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Clinical Prep > E-med rosh Qs > Flashcards

E-med rosh Qs Flashcards

1
Q

Amitriptyline (TCA) overdose

A

“anti-cholinergic sx”

tachy
dry mouth
dilated eyes
warm, flushed skin

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2
Q

EKG abnormalities seen with TCA (Amitriptyine) overdose

A

Widened QRS and prolonged QTc

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3
Q

More serious consequences of TCA overdose

A

seizures (tx w Diazepam)

QRS >100 and dysrhythm (tx w Sodium Bicarb)

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4
Q

Bilateral interfacetal dislocation

A

unstable neck dislocation

from Hyperflexion

Severe neurologic sequelae common

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5
Q

Tx of B-blocker overdose

A

Fluids
Glucagon
Calcium

Vasopressor, Insulin

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6
Q

B-blocker OD

Propranolol

A

Hypotension, bradycardic, heart block

Hypoglycemic

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7
Q

Tx of B-blocker Toxicity

A

Glucagon

High dose insulin

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8
Q

Lead poisoning may present as

A

GI sx

Microcytic Anemia w Basophilic stippling

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9
Q

Tx to Lead poisoning

A

Succimer

it SUCCS to eat LEAD

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10
Q

HA, joint pain, constipation
“lead lines” on X Ray at metaphyses
Hypochromic, “basophilic stippling”

Tx: Succimer

A

Lead poisoning

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11
Q

Trauma to eye often results in

A

Hyphema

blood in anterior chamber

Emergent Ophtho consult

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12
Q

Sx of Hyphema

after trauma

A

Decreased vision, photophobia, pain, absence of red reflex

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13
Q

Tx of Hyphema

A

eye protection, limited activity, head elevation of 30-45 degrees

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14
Q

Iron tabs often have “candy like” appearance so may be OD’d by kids

A

Tx is: Deferoxamine

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15
Q

Tx of Tylenol toxicity

A

N-acetylcyestine (NAC)

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16
Q

NAC is tx for

A

Tylenol (acetaminophen) toxicity

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17
Q

Signs of Tylenol OD`

A

N/v at first

Then, Metabolic acidosis, liver/kidney failure, coag defects, coma, death

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18
Q

Abdominal X Ray of kid shows radiopaque particles in stomach

A

Iron

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19
Q

Anticholinergic OD

flushed, hot skin
decreased/absent bowel sounds
urinary retention
seizures

A

TCA OVERDOSE

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20
Q

Tx of TCA overdose

A

Diazepam or Lorazepam for seizures

Sodium bicarb to combat the Na channel blockade

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21
Q

Dose of Epi for airway compromise

A

0.3-0.5 mg

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22
Q

Atlanto-occipital dislocation

A

“Internal decapitation”

YIKES

Manage airway, make sure HemoD stable, Rigid C collar

Def tx: Halo placement

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23
Q

Sx of Atlanto Occipital dislocation

High speed MVA is often the mechanism

A

Cruciate paralysis of Upper extremities, sparing lower

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24
Q

Cat bite treatment

A

Augmentin

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25
Q

Inspiratory stridor

A

upper airway obstruction

26
Q

What will an obstructed lung look like on X Ray in comparison to an Un-obstructed?

A

Obstructed: darker, bc the air can’t exit the lung, making it appear hypodense

Un-Obstructed: more white on X Ray, bc the air is exhaled

27
Q

Stab wound to back

Unable to move L leg, and R leg is numb

A

Brown Sequard syndrome

hemisection of spinal cord, often d/t Penetrating injury

28
Q

Brown Sequard syndrome

A

Proprioception/Vibratory, motor loss of Same side of injury

Pain/temperature loss of opposite side

29
Q

Phases of Tylenol Toxicity

A

<24h: n/v

1-3d: elevated ALT/AST, INR, bilirubin, RUQ pain

3-5d: multi organ failure, coma, death

4d-2w: complete resolve of Liver dysfx

30
Q

N-acetylcysteine is tx of

A

Tylenol toxicity

31
Q

Tx of Anatomical Snuffbox (possible Scaphoid fx)

if inital X Ray is unremarkable

A

Place in “Thumb spice”

Refer to Ortho

Repeat X ray in 2 weeks

32
Q

Signs of ASA overdose

A

n/v/d
Vertigo, Tinnitus

Vitals: tachypnea, tachycardia, Fever

33
Q

Broselow Tape

A

Tape to estimate a child’s weight based on their height

“Red to head” place the red tape towards the child’s head, and run the length down rest of body

34
Q

Defibrillation

A

for the pulseless patient

immediate life threatening

V-fib and V-tachy

35
Q

Cardioversion

A

to convert an Arrhythmia back to Sinus rhythm

36
Q

Cardioversion

A

for Persistent tachyarrhythmias

Synchronized on the R wave

37
Q

Cardioversion strength

A

50-200 joules

38
Q

Defibrillation strength

A

200-360 joules

39
Q

What is transcutaneous pacing used for?

A

Temporary stabilization of Sx-atic Bradycardia

Most pts tolerate pacing for <15 minutes

40
Q

3 diff interventions to heart

A

Transcutaneous pacing

Synchronized Cardioversion

Defibrillation

41
Q

Difference b/w Transcutaneous pacing and Synchronized cardioversion

A

Transc Pac: providing signal to heart when it’s own natural isnt working- to control HR /rhythm (bradycardias)

Synch Cardioversion: delivering a selected dose of electricity to heart at specific period at the cardiac cycle- R WAVE!!!- to reset the heart’s intrinsic firing rate (tachyarrhythmias)

42
Q

Obturator sign

A

to test for appendicitis

rotate the hip INTERNALLY

43
Q

Rovsing sign

A

the REFERRED pain, pressing on LLQ elicits pain in the RLQ

44
Q

Tx of b-blocker dose

A

Glucagon
and
High dose insulin

45
Q

Farmer poisoning

A

Cholinergic
Organophosphate

SLUDGE, or DUMBBELLS

46
Q

SLUDGE

(cholinergic) poisoning

A 
salivation
lacrimation
urination
diarrhea
GI cramps
emesis
47
Q

DUMBBELLS

cholinergic poisoning

A 
diarrhea
urination
miosis (PINPOINT eyes)
bradycardia
bronchospasm
emesis
lacrimation
lethargy
salivation
seizure
48
Q

Treatment of farm, organophosphate poisoning

A

Atropine

2-PAM

49
Q

“Hot as a hare, dry as a bone, mad as a hatter” applies to

A

Anticholinergic poisoning

elevated temp, flushing, dry skin and M.M., AMS, dilated eyes

50
Q

What type of eyes are a/w SLUDGE?

organophosphate

A

Pinpoint eyes, miosis

51
Q

SLUDGE AND THE KILLER B’S

A

Bradycardia
Bronchorrhea (excessive d/c of watery mucus from the lungs–> wet cough)
Bronchospasm

52
Q

Anterior cord spinal trauma lesion

A

Complete loss of everything below lesion EXCEPT Vibratory and Proprioception

53
Q

Most common cause of Anterior Cord Syndrome injury

A

Flexion injury

54
Q

Brown Sequard injury

A

penetrating trauma

55
Q

Hyperextension injury to spinal cord

A

Central cord injury

Upper>lower extremity sensory and motor loss

56
Q

Thoracentesis

A

to remove FLUID from pleural space i.e. in effusion

57
Q

Thoracostomy

A

for PNX

Thoracostomy with Chest tube placement

If chest tube not available, Needle Decompression should be done

58
Q

Opioid overdose

i.e. Methadone

A

Resp depression
Sedation
Pinpoint eyes
Prolonged QTC

Torsades de pointe may be described as “QRS complex twisting around isoelectric line”

59
Q

Tx for Cat bite

A

Augmentin

60
Q

Tx for Cat bite if pt is PCN allergic

A

Doxy + Cipro

61
Q

Antidote for Amitriptyline (TCA) poisoning

A

Sodium bicarb

Clinical Prep (41 decks)

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