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EM Surg Uworld Flashcards

1
Q

eschar causes compartment syndrome

A

do escharotomy

if Sx don’t improve then fasciotomy

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2
Q

lithium in pregnancy

A

ebstein anomaly
malformed inferiorly attached tricuspid valve
causes right ventrilce to become part of right atrium

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3
Q

lithium in second or third trimester

A

goiter

transient neonatal Neuromuscular dysfunction

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4
Q

Tx tourette

A

risperidone

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5
Q

Sx iron poisoning

A

abdominal pain, comiting, diarrhea, hypotensive shock with reflex tachycardia
metabolic acidosis

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6
Q

Dx findings for iron poisoning

A

anion gap metabolic acidosis and radiopaque pills

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7
Q

Tx iron poisoning

A

whole bowel irrigaiton
deferoxamine
supportive ABC

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8
Q

aspiritn OD

A

tinnitus, fever, hyperapnea (respiratory alkalosis) and metabolic acidosis

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9
Q

acute OD of vitamin A

A

nausea vomiting and blurry vision

can lead to pseudotumor cerebri (ICP)

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10
Q

vit D toxicity

A

hypercalcemia: n/v confusion, polyuria and polydipsia

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11
Q

vit K toxicity

A

hemolytic anemia and hyperbilirubinemia in infants

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12
Q

when to kids have imaginary friends

A

2-6 years old

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13
Q

how does NaHCO3 help with TCA OD

A

sodium alleviated depressant action on myocardial Na channels

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14
Q

signs of TCA OD

A

mental status changes
seizures and resp depression
sinus tachy, hypotension
prolonged PR QRS QT
arrhythmias
dry mouth, blurred vision, dilated pupils
urinary retention, flushing, hyperthermia

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15
Q

Tx TCA OD

A

O2
IV
activated charcoal if within 2 hours
IV NaHCO3 for QRS widening or arrhythmia

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16
Q

methanol toxicity

A

nausea, HA vomiting, epigastric pain

can cause vision loss and coma

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17
Q

what ingestion causes extremely low bicarb and metabolic acidosis

A

methanol ingestion and ethylene glycol ingestion

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18
Q

hyperemic optic disc

A

methanol ingestion

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19
Q

what causes heat stroke

A

inadequate/failure of thermoregulation

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20
Q

screening serum lead is elevated in child, next step

A

measure venous lead

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21
Q

when is chelation Tx given for lead poisoning

A

> 45 ug/dL

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22
Q

Tx trichotillomania

A

CBT

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23
Q

target rate for rewarming patient with hypothermia

A

1-2 C/hr

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24
Q

benzo OD signs

A

slurred speech
ataxia
drowsiness

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25
what to use of neuroleptic malignant syndrome
dantrolene | then bromocriptine and amantadine
26
what drugs cause neuroleptic malignant syndrome
haloperidol | and aytpicals like risperidone
27
PCP intoxication
hallucinations, dissociative feelings, agitaiton, confusion, pupillary dilation tachy and nystagmus
28
patient beginint to have alcohol withdrawl
give chlordiazepoxide (librium) its a benzo and used for this
29
next step after caustic ingestion
upper GI endoscopy within first 12-24 hours in hemodynamically stable patients
30
if suspect perforation after ingestion caustic material
abcominal XR with water soluble contrast
31
smoke inhalation at risk for
cyanide poisoning and carbon monoxide poisoning
32
Tx cyanide poisoning from inhalation
hydroxocobalamin | Na thiosulfate
33
what induce methemoglobinemia
nitrites
34
acute toxicity cyanide
HA, vertigo, dizziness, hyperventilation,t achy nausea and vomiting Cv and resp depression coma, seizures, brady, hypotension and cardioresp arrest
35
how do nitrites induce methemoglobinemia
increase ferric iron Fe3+ in circulating Hb and cyanide binds this
36
how does cyanide cause lactic acidosis
inhibit ETC in mitochondria blocking production ATP from ox phos forces anaerobic metabolism causes tachypnea and fall in arterial PaCO2
37
effects of heroin and methadone on fetus
IUGR, macrocephaly, SIDS, neonatal abstinence syndrome
38
neonatal abstinence syndrome
first few days of life with irritability, high pitch cry, poor sleeping, tremors, seizures, sweating, sneezing, tachypnea, poor feeding, vomiting and diarrhea
39
signs of ethylene glycol ingestion
flank pain, hematuria, oliguria cranial nerve palsies and tetany
40
lab results in ethylene glycol ingestion
high osmolar ga high anion gap metabolic acidosis Ca oxalate crystals in urine
41
Tx for ethylene glycol ingestion
fomepizole which competetively binds alcohol dehydrogenase NaHCO3 for acidosis hemodialysis may be required
42
signs opioid withdrawl
n/v/d cramps dysphoria restlessness rhinorrhea, lacrimation, myalgias and arthralgias mydriasis, goose bumps, hyperactive bowel sounds
43
Tx withdrawl opioid
methadone
44
bath salt intoxication
severe agitation, combativeness, psychosis, delirium, myoclonus and rarely seizures
45
signs of CO poisoning
HA, n/v abdominal pain, confusion, coma | pink hue to skin color
46
Tx CO poisoning
hyperbaric O2
47
which antipsychotic can contribute to hypothermia
fluphenazine because it inhibits the body's shivering mechanism and autonomic thermoregulation
48
Patient with tourrettes is most likely to develop what at later age
ADHD and OCD
49
patient with normal labs but claims to have taken lots of acetominophen 2 hours ago
give activated charcoad if within 4 hours of ingestion
50
how long can acetominophen intoxication be asymptomatic
24 hours
51
signs of benadryl toxicity | anticholinergic
``` dry mouth blurry vision hyperthermia urinary retention decreased bowel sounds ```
52
serotonin syndrome
tachy hyperthermia, inc bowel sounds, HTN, metnal statu changes, dilated pupils and clonus or hyperreflexia
53
what do people die from in TCA Od
TCA induced hypotension
54
what is buspirone
anti anxiety drug
55
Cyanide poisoning
HA vomiting, abdominal pain and flushed skin | inhalational can cause bitter almond odor
56
thoracic GSW and FAST exam was limited due to body habitus | next step
ex lap
57
US shows blood in peritoneal cavity in hemodynamically unstable patient
urgent laparotomy
58
CT shows ruptured aorta with blood collection in adventitial layer next step
exploratory abdominal surgery
59
hemodynamically stable patient with US showing blood in spleno renal angle after MVA next step
CT scan
60
chronic growth on hard palate of mouth
torus palatinus
61
patient had last tetanus shot 12 years ago and has deep laceration from rusty barbed wire fence next step
administer tetanus diptheria toxoid vaccine only
62
when do you give tetanus Ig
if dirty or severe wound in unimmunizaed, or less than 3 tetanus toxoid doses
63
preferred airway in someone with facial lacerations or temporal skull fracture but no significant facial trauma
orotracheal
64
what intubation is contraindicated with basilar skull fractures
nasotracheal
65
MVA accident and BP not responding to IV fluids | abdominal distention and absent bowel sounds
go to surgery ex lap
66
post MVA persistent pneumothorax despite chest tube placement subcutaneous emphysema
tracheobronchial performation
67
components of glascow coma scale
eye opening, verbal response | motor response
68
management penile fracture
retrograde urethrogram followed by surgical exploration of penis
69
next step after seeing pneumoperitoneum (air under diaphragm) on CXR
abdominal CT
70
complicaiton of rhinoplasty that results in whistling noise during rsepiration
septal perforation from a hematoma
71
penetrating injury to abdomen
ex lap
72
how to identify splenic injury
abdominal CT with contrast if patient is stable
73
blunt abdominal trauma, FAST is negative 8 hours later has LUQ pain with left shoulder pain and mild nausea, low BP and tachycardia fluids help a little
splenic injury
74
what is msot sensitive vital sign for blood loss
heart rate
75
abdominal pain that refers to the shoulder
peritonitis and irritation of diaphramg. kehr sign | '
76
which part of bladder is convered by peritoneum
the dome is the only park
77
bladder area most susceptible to rupture from blunt trauma if bladder is distended
dome
78
nasopharyngeal carcinoma is associated with what
EBV mediterranean or far eastern descent smoking nitrosamine consumption (salted fish)

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