Common Problems in Acute Care #2 Flashcards
Most overdoses are treated how?
With supportive care
How does Tylenol overdose present?
Usually asymptomatic at first, then N/V with RUQ pain around 24-48 hours
What medication is used for Tylenol overdose?
N-Acetylcysteine (Mucomyst)
Tinnitus is seen in what overdose?
Salicylate
What is used to treat salicylate OD?
Activated charcoal
Blurred vision, miosis, and bradycardia can be signs of what overdose?
Organophosphate
What drug is used in organophosphate toxicity?
Atropine
How might antidepressant toxicity be tx?
IV benzos
What drug is used to treat serotonin syndrome?
Dantrolene sodium
What drug is used to treat benzo overdose?
Flumazenil
What drug is used to treat beta blocker OD?
Glucagon
Which drug is used to tx ethylene glycol (antifreeze) OD?
Fomepizole (Antizol)
Second degree burn is also called what?
Partial thickness
Each arm is what % in Rule of Nines?
9%
Each leg is what % in Rule of Nines?
18%
What electrolyte abnormality should you monitor for early in major burns (first 24-48 hours)?
Hyperkalemia
What electrolyte abnormality should you monitor for later in burns (around three days after)?
Hypokalemia
What should body temp be maintained at in the burn pt?
37-37.5
What two pain meds are most commonly used for pain management in burn pts?
Fentanyl or morphine
Partial thickness burns of greater than what % of TBSA require transfer to a burn center?
Greater than 10%
T4 cells are the same as what?
CD4 cells
How is AIDs diagnosed?
CD4 count < 200 and/or presence of an opportunistic infection
What test is initially used to diagnose HIV?
HIV - 1/2 antigen/antibody combination immunoassay
What is a normal CD4 count?
500-1200
What should viral load ideally be in an HIV pt?
Zero/undetectable
What can an HIV take Bactrim prophylactically for?
PCP PNA
When should ART be started in an HIV pt?
As soon as you know pt is positive
Truvada (emtricitabine/tenofovir disoproxil fumarate) is prescribed for what?
To prevent HIV in all people at risk via sex or IV drug use
Descovy (emtricitabine/tenofovir alafenamide) is prescribed for what?
To prevent HIV in people at risk via sex, excluding receptive vaginal sex
What is the advantage of emtricitabine/tenofovir alafenamide over emtricitabine/tenofovir disoproxil fumarate?
Improved renal and bone safety
Which type of arthritis generally involves the weight bearing joints?
Osteoarthritis
Where do Heberden’s nodes appear?
DIPs
Where do Bouchard’s nodes develop?
PIPs
When do osteoarthritis pts feel better?
In the AM
Where should you use canes in osteo?
On the opposite side from the affected side
Is rheumatoid arthritis symmetrical or asymmetrical?
Symmetrical
Ulnar devation is seen in what?
Rheumatoid arthritis
If someone is on methotrexate, what lab values should be monitored?
LFTs
What type of fracture would you give abx for?
Open fx
What is an avulsion fx?
Bone fragments are pulled off by attached ligament or tendon
What is a subluxation?
Incomplete dislocation
Paresthesias after orthopedic surgery may suggest what?
Compartment syndrome
How do you diagnose compartment syndrome?
With a tonometer
What are normal compartment pressures?
0-8 mm Hg
A compartment pressure at or above what indicates compartment syndrome and need for fasciotomy?
Above 30 mm Hg
What lab test is used to diagnose lupus?
ANA
What broad class of drugs can often cause a lupus-like syndrome?
Cardiac meds
How is temporal arteritis tx?
Prednisone
A cup greater than 1/2 the diameter of the disc when assessing the eye can indicate what?
Glaucoma
How do arteries differ from veins in the eye in appearance?
Arteries are brighter red and narrower than veins
What is the earliest sign of diabetic retinopathy?
Microaneurysms
What is AV nicking in the eye a sign of?
Chronic HTN
What is arcus senilis and what is it a sign of?
Cloudy appearance of the cornea with white circle; 2/2 hyperlipidemia
Is there usually pain in conjunctivitis?
No
What kind of discharge does viral conjunctivitis have?
Watery
What is the pathology of glaucoma?
Increased intraocular pressure
Which type of glaucoma is acute?
Closed angle
What is normal intraocular pressure?
10-20 mm Hg
Is glaucoma painful?
Yes
What is the first line drug class for chronic (open) angle glaucoma?
Prostaglandin analogs
What do prostaglandin analogs end in?
-pro
Are cataracts painful?
No.
Diplopia in a single eye can be a sign of what?
Cataracts
Halos around lights can be a sign of what?
Cataracts
What is sarcoidosis and in what age does it occur?
Decreased muscle mass - in the elderly
What is immunosenescence?
Immune system’s diminished function with age
