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Emergency Medicine > EM II > Flashcards

EM II Flashcards

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1
Q

Airway Interventions flow chart:

  • […]
  • reposition the airway- jaw thrust
  • BVM ventilation- 2 person
  • intubation with RSI
A

Airway Interventions flow chart:

  • verbal/tactile stimulation- sternal rub
  • reposition the airway- jaw thrust
  • BVM ventilation- 2 person
  • intubation with RSI
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2
Q

Airway Interventions flow chart:

  • verbal/tactile stimulation- sternal rub
  • […]
  • BVM ventilation- 2 person
  • intubation with RSI
A

Airway Interventions flow chart:

  • verbal/tactile stimulation- sternal rub
  • reposition the airway- jaw thrust
  • BVM ventilation- 2 person
  • intubation with RSI
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3
Q

Airway Interventions flow chart:

  • verbal/tactile stimulation- sternal rub
  • reposition the airway- jaw thrust
  • […]
  • intubation with RSI
A

Airway Interventions flow chart:

  • verbal/tactile stimulation- sternal rub
  • reposition the airway- jaw thrust
  • BVM ventilation- 2 person
  • intubation with RSI
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4
Q

Airway Interventions flow chart:

  • verbal/tactile stimulation- sternal rub
  • reposition the airway- jaw thrust
  • BVM ventilation- 2 person
  • […]
A

Airway Interventions flow chart:

  • verbal/tactile stimulation- sternal rub
  • reposition the airway- jaw thrust
  • BVM ventilation- 2 person
  • intubation with RSI - Rapid Sequence Intubation

https://emedicine.medscape.com/article/80222-overview

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5
Q

All AMS pts are […] until proven otherwise!

A

All AMS pts are hypoglycemic until proven otherwise!

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6
Q

Always check a […] level before acting on Hyperkalemia.

A

Always check a hemolysis level before acting on Hyperkalemia.

K 5.5 and 2+ hemolysis = ok

K 8 and 1+ hemolysis = bad

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7
Q

Always determine onset in […] prior to cardioverting.

A

Always determine onset in AFib (<48hrs) prior to cardioverting.

if >48hrs need anticoagulation

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8
Q

Always get […] prior to performing Procedural Sedation.

A

Always get consent prior to performing Procedural Sedation.

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9
Q

Always label syringes and IV bags if you mix […].

A

Always label syringes and IV bags if you mix push dose/epi drip.

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10
Q

Always perform […] on all Psych pts.

A

Always perform full physical exam on all Psych pts.

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11
Q

Always treat […] in pregnancy.

A

Always treat UTI’s in pregnancy.

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12
Q

AMS ddx: (AEIOUTIPS)

  • A[…]
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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13
Q

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • E[…]
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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14
Q

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • I[…]
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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15
Q

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • O[…]
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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16
Q

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • U[…]
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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17
Q

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • T[…]
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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18
Q

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • I[…]
  • Psych/polypharmacy
  • Stroke/SAH
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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19
Q

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • P[…]
  • Stroke/SAH
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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20
Q

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • S[…]
A

AMS ddx: (AEIOUTIPS)

  • Alcohol/acidosis
  • Electrolytes
  • Infection/ischemia
  • Oxygen (hypoxia)
  • Uremia
  • Toxidrome/trauma
  • Insulin
  • Psych/polypharmacy
  • Stroke/SAH

“TINE”

Trauma/tox

Infection/ischemia

Neuro

Electrolytes/endocrine

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21
Q

AMS exam: (6)

  • […]
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
A

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
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22
Q

AMS exam: (6)

  • basic “ED Neuro Exam”
  • […]
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
A

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
How well did you know this?
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23
Q

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • […]
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
A

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
How well did you know this?
1
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2
3
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24
Q

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • […]
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
A

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
How well did you know this?
1
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25
Q

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • […]
  • skin- decubitus ulcers, rash, petechiae
A

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
How well did you know this?
1
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26
Q

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • […]
A

AMS exam: (6)

  • basic “ED Neuro Exam”
  • pupils - size + nystagmus
  • axilla- dry?
  • lungs- pna?
  • abd- tenderness/pain
  • skin- decubitus ulcers, rash, petechiae
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27
Q

AMS Stroke with no intacranial bleed and within […] hrs onset can give […].

A

AMS Stroke with no intacranial bleed and within 4 hrs onset can give TPA.

read through TPA contraindications!

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28
Q

Anaerobic abx coverage:

  • […]
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
A

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
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29
Q

Anaerobic abx coverage:

  • flagyl (metro)
  • […]
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
A

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
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30
Q

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • […]
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
A

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
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3
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31
Q

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • […]
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
A

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
How well did you know this?
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32
Q

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • […]
  • moxifloxacin
  • carbipenem
  • tigecycline
A

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
How well did you know this?
1
Not at all
2
3
4
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33
Q

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • […]
  • tigecycline
A

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
How well did you know this?
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3
4
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34
Q

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • […]
  • carbipenem
  • tigecycline
A

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
How well did you know this?
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2
3
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35
Q

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • […]
A

Anaerobic abx coverage:

  • flagyl (metro)
  • clindamycin
  • augmentin (amox/clav)
  • unasyn (amp/sulb)
  • zosyn (pip/tazo)
  • moxifloxacin
  • carbipenem
  • tigecycline
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36
Q

Anaphlyaxis pt on beta blockers needs:

  • […]
  • glucagon 1-5mg IV slowly
  • zofran 4mg
A

Anaphlyaxis pt on beta blockers needs:

  • epi- IM/epi pen/push dose
  • glucagon 1-5mg IV slowly
  • zofran 4mg

glucagon to counteract BB

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37
Q

Anaphlyaxis pt on beta blockers needs:

  • epi- IM/epi pen/push dose
  • […]
  • zofran 4mg
A

Anaphlyaxis pt on beta blockers needs:

  • epi- IM/epi pen/push dose
  • glucagon 1-5mg IV slowly
  • zofran 4mg

glucagon to counteract BB

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38
Q

Anaphlyaxis pt on beta blockers needs:

  • epi- IM/epi pen/push dose
  • glucagon 1-5mg IV slowly
  • […]
A

Anaphlyaxis pt on beta blockers needs:

  • epi- IM/epi pen/push dose
  • glucagon 1-5mg IV slowly
  • zofran 4mg

glucagon to counteract BB

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39
Q

Anaphylaxis first step is […].

A

Anaphylaxis first step is rapid ABC’s.

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40
Q

Anaphylaxis pts who don’t improve with IM epi can receive […].

A

Anaphylaxis pts who don’t improve with IM epi can receive IV epi.

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41
Q

Anatomical EKG locations are:

  • inferior = […]
  • anterior/septal = V1 - V3
  • lateral = I and AVL + V4-V6
  • isolation = AVR
A

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = V1 - V3
  • lateral = I and AVL + V4-V6
  • isolation = AVR
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42
Q

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = […]
  • lateral = I and AVL + V4-V6
  • isolation = AVR
A

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = V1 - V3
  • lateral = I and AVL + V4-V6
  • isolation = AVR
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43
Q

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = V1 - V3
  • lateral = […] + V4-V6
  • isolation = AVR
A

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = V1 - V3
  • lateral = I and AVL + V4-V6
  • isolation = AVR
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44
Q

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = V1 - V3
  • lateral = I and AVL + […]
  • isolation = AVR
A

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = V1 - V3
  • lateral = I and AVL + V4-V6
  • isolation = AVR
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45
Q

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = V1 - V3
  • lateral = I and AVL + V4-V6
  • isolation = […]
A

Anatomical EKG locations are:

  • inferior = II, III, AVF
  • anterior/septal = V1 - V3
  • lateral = I and AVL + V4-V6
  • isolation = AVR
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46
Q

Anion Gap = […]

A

Anion Gap = [Na - (Cl +HCO3)]

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47
Q

Anti-Hypertensives quick doses:

  • labetalol: 10-40mg IV q10min => 0.5-2 mg/min IV
  • hydralazine: […]
  • nicardipine: 5mg/h => +2.5mg/hr (max15mg/hr)
  • nitroglycerin: 5-20mcg/min IV
A

Anti-Hypertensives quick doses:

  • labetalol: 10-40mg IV q10min => 0.5-2 mg/min IV
  • hydralazine: 10mg slow IV Q6 (up to max 40mg)
  • nicardipine: 5mg/h => +2.5mg/hr (max15mg/hr)
  • nitroglycerin: 5-20mcg/min IV
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48
Q

Anti-Hypertensives quick doses:

  • labetalol: 10-40mg IV q10min => 0.5-2 mg/min IV
  • hydralazine: 10mg slow IV Q6 (up to max 40mg)
  • nicardipine: […]
  • nitroglycerin: 5-20mcg/min IV
A

Anti-Hypertensives quick doses:

  • labetalol: 10-40mg IV q10min => 0.5-2 mg/min IV
  • hydralazine: 10mg slow IV Q6 (up to max 40mg)
  • nicardipine: 5mg/h => +2.5mg/hr (max15mg/hr)
  • nitroglycerin
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49
Q

Anti-Hypertensives quick doses:

  • labetalol: […]
  • hydralazine: 10mg slow IV Q6 (up to max 40mg)
  • nicardipine: 5mg/h => +2.5mg/hr (max15mg/hr)
  • nitroglycerin: 5-20mcg/min IV
A

Anti-Hypertensives quick doses:

  • labetalol: 10-40mg IV q10min => 0.5-2 mg/min IV
  • hydralazine: 10mg slow IV Q6 (up to max 40mg)
  • nicardipine: 5mg/h => +2.5mg/hr (max15mg/hr)
  • nitroglycerin: 5-20mcg/min IV
50
Q

Anti-Hypertensives quick doses:

  • labetalol: 10-40mg IV q10min => 0.5-2 mg/min IV
  • hydralazine: 10mg slow IV Q6 (up to max 40mg)
  • nicardipine: 5mg/h => +2.5mg/hr (max15mg/hr)
  • nitroglycerin: […]
A

Anti-Hypertensives quick doses:

  • labetalol: 10-40mg IV q10min => 0.5-2 mg/min IV
  • hydralazine: 10mg slow IV Q6 (up to max 40mg)
  • nicardipine: 5mg/h => +2.5mg/hr (max15mg/hr)
  • nitroglycerin: 5-20mcg/min IV
51
Q

Anyphylaxis assesment triangle:

  • […]
  • work of breathing
  • color- skin color
A

Anyphylaxis assesment triangle:

  • appearance- overall
  • work of breathing
  • color- skin color
52
Q

Anyphylaxis assesment triangle:

  • appearance- overall
  • […]
  • color- skin color
A

Anyphylaxis assesment triangle:

  • appearance- overall
  • work of breathing
  • color- skin color
53
Q

Anyphylaxis assesment triangle:

  • appearance- overall
  • work of breathing
  • […]
A

Anyphylaxis assesment triangle:

  • appearance- overall
  • work of breathing
  • color- skin color
54
Q

Anything that irritates the tympanic membrane can cause […].

A

Anything that irritates the tympanic membrane can cause dizziness.

55
Q

Aortic Dissection CXR shows […] (60-70% sn).

A

Aortic Dissection CXR shows widened mediastinum (60-70% sn).

>6cm (some say 8cm)

56
Q

Aortic Dissection presents with […] radiating to back/shoulder.

A

Aortic Dissection presents with ripping chest pain radiating to back/shoulder.

57
Q

Aortic Dissection presents with ripping chest pain radiating to […].

A

Aortic Dissection presents with ripping chest pain radiating to back/shoulder.

58
Q

Aortic Dissection prx:

  • […]
  • hx of htn
  • pulse and motor deficits
A

Aortic Dissection prx:

  • ripping/tearing chest/back pain
  • hx of htn
  • pulse and motor deficits
59
Q

Aortic Dissection prx:

  • ripping/tearing chest/back pain
  • […]
  • pulse and motor deficits
A

Aortic Dissection prx:

  • ripping/tearing chest/back pain
  • hx of htn
  • pulse and motor deficits
60
Q

Aortic Dissection prx:

  • ripping/tearing chest/back pain
  • hx of htn
  • […]
A

Aortic Dissection prx:

  • ripping/tearing chest/back pain
  • hx of htn
  • pulse and motor deficits
61
Q

Aortic Dissection risk factors:

  • […]
  • smoking
  • age 60+
  • pregnancy
  • connective tissue dz (marfans/ED)
A

Aortic Dissection risk factors:

  • HTN #1
  • smoking
  • age 60+
  • pregnancy
  • connective tissue dz (marfans/ED)
62
Q

Aortic Dissection risk factors:

  • HTN #1
  • […]
  • age 60+
  • pregnancy
  • connective tissue dz (marfans/ED)
A

Aortic Dissection risk factors:

  • HTN #1
  • smoking
  • age 60+
  • pregnancy
  • connective tissue dz (marfans/ED)
63
Q

Aortic Dissection risk factors:

  • HTN #1
  • smoking
  • […]
  • pregnancy
  • connective tissue dz (marfans/ED)
A

Aortic Dissection risk factors:

  • HTN #1
  • smoking
  • age 60+
  • pregnancy
  • connective tissue dz (marfans/ED)
64
Q

Aortic Dissection risk factors:

  • HTN #1
  • smoking
  • age 60+
  • […]
  • connective tissue dz (marfans/ED)
A

Aortic Dissection risk factors:

  • HTN #1
  • smoking
  • age 60+
  • pregnancy
  • connective tissue dz (marfans/ED)
65
Q

Aortic Dissection risk factors:

  • HTN #1
  • smoking
  • age 60+
  • pregnancy
  • […]
A

Aortic Dissection risk factors:

  • HTN #1
  • smoking
  • age 60+
  • pregnancy
  • connective tissue dz (marfans/ED)
66
Q

Aortic Dissection tx:

  • […]
  • nicardipine 2mg IV => 5mg/hr (titrate up by 2.5mg/hr)
  • fentanyl 1mcg/kg IV
  • surgery cs
A

Aortic Dissection tx:

  • esmolol 500mcg/kg over 1 min => 50mcg/kg/min
  • nicardipine 2mg IV => 5mg/hr (titrate up by 2.5mg/hr)
  • fentanyl 1mcg/kg IV
  • surgery cs

start with esmolol for BB effects

67
Q

Aortic Dissection tx:

  • esmolol 500mcg/kg over 1 min => 50mcg/kg/min
  • […]
  • fentanyl 1mcg/kg IV
  • surgery cs
A

Aortic Dissection tx:

  • esmolol 500mcg/kg over 1 min => 50mcg/kg/min
  • nicardipine 2mg IV => 5mg/hr (titrate up by 2.5mg/hr)
  • fentanyl 1mcg/kg IV
  • surgery cs

start with esmolol for BB effects

68
Q

Aortic Dissection tx:

  • esmolol 500mcg/kg over 1 min => 50mcg/kg/min
  • nicardipine 2mg IV => 5mg/hr (titrate up by 2.5mg/hr)
  • […]
  • surgery cs
A

Aortic Dissection tx:

  • esmolol 500mcg/kg over 1 min => 50mcg/kg/min
  • nicardipine 2mg IV => 5mg/hr (titrate up by 2.5mg/hr)
  • fentanyl 1mcg/kg IV
  • surgery cs

start with esmolol for BB effects

69
Q

Aortic Dissection tx:

  • esmolol 500mcg/kg over 1 min => 50mcg/kg/min
  • nicardipine 2mg IV => 5mg/hr (titrate up by 2.5mg/hr)
  • fentanyl 1mcg/kg IV
  • […]
A

Aortic Dissection tx:

  • esmolol 500mcg/kg over 1 min => 50mcg/kg/min
  • nicardipine 2mg IV => 5mg/hr (titrate up by 2.5mg/hr)
  • fentanyl 1mcg/kg IV
  • surgery cs

start with esmolol for BB effects

70
Q

Aortic Dissection w/u:

• […]

A

Aortic Dissection w/u:

• CTA

TEE if dye allergy or bad kidneys

71
Q

APAP liver metabolism:

  • 90% = […]
  • 10% = P450 into NAPQI => glutathione
A

APAP (acetaminophen) liver metabolism:

  • 90% = sulfation + glucuronidation
  • 10% = P450 into NAPQI => glutathione
72
Q

APAP (acetaminophen) liver metabolism:

  • 90% = sulfation + glucuronidation
  • 10% = […]
A

APAP liver metabolism:

  • 90% = sulfation + glucuronidation
  • 10% = P450 into NAPQI => glutathione
73
Q

APAP OD can be […] and lethal.

A

APAP OD can be asymptomatic and lethal.

74
Q

APAP OD can be asymptomatic and […].

A

APAP OD can be asymptomatic and lethal.

75
Q

APAP OD dispo: (3)

  • pt asx/mild sxs => […]
  • pt tx with NAC => admitted
  • pt with sxs hepatotoxicity => ICU
A

APAP OD dispo: (3)

  • pt asx/mild sxs => admit to obs
  • pt tx with NAC => admitted
  • pt with sxs hepatotoxicity => ICU
76
Q

APAP OD dispo: (3)

  • pt asx/mild sxs => admit to obs
  • pt tx with NAC => […]
  • pt with sxs hepatotoxicity => ICU
A

APAP OD dispo: (3)

  • pt asx/mild sxs => admit to obs
  • pt tx with NAC => admitted
  • pt with sxs hepatotoxicity => ICU
77
Q

APAP OD dispo: (3)

  • pt asx/mild sxs => admit to obs
  • pt tx with NAC => admitted
  • pt with sxs hepatotoxicity => […]
A

APAP OD dispo: (3)

  • pt asx/mild sxs => admit to obs
  • pt tx with NAC => admitted
  • pt with sxs hepatotoxicity => ICU
78
Q

APAP OD doesn’t cause liver damage immediately so you have […].

A

APAP OD doesn’t cause liver damage immediately so you have time ~4hrs to wait on serum lvl.

79
Q

APAP OD meds that worsen outcome:

  • […]
  • anti-TB drugs
  • TMP-SMX
  • zidovudine
  • herbal supplements
A

APAP OD meds that worsen outcome:

  • anticonvulsants
  • anti-TB drugs
  • TMP-SMX
  • zidovudine
  • herbal supplements
80
Q

APAP OD meds that worsen outcome:

  • anticonvulsants
  • […]
  • TMP-SMX
  • zidovudine
  • herbal supplements
A

APAP OD meds that worsen outcome:

  • anticonvulsants
  • anti-TB drugs
  • TMP-SMX
  • zidovudine
  • herbal supplements
81
Q

APAP OD meds that worsen outcome:

  • anticonvulsants
  • anti-TB drugs
  • […]
  • zidovudine
  • herbal supplements
A

APAP OD meds that worsen outcome:

  • anticonvulsants
  • anti-TB drugs
  • TMP-SMX
  • zidovudine
  • herbal supplements
82
Q

APAP OD meds that worsen outcome:

  • anticonvulsants
  • anti-TB drugs
  • TMP-SMX
  • […]
  • herbal supplements
A

APAP OD meds that worsen outcome:

  • anticonvulsants
  • anti-TB drugs
  • TMP-SMX
  • zidovudine
  • herbal supplements
83
Q

APAP OD meds that worsen outcome:

  • anticonvulsants
  • anti-TB drugs
  • TMP-SMX
  • zidovudine
  • […]
A

APAP OD meds that worsen outcome:

  • anticonvulsants
  • anti-TB drugs
  • TMP-SMX
  • zidovudine
  • herbal supplements
84
Q

APAP OD occurs due to increased […] and decreased glutathione.

A

APAP OD occurs due to increased NAPQI and decreased glutathione.

85
Q

APAP OD occurs due to increased NAPQI and decreased […].

A

APAP OD occurs due to increased NAPQI and decreased glutathione.

86
Q

APAP OD pts who qualify for NAC:

  • […]
  • single APAP ingestion >150mg who can’t get APAP level in under 8 hrs
  • pt with uknown time of ingestion and APAP >10mcg/ml
  • pt with >24hrs post ingestion evidence of liver injury
A

APAP OD pts who qualify for NAC:

  • pt above line on Rumack-Mathew nomogram
  • single APAP ingestion >150mg who can’t get APAP level in under 8 hrs
  • pt with uknown time of ingestion and APAP >10mcg/ml
  • pt with >24hrs post ingestion evidence of liver injury
87
Q

APAP OD pts who qualify for NAC:

  • pt above line on Rumack-Mathew nomogram
  • […]
  • pt with uknown time of ingestion and APAP >10mcg/ml
  • pt with >24hrs post ingestion evidence of liver injury
A

APAP OD pts who qualify for NAC:

  • pt above line on Rumack-Mathew nomogram
  • single APAP ingestion >150mg who can’t get APAP level in under 8 hrs
  • pt with uknown time of ingestion and APAP >10mcg/ml
  • pt with >24hrs post ingestion evidence of liver injury
88
Q

APAP OD pts who qualify for NAC:

  • pt above line on Rumack-Mathew nomogram
  • single APAP ingestion >150mg who can’t get APAP level in under 8 hrs
  • […]
  • pt with >24hrs post ingestion evidence of liver injury
A

APAP OD pts who qualify for NAC:

  • pt above line on Rumack-Mathew nomogram
  • single APAP ingestion >150mg who can’t get APAP level in under 8 hrs
  • pt with uknown time of ingestion and APAP >10mcg/ml
  • pt with >24hrs post ingestion evidence of liver injury
89
Q

APAP OD pts who qualify for NAC:

  • pt above line on Rumack-Mathew nomogram
  • single APAP ingestion >150mg who can’t get APAP level in under 8 hrs
  • pt with uknown time of ingestion and APAP >10mcg/ml
  • […]
A

APAP OD pts who qualify for NAC:

  • pt above line on Rumack-Mathew nomogram
  • single APAP ingestion >150mg who can’t get APAP level in under 8 hrs
  • pt with uknown time of ingestion and APAP >10mcg/ml
  • pt with >24hrs post ingestion evidence of liver injury
90
Q

APAP OD stages:

  • I = […]
  • II = 24-72hr
  • III = 72-96hr
  • IV = 4d-2wk
A

APAP OD stages:

  • I = 30min-24hr
  • II = 24-72hr
  • III = 72-96hr
  • IV = 4d-2wk
91
Q

APAP OD stages:

  • I = 30min-24hr
  • II = […]
  • III = 72-96hr
  • IV = 4d-2wk
A

APAP OD stages:

  • I = 30min-24hr
  • II = 24-72hr
  • III = 72-96hr
  • IV = 4d-2wk
92
Q

APAP OD stages:

  • I = 30min-24hr
  • II = 24-72hr
  • III = […]
  • IV = 4d-2wk
A

APAP OD stages:

  • I = 30min-24hr
  • II = 24-72hr
  • III = 72-96hr
  • IV = 4d-2wk
93
Q

APAP OD stages:

  • I = 30min-24hr
  • II = 24-72hr
  • III = 72-96hr
  • IV = […]
A

APAP OD stages:

  • I = 30min-24hr
  • II = 24-72hr
  • III = 72-96hr
  • IV = 4d-2wk
94
Q

APAP OD tx: (+ doses)

  • […]
  • NAC 150 mg/kg IV in 100ml D5W => 50 mg/kg in 250ml D5W

• +/- activated charcoal 1g/kg PO within 4 hrs of ingestion (max 50g)

A

APAP OD tx: (+ doses)

  • ABCs: O2, IVFs, EKG
  • NAC 150 mg/kg IV in 100ml D5W => 50 mg/kg in 250ml D5W

• +/- activated charcoal 1g/kg PO within 4 hrs of ingestion (max 50g)

95
Q

APAP OD tx: (+ doses)

  • ABCs: O2, IVFs, EKG
  • NAC 150 mg/kg IV in 100ml D5W => 50 mg/kg in 250ml D5W

• +/- […]

A

APAP OD tx: (+ doses)

  • ABCs: O2, IVFs, EKG
  • NAC 150 mg/kg IV in 100ml D5W => 50 mg/kg in 250ml D5W

• +/- activated charcoal 1g/kg PO within 4 hrs of ingestion (max 50g)

96
Q

APAP OD tx: (+ doses)

  • ABCs: O2, IVFs, EKG
  • […]

• +/- activated charcoal 1g/kg PO within 4 hrs of ingestion (max 50g)

A

APAP OD tx: (+ doses)

  • ABCs: O2, IVFs, EKG
  • NAC 150 mg/kg IV in 100ml D5W => 50 mg/kg in 250ml D5W

• +/- activated charcoal 1g/kg PO within 4 hrs of ingestion (max 50g)

97
Q

APAP OD w/u:

• […]

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
98
Q

APAP OD w/u:

• serum APAP

  • […]
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
99
Q

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • […]
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
100
Q

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • […]

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
101
Q

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• […]

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
102
Q

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • […]
  • urine hCG
  • EKG
  • EtOH
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
103
Q

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • […]
  • EKG
  • EtOH
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
104
Q

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • […]
  • EtOH
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
105
Q

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • […]
  • ASA
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
106
Q

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • […]
A

APAP OD w/u:

• serum APAP

  • CBC/CMP
  • ABG/VBG (acidosis)
  • coags

• LFTs

  • ammonia
  • urine hCG
  • EKG
  • EtOH
  • ASA
107
Q

ASA alternate preparations:

  • […]
  • bismuth subsalicylate (pepto)
  • methyl salicylate (oil of wintergreen
A

ASA alternate preparations:

  • salicylic acid (acne)
  • bismuth subsalicylate (pepto)
  • methyl salic
108
Q

ASA alternate preparations:

  • salicylic acid (acne)
  • […]
  • methyl salicylate (oil of wintergreen)
A

ASA alternate preparations:

  • salicylic acid (acne)
  • bismuth subsalicylate (pepto)
  • methyl salicylate (oil of wintergreen)
109
Q

ASA alternate preparations:

  • salicylic acid (acne)
  • bismuth subsalicylate (pepto)
  • […]
A

ASA alternate preparations:

  • salicylic acid (acne)
  • bismuth subsalicylate (pepto)
  • methyl salicylate (oil of wintergreen)
110
Q

ASA is […] to salicylate within intestinal wall/liver/RBCs.

A

ASA is hydrolyzed to salicylate within intestinal wall/liver/RBCs.

111
Q

ASA is hydrolyzed to salicylate within […].

A

ASA is hydrolyzed to salicylate within intestinal wall/liver/RBCs.

112
Q

ASA OD dispo is […].

A

ASA OD dispo is admission.

113
Q

ASA OD exam:

  • […]
  • vital signs- tachypnea, hyperthermia, hypotension, or tachycardia
  • lungs- hyperpnea, crackles, signs of pulmonary edema
  • GU- oliguria
A

ASA OD exam:

  • general- AOx3, confused, agitated, restless
  • vital signs- tachypnea, hyperthermia, hypotension, or tachycardia
  • lungs- hyperpnea, crackles, signs of pulmonary edema
  • GU- oliguria
114
Q

ASA OD exam:

  • general- AOx3, confused, agitated, restless
  • […]
  • lungs- hyperpnea, crackles, signs of pulmonary edema
  • GU- oliguria
A

ASA OD exam:

  • general- AOx3, confused, agitated, restless
  • vital signs- tachypnea, hyperthermia, hypotension, or tachycardia
  • lungs- hyperpnea, crackles, signs of pulmonary edema
  • GU- oliguria
115
Q

ASA OD exam:

  • general- AOx3, confused, agitated, restless
  • vital signs- tachypnea, hyperthermia, hypotension, or tachycardia
  • […]
  • GU- oliguria
A

ASA OD exam:

  • general- AOx3, confused, agitated, restless
  • vital signs- tachypnea, hyperthermia, hypotension, or tachycardia
  • lungs- hyperpnea, crackles, signs of pulmonary edema
  • GU- oliguria
116
Q

ASA OD exam:

  • general- AOx3, confused, agitated, restless
  • vital signs- tachypnea, hyperthermia, hypotension, or tachycardia
  • lungs- hyperpnea, crackles, signs of pulmonary edema
  • […]
A

ASA OD exam:

  • general- AOx3, confused, agitated, restless
  • vital signs- tachypnea, hyperthermia, hypotension, or tachycardia
  • lungs- hyperpnea, crackles, signs of pulmonary edema
  • GU- oliguria
117
Q

ASA OD floor monitoring:

  • […]
  • serial ASA lvl Q2
  • serial BMP/ABG/pH Q2
A

ASA OD floor monitoring:

  • continuous respiratory/cardiac monitoring
  • serial ASA lvl Q2
  • serial BMP/ABG/pH Q2
118
Q

ASA OD floor monitoring:

  • continuous respiratory/cardiac monitoring
  • […]
  • serial BMP/ABG/pH Q2
A

ASA OD floor monitoring:

  • continuous respiratory/cardiac monitoring
  • serial ASA lvl Q2
  • serial BMP/ABG/pH Q2
119
Q

ASA OD floor monitoring:

  • continuous respiratory/cardiac monitoring
  • serial ASA lvl Q2
  • […]
A

ASA OD floor monitoring:

  • continuous respiratory/cardiac monitoring
  • serial ASA lvl Q2
  • serial BMP/ABG/pH Q2
120
Q

ASA OD hemodialysis indications: (6)

  • […]
  • intubated
  • oliguric renal failure
  • pulmonary/cerebral edema
  • AMS
  • clinical deterioration
A

ASA OD hemodialysis indications: (6)

  • ASA >100mg/dL (>50 if chronic)
  • intubated
  • oliguric renal failure
  • pulmonary/cerebral edema
  • AMS
  • clinical deterioration

Emergency Medicine (6 decks)

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