Cinco de MAYyyOOOO Flashcards
Dacocytitis path, tx, dispo/
Nasolacrimal duct infection
Augmentin- consider MRSA
Dispo to ophtho 24 hrs
Cr 5, BUN 75- think what type AKI
Pos renal 10-20 ration
<10 = intrisinc
Septal hematoma Dx, Tx, dispo
outpuchinginto nare of peirchonrium. necrosis, saddle nares, obstruciton complications with it
gauze in lidocaine, incise and drain it. Pack both sides.. Follow up ENT 24 hrs
young, bunch of diarrhea, pancreatitis, recent PNA…
CF
vitmain deficincies ADEK
Kid tube size
kid tube length
prbc transfuin
age/4+4 tube size x3 10 cc/kg less likely c spine injnrueis SCWIRA needs MRI
Stingray- Hot water
jelly fish- Vinegar
intoxicated down- nitrogen narcosis, ascent
vertigo diving down-Barotrauma
SOB ascending- Barotrauma, PTX, volume expanding in lungs
Descent- nitrogen narcosis, barotruam ear, mask squeeze
Scent- pulm barotrauma
surfacing- Air emoi and decomrpession sickness
hem shock transfusion stuff
1:1:1 has shown best outcome
give plasma and rbcs up front
you can also give 1 g TXA over 10 minutes follow by 1 g over 8 hours if injury was within 3 hours
think about reversing coagulapthy if the have one in PMH
after 6 units- check fibrinogen level, if 5200 then gie Cryo.
- find the hole and stop it
- chase it with 1:1
- reverse coaglaopthy
- think TXA
syncope, AS mumur, HTN- what med?
NOT BB!
Lisinopril
recent diarrhea now arthritis - why?
reactive arthritis HLA b27
Polycysitc kidney disease die form
CAD or SAH
what 2 (3ish) things do you need to a kid cric
16 G needle
- 0 ETT adapter
- 5 cc syringe: aspirate air, easy to go thru and thru here
then BVM them to temporize them - take the pop off valve off to overcome necessary pressure (takes a lot)
Tylenol and NAC stuff
If >8 hours- you gotta start NAC and not wait, not as effective after 8 hours
watch out for anaplhyalxis
150 mg/kg loading bolus (max 15 g)
RA patient with neck pain…
NEED to check for Atlantoaxial subluxation
- bony errosin and pannus around odontoid
if no compression symptoms- C collar follow up
compression- surgery
what do labs look like in sickler aplastic crisis?
only hgb down, retic up
wbc up or normal
Parvo gets at the RBC precursor only
PSGn after what two infections
Pharyngitis
Impetgito (even if treated)
SJS tx and dispo
SUpportuv, hydration, Burn center or ICU
can occur after mycoplasma or HSV infection or drugs
autoimmune against epideermis and mucous membranes
from target to bullae!
HSP is is IGA vascultiis
central socotoma?
MS will devleop soon. APD and optic neuritis
What is erythema infectiousium?
what is papular acrodermatitis or GC syndrome?
slapped cheek with oral sparing
recent infections and now a mild itchy, symmetrical, little raised red rash face, butt legs
NEW STD recs?
500 CFTX and Doxy BID 7 days
PID CFTX and DOXY 14 days
Dissemintated (Rash, arthragias)- CFTX and cefixime?
Hypothermia perals
If you re-warm them to 90 and still no pulse- you can stop
Amio and epi don’t work at <82 degrees
1 shock, if it doesnt wokr gotta rewarm! <82 degrees dont work
sexual assault full meds to give
PEP
CFTX azithro metronidoazole HIV Hep B vaccine and Ig
HIV 0.3%
Hep B and Hep C is 2-3% risk. Hep B is only vaccine and Ig not much doen for HEp C
PCR hep C, Hep B s Ag, Rapid HIV
TV pacemaker pearls
Gotta be at least 20 cm, STE on ecg monitor shows right spot, pacer spike then QRS all means you are in the right spot. rate ~80 and output to 5 mA.
then decrease and see what trheshold is and put it back up 3x that amount
SALTER
Separaterd above lower thru rammed
PSGN is a type….
3 hypersensitivity
2 CANT miss Dx in ED
Hand stuff
Posterior strokes
NIH of 5 is techincially pusing TPA
*remember of your anchoring bias on NSTEMI torp positive that came in as a neuro patient
what is epirodrmoid cyst and what to do
ANgle of mandible cyst, neck cyst. Sebacous, ketirnacous thick waxy fluid. I & D and the try to excise it. if inflamed, maybe pass on ID it
peritoneal dlaysis X # of WBC needed
100
outpatient abx if they look well __ into the peritoenum
in order MI predicotrs
Exertion
radiation
pressure like
diaphroesis
Nausea, headcahe, head stuff after HD?
rapid removal of BUN- slight cerebral edema- just slow HD and think about manntil
disequilibrium syndrome
acute repsiraotry distress, new murmur?
If AR then afterload reduction and pressors
Septal hematoma care
ID
and then PAck it!
Pilondial cyst dispo
ID, keflex if infect, Outpatient urgery
ASA lvl for dialysis?
100 acute
what is your next drug if adenosine doesnt work?
2.5 mg/min Dilt w/ max of 40- works in 8-10 minutes.
Dont use in CHF
Hyponatremia approach
Correct glucose
Volume status
calculate Osms
Acute or chronic (48 hours) mild mod severe to 130, 120-130, below 120 Symptoms: mild, moderate severe Admit, acute, 120, symptoms
100-150 cc bolus 10 mins up to X3
improve 2-3 over first hour. then 6 in 6 hours. 1 bolus gets yo 2-3 usually. A single bolus is very safe.
if nto super bad, jsut fluid restrict and watch!
Lis Franc
>2 mm difference dorsal displacent on lateral get a 2 foot view to compare can be off a curb! US 2.5 mm to 1/2 TM joint
asthma exacerbation outpatient tx
albulterol and oral steroids
kid not getting better with fludis and pressors needs…
3 mg/kg hydrocortisone
What is enopthalmitis?
iritis?
emergency- hypopyn usually- infection of aquesous flow
iritis = ant uveitis- CMV/HErpes,auto immune- cil flush with a flare
You do a pelvic on a preggo, looks like possible infeciton- need to do a..
bimanual! PID = in patient abx
MC seconary bacterial PNA
Strpe pneumo
then staph
E candidAISS TX
Oral fluc
nystaitn is mouth
what is immersion foot
trench foot
NV damage from cold/wet sock
cyosnis, maybe sloughing
frost ni is superficial and tingling
bite=ice crystal, ischemia
abdominal comaprtment syndorme
above 20
organ faiure, reduced CO
diruetics, vs HD- foley cathter, paralyze and sedate
,may different causes
black widwo spasms tx
clacium
aflutter
treat like a fib - it can be irregular with variable AV block
regular- little letricity like 50 J
HD requirements
potassium > 6 mEq/L, creatinine > 10 mg/dL, uric acid > 10 mg/dL, symptomatic hypocalcemia, serum phosphorus > 10 mg/dL, and volume overload, as it limits the ability to administer intravenous fluids.
fluids first line TLS therapy- check G6PD for rasvburicase
what order of stuff do you do for meningitis
dex
abx
ct
lumbar puncture
treatment mobitz 1
aysmtpatic and usally nothigng
how to trreat brash?
fluids
pressors
hypoerK stuff
Why acute dystonic reaction
remember anti dopamine- so excess acyehtlcholine - give benadryl
seizure +/-, HA, vision loss, AMS HTN
PRES
BP up and endothelian dysfynciton leading to vsaogenic edema
peppery taste…
scromboid with flusign and headache
SSSS stuff
starts on face, usually after URI, has a focal exotxoin point and spreads to the rest of the body (bullae wont spread the toxin)
anti staph nafcillin or vanc if ba d
Charcoal indications and cotnras
No AMS (pneumonitis is severe), within 1 hour, has to be a toxic dose heavy metals (e.g., arsenic, lead, iron), inorganic ions (e.g., lithium, sodium, calcium, potassium), corrosives (e.g., acids, alkali), hydrocarbons (e.g., gasoline), alcohols (e.g., ethanol, ethylene glycol, isopropanol), essential oils, and boric acid a single pill of clonidine, chloroquine, beta-blockers, calcium channel blockers (e.g., verapamil), imidazolines, organophosphates, opioids, sulfonylureas, and tricyclic antidepressants can cause severe morbidity and even deat
If they need a scope, AMS, >1 hr,
febrile , appears well, bilateral ear infeciotn tx
amox
erythema nodosum associated with
sarcoids
slef limited
burst eard drum stuff
keep dry and follw up- no ppx abx
clotting
protein C puts the brakes on clotting cascade- none of it =prothrombotic
facto 5 leidine- factor 5 helps the blood clot. Protein C not able to put the brakes on so= prothrombotic state
humerus fx check for
radius nerve wrist drop
what is neutropenic enterocolitis?
typhlitis - polymicorbial infeciton in ileocecal region
fever, abd pain, chemo
supportive and Abx, bowel rest
BB OD tx
atoprine, glucagon, fluds
then epi
then pace
Lye ingestion management
Endoscopic and airway
no charcoal, gotta go in and see the damage
bipolar 1 vs 2
1=mania
2=hypomania and dperession
what is tripod fx
maxilla, zygoma, lateral orbit
surgery or else dental paraestheias
when to tx chicken pox
over 12
immunocompromised - watch out pnumonitis, encpehalits, superimposed infection
head down rash, vaccine is live
refeeding sstuff
replace phosphate first! a nromal heart rate means poor heart function. watch out out for diaphragm weakness.
give phosphate, thiamine and other eleccytrolyres
