q

testing for syphillis

A

postive darkfield microscopy, RPR and VDRL are tests tof ollow for cure, positive after 14 days of chancre, can have false positives, Treponemal FTA ABS confirmatory- positive for life- best sens/spec

39
Q

jarisch herxheimer exn

A

release of endotoxin from pcn killing spirochetes- FEver, arthalgias, HA mylaigas

40
Q

painful genital lesions and UNILATERAL Adenopathy, buboes

A

chancroid

41
Q

groove sign- adenopathy above and below the inguinal ligament

A

LGV- chlamydia trachomatis- send NAAT - tx 3 weeks docycyline

42
Q

single painless ulcer, minimal, no sysetmic sxs

A

syphilis, tx pcn

43
Q

multiple shallow painless ulcers, flu like sxs precede lesions,

A

herpes- tx acyclovir

44
Q

single or multiple ulcers, with fluctuance adenopathy

A

chancroid, ceftraixone

45
Q

multiplepainless ulcers, groove sign

A

LGV- doxy

46
Q

most common STD

A

chlamydia- can cause infertility PID, co infxn w gonorrhea- cervicits, urethritis, PID, STERILE PYURIA, work up NAAT

47
Q

RUQ shoulder pain normal LFT hx PID

A

fitz hugh curtis

48
Q

yellow green frithy smelly discharge, punctate hemorrhages on cervix

A

vaginitis- flagellated protozoan- trichomonas - strawberry cervix - tx partner, warn disulfiram - in pregnangy associated with PPROM

49
Q

mcc vaginal discharge

A

BV - lactobacilli replaced by garderella and anerobes - thin white homogenous discharge, clue cells- ph >4.5, fishy odoer KOH whiff test -t x pregnant pateitns - risk PPROM, preterm labor - all symptoatic women and pregannt women get treated- do not treat asyptomatic women if not pregnant

50
Q

vulvar itching, diabetes hx, cotage cheese non odorous

A

candida vaginitis , tx fluconazole , imidazoles if pregnant

51
Q

when do corpus luteal cysts occurs

A

lsat 2 weeks of cycle- occur after mittleshemrerz when egg pops out- it gets vascular

52
Q

ovarian mass, choloclate cyst, pelvic tenderness

A

endometrosis, endometrial tissue outsidue ueterus, can even go to lungs and cause ptx

53
Q

leiomyomas fibroids mc in who

A

aa women, pelvic pain, abnormal bbleeding, anemia - tx nsaids, hormones

54
Q

mc gynegoli cnacer

A

uterine cancer (edometiral)- adenosarcoma mc, sarcoma worst

55
Q

vaginal bleeding in post menopausal woman

A

uterine cancer (endometrial)

56
Q

ascites in female - new onset

A

ovarian cancer- peak 55-65, rf infertiity, high fat diet, br ca colon ca - abd pain bloating weight loss, pleural effusion

57
Q

how does bhcg inrease

A

doubles eyver 2-3 days

58
Q

bleeing, pain, closed os, < 20 weeks,

A

th ab - vaignal rest

59
Q

bleeding open os < 20 weeks

A

inevitable, d/c

60
Q

bleedng tissue at os products of conception

A

incomplete ab d/c

61
Q

when can you do mtx for ectopic

A

tubal mass < 4cm, no fetal cardiac activiity - inhibits cell division

62
Q

treatment of IgG anti D abs

A

RhoGAM– prevent destroying rH+ fetal red cells in maternal circulation - so mom doesnt deveop rh+ abs- indicated in trauma or abortion, hemorrhage

63
Q

pregannt woman in trauma, bleeding

A

abruptio placentae- 3rd tripmester- needs L/D montioring- can also happen in cocain use and hypetension - US not senstive, fetal monitoring for distress - complications DIC

64
Q

when is pelvic exam contraindicated

A

placnta previa - over the os- panless 3rd trimeser bleeding- older multiparity smoking, prior c section - ultrasound

65
Q

painless 3rd trimester bleeding

A

previa no EXAM get US

66
Q

pregnant woman with proteinuria, low platelets, elevated liver enzymes , bp 140/90

A

pre E

67
Q

pregnancy with headache, vision changes, edema, RUQ pain

A

preE

68
Q

how to treat hypermag tox in PreE

A

ca gluconate

69
Q

contraindicated in pregnancy - what do you tx anticoag with

A

LMWH- CI drugs are ASA, NSAIDS ACE inhib, AG, warfarin, live vaccins MMR - anticonvulsants, ErgotAlkalodis

70
Q

when is preterm labor defined

A

37 weeks

71
Q

how to dx PPROM

A

nitrazine test- Blue >6.5, amniotic fluid

72
Q

in labor, exam looks like purple thumb

A

umbilica cord prolapse - KNEE CHST, elevated cord- immeidate c section

73
Q

Code BLUE L/D- 2nd 3rd trimester -

A

AFE- release amionitic fluid into maternal circultion- sudden CV colapse- shock - DIC

74
Q

PPH - which is MCC tx

A

uterine atony- enlarged uterus- fundal massage, oxytocin, IV fluids

75
Q

trauma in preg when to monitor

A

> 20 weks, minium 4 hours, signs of distress 8 contractions /hr suggest sabruption,

76
Q

breast infx, bug? breast feed ok? tx

A

staph, continue feeding, dicloacillin

77
Q

fever, abdominal pain, post partum, foul smelling lochi

A

endometritis

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