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BOARDS > Emergency/Crit Care > Flashcards

Emergency/Crit Care Flashcards

1
Q

ICP treatment

A

mannitol and hypertonic solutions

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2
Q

sign of uncal herniation

A

unilateral pupil dilation

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3
Q

cushings triad

A

bradycardia, hypertension, irregular respirations

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4
Q

malignant hyperthermia treatment

A

hyperventilation, oxygenation and dantrolene

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5
Q

metabolic acidosis, hyperthermia, cardiac arrhythmias, elevated CK, muscle rigidity, fever

A

malignant hyperthermia

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6
Q

ARDS definition

A
  1. noncardiogenic pulmonary edema
  2. impaired oxygenation
  3. bilateral pulmonary infiltrates
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7
Q

ARDS has a better prognosis if it occurs in the context of

A

trauma

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8
Q

initial xray finding when progressing to ARDS

A

fine reticular infiltrate

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9
Q

most important element of respiratory support in ARDS

A

PEEP

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10
Q

treatment of near drowning episode with ARDS not improving on supportive measures

A

steroids

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11
Q

unfavorable prognosis with near drowning if

A

submersion >25 minutes, apnea or coma, initial pH <7.0

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12
Q

flail chest

A

2 or more rib fractures in 2 or more locations causing paradoxic chest movements

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13
Q

next step with flail chest and tachypnea

A

chest tube placement

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14
Q

blunt abdominal trauma diagnostic tool

A

abdominal CT w/ contrast

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15
Q

normal ejection fraction

A

55%

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16
Q

acute heart failure ejection fraction

A

<25%

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17
Q

best initial IV therapy for heart failure

A

furosemide (acts within minutes)

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18
Q

poor perfusion with tachycardia, diminished pulses and gallop rhythm

A

cariogenic shock

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19
Q

cardiogenic shock initial treatment

A

dobutamine

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20
Q

brain death studies

A

radionucleotide scan OR angiography

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21
Q

angiography finding consistent with brain death

A

absence of vertebral and carotid artery blood flow

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22
Q

chest compressions

A

1/3 to 1/2 Anteroposterior depth of chest (~2 in or 5 cm)

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23
Q

compression rate

A

100/minute

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24
Q

one rescuer CPR

A

30:2, activate EMS and get AED after 5 cycles

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25
infant CPR chest compression depth
1.5 inches or 4 cm
26
pulse check
5 to 10 seconds. brachial for infants. carotid or fem for children
27
intubated CPR breaths
1 breath every 6 to 8 seconds OR 8 to 10 breaths/minutes
28
rescue breaths without compressions
1 breath every 3 to 5 seconds (12 to 20/minute)
29
preferred IO site
anteromedial surface of the proximal tibia
30
ET tube size calculation
age/4 + 4
31
tidal volume calculation
7mL/kg
32
meds that can be given by ET tube
``` LANE Lidocaine Atropine Narcan Epinephrine ```
33
atropine indications
bradycardia
34
antibiotics for bites if penicillin allergic
bactrim and clindamycin
35
target lesion that becomes necrotic and is usually self limited
brown recluse (loxosceles recluse)
36
puncture wound that then develops systemic symptoms (muscle aches and HTN)
black widow (latrodectus mactans)
37
black widow treatment
benzodiazepines for muscle spasm, antivenin if supportive measures aren't working
38
nonvenomous snake bites management
wound cleaning and tetanus
39
venomous snake bite management
immobilize limb and let it hand at side
40
severe head injuries can lead to
SIADH
41
tearing of small blood vessels of the Pia mater
subarachnoid hemorrhage
42
lucid period followed by deterioration later
epidural hematoma
43
bloody atrauamtic LP think
epidural hematoma or herpes
44
lens shaped bleed
epidural hematoma - emergent surgical intervention
45
head CT after head trauma if
prolonged LOC, protracted vomiting, progressive headaches, retrograde amnesia, lethargy
46
most common skull fracture
linear parietal fracture
47
hemotympanum, hearing loss, facial paralysis and CSF otorrhea
temporal bone fracture
48
clear rhinorrhea, ecchymoses behind hear, periorbital ecchymoses
basilar skull fracture
49
increased risk of what w. basilar skull fracture
meningitis
50
basilar skull fracture may involve
6th and 7th nerve palsies
51
non accidental burns
full thickness, stocking and glove, distinct margins, varying depth
52
how many half lives for 97% of drug to be cleared
five
53
how many half lives to reach a steady state
five after most recent dose change
54
meds that cannot be taken with dairy
tetracycline, doxycycline and ciprofloxacin
55
meds that can't be taken with iron supplements
antacid
56
meds that inhibit CYP
erythromycin, ciprofloxacin, cimetidine, omeprazole (cause increased bioavailability/toxicity of beta blockers, warfarin, metronidazole)
57
meds that induce CYP
rifampin, phenobarbital, carbamazepine, phenytoin (cause faster elimination of beta blockers, warfarin, metronidazole)
58
meds that inhibit renal metabolism of digoxin
quinidine and amiodarone
59
beta blocker CNS side effect
trouble sleeping
60
beta blocker smooth muscle side effect
bronco spams and cold extremities
61
beta blocker cardiac side effect
bradycardia and heart block
62
cardioselective beta blocker
atenolol (propranolol is not and could exacerbate asthma)
63
acetazolamide MOA
causes metabolic acidosis - prevents reuptake of bicarb in proximal tubule which make urine alkaline
64
loop diuretic MOA
blocks absorption of Na and Cl and results in wasting Ca, K+ and H+, resulting in hypochloremic hypokalemic metabolic alkalosis
65
thiazide MOA
blocks absorption of Na, Cl and water at distal tubule resulting in contraction metabolic alkalosis
66
mannitol MOA
keeps water in tubules with osmotic diuresis without an acid base effect
67
potassium sparing diuretic
spironolactone
68
5 phases of iron toxicity
1. GI 2. stability 3. systemic 4. hepatic 5. GI/pyloric scarring
69
most likely ingestion with neck spasms, tongue thrusting and oculogyric crisis
phenothiazine or other antipsychotic
70
type 1 salter harris
straight across/through the physis
71
type 2 salter harris
above (through physis and metaphysis)
72
type 3 salter harris
lower (through epiphysis and growth plate)
73
type 4 salter harris
through (through epiphysis, physis and metaphysis)
74
type 5 salter harris
rammed/crushed
75
ingestions that cause mydriasis
atropine, anticholinergics, antihistamines, amphetamines, cocaine

BOARDS (24 decks)

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