em 2 Flashcards
reasons to do ct before lp
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
difference between encephalitis and meningitis
encephalitis has altered brain function and neurological findings (i.e. personality changes, paralysis, hallucinations, altered smell, problems w/ speech)
treatment of encephalitis
acyclovir 10mg/kg empiric tx for hsv
what must you do on any hot swollen joint
arthrocentesis
how to send joint fluid analysis
culture + sensitivity + r/o gonorhea
what do you do if suspect gonoorrhea
do cervical, urethral, and rectal cultures (do this cause joint fluid usually doesn’t show gonorrhea
tx of gram negative bactrameia
gentamycin + cefepime (antipseudomonal cephalosporin) +/- vanco
tx for gram positive bactraemia
empiric tx- vanco
mssa-pcn, naficillin, vanco,
mrsa-vanco
work up should include echo to check for infective endocarditis
3 reasons what make soft tissue infxn an emergency
infxn around face or hand
cellulitis in presence of pvd or diabetes
local infxn in presence of hiv or leukemia
malaria sxs
uncomplicated fever, malaise, myalgia, arthralgia, and HA
complicated-fever, anemia, splenomegaly, alterned consciousness, ards, etc…
abx for wound botulism
pcn g or metronidazole
where is small pox rash most prominent
face and extremities (palms and soles)
what causes mediastinal widening
inhalation anthrax
cutaneous anthrax tx
cipro and doxy
cipro can’t exceed 1 gram daily in children
gastric lavage indications
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)