Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 > EM > Flashcards

EM Flashcards

1
Q

What are almost never used in ingestions?

A

Ipecac (only used at home)
Cathartics (speeding up GI transit time doesn’t help)
Diuretics (can cause pulmonary edema)
Whole bowl irrigation (only for iron/lithium/drug smuggling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 most common and thus the “When in doubt” answers for overdose?

A

APAP

ASA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the best initial treatment for AMS of unknown etiology?

A

opiate antagonist and glucose (opiates/DM are very common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the NOT treatment for benzo overdose?

A

NOT flumazenil because it can cause seizures in acute withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which overdose patients get charcoal?

A

All of them (it is benign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the toxic levels of APAP?
How do you treat APAP OD? >24 hours?
How do you measure APAP ingestion?
Does charcoal inactivate APAP?

A

8-10g (10-15g is fatal)
N acetylcysteine –> nothing
Drug level
No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the keys to diagnosing ASA overdose?

How do you treat it?

A

Tinnitus, RespAlk, MetAcid (from lactate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What % is gastric lavage useful?

A

50% at 1 hour, 15% at 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the danger of using Flumazenil on a patient who you suspect had a TCA OD?
What is the initial test for this patient?

A

BZs prevent seizures in these patients

EKG (wide QRS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs of a TCA OD?

How is it treated?

A

Dry mouth/constipation/urinary retention

NaHCO3 (protects the heart from arrhythmia but does not increase urinary excretion like in ASA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do you give and what do you not give in caustic OD?

A

Give fluids

Do not give opposite caustics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common cause of death in fires?

A

CO poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the pH and pO2 in CO poisoning?

A

Acidic (lactic acidosis)

Normal (does not detach from Hb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the best initial treatment for CO poison?

How do you treat severe CO poison?

A

100% O2

Hyperbaric O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which drugs can cause methemoglobinemia?

A

Anesthetics (benzocaine)
Nitrates
Dapsone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What color is the blood in methemoglobinemia

A

Brown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cyanosis + normal pO2 = ?

Treatment?

A

Methemoglobinemia

Methylene blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do organophosphates/nerve gas cause, how are they absorbed, and how are they treated?

A 
ACh increase (wet)
Skin
Pralidoxime (AChE inactivator) + Atropine (blocks ACh effects)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What predisposes to Digoxin toxicity and why?

A

HypoK

K and Dig compete for same site on Na/KATPase (less K bound=more Dig bound)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the Sx of Digoxin toxicity?
What are the tests for Dig toxicity?
How do you treat?

A

HyperK + yellow halos + rhythm disturbance
Initial: K+ level + EKG (any arrhythmia)
Accurate: digoxin level
Treat: dAb + K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the initial and accurate lead poisoning tests?

A

Initial: free erythrocyte protoporphyrin
Accurate: lead level (sideroblastic anemia seen on Prussian Blue stain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you treat lead poison orally or parenterally?

A

Oral: Succimer
Parenteral: EDTA, Dimercaprol

23
Q

What are the 2 types of Mercury poisoning and how do you reverse each of them?

A

Neuro: nervous/jittery/hallucinate –> Dimercaprol/Succimer
Lung: interstitial fibrosis –> nothing

24
Q

What are the similarities of Methanol and ethylene glycol poisoning?

A

AG MetAcid
Osmolar Gap
Tx: fomepizole + dialysis

25
Q

Differences in methanol and ethylene glycol?

A

Metabolites: formaldehyde vs oxalate
Presentation: ocular toxicity vs renal toxicity
Initial dx: retinal inflammation vs oxalate crystals/low Ca

26
Q

What is the Osmolar Gap?

A

Difference in measured and calculated serum osmolalality

Serum=2*Na + BUN/2.8 + Glucose/18

27
Q

Name 3 beneficial treatments of snake bites

A

Pressure
Immobilization
Antivenom

28
Q

What medication is given for dog/cat/human bites?

A

Amox + Clavulanic Acid

29
Q

What lab value is abnormal in a black widow bite

A

Low Ca

30
Q

What is the best initial test for detecting a head bleed

A

NonCon CT

31
Q

How do you manage a large hematoma in the brain?

A

Intubate/hyperventilate (decreases pCO2)
Mannitol (decrease intravascular volume)
Drainage

32
Q

What is stress ulcer prophylaxis and who gets it?

A

PPI

Head trauma > Burns = ET intubation > Coagulopathy w/respiratory failure

33
Q

What is the most common causes of death in burns?

What is the initial burn treatment?

A

smoke inhalation/CO poison > volume loss

100% O2

34
Q

What fluid do you give burn victims and how do you calculate?

A

Ringers (NS 2nd choice)

4mL x %burned x Kg body weight –> 1/2 1st 8 hrs, 1/4 next 8

35
Q

What is the most common cause of death for burn victims several weeks later?
How do you prevent this?

A 
Infection
Topical Abx (silver sulfadiazine)
36
Q

What is the most common cause of death from hypothermia?

First initial step in hypothermia?

A 
Cardiac arrhythmia (J point elevation)
EKG
37
Q

What is different in salt vs fresh water drowning?

A

Salt: acts like CHF with wet heavy lungs
Fresh: hypotonic causes hemolysis

38
Q

What is the treatment for Asystole

A

CPR + Epi (or Vasopressin)

39
Q

Which rhythms are shockable with unsynchronized cardioversion?
What is the role of medications (E/pressors)?

A

VF + VT without a pulse

Make defibrillation more likely to succeed

40
Q

What other medications can be given if E/vasopressin do not help?

A

Amiodarone > Lidocaine

41
Q

How is VTach managed?

A

Entirely based on hemodynamics
Pulse less: same as VF
Hemodynamically stable: Amiodarone > Lidocaine > Procainamide > Cardioversion
Unstable: cardioversion frequently&raquo_space;> meds

42
Q

What are the qualities of hemodynamic instability?

A

Chest pain
Dyspnea/CHF
HypoTN
Confusion

43
Q

How do you diagnose PEA with EKG

A

Normal EKG but no pulse

44
Q

Which afib patients receive anticoagulation and which do not?

A

Chronic afib does, acute does not

45
Q

Therapy for Afib/Flutter

A

1) rate control (Beta blockers/Ca2+/Dig) to

46
Q

What is the definition of major bleeding from Warfarin?

A

intracranial hemorrhage

Requires a transfusion

47
Q

How do you calculate a CHADS score?

What score is treated with ASA only?

A

CHF/Cardiomegaly, HTN, Age>75, DM, Stroke/TIA (2pts)

1

48
Q

What are the initial treatments for SVT?

A

Vogal maneuvers > Adenosine > BBlock/Ca2+/Dig

49
Q

What are 3 reasons that WPW would be the most likely dx?

A

SVT alternating with VTach
SVT gets worse after Diltiazem or Dig
Delta wave

50
Q

What is the most accurate test for WPW?
What is the acute tx?
Chronic tx?
Dangerous drugs?

A

Electrophysiology studies (EP)
Procainamide = Amiodarone
RF ablation
Dig/Ca2+ blockers

51
Q

What is multimodal atrial tachy associated with and what should you avoid?

A

chronic lung disease (COPD)

Beta blockers

52
Q

What is the next step in a patient who develops an arrhythmia

A

Angiography for angioplasty or bypass

53
Q

What test is used to determine the risk of recurrence for a ventricular arrhythmia?

A

Echo

54
Q

When are EP studies useful?

A

To detect the source of a ventricular arrhythmia

Step 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions