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Rosh > Cinco de MAYyyOOOO > Flashcards

Cinco de MAYyyOOOO Flashcards

1
Q

Dacocytitis path, tx, dispo/

A

Nasolacrimal duct infection
Augmentin- consider MRSA
Dispo to ophtho 24 hrs

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2
Q

Cr 5, BUN 75- think what type AKI

A

Pos renal 10-20 ration

<10 = intrisinc

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3
Q

Septal hematoma Dx, Tx, dispo

A

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

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4
Q

young, bunch of diarrhea, pancreatitis, recent PNA…

A

CF

vitmain deficincies ADEK

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5
Q

Kid tube size
kid tube length
prbc transfuin

A 
age/4+4
tube size x3
10 cc/kg
less likely c spine injnrueis
SCWIRA needs MRI
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6
Q

Stingray- Hot water
jelly fish- Vinegar
intoxicated down- nitrogen narcosis, ascent

vertigo diving down-Barotrauma

SOB ascending- Barotrauma, PTX, volume expanding in lungs

A

Descent- nitrogen narcosis, barotruam ear, mask squeeze

Scent- pulm barotrauma

surfacing- Air emoi and decomrpession sickness

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7
Q

hem shock transfusion stuff

A

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.

  1. find the hole and stop it
  2. chase it with 1:1
  3. reverse coaglaopthy
  4. think TXA
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8
Q

syncope, AS mumur, HTN- what med?

A

NOT BB!

Lisinopril

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9
Q

recent diarrhea now arthritis - why?

A

reactive arthritis HLA b27

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10
Q

Polycysitc kidney disease die form

A

CAD or SAH

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11
Q

what 2 (3ish) things do you need to a kid cric

A

16 G needle

  1. 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)

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12
Q

Tylenol and NAC stuff

A

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)

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13
Q

RA patient with neck pain…

A

NEED to check for Atlantoaxial subluxation
- bony errosin and pannus around odontoid
if no compression symptoms- C collar follow up
compression- surgery

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14
Q

what do labs look like in sickler aplastic crisis?

A

only hgb down, retic up

wbc up or normal

Parvo gets at the RBC precursor only

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15
Q

PSGn after what two infections

A

Pharyngitis

Impetgito (even if treated)

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16
Q

SJS tx and dispo

A

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

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17
Q

central socotoma?

A

MS will devleop soon. APD and optic neuritis

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18
Q

What is erythema infectiousium?

what is papular acrodermatitis or GC syndrome?

A

slapped cheek with oral sparing

recent infections and now a mild itchy, symmetrical, little raised red rash face, butt legs

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19
Q

NEW STD recs?

A

500 CFTX and Doxy BID 7 days

PID CFTX and DOXY 14 days

Dissemintated (Rash, arthragias)- CFTX and cefixime?

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20
Q

Hypothermia perals

A

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

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21
Q

sexual assault full meds to give

PEP

A

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

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22
Q

TV pacemaker pearls

A

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

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23
Q

SALTER

A 
Separaterd
above
lower
thru
rammed
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24
Q

PSGN is a type….

A

3 hypersensitivity

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25
Q

2 CANT miss Dx in ED

A

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

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26
Q

what is epirodrmoid cyst and what to do

A

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

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27
Q

peritoneal dlaysis X # of WBC needed

A

100

outpatient abx if they look well __ into the peritoenum

28
Q

in order MI predicotrs

A

Exertion
radiation
pressure like
diaphroesis

29
Q

Nausea, headcahe, head stuff after HD?

A

rapid removal of BUN- slight cerebral edema- just slow HD and think about manntil

disequilibrium syndrome

30
Q

acute repsiraotry distress, new murmur?

A

If AR then afterload reduction and pressors

31
Q

Septal hematoma care

A

ID

and then PAck it!

32
Q

Pilondial cyst dispo

A

ID, keflex if infect, Outpatient urgery

33
Q

ASA lvl for dialysis?

A

100 acute

34
Q

what is your next drug if adenosine doesnt work?

A

2.5 mg/min Dilt w/ max of 40- works in 8-10 minutes.

Dont use in CHF

35
Q

Hyponatremia approach

A

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!

36
Q

Lis Franc

A 
>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
37
Q

asthma exacerbation outpatient tx

A

albulterol and oral steroids

38
Q

kid not getting better with fludis and pressors needs…

A

3 mg/kg hydrocortisone

39
Q

What is enopthalmitis?

iritis?

A

emergency- hypopyn usually- infection of aquesous flow

iritis = ant uveitis- CMV/HErpes,auto immune- cil flush with a flare

40
Q

You do a pelvic on a preggo, looks like possible infeciton- need to do a..

A

bimanual! PID = in patient abx

41
Q

MC seconary bacterial PNA

A

Strpe pneumo

then staph

42
Q

E candidAISS TX

A

Oral fluc

nystaitn is mouth

43
Q

what is immersion foot

A

trench foot
NV damage from cold/wet sock
cyosnis, maybe sloughing

frost ni is superficial and tingling
bite=ice crystal, ischemia

44
Q

abdominal comaprtment syndorme

A

above 20
organ faiure, reduced CO
diruetics, vs HD- foley cathter, paralyze and sedate

,may different causes

45
Q

black widwo spasms tx

A

clacium

46
Q

aflutter

A

treat like a fib - it can be irregular with variable AV block

regular- little letricity like 50 J

47
Q

HD requirements

A

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

48
Q

what order of stuff do you do for meningitis

A

dex
abx
ct
lumbar puncture

49
Q

treatment mobitz 1

A

aysmtpatic and usally nothigng

50
Q

how to trreat brash?

A

fluids
pressors
hypoerK stuff

51
Q

Why acute dystonic reaction

A

remember anti dopamine- so excess acyehtlcholine - give benadryl

52
Q

seizure +/-, HA, vision loss, AMS HTN

A

PRES

BP up and endothelian dysfynciton leading to vsaogenic edema

53
Q

peppery taste…

A

scromboid with flusign and headache

54
Q

SSSS stuff

A

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

55
Q

Charcoal indications and cotnras

A 
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,

56
Q

febrile , appears well, bilateral ear infeciotn tx

A

amox

57
Q

erythema nodosum associated with

A

sarcoids

slef limited

58
Q

burst eard drum stuff

A

keep dry and follw up- no ppx abx

59
Q

clotting

A

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

60
Q

humerus fx check for

A

radius nerve wrist drop

61
Q

what is neutropenic enterocolitis?

A

typhlitis - polymicorbial infeciton in ileocecal region
fever, abd pain, chemo
supportive and Abx, bowel rest

62
Q

BB OD tx

A

atoprine, glucagon, fluds
then epi
then pace

63
Q

Lye ingestion management

A

Endoscopic and airway

no charcoal, gotta go in and see the damage

64
Q

bipolar 1 vs 2

A

1=mania

2=hypomania and dperession

65
Q

what is tripod fx

A

maxilla, zygoma, lateral orbit

surgery or else dental paraestheias

66
Q

when to tx chicken pox

A

over 12
immunocompromised - watch out pnumonitis, encpehalits, superimposed infection

head down rash, vaccine is live

67
Q

refeeding sstuff

A

replace phosphate first! a nromal heart rate means poor heart function. watch out out for diaphragm weakness.
give phosphate, thiamine and other eleccytrolyres

Rosh (14 decks)

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