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Peds Boards > ED/Critical Care > Flashcards

ED/Critical Care Flashcards

1
Q
  • bradycardia
  • HTN
  • Irregular respirations
A

Cushing Triad

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2
Q
  • tachycardia, muscle rigidity, increased CO2, acidosis, and fever following administration of general anesthesia
  • Tx: hyperventilation, oxygen, and dantrolene
A

Malignant Hyperthermia

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3
Q
  • heart rate that increases with crying
  • soft vibratory ejection murmur
  • intermittent brisk jugular venous pulse wave of the neck
A

Complete Heart Block

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4
Q
  • fatigue, vomiting, HA, muscle weakness, wt loss, and salt wasting
  • hypoglycemia, hyperkalemia, hyponatremia, elevated ADH
A

Adrenal Insufficiency

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5
Q
  • afebrile pt presenting with seizure, no trauma, previous seizure history, and developmentally normal
  • may have spent a lot of time swimming
  • hyponatremia
A

Water Intoxication

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6
Q

When can a near drowning patient be discharged home?

A
  • submerged for less than 1 minute
  • no LOC
  • no resuscitation required
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7
Q

What are the risks for future deterioration in a near drowning patient?

A
  • history of apnea or CPR in the field
  • seizure or disorientation or respiratory failure
  • arterial desaturation and/or tachypnea
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8
Q
  • pulmonary edema
  • increased permeability of the alveolar capillary membranes
  • Xray: fine reticular infiltrate
  • worse after 8 hrs
  • MOSF
A

Acute Respiratory Distress Syndrome

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9
Q

-next step in a pt with flail chest or hemothorax

A

Chest tube

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10
Q

-most helpful vent setting in a pt with ARDS

A

PEEP

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11
Q
  • infant with poor wt gain, tachycardia, and tachypnea
  • CXR: cardiomegaly
  • EF < 25%
  • tricuspid or mitral valve regurg
  • Tx: Lasix for acute failure
A

Acute Heart Failure

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12
Q
  • FTT and poor feeding

- Tx: ACE inhibitor

A

Chronic Heart Failure

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13
Q
  • gray color, poor cap refill, thready pulses

- develop gallop, HSM, and JVD after fluid resuscitation

A

Cardiogenic Shock

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14
Q
  • presents with muffled heart sounds and pulsus paradoxus

- decreased blood pressure during inspiration

A

Cardiac Tamponade

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15
Q
  • irreversible absence of cardiorespiratory function
  • absence of carotid artery blood flow
  • Dx: radionucleotide scan or angiography
A

Brain Death

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16
Q
  • -elevated serum ammonia
  • change in mental status
  • chronic tremor and anxiety (Wilson’s)
A

Liver Failure

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17
Q
  • Lidocaine
  • Atropine
  • Narcan
  • Epinephrine
A

Meds that can be given by ETT

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18
Q
  • hypocalcemia
  • Hyperkalemia
  • CCB ingestion
  • hypermagnesemia
A

Indications for Calcium administration

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19
Q

-morning stiffness, evanescent rash, and fever for over a week

A

JRA

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20
Q

-patient most in need of antipyretics

A

pt with CHF (reduces cardiac output demand)

21
Q

-what bugs to cover for in cat bites

A

anaerobes, S. aureus, and pasturella

22
Q

-most important first step in management of bite wounds

A

high pressure irrigation

23
Q

When are Abx indicated for lacerations?

A 
Dirty cuts
Crush injuries
Cat bites
Bites that penetrate cartilage
Cuticles (feet and extremities)
Immunocompromised
24
Q
  • self limited local painful lesion caused by spider bite
  • target lesion with a red circle surrounding a white ring that appears within hours
  • Tx: supportive
A

Brown Recluse Spider Bite

25
Q
  • spider bite that appears as a puncture wound
  • symptoms within 8 hours inclde muscle aches and HTN
  • Tx: narcotics and anti-hypertensives
A

Black widow

26
Q

-best initial treatment for hypothermia

A

Internal rewarming

27
Q
  • Risks: bites closer to the brain, unprovoked, unvaccinated animal
  • uncommon in small rodents
  • MC in carnivores (esp bat), also the woodchuck
  • Tx: wash and debride, HRIG, vaccine
  • observe if animal is domestic
A

Rabies

28
Q

What happens when phenytoin is given too rapidly?

A

Bradycardia

29
Q

-bloody discharge from the ear or hemotympanum

A

Temporal Bone Fracture

30
Q

-atraumatic tap with lots of RBCs

A

Epidural hematoma

31
Q

-poor prognosis for coma

A

Cerebral Bleeding
Brain Edema
Coma lasting longer than 6 hrs

32
Q
  • clear rhinorrhea

- bruising over the mastoid bone or black and blue eyes, abducens CN palsy

A

Basilar Skull fracture

33
Q

-treatment of nasal septal hematoma or cauliflower ear

A

ENT C/S for drainage

34
Q
  • within 3 months of life
  • fever, swelling of the tissues of the face, jaws, and cortical thickening of the long and facial bones
  • mimics NAT
A

Infantile cortical hyperostosis (Caffrey Disease)

35
Q

-what disease could periorbital ecchymoses indicate?

A

Neuroblastoma

36
Q
  • bucket handle fractures
  • corner fractures (due to pulling an extremity)
  • spiral fractures in infants
  • rib fractures
  • multiple skull fractures
  • spinous process fractures
  • scapula fractures
  • sternum fractures
A

Fractures due to abuse

37
Q
  • fracture caused by falling on an outstretched arm that is hyperextended at the elbow
  • at risk for neurovascular compromise
  • pallor, cyanosis of the distal extremity, pain on passive extension of the fingers
  • Dx: posterior fat pad on Xray
A

Supracondylar fx

38
Q
  • fall on outstretched arm or directly on the shoulder
  • holding arm with opposite hand
  • most heal without intervention
  • medial fracture with ant or post displacement at risk for possible displacement of the trachea or mediastinal structures
  • Tx: shoulder immobilization
A

Clavicle fracture

39
Q
  • palpable step off of the right shoulder joint in the absence of creptius
  • older skeletally mature teens
  • pain over the distal clavicle with point tenderness over the superior aspect
  • cannot raise arm above head
A

AC separation

40
Q
  • fall on an outstretched hand
  • cortex and periosteum remain intact
  • one side is broken, the other is bent
A

Greenstick fx

41
Q

-a head CT is indicated for what symptoms following head trauma

A 
prolonged LOC
protracted vomiting
progressing HA
retrograde amnesia
lethargy
42
Q

-first step in a pt with suspected skull fracture or head bleed

A

ABCs

43
Q
  • full thickness burns
  • distinct margins
  • varying depth
  • sparing of the interdigital areas*
  • stocking glove distriibution
A

Non-Accidental Burns

44
Q

-first step in the treatment of burns

A

debridement and irrigation (Abx are not indicated)

45
Q

-what is the rule of 9s?

A 
Child older than 9
arms=9% each (9x1)
legs= 18% each (9x2)
trunk= 36% (9x3)
head and neck= 10% (9x1)
perineum- 1%
46
Q

-the only positive culture the is definitive conformation of sexual abuse

A

Gonorrhea (chlamydia can be vertically transmitted and persists for up to 3 years)

47
Q
  • vaginal bleeding in an AA girl 3-8 years
  • hyperemic donut shaped mass
  • Tx: warm sitz baths and /u with urology
A

urethral prolapse

48
Q
  • HA, vomiting, high fever, delirium
  • papules->vesicles->pustules->scabs
  • lesions in the same stage of evolution
  • Dx: pharyngeal swab, or culture the lesions
  • spread by direct contact or airborne exposure
  • AKA variola
  • Tx: cidofovir (experimental)
A

Smallpox

Peds Boards (23 decks)

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