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Final Exam Prep > Common Problems In Acute Care > Flashcards

Common Problems In Acute Care Flashcards

1
Q

Differentiate between 1st, 2nd, and 3rd degree burns

A

1st: Dry, Red, NO BLISTERS, epidermis only
2nd: (Partial thickness), Moist, Blisters, extends beyond the dermis
3rd: (Full thickness), Dry, leathery, waxy, extend from epidermis to dermis, underlying fat/muscle/bone

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2
Q

Rule of nines for burns

A

Each arm= 9%
Each Leg= 18%
Thorax: 18% front, 18% back
Head= 9%
Genitals= 1%

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3
Q

Fluid resuscitation in Burns; include Parklands Formula

A

PF: 4mls/kg x TBSA% burned during the first 24 hours
1/2 needs to be administered in the first 8 hours and the remaining is given over the next 16 hours

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4
Q

Metabolic complications of burns

A

Metabolic acidosis
Hyperkalemia during the first 24 -48 hours then hypokalemia 3 days post

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5
Q

Indications for prophylactic intubation in burns

A

Burn to the face
Singed eyebrows
Dark soot from nares or mouth

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6
Q

What is the immediate post burn regimen

A

Submerse the area in clean water
Wrap in clean dry towels and go to hospital
Sterile saline to area
Maintain temp 37-37.5 C
Fentanyl or morphine for pain

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7
Q

What is used to remove tar from a tar burn

A

Petroleum based products

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8
Q

What constitutes a burn center referral

A

-Partial thickness >10% TBSA
-Burns to face, hands, feet, genitalia, or joints
-3rd degree
-Electrical/chemical/inhalation
-Trauma
-Children

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9
Q

Differentiate between a fracture and dislocation

A

F: Broken or crushed bone
D: disruption between relationship of normal joint surfaces

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10
Q

Subluxation

A

Incomplete dislocation

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11
Q

Differentiate between a closed, open, and avulsion fracture

A

C: skin is not broken
O: Skin is broken
A: Bone fragments are pulled off by attached ligaments and tendons

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12
Q

What is Giant Cell Arteritis, S/S, Labs, and Management

A

Inflammatory condition that can lead to blindness
S/s: headache, scalp tenderness, jaw claudication, temporal artery is nodular/enlarged/tender, fever (104), chills/rigors
Labs: high ESR, normal WBC, and temporal artery biopsy
TX: prednisone and a referral

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13
Q

Describe Diabetic Retinopathy on exam and what is the earliest sign

A

Earliest sign is micro aneurysms, flame shaped hemorrhages, cotton wool spots

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14
Q

What is AV nicking a sign of

A

Chronic hypertension

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15
Q

What is arcus Aenilis

A

A cloudy appearance of the cornea with a gray/white arc due to the deposition of lipids, has no effect on vision

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16
Q

Treatment for chemical conjunctivitis

A

Flush with NSS

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17
Q

Bacterial conjunctivitis discharge and tx

A

Purulent
Flouroquiniolone drops or tobramycin, gentamycin drops

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18
Q

Gonococcal conjunctivitis discharge and treatment

A

Copious purulent
Ceftriaxone 250mg IM + azithromycin

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19
Q

Chlamydia conjunctivitis treatment

A

Ceftriaxone 250mg IM + azithromycin

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20
Q

Allergic conjunctivitis discharge and treatment

A

Stringy, tearing
Oral antihistamines, referral to allergist and ophthalmologist

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21
Q

Viral conjunctivitis discharge and treatment for mild and moderate

A

Watery
Mild: saline drops and artificial tears
Moderate: antihistamines, NSAIDs, ABX drops

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22
Q

Herpetic conjunctivitis discharge and treatment

A

Bright red and irritated
Refer to an ophthalmologist

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23
Q

Corneal abrasion tx

A

Anesthetize eye for exam
Topical ABX especially for those with contacts
NO steroid drops

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24
Q

S/S of open vs closed Glaucoma

A

Increased intraoccqular pressure
Open (Chronic): asymptomatic, elevated IOP, cupping of disc, constriction of visual fields
Closed (Acute): Extreme pain, blurred vision, halos around lights, pupils fixed or dilated

25
Q

Labs/ Diagnostics and treatment of Glaucoma

A

Labs: Tonometry
Tx:
-Open: Prostaglandin analogs (Prost drops), Alpha 2 adrenergic agonists (Brimonidine), Beta adrenergic blockers (Timolol), Mitotic agents (pilocarpine)
-Closed: Carbonic anhydrase inhibitors (Acetazolamide/ Diamox), Osmotic diuretics (mannitol), Surgery

26
Q

What is the highest treatable cause of blindness

A

Cataracts

27
Q

causes of cataracts

A

Aging, heredity, trauma, toxins, congenital, diabetes, UV sun exposure

28
Q

S/s of cataracts

A

Painless, clouded vision, difficulty seeing at night, diplopia, no red reflex, opacity of lens

29
Q

Cataract management

A

Refer to surgery

30
Q

S/s of HIV

A

Flu like symptoms
Fever, night sweats, and weight loss

31
Q

when does HIV become AIDS

A

CD4 count <200
And/or an opportunistic infection is present in an HIV patient

32
Q

Labs and diagnostics of HIV/AIDS

A

HIV 1/2 antigen/antibody conversion, if positive then test HIV1/HIV2 antibody differentiation immunoassay
CD4 count
PCR for viral load

33
Q

Normal CD4 Count

A

500-1200

34
Q

What is given to HIV patients to prevent PJP and Mycobacterium Adium

A

PJP: Bactrim
MA: Azithromycin

35
Q

Indications for HIV pre exposure prophylaxis

A

Anal/vaginal sex in the past 6 months and have:
-HIV + partner, not consistently used a condom, been diagnosed with an STD in the past 6 months
For People who inject drugs:
-HIV + partner
-Share needles

36
Q

Which PrEP agent is recommended for patients who have high risk sex AND drug use

A

Truvada

37
Q

What PrEP agent is recommended for patients with high risk sex EXCLUDING vaginal sex

A

Descovy

38
Q

Differentiate the patho behind OA and RA

A

OA: denegerative joint disease
RA: autoimmune inflammation of connective tissue

39
Q

Differentiate the inflammation of OA vs RA

A

OA: Asymmetrical
RA: Symmetrical

40
Q

Herberden’ s vs Bouchard’s nodes

A

H: DIPs
B: PIPs

41
Q

Stiffness and pain in OA vs RA

A

OA: better in morning worse as day goes on
RA: worse in morning, better as day goes on

42
Q

Synovial aspirate in OA vs RA

A

OA: normal
RA: WBCs

43
Q

Management of OA

A

ASA, Acetaminophen, NSAIDS, COX2 inhibitors (Celebrex)

44
Q

RA management

A

High dose salicylates, NSAIDS, DMARDS, corticosteroids

45
Q

S/s of Lupus

A

Fever, anorexia, malaise, weight loss, butterfly rash, alopecia, raynauds, joint symptoms (early manifestation)
SPLINTER HEMORRHAGES

46
Q

Labs and diagnostics in SLE

A

ANA positive
Antiphospholipid antibodies
Anemia, leukopenia, and thrombocytopenia

47
Q

Management of SLE

A

Bed rest, naps, sun protection, topical glucocorticoids for skin lesions, NSAIDS, hydroxychloroquine, glucocorticoids

48
Q

Which joints are mainly effected in OA and RA

A

PIPs

49
Q

What are 2 herbals that women take for cramps?

A

Primrose and black kohosh

50
Q

What medication can mimic lupus symptoms

A

Procanimide

51
Q

Who is the worst off in ALL

A

> 60 yrs old, difficult to get into remission

52
Q

What xray results indicate RA

A

Osteopenia

53
Q

What effect does hodgkins lympphoma have on RBCs, EBCs, and plasma cells

A

Increases them

54
Q

What is Thromboangitis obliterans and how do you treat it?

A

Small blood clots that get stuck in small vessels
Pentoxifylline

55
Q

What is sodium polystyrene sulfonate

A

Kayexalate used to treat hyperkalemia

56
Q

Typical antiregection meds

A

Corticosteroid plus antimetabolites (Imuran or cellcept) plus CAlcineurin inhibitor (prograf)

57
Q

What are two normal artery to vein ratio in the retina

A

4:5 and 2:3

58
Q

What drugs are contraindicated with ST. Johns wort

A

SSRIs, Oral contraceptives, digoxin, alprazolam, amitryptilyine, narcotics, antiretrovirals

59
Q

What is given to patients with corneal abrasions to decrease itching

A

Levocalbastine

Final Exam Prep (19 decks)

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