Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Rosh > Case conf > Flashcards

Case conf Flashcards

1
Q

HypoK pearls

A

HyperK widens QRS
HypoK prolongs QT (flattens T/ Biphasic T or U)
Give mag with it, give more than you think (100 for .3)
DC patient if QT is under 500, K 3.0 or higher, and not N/v (fix underlying) so they can swallow K replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

top peds rashes to think about

A

SSSS
SJS
Kawaski
Scarlet fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Super deep laceration repair

A

Close th emeat, jsut get it close and put a word catheter in and have them follow up in a week to repair again
msucle will tear- fidn the fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

peds arrest pearls

A

Calcium glcuonate 100 mg/kg
calcium chlride 20 mg/kg

Bicarb 2meq/kg

blood 10 cc/kg

epi .01 mg/kg

2j/kg shock (2J showed better than 4 J)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Complete white out of 1 lung DDX and approach

A
  1. Trachea pulled toward white lung
    - Atelectasis
    - L/R main stem
    - Pnuemonectomy
  2. Teachea away
    - HTX
    - PLeural effusion
    - Diaphram injury
  3. Trachea midline
    - Aspiration
    - COnsilidation
    - Pulem edema, ARDS, TRALI

put the good lung down with gravity UNLESS! lots of pus and blood then good lung up so no blood or pus cna drain into good lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ddx for SInus tach

A

Vitals: hypocxia SHock, fever
Chest pain: PE, Tmaponade, ACS, peri, myocard

Endocrine: Thyrotixcosis, pheo

Autonomic: Stimnulants/drugs/ withdrawal

Other: pain, anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hyperthyroid scale?

Tx?

A

Birch wortofsky

Steroids 300 mg IV hyrdocortisone

20 mg propanolol or esmlol (Unless they have CHF! listne to lungs)

MEthimazole
wait 1 hour then

potassium iodide

Causes: same 5 Is for DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When you see ST changes in lead AVL look to which lead ext?

A

lead 3- direct oppositie of it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Upright T waves in lead v1- good or bad?

A

bad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anisoicira DDx

A 
Brain- herniation/bleed
Eye- Cn3 or gluaocma
Trauma (iritis)
recent surgery or iris irritation
Drugs- anticholinergic or sympathomimetic (flower or cocaine snoorting or nebz arolsiolzed, scop patch)

pilocaprine challenge
Stays dilated- Rx mediated
constircts= oculomotor nerve palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

2 of 3 tings needed ot make pancreaitits dx

A

lipase 3x nromla limit
tendenr belly
CT imaging

Order LDH for inpatinet or TG3
insulin drips may be needed

can send home if stable

think abuot necrosis, thrombosis, pseudocyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hypothermia Tx

A

COntinuous core temp
Abx, synthrid, steorids (adrenal insufficiency)
Bair hugger, blankets
Warm IV fluids (take awhiel and not perfect)
Heated humidifed air!!!!

ECMO or CRRT can be used too- you want to get to at least 32 degrees celsius

check for pH, K

high dose thiamine for possible wernickes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PALS one ventilation every 6 or 4 seconds in kids?

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Valproate symptom, reaosn and tx

A

ataxia, AMS
Ammonia too high
L-canrintie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

cold damp, hot dog fish lloking toes with painful lesions?

A

chillblains or pernio- Warm and maybe CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define acute chest and what is TX?

A

Adequate and immediate pain control

●Fluid management to prevent hypovolemia

●Supplementary oxygen and incentive spirometry

●Blood transfusion

●Antibiotics

●Venous thromboembolism (VTE) prophylaxis

new radiodensity on chest radiograph accompanied by fever and/or respiratory symptoms

think about PE, ACS PNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

DEEP intverted t waves
3 causes non cardiac
5 cardiac

A

HypoK, ICP elevated, PE

Cardiac: ischemia, Pericaditis, myocarditis, Takosubo, HOCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

treating ethylene glycol, 5 txs?

A
  1. Fomeipozle 15 mg/kg loading dose and then 10 mg/kg q 12 hr
  2. 100 mg IV thiamine and B6
  3. correct acidosis with bicarb drip
  4. HD if ph <7.3, EG levels >50 or 300 after formpeizole given, AKI
  5. call position control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is your STEMI criteria

A

1 mm in all leads

V2 and V3:
Females: 1 mm
Males >40 2.5 mm
Males <40 2.0 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What mneunomic do you use for Reciprocal changes?

A

PAILS

Remember in inferior MI your RCA supplies posterior decsning too so youget posterior MI changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is monteggia fx

A

Proximal Ulna fx, radius dislocaiton

Galezzia- distla radius fx, ulna dislocation

check for nerve invvlement- this is long arm splint and operation

22
Q

Frozen shoudler

A

Phase 1: intial, painful, worse a tnight, stiff- months
phase 2- decreased ROM (up to 2 years)
Phase 3?

rule out fracture, dislocaiton, buritis, Rotator cuff injury, impingement, septic arthritis

NSAID, rest, possible injection, referral, PT

23
Q

PCP receptpor it blocks and pulmonary menifiestatoion?

A

NMDA glutamate

Leaky caps in lngs for pulm edema

24
Q

Non cards pulm edema ddx

A 
Drugs- opioids, naloxone, phencyclidine, and salicylates.
infection
PE
recent thoracentesis
ARDS
inhalation injury
aspiration
25
Q

Thrombytics dosing

Reperfusion stuff

A

15 mg over 2 min tpa
Accelerated idioventricular rhythm after tpa - kind of looks like v tach but negative deflecthon axis in 1/F - self resolving and normal
If inferior- get ready to pace

26
Q

5 steps to VT or SV abberancy- stable

A 
modified valsalva
12 mg Adenosine
Lidoncaine 1.5 mg/kg over 15 seconds 
procainamide up to 500 mgs
DC cardioversion

lido and procaine can go to gotehr - don’t mix with amio

27
Q

5 causes agitation in trauma patients

A 
Hypoxia 
HupoG
Blood in head 
Hem shock 
Hyper sympathetic alike coke
28
Q

Tca OD

A

Push 1 amp bicarb and then do a drip Shoot for 7.5-7.55 no higher you can do harm with protein binding etc!bdont pish a lot do
Blind bicarb

1 amp is 0.1 increase and 1 meq/kg get you 0.1-0.15

Qrs is marker of disease>100 is bad news

29
Q

Wood FB dispo

A

Admit - very dirty and infected

30
Q

What kills with adenosine

A

Dehydrated old sinus tach

Wide irregular and now uses bypass tract

31
Q

Adenosine vs silt in svt

A

Adenosine 12 in young and need quick

Silt 2.5 mg/min for old and a littler longer takes 10-15 min. Max at about 25 min. Pee treat with 3 cc calcium glauconate(doesn’t block chronograpy and helps with negativeniontorope effect to help with hypotension.) and has 98% conversion rate vs 86% adenosine 12mg

32
Q

Epi drip anaphylaxis

A

2mcg min
Im Epi is .3 or 300 mcg
Be careful of what you give IV - not 1 mg Epi IV!

33
Q

Sine wave

A 
Hyper K
Acidosis 
Bb 
Ccb 
Tca

Give bicarb!

34
Q

When to terminate arrests

A

No ROSC
unwitnessed
non shcokable rhythm
EPi and no return of pulse

no IV and asytole =dead, n ouse of ETT epi
reversible in the field- decomrpess, oxygenate and ventilate (HR <40 after epi magic number to stop)

35
Q

If you bolus Esmolol after mult shocks for v fib- start smolol and wait at least 5-7 minutes

A

that is all

36
Q

5 tx for non pregnan VB

A

blood
sto pcoagulaopathy (vwf?)
IV estrogen 25 mg q6 (dont do it is combined ocps) will stop in 6 hours
TXA 1 g (good data post partum bu tno downside to this)
Surgical or reboa

37
Q

Wide complex tachycardia

A

always think about:

  1. HyperK
  2. Sodium channel blockade OD
  3. Dig toxicity
    - and always give clacium and bicarb when thinking about this. Never give Amio/procain to this (lido is more shrot and safe)

Adensonise if you really can rule out VT. Never give in old people, irregular ryghtms but wide is controverisal in giving adenosine.

Lidocaine 1-1.5 mg/kg is the preferred drug in wide compelx tachyarrythmia (short on and off). Procaine 17 mg/kg or amio is your other choices but has side effects

if polymorphic VT: add magnesium. Overdrive pacing is what you do too (add 30 bpm over theri HR to narrow the complex)

38
Q

5 things to look if VT?

A 
Irregular then your done
P waves before qrs= done
Fusion 
Capture
Concordance v1-v6 and Axis (if neg, neg then VR
39
Q

Treating stable wide complex tacky

A

Modified valsalva
Adenosine (only if regular, kills if irregular)
Lidocaine is 20% of time
Procaine should work after 5 min- 100 mg/min 2 min, 50 3 min, then 35 for 4 min

40
Q

Nec fasc
1 lab
1 score
Gas on CT?

A

Low sodium
lrinec
48% sensitive, 92% spec- clinical diagnosis and rapidly spreading

41
Q

No access hypoG ?

A

1 mg IM glucagon or 3 mg intransal

Maybe IO too

42
Q

IO stuff

A

Want meta-epilhysis junction
Medial mal kid- just above the mm
anterior med midline femur 2-3 cm above tibia

43
Q

Night time pain, limp, peds - think….

A

Leukemia- 15% have limp

44
Q

Displaced supracondylar peds with NV not intact-

A

Don’t reduce- can do more damage- transfer for surgery

45
Q

Depressions in a retired leads and elevation in avr in SVT is…

A

Normal . Less normal if older

Trop leak is normal in young person if it goes in for awhile

46
Q

Want to give dilt but old and slightly on hypotension side…

A

Give calcium gluconate with it

2.5 mg/min max 50 mg over 20 min for svt if you want dilt

47
Q

Anaphylaxis updated lit pearls

A

5 min before a re dose epi
25 benadryl is best first line dose- but no real acute effects and MAY delay epi usage
If you need second dose of epi then start fluids, nto needed up frnt
Major change!: 3rd line is steroids and recoemmend against it bc it has no literature (cory is still giving, especially if severe anaphylaxis)
Still use 0.3 cc 1 min in 1cc IM epi
5% biphasic reactions-
if severe anaphylaxis or 2 doses at least 6 hours obs

48
Q

A fob can be rate controlled and sent home

A flutter can worsen the block snd needs to be in usually

A

Yup

49
Q

Incidence of stroke shocking a fib no AC

A

5%

Becarwful of things that look irrwfualr but also look like Vtach

50
Q

K centra used for

A

Wardarin
Xarelto
Eliquis

Rosh (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions