em 2 Flashcards

1
Q

reasons to do ct before lp

A
immunocompromised
h/o seizure w/in 1 week
abnormal level of consciousness
h/o cns diseae (mass, lesion, stroke, focal infxn)
Papilledema
focal neurological deficit
possible focal infxn
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2
Q

difference between encephalitis and meningitis

A

encephalitis has altered brain function and neurological findings (i.e. personality changes, paralysis, hallucinations, altered smell, problems w/ speech)

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3
Q

treatment of encephalitis

A

acyclovir 10mg/kg empiric tx for hsv

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4
Q

what must you do on any hot swollen joint

A

arthrocentesis

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5
Q

how to send joint fluid analysis

A

culture + sensitivity + r/o gonorhea

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6
Q

what do you do if suspect gonoorrhea

A

do cervical, urethral, and rectal cultures (do this cause joint fluid usually doesn’t show gonorrhea

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7
Q

tx of gram negative bactrameia

A

gentamycin + cefepime (antipseudomonal cephalosporin) +/- vanco

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8
Q

tx for gram positive bactraemia

A

empiric tx- vanco
mssa-pcn, naficillin, vanco,
mrsa-vanco
work up should include echo to check for infective endocarditis

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9
Q

3 reasons what make soft tissue infxn an emergency

A

infxn around face or hand
cellulitis in presence of pvd or diabetes
local infxn in presence of hiv or leukemia

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10
Q

malaria sxs

A

uncomplicated fever, malaise, myalgia, arthralgia, and HA

complicated-fever, anemia, splenomegaly, alterned consciousness, ards, etc…

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11
Q

abx for wound botulism

A

pcn g or metronidazole

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12
Q

where is small pox rash most prominent

A

face and extremities (palms and soles)

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13
Q

what causes mediastinal widening

A

inhalation anthrax

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14
Q

cutaneous anthrax tx

A

cipro and doxy

cipro can’t exceed 1 gram daily in children

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15
Q

gastric lavage indications

A

suspected serious ingestoins when emesis has failed
pts are lethargic or otherwise uncooperative
when gag reflex is markedly depressed
when pts have ingested rapidly acting convulsants (can’t induce emesis in these)

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16
Q

what must the toxin be for hemodialsis

A
relatively water soluble and not highly protein bound
indicated for MELS
methanol 
etylene glycol
lithium
salicylate
17
Q

what is the benefit of hemoperfusion over hemodialsis

A

drug or toxin is in direct contact with absorbent material

18
Q

hemoperfusion

A
small volume of distribution and slow rate of intrinsic clearance
usuful for tri pep td
tricyclic antidepresant
paraquat
ethchlorvynol
phenobarbital
theophyline
digitoxin
19
Q

cocaine overdoses

A

euphoria, excitement, restlessness, toxic psychosis, seizures, hypertension, tachycardia, hyperthermia, and possible MI

20
Q

tca overdose

A

Delerium, blurred vision, mydriasis, hallucinations, coma, dry mucous membranes, inhibition of sweating, hyperthermia, tachycardia

21
Q

when to use phystigme for overdose

A

cns problems

22
Q

when to never use phystigme

A

tricyclic overdose, asthma, or mechanical bowel or bladder obstruction

23
Q

best way to monitor chelation therapy for arsenic intoxication

A

24 hour urine arsenic level

24
Q

acute arsenic ingestion

A

gi lavage and charcal and dimercaperaol
chronic use is pencil amine
Chelation therapy is of no value in the acute exposure to arsine gas

25
Q

tx for carbon monoxide poisoning

A

100% fi02 for 4 hour

26
Q

if hyperkalemia in dig toxicity >7

A

glucose + insulin thearpy

27
Q

organophosphate

A

DUMBELS –Diarrhea, Urination, Miosis, Bronchospasms, Excitation, Lacrimation, Salivation

28
Q

main things that differentiate thyroid storm from hyperthyroid

A

fever and cns dysfunctoin (agitation, stupor, confusion, delirium, coma, seizure) in storm

29
Q

what do 1st and 2nd gen antipsychotics do

A

lower seizure threshold

30
Q

never give hypotonic solution in

A

increase ice
trauma
burns
liver disease

31
Q

when not to use lactated ringer

A
kidney failure
liver disease (can't metabolize lactate)
32
Q

when are packed rbc always indicated

A

hgb <6

33
Q

indications for platelets

A

<50,000