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Emergency Medicine > Case files: EM > Flashcards

Case files: EM Flashcards

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1
Q

What is the differential of sore throat? (obviously the list could go on, but name common and can’t miss) ()

A
  1. Strep pharyngitis
  2. Viral pharyngitis
  3. Peritonsillar abscess
  4. Retropharyngeal abscess
  5. Ludwig’s angina
  6. Epiglottitis
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2
Q

What are the components of the Centor criteria?

A

1+ point for each positive finding except -1 point for number 6 if positive:

  1. Tonsilar exudates?
  2. Tender anterior cervical adenopathy?
  3. Fever?
  4. Abscence of cough?
  5. Age less than 15?
  6. Age more than 45?
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3
Q

Regarding Centor scores, what are the indications for a score of 0-1? 2-3? 4+?

A
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4
Q

What are the non-supperative complications of strep pharyngitis? (4)

A
  1. Rheumatic fever
  2. Streptococcal toxic shock syndrome
  3. Post-strep glomerulonephritis
  4. PANDAS (pediatric autoimmune neuropsychiatric disorder associated with GAS)
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5
Q

What are the supperative complications of strep pharyngitis? (7)

A
  1. tonsillopharyngeal cellulitis
  2. Peritonsillar abscess
  3. Retropharyngeal abscess
  4. Sinusitis
  5. Meningitis
  6. Brain abscess
  7. Streptococcal bacteremia
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6
Q

What is the presentation of epiglottitis? How do you diagnose? What is the treatment?

A
  1. Sudden onset of fever, drooling, tachypnea, stridor, toxic appearing
  2. Lateral cervial Xray (thumb-printing sign)
  3. ENT consult, Helium-O2 mixture, cefuroxime
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7
Q

What is the presentation of retropharyngeal abscess? How do you diagnose? What is the treatment?

A
  1. Fever, sore throat, stiff neck, no trismus
  2. Lateral cervical Xray or CT
  3. Stabilize airway, surgical drainage, abx (penicillin and metronidazole)
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8
Q

What is the presentation of ludwig angina? How do you diagnose? What is the treatment?

A
  1. Fever; chills; trismus; submaxillary, sublingual, or submental mass with jaw elevation of tongue; jaw swelling
  2. Lateral cervical Xray or CT
  3. Stabilize airway, surgical drainage, abx (penicillin and metronidazole)
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9
Q

What is the presentation of peritonsillar abscess? How do you diagnose? What is the treatment?

A
  1. Fever, sore throat, dysphagia, trismus, swelling in the peritonsillar region with uvula deviation, hot potato voice
  2. Cervical Xray or CT
  3. Abscess drainage, abx (penicillin and metronidazole)
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10
Q

What is the definition of unstable angina?

A

ACS (UA, NSTEMI, STEMI)

acute onset of chest pain in the absence of elevated cardiac biomarkers

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11
Q

What is the definition of NSTEMI?

A

ACS (UA, NSTEMI, STEMI)

acute chest pain with the presence or absence of ST-depression, but not ST-elevation, with positive cardiac biomarkers

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12
Q

What is the definition of STEMI?

A

ACS (UA, NSTEMI, STEMI)

acute chest pain with ST-elevation found in two or more contiguous leads (resulting in Q waves if perfusion is not soon restored) with positive cardiac biomarkers

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13
Q

What are the 3 indications for immediate reprofusion therapy in a STEMI?

A
  1. ST-elevation in 2 contiguous leads and <12h since onset of pain
  2. New LBBB
  3. ST-elevation in posterior leads (V1-V3) or ST depression in V1-V3 with prominent R wave and upright T wave suggestive of a posterior STEMI
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14
Q

What are risk factors for CAD?

A

DM
HLD
HTN
Age (45+ in men and 55+ in women)
Tobacco
Family history
Sympathomimetics (cocaine, amphetamines)
Rheumatologic conditions (RA, SLE)

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15
Q

When are nitroglycerine and beta-blockers contraindicated in ACS?

A

Nitro should NOT be given if recent use of viagra, if hypotensive, or if patient is having a right-sided MI

Beta-blockers can be contraindicated if they have severe reactive airway disease (non-DHP Ca+ blockers can be substituted)

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16
Q

When a patient presents with chest pain, what meds should you give them?

A

Morphine, O2, Nitro, and most importanly ASA as it decreases mortality

17
Q

What are common diseases associated with atrial fibrillation?

A
18
Q

What is atrial fibrillation with rapid ventricular response?

A

irregularly irregular rhythm with a rate 100+ bpm

19
Q

What are serious early complications of a fib with RVR? late complications?

A

early - decreased CO (loss of atrial “kick” aka contraction)

late - thromboembolism and cardiomyopathy

20
Q

What is the algorhythm for a fib? (Use Online MedEd)

A
21
Q

What are the contraindications for the use of RATE CONTROLLING agenets in patients with a fib?

A
  1. unstable patients
  2. patient also has WPW syndrome (can lead to accelerated conduction in accessory pathway which can potentially induce V fib)
22
Q

What are the components and points of CHADS2?

A

CHF +1
HTN +1
Age 75+ +1
DM +1
Stroke or TIA +2

23
Q

What is ddx for regular tachyarrhythmias with narrow QRS complex?

A
24
Q

What is ddx for regular tachyarrhythmias with wide QRS complex?

A
25
Q

What is ddx for irregular tachyarrhythmias with narrow QRS complex?

A
26
Q

What is ddx for irregular tachyarrhythmias with wide QRS complex?

A
27
Q

How do you treat narrow and wide QRS complex tachyarrhythmias? (Use Online MedEd algorhythm)

A
28
Q

How do you treat a patient who experienced nonsustained ventricular tachycardia?

A

Treat underlying heart diasese. No need for amioderone or other rate controlling drugs if not in VT

29
Q

A patient presents with a tachyarrhythmia. You are unable to determine if they are experiencing VT or SVT with aberrancy. How do you treat the patient?

A

Assume the patient is in VT

Amioderone 1st line
Lidocaine 2nd line

30
Q

What are the criteria for SIRS?

A

Two or more of the following:

Temp >38C or <36C
HR >90
RR >20 OR PaCO2 <32mmHg
WBC >12,000 OR <4,000 OR >10% bands

31
Q
A

Emergency Medicine (1 decks)

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