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Clin Med V and VI > Emerency Medicine > Flashcards

Emerency Medicine Flashcards

1
Q

MCC of shock

A

Hemorrhage and hypovolemia

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2
Q

Trauma labs

A
  • CBC
  • PT
  • PTT
  • CMP
  • Amylase
  • Beta hcg
  • Blood glucose and urine dipstick
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3
Q

With what pathology is Beck’s triad associated?

A

Cardiac tamponade

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4
Q

Triad of symptoms associated with cardiac tamponade (name of the triad and the symptoms)

A

Becks triad:

  • Muffled heart sounds
  • Neck vein distention
  • Low blood pressure
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5
Q

Perfect Glasgow coma scale score

A

15

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6
Q

Lowest possible Glasgow come scale score

A

3

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7
Q

Glasgow score for eyes opening spontaneously

A

4

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8
Q

Glasgow score for eyes opening only when the patient is told to do so

A

3

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9
Q

Glasgow score for eyes opening after painful stimuli

A

2

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10
Q

Glasgow score for no eye-opening response

A

1

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11
Q

Glasgow score for speaking and making sense (patient is oriented)

A

5

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12
Q

Glasgow score for when the patient speaks, but is confused (disoriented)

A

4

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13
Q

Glasgow score for when the patient does not speak, but makes sounds

A

2

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14
Q

Glasgow score for when the patient speaks, but makes no sense

A

3

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15
Q

Glasgow score for when the patient does not speak

A

1

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16
Q

Glasgow score for when the patient obeys verbal commands to move

A

6

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17
Q

Glasgow score for when the patient responds to painful stimuli and is able to localize the pain

A

5

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18
Q

Glasgow score for when the patient responds to painful stimuli and flexes or withdrawals away from the pain

A

4

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19
Q

Glasgow score for when the patient responds to painful stimuli and displays abnormal flexion (decorticate rigidity)

A

3

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20
Q

Glasgow score for when the patient responds to painful stimuli and displays abnormal extension (decerebrate rigidity)

A

2

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21
Q

Glasgow score for when the patient has no response to pain

A

1

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22
Q

First places we’ll look for bleeding if the patient is becoming shocky from hypovolemia

A

Thorax and abdomen

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23
Q

Stage of hemorrhagic shock:

  • Agitated mental status
  • Pulse > 100
A

II

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24
Q

How much blood (volume) has a patient in stage II hemorrhagic shock lost?

A

0.75 - 1.5 L

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25
Q

What type of fluids should you give a patient in stage II hemorrhagic shock?

A

Lactated ringers

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26
Q

How much blood (volume) has a patient in stage I hemorrhagic shock lost?

A

0 - 0.75 L

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27
Q

How much blood (volume) has a patient in stage III hemorrhagic shock lost?

A

1.5 - 2.5L

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28
Q

How much blood (volume) has a patient in stage IV hemorrhagic shock lost?

A

> 2.5 L

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29
Q

What type of fluids should you give a patient in stage I hemorrhagic shock?

A

Lactated ringers

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30
Q

What type of fluids should you give a patient in stage III hemorrhagic shock?

A

Normal saline and blood

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31
Q

What type of fluids should you give a patient in stage IV hemorrhagic shock?

A

Normal saline and blood

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32
Q

Stage of hemorrhagic shock:

  • Agitated mental status
  • Pulse < 100
A

Stage I

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33
Q

Stage of hemorrhagic shock:

  • Confused mental status
  • Pulse > 120
A

Stage III

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34
Q

Stage of hemorrhagic shock:

  • Lethargic mental status
  • Pulse > 140
A

Stage IV

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35
Q

Second place we’ll look for bleeding if the patient is becoming shocky from hypovolemia

A

Pelvis

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36
Q

Third place we’ll look for bleeding if the patient is becoming shocky from hypovolemia

A

Long bones

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37
Q

Fluid resuscitation bolus for adults

A

1-2L

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38
Q

Fluid resuscitation bolus for peds

A

20mL/kg

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39
Q

If you’re going to administer blood, what type of fluid must be used?

A

Normal saline

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40
Q

Imaging requirements to clear a C-spine

A
  • AP, Lateral, and Odontoid views
  • Visualization of 7 cervical vertebrae on AP/Lateral
  • Visualization of C7-T1
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41
Q

What test do we need to perform on every female?

A

HCG

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42
Q

Most common type of impact in a MVA

A

Rotational impact

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43
Q

2nd most common type of MVA impact

A

Frontal impact

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44
Q

Glasgow coma scale scores that indicate “mild” brain injury

A

> = 14

45
Q

Glasgow coma scale scores that indicate “moderate” brain injury

A

9-13

46
Q

Glasgow coma scale scores that indicate “severe” brain injury

A

< 9

47
Q

Contrecoup brain injury

A

Injury that occurs on the side of the brain opposite to the impact

48
Q

Patient fell down stairs and hit her head. When EMS got there, she was lucid and talking. But in the ambulance she became lethargic and was unconscious by the time she made it to the hospital (30 miles away from her home). What type of head bleed do you suspect?

A

Epidural hematoma

49
Q

Normal range of intracranial pressure

A

0-15mmHg

50
Q

Triad of symptoms associated with increased ICP that results from a head injury (name of the triad and the symptoms)

A

Cushing’s triad:

  • Hypertension
  • Bradycardia
  • Agonal respirations
51
Q

The head comprises what % of the total adult BSA?

A

4.5 front, 4.5 back, for 9% total

52
Q

The front of the torso comprises what % of the total adult BSA?

A

18%

53
Q

The back of the torso comprises what % of the total adult BSA?

A

18%

54
Q

Each arm comprises what % of the total adult BSA?

A

4.5 front, 4.5 back, for 9% total

55
Q

Each leg comprises what % of the total adult BSA?

A

9 front, 9 back, for 18% total

56
Q

The perineum comprises what % of the total adult BSA?

A

1%

57
Q

The head comprises what % of the total pediatric BSA?

A

7 front, 7 back, for 14% total

58
Q

The front of the torso comprises what % of the total pediatric BSA?

A

18%

59
Q

The back of the torso comprises what % of the total pediatric BSA?

A

18%

60
Q

Each arm comprises what % of the total pediatric BSA?

A

4.5 front, 4.5 back, for 9% total

61
Q

Each leg comprises what % of the total pediatric BSA?

A

8 front, 8 back, for 16% total

62
Q

What type of fluids do we give when fluid resuscitating burn victims?

A

Ringer’s lactate solution

63
Q

Test best for patients in whom you suspect CO poisoning

A

Carboxyhemoglobin

64
Q

Treatment for lower airway burn

A

Pulmonary lavage

65
Q

Effects of hydrogen sulfide

A
  • Paralyzes the olfactory nerve and the respiratory center

- Forms acid in the lungs

66
Q

Effects of methane

A

-Displaces oxygen

67
Q

Patient comes into the ER with an asthma attack. What signs would you look for that would indicate respiratory failure?

A
  • Absence of wheezing
  • Lethargy, Confusion
  • Suprasternal retractions
68
Q

What early blood gas changes would you expect to find in a patient experiencing an asthma attack?

A

Decreased PaO2

Decreased PaCO2

69
Q

What mid-late blood gas changes would you expect to find in a patient experiencing an asthma attack?

A

Decreased PaO2

Normal PaCO2

70
Q

What late blood gas changes would you expect to find in a patient experiencing an asthma attack?

A

Decreased PaO2

Increased PaCO2

71
Q

Under what circumstances would you admit a patient who had an asthma attack rather than discharging them home?

A
  • Significant hypoxia
  • Initial PEFR was < 50%
  • Their post-treatment PEFR is >50% but <70%
  • They are drowsy or confused
72
Q

What do mast cells release in response to antigen?

A
  • Histamine
  • SRSA
  • Heparin
  • ECF (Eosinophil Chemotactic Factor)
73
Q

General effects of histamine

A
  • Vasodilation
  • Makes cells more permeable
  • Increases capillary permeability
  • Causes smooth muscle spasm
74
Q

Gold standard imaging modality for pneumothorax

A

Upright PA CXR

75
Q

Most common cause of an acute CHF exacerbation

A

Acute MI or ischemia

76
Q

MCC of death from an acute CHF exacerbation

A

Vfib

77
Q

What’s a good lab to order if you want to see how long a patient has had CHF?

A

Beta natriuretic peptide (BNP)

78
Q

What should we be mindful of in any patient complaining of SOB?

A

A pulmonary embolism!

79
Q

Virchow’s triad

A
  • Hypercoagulability
  • Venous stasis
  • Endothelial injury
80
Q

Most common sign of a PE

A

Tachypnea

81
Q

Signs and symptoms of a PE

A 
Tachypnea
Tachycardia
Hypoxemia
Hemoptysis
Diaphroesis
Dyspnea
82
Q

Gold standard for diagnosing an acute PE

A

Pulmonary angiography

83
Q

What type of syncope do we need to rule out first?

A

Cardiogenic

84
Q

Important lab findings in a DKA patient

A
  • Glucosuria
  • Ketonuria
  • Hyperglycemia > 300mg/dL
  • Ketonemia
  • Acidosis
85
Q

First treatment response to DKA

A

Isotonic fluids

86
Q

Insulin dose for DKA

A

Infusion of 0.1 units/kg/hour

87
Q

After initial stabilization with isotonic saline, what type of fluid do we use to maintain supportive therapy for a DKA patient?

A

Hypotonic saline to provide for intracellular volume

88
Q

3 characteristics of HHNC

A
  • Hyperglycemia
  • Hyperosmolarity
  • Absence of significant ketosis
89
Q

What’s in the “coma cocktail”?

A
  • Dextrose
  • Oxygen
  • Narcan
  • Thiamine
90
Q

What type of overdose is associated with SLUDGE syndrome?

A

Cholinergic

91
Q

What type of overdose is associated with the Alice in Wonderland syndrome?

A

Anticholinergic

92
Q

SLUDGE syndrome

A
  • Salivation
  • Lacrimation
  • Urination
  • Defecation
  • GI cramps
  • Emesis
93
Q

Common “syndrome” of symptoms associated with anticholinergic overdose

A
  • Altered mental status
  • Flushing
  • Dry mucus membranes
  • Mydriasis
  • Hyperthermia
94
Q

Tx for cholinergic overdose

A

Atropine or Pralidoxime

95
Q

Treatment for anticholinergic overdose

A

Physostigmine

Cooling, supportive treatment

96
Q

During what time frame is orogastric lavage is helpful in an overdose situation?

A

Within 1 hour of ingestion

97
Q

What do we give with our first dose of activated charcoal?

A

A cathartic like sorbitol or mag citrate

98
Q

What substance helps conjugate Tylenol metabolites in the liver to help with excretion?

A

Glutathione

99
Q

Toxic dose of acetaminophen in adults

A

150mg/kg or >7.5g in 24 hours

100
Q

What do we give if a toxic dose of acetaminophen has been ingested?

A

NAC (N-acetylcysteine)

101
Q

Gold standard imaging study for an aortic dissection?

A

CT with angiography

102
Q

Target systolic BP in patient with aortic dissection

A

120-130 max

103
Q

Is the venom of pit vipers hemotoxic or neurotoxic?

A

Hemotoxic

104
Q

Is the venom of coral snakes hemotoxic or neurotoxic?

A

Neurotoxic

105
Q

Prophylactic abx tx for dog bites

A

Augmentin

106
Q

MC pathogen in cat bites

A

pasteurella multocida

107
Q

Abx good for cat bites

A

Penicillin-based abx

108
Q

Absorbable suture material

A
  • Vicryl

- Cat gut

109
Q

Non-Absorbable suture material

A

-Nylon, silk, prolene

Clin Med V and VI (5 decks)

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