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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
Q

infant CPR chest compression depth

A

1.5 inches or 4 cm

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26
Q

pulse check

A

5 to 10 seconds. brachial for infants. carotid or fem for children

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27
Q

intubated CPR breaths

A

1 breath every 6 to 8 seconds OR 8 to 10 breaths/minutes

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28
Q

rescue breaths without compressions

A

1 breath every 3 to 5 seconds (12 to 20/minute)

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29
Q

preferred IO site

A

anteromedial surface of the proximal tibia

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30
Q

ET tube size calculation

A

age/4 + 4

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31
Q

tidal volume calculation

A

7mL/kg

32
Q

meds that can be given by ET tube

A 
LANE
Lidocaine
Atropine
Narcan
Epinephrine
33
Q

atropine indications

A

bradycardia

34
Q

antibiotics for bites if penicillin allergic

A

bactrim and clindamycin

35
Q

target lesion that becomes necrotic and is usually self limited

A

brown recluse (loxosceles recluse)

36
Q

puncture wound that then develops systemic symptoms (muscle aches and HTN)

A

black widow (latrodectus mactans)

37
Q

black widow treatment

A

benzodiazepines for muscle spasm, antivenin if supportive measures aren’t working

38
Q

nonvenomous snake bites management

A

wound cleaning and tetanus

39
Q

venomous snake bite management

A

immobilize limb and let it hand at side

40
Q

severe head injuries can lead to

A

SIADH

41
Q

tearing of small blood vessels of the Pia mater

A

subarachnoid hemorrhage

42
Q

lucid period followed by deterioration later

A

epidural hematoma

43
Q

bloody atrauamtic LP think

A

epidural hematoma or herpes

44
Q

lens shaped bleed

A

epidural hematoma - emergent surgical intervention

45
Q

head CT after head trauma if

A

prolonged LOC, protracted vomiting, progressive headaches, retrograde amnesia, lethargy

46
Q

most common skull fracture

A

linear parietal fracture

47
Q

hemotympanum, hearing loss, facial paralysis and CSF otorrhea

A

temporal bone fracture

48
Q

clear rhinorrhea, ecchymoses behind hear, periorbital ecchymoses

A

basilar skull fracture

49
Q

increased risk of what w. basilar skull fracture

A

meningitis

50
Q

basilar skull fracture may involve

A

6th and 7th nerve palsies

51
Q

non accidental burns

A

full thickness, stocking and glove, distinct margins, varying depth

52
Q

how many half lives for 97% of drug to be cleared

A

five

53
Q

how many half lives to reach a steady state

A

five after most recent dose change

54
Q

meds that cannot be taken with dairy

A

tetracycline, doxycycline and ciprofloxacin

55
Q

meds that can’t be taken with iron supplements

A

antacid

56
Q

meds that inhibit CYP

A

erythromycin, ciprofloxacin, cimetidine, omeprazole (cause increased bioavailability/toxicity of beta blockers, warfarin, metronidazole)

57
Q

meds that induce CYP

A

rifampin, phenobarbital, carbamazepine, phenytoin (cause faster elimination of beta blockers, warfarin, metronidazole)

58
Q

meds that inhibit renal metabolism of digoxin

A

quinidine and amiodarone

59
Q

beta blocker CNS side effect

A

trouble sleeping

60
Q

beta blocker smooth muscle side effect

A

bronco spams and cold extremities

61
Q

beta blocker cardiac side effect

A

bradycardia and heart block

62
Q

cardioselective beta blocker

A

atenolol (propranolol is not and could exacerbate asthma)

63
Q

acetazolamide MOA

A

causes metabolic acidosis - prevents reuptake of bicarb in proximal tubule which make urine alkaline

64
Q

loop diuretic MOA

A

blocks absorption of Na and Cl and results in wasting Ca, K+ and H+, resulting in hypochloremic hypokalemic metabolic alkalosis

65
Q

thiazide MOA

A

blocks absorption of Na, Cl and water at distal tubule resulting in contraction metabolic alkalosis

66
Q

mannitol MOA

A

keeps water in tubules with osmotic diuresis without an acid base effect

67
Q

potassium sparing diuretic

A

spironolactone

68
Q

5 phases of iron toxicity

A
  1. GI
  2. stability
  3. systemic
  4. hepatic
  5. GI/pyloric scarring
69
Q

most likely ingestion with neck spasms, tongue thrusting and oculogyric crisis

A

phenothiazine or other antipsychotic

70
Q

type 1 salter harris

A

straight across/through the physis

71
Q

type 2 salter harris

A

above (through physis and metaphysis)

72
Q

type 3 salter harris

A

lower (through epiphysis and growth plate)

73
Q

type 4 salter harris

A

through (through epiphysis, physis and metaphysis)

74
Q

type 5 salter harris

A

rammed/crushed

75
Q

ingestions that cause mydriasis

A

atropine, anticholinergics, antihistamines, amphetamines, cocaine

BOARDS (24 decks)

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