Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

General Peds Boards > Critical Care/ER > Flashcards

Critical Care/ER Flashcards

1
Q

Malignant hyperthermia symptoms and genetics

A
  • Defect in skeletal muscle calcium homeostasis
  • Prolonged opening of ryanodine receptor leads to an excess of cytosolic calcium and prolonged muscle contraction
  • Increased oxygen consumption –> lactic acidosis, hyperthermia, hypoxia, hypercarbia
  • TX: DANTROLENE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of malignant hyperthermia

A

Succinylcholine, inhaled anesthetics (halothane, isoflurane, desflurane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Signs of bad prognosis for drowning

A
  • Submersion > 25 minutes
  • > 25 minutes of CPR at the scene
  • Apnea or coma at admission
  • Need for cardiac meds to establish perfusing rhythm
  • Initial arterial pH of < 7.1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Flail chest symptoms and treatment

A
  • Paradoxical chest wall movements
  • 2 or more rib fractures in 2 or more locations
  • Tx: Chest tube if respiratory distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pediatric CPR rules

A
  • 1/3 to 1/2 of the anteroposterior depth of the chest
  • Rate of 100/minute with complete chest recoil
  • One rescuer: 30 compressions to 2 ventilations
  • Two rescuer: 15 compressions to 2 ventilations
  • If you have an airway: ventilation should be 1 breath every 6 seconds and CPR continuously at 100/minute
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Indication for IV antibiotics in burn patients

A
  • Change in appearance of the wound including new discoloration is most suggestive of an infection
  • Major infections: wound infections, pneumonia, bloostream infections, UTIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of right shift of Hgb-dissociation curve

A 
CADET
C: Increased CO2
A: Acidosis
D: DPG
E: Exercise
T: Temperature
  • Right shift means oxygen is extracted easier at the tissue level (tissues need more oxygen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pressor for cold shock

A

Epinephrine (beta activity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pressor for warm shock

A

Norepinephrine (alpha activity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Order for treatment of shock

A
  • Fluid boluses (60/kg) + antibiotics
  • Norepinephrine
  • Epinephrine
  • Vasopressin
  • Steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Vitals in neurogenic shock

A

Hypotension and bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of anaphylactic shock

A

Epinephrine
Steroids
Anti-histamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Brain death criteria

A
  • Known and irreveresible cause of coma
  • Absence of hypotension, hypothermia, metabolic abnormalities, sedating effect of medication
  • Two brain death exams by different physicians done 12-24 hours apart (must have absence of brainstem reflexes including reflex to breathe)
  • No ancillary studies are necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Requirement for organ donation

A

EITHER cardiac OR brain death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Brain death exam cranial nerves

A
  • Pupillary (fixed/dilated): CN II and III
  • Corneal reflex: CN V and VII
  • Vestibulo-occular: CN VI and VIII (Normal cold opposite warm same: COWS)
  • Occulocephalic (Doll’s eyes): CN III, IV, VI, VIII
  • Tracheal (Cough/gag): CN IX
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Complications of specific face laceration

A
  • Vermillion border - line that up first
  • Forehead - rule out fracture
  • Eyebrow - may have poor hair regrowth
  • Eyelid - may have lacrimal duct injuries, globe injury, or muscle injury
  • Ear - can get cartilage necrosis
17
Q

Sequelae of puncture wounds

A

Cellulitis, osteomyelitis, foreign body, septic joint

18
Q

ET tube size rules

A

Child’s age dived by 4 plus 4

19
Q

Things to think about with acute decompensation in an intubated patient

A

DOPE

  • Displacement of ETT
  • Obstruction of ETT
  • Pneumothorax
  • Equipment failure
20
Q

Definition of BRUE

A
  • Sudden alteration in breathing, cyanosis/pallor, change in tone, altered level of responsviness, recovered successfully with no medical intervention
21
Q

Low risk BRUE symptoms

A
  • Age > 60 days
  • Gestational age > 32 weeks
  • First episode
  • Duration < 1 minute
  • No CPR by a trained medical provider
22
Q

Shape of dog/human/cat bites

A
  • Human: half moon
  • Dog: tear
  • Cat: puncture
23
Q

Treatment with antibiotics for dog and cat bites

A
  • Augmentin (to cover Staph and pasturella) or cephalosporins or clinda plus bactrim
  • Especially if on hands, feet, genitals, or face
24
Q

Brown recluse spider bite/management

A
  • Target lesion –> appears within hours
  • Bite becomes necrotic
  • Self limited
25
Q

Black widow spider bite/management

A
  • Puncture wound
  • Muscle aches and hypertension within 8 hours
  • Tx: local wound care, tetanus prophylaxis, benzos for severe muscle spasms, antivenom if supportive measure don’t work
26
Q

Snake bite/management

A
  • Venomous snakes: triangular head/fangs, red/yellow
  • Non-venomous: round face
  • Local erythema/swelling followed by enlarged lymph nodes
  • If venomous: immobilize the limb and let it hang at patient’s side, antivenom if symptoms of coauglopathy/hypotension
27
Q

Linear skull fractures characteristics

A
  • Most common type in kids
  • Often in the parietal region
  • 15-30% have underlying intracranial injury
  • Can have scalp hematomas (predictive of skull fractures in kids < 1 year if non-frontal)
  • Diagnosis is by CT, not xray
28
Q

Indications for neurosurgical consultation

A
  • Depressed skull fractures, basilar skull fractures, skull fractures with intracranial injury
29
Q

Temporal bone fracture symptoms

A
  • Visible bleeding from the ear or hemotypmanum
  • Hearing loss, facial paraylsis
  • CSF otorrhea
30
Q

Basilar skull fracture symptoms

A
  • Clear rhinorrhea, clear otorrhea (actually CSF)

- Bruising behind ear (battle sign) or under eyes (raccoon eyes)

31
Q

Signs that a burn was non-accidental

A

Clear demarcation, stocking glove distribution, full thickness burns

32
Q

Burns that have to get sent to a referral center

A
  • Moderate or severe burns ( > 10% TBSA)
  • Any full thickness burn
  • Electrical or chemical burns
  • Inhalation injuries
  • Burns involving hands, feet, face, genitalia, perineum, or major joints
33
Q

Burn thickness levels

A
  • Superficial: only epidermis
  • Partial thickness (second degree): epidermis and superficial dermis
  • Full thickness (third degree): epidermis and dermis ( white/leathery with no pain)
34
Q

Burns rule of 9s

A
  • Arms: 9% each (4.5% front/back)
  • Legs: 18% each (9% front/back)
  • Trunk: 36% (18% front/back)
  • Head and neck: 9% (4.5% front/back)
  • Perineum: 1%
35
Q

Most sensitive imaging to look for foreign body in a wound

A

Ultrasound

36
Q

Things to think about with human bite

A

HIV/Hepatitis B status

- If deep wound or hand/foot the need antibiotics

37
Q

Management of abdominal trauma with hematuria

A
  • Rectal exam to assess for neuro status and blood
  • Assess pelvis stability
  • Assess for blood at the urethra
  • FAST
  • CT is standard of care when suspecting abdominal injuries
38
Q

Contraindication to bladder cath

A

Suspected urethral trauma (often a/w pelvic fx) - blood at urethral meatus or gross hematuria

39
Q

Clinical findings with subluxation of the radial head

A
  • Hold arm flexed to body, imaging normal, no tenderness/swelling at the elbow (nursemaid’s elbow)
  • Age 6 months to 5 years

General Peds Boards (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions