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Emergency Medicine > disaster medicine/abuse > Flashcards

disaster medicine/abuse Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

tag color:

red:
yellow:
green:
black:

A

immediate, life threatening

delayed, non life threatening

minimal, minor injuries

expectant deceased or expected to die

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2
Q

vectors: like anthrax

how are they released?

some places they are released?

A

aerosol

water supply
subway
major social events

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3
Q

category A bioterrorism agents:

highest priority agents, they can grow easily, are sturdy and resistant to destruction, can infect large numbers of people

some examples are:

A

anthrax, smallpox, plague, botulism, tularemia, viral hemorrhagic fever

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4
Q

smallpox:

incubation:
vulnerable to what?

how is it spread?

A 
12 days 
bacterial superinfx (encephalitis, keratitis, corneal ulcerations)

airborne or contact

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5
Q

tx of small pox?

A

cidofovir (not super effective)

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6
Q

prevention of small pox?

A

VIG (caccinia immune globulin) among exposed individuals

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7
Q

anthrax: red papular lesions occur when?

A

after 2 weeks of exposure

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8
Q

what does the red papular lesion become in anthrax?

A

progresses to necrotic ulceration and black eschar

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9
Q

anthrax: inhalaion: like a URI that progresses to what?

A

sepsis, delirium, lethargy/somnolence, meningeal irritation

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10
Q

Anthrax: GI: diffuse adb pain, D and fever

what else can occur?

A

hematemsis, melena, bowel perf

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11
Q

tx of anthrax:

A

cipro or doxy

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12
Q

what can be used for post exposure prophylaxis when no other options are avaliable?

A

monoclonal antibodies (human anthrax globulin)

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13
Q

plague is caused by what?

A

yersinia pestis (fleas/rats)

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14
Q

3 forms of plague:

bubonic:
septicemic:

Pneumonic:

A

inflammaion of tonsils, adenoids, spleen, thymus, severe lymph node swelling (buboes)

bacteremia, fever, chills, internal bleeding

most severe, contagios, potential for bioterrorism

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15
Q

testing for plague:

bubonic:
speticemic:
penumonic:

A

buboes fluid sampling

blood culture

cxr, sputum culture

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16
Q

tx for plague:

A

Gent, doxy, CIPRO

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17
Q

Tularemia: tick borne

glandular: 
ulceroglandular:
oculoglandular:
penumonic: 
typhoidal:
A

painful lymph nodes, fever, chills, HA, fatigue

same with skin ulcers

eye pain, redness, discharge, ulcer on insid eof eyelid

sore throat, mouth ulcers, V, D (poorly cooked wild animals meat or contaminated water)

URI

rare but serious, fever, fatigure, hepato/splenomegaly

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18
Q

tests for tularemia?

A

blood/sputum cultures to check for F tularenia or check for AB in blood (PCR)

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19
Q

tx for tularemia:

A

streptomycin, gentamycin, doxy

NO CIPRO!!!!!!!

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20
Q

ebola, dengue, lassa, yellow fever, marburg HF are all what?

A

viral hemorrhagic fever

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21
Q

viral hemorrhagic fevers interfere with what?

A

clotting

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22
Q

what can viral hemorrhagic fevers progress to?

A

shock, CNS malfunction, demerium, hepatorenal failure

23
Q

tx for viral hemorrhagic fever?

A

no tx, some immunizations (antiviral ribavirin may help shorten course)

24
Q

Q fever is caused by what?

A

coxiella burnetti

25
Q

this is a latent component that resurfaces months to years later causing damage to heart, liver, brain or lungs

A

Q fever

26
Q

transmitted from animals, livestock or sheep, mild initial may not rquire tx

A

q fever (coxiella burnetti)

27
Q

recurrence in q fever requires ab for how long?

A

18 months

28
Q

testing for q fever:

A

antibodies to coxiella burnetti, echo

29
Q

tx for q fever?

A

antibotics or valve replacement

30
Q

west nile, eastern equine, japanese, tick born encephalitis are all what?

A

viral encephalitis

31
Q

Headache, flulike symptoms, nausea, vomiting, anorexia, lethargy, nuchal rigidity

what dxs?

A

viral encephalitis

32
Q

tests for viral encephalitis?

A

lumbar puncture, HEAD CT/mri, eeg, brain biopsy

tx is symptomatic

33
Q

staphylococcal entertoxin B: food poisoning, bad meat, dairy, bakery

how long do symptoms show up?

A

4-10 hours later, N/V/D!!

can give zofran if its bad

34
Q

salmonella:

water borne-streams, food posioning, fever, D

how long does it last, how can we test it?

A

7-10 days
stool culture

(can possible give cipro but usually symptomatic tx)

35
Q

Nerve agents:

affect both main types of what?

A

cholinergic (muscarinic and nicotinic)

36
Q

Sarin, tabun, Soman, VX are all what?

A

nerve agents

37
Q

miosis and rhinorrhea, along with bronchorrhea, paralysis, death, LOC, seizures can all occur with what?

A

nerve agents

38
Q

nerve agents or cyanide are what chemiclas?

A

quick onset

39
Q

liquid exposure:

vapor exposure:

how long till symptoms develop?

A

delayed symptoms, require prolonged exposure

rapid onset

40
Q

tx for nerve agents:

A

Atropine!!!

pralidoxime chloride, diazepam if seizures

41
Q

blood agents:

cyanide:

low concentrations: flushing, cherry red, anxious,

high concentrations:

15 seconds:
30 seconds:
3-5 min:
6-10 min:

A

anxious, hyperventiliation
seizures

apnea

asystole

42
Q

cyanide: tx:

A

amyl nitrate pearls

combo of hydroxocobalamin, sodium nitrite and sodium thiosulfate is ideal

43
Q

sulfur mustard gas, lewisite are what?

A

blister agents

skin redness, burns, conjunctivitis, upper airway iritiation

tx: vaseline, cough suppressants, O2

44
Q

phosgene, chlorine, ammonia these are what?

A

choking agents

delayed chest tightness, pulmonary edema

wash eyes, flush, airway manangement

45
Q

mace, pepper spray, tear gas

A

crowd/riot control

check opthalmic ph

tx: wash, SABA, O2, eye irrigation

46
Q

1 leading cause of death b/w 1-12 months of age?

A

child abuse

47
Q

failure to meet child’s basic needs?

A

neglect

48
Q

mc reported and confirmed child abuse?

A

neglect

49
Q

failure to thrive, recurrent skin infx or gastroenteritis, occiptial alopecia from lying on back all day?

A

neglect in early infancy

50
Q

weight gain on hospitilization and unimmunized

A

neglect

51
Q

bowel disorders, anorexia, soiling onself, failing in school, disruptive behavior, fears, withdrawn, these can all correlate with what?

A

physical abuse

52
Q

doubel bubble sign on xray from abdominal trauma

A

duodenal hematoma from physical abuse

53
Q

retinal hemorrhages and intracerebral hemorrhage associated with what?

A

shaken baby syndrome

54
Q

spiral fractures or multiple fractures of different stages of healing?

A

physical abuse

Emergency Medicine (2 decks)

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