Day 15 Review - Ob4, Peds1, Peds2 Flashcards
Why thiamine given in glucose infusion to alcoholics w/ hypoglycemia?
Glucose in absence of thiamine can worsen Wernicke encephalopathy (mamillary bodies)
Sx of Lacunar stroke
5 syndromes: (1) Pure motor hemiparesis (2) Pure sensory (3) Ataxic hemiparesis (4 Sensory-motor (5) Dysarthria clumsy hand
Meds/Interventions in tx of CP to alleviate contractures & improve function
Pharm: Dantrolene, Baclofen; Benzos, Botox; NonPharm: PT, Bracing (risk of ulcers), Surgery
2 most common primary brain tumors in adults
Gliobastoma, Meningioma; Recall: Brain tumor mnemonic in order of decreasing incidence - MGM Studios = Metastasis, Glioblastoma, Meningioma, Schwannoma
3 most common primary brain tumors in children
Astrocytoma, Medulloblastoma, Ependymoma
ACLS tx V fib
Immediate CPR; 360 J; Epi or Vasopressin as 1st dose; Subsequent doses Epi; Continue CPR & repeat Epi q 3-5 min, repeat defibrillator
Vasopressor: theoretically causes renal vasodilation
Dopamine (does not do this so much)
Vasopressor: High dose optimizes alpha1 vasoconstriction
Epinephrine
Vasopressor: ADH analog
Vasopressin
Vasopressor: Best choice for anaphylactic shock
Epinephrine
Vasopressor: Best choice for septic shock
Norepinephrine (causes vasoconstriction)
Vasopressor: Best choice for cardiogenic shock
Dobutamine
Vasopressor: Causes vasoconstriction but w/ bradycardia
Phenylephrine
Next step eval penetrating injuries to different zones of neck
Zones follow arterial blood flow 1-3; Zone 1 (clavicle to cricoid cartilage): 4 vessel arteriogram or CT angiogram; Zone 2 (cricoid cartilage to angle of mandible): easy to access in surgery, surgical exploration; Zone 3 (above angle of mandible): also 4 vessel arteriogram or CT angiogram, triple endoscopy - esophagus, larynx, bronchi
How to prevent flushing reaction of niacin
ASA; Also taking it at night or using it long-term helps
EKG finding seen in WPW & Cause
Delta wave prior to QRS; Reentry thru accessory conduction pathway
Tx SVT 2/2 WPV v. SVT due to other etiologies
Tx WPW: Amiodarone or Procainamide; Tx other SVT: Adenosine
Most sensitive & specific test for dx chronic pancreatitis
Low fecal elastase levels
Supplements given to women on anticonvulsants during pregnancy
Folate (for phenytoin & carbamazepine, up to 4 mg daily, throughout pregnancy but extremely important in 1st trimester); Vitamin K (in last month of pregnancy to augment coagulability during delivery)
Next step mgt AGUS pap smear
Colpo (especially including endocervical curettage); If 35+ or risk factors for endometrial hyperplasia, then endometrial bx
