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PANCE Questions > Emergency Med > Flashcards

Emergency Med Flashcards

1
Q

Gram stain of strep pneumonia

A

Gram positive diplococci

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2
Q

atropine use

A

Severe Bradycardia

MOI: Inhibits vagal response (stops PNS so SNS takes over with epi/norepi naturally)

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3
Q

Black Widow bite characteristics

A

two fang marks
Systemic reaction= Latrodectism: Muscle spasm, tachycardia, N/V
tx: antivenom (can cause serum sickness, III hypersensitivity)

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4
Q

Brown Recluse bite characteristics

A

Midwest and central US
local NECROTIC lesion
systemic reaction= Loxoscelism: hemolysis
tx corticosteroids, hydration, analgesics

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5
Q

Coral snake features

A

red on black, venom lack
red on yellow, kill a fellow
if bite: neurologic sx, tremors, diplopia, fixed pupils
Tx. antivenin (No ice, tourniquet, suction, etc.)

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6
Q

Lyme disease features

A 
Borrelia burgdorfi
deer tick spread
flu like sx, fever, weakness, joint pain
Characteristic rash: erythema migrans, "bulls eye" rash
tx. doxy
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7
Q

ITP

A

Usually after viral illness in kids
autoimmune disease
labs with thrombocytopenia, prolonged bleeding time, normal PT/PTT
Tx with prednisone if platelets

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8
Q

Drugs that cause secondary ITP

A

Sulfonamides, Thiazides, Cimetidine (H2 blocker), Heparin (HIT)

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9
Q

TTP diagnostic pentad

A

Hemolytic anemia (schistiocytes, elevated bili)
Low platelets
Fever
Neurologic manifestation (HA, confusion, seizure)
Renal manifestation (hematuria, proteinuria, increased BUN/Cr)

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10
Q

HUS

A

more renal less neuro than TTP

precipitated by a diarrhea illness, especially E Coli

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11
Q

Supplements needed for sickle cell patients

A

Folic acid (at 1 year age) and PCN V (at 2 months)

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12
Q

Cushing reflex (triad) of head trauma (increased ICP)

A

progressive hypertension
bradycardia
decreases respiratory rate

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13
Q

Diffuse axonal injury

A

deceleration methods transmit sheering forces diffusely

MOI of shaken baby syndrome

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14
Q

Subdural vs epidural hematomia imaging

A

SDH: crescent shaped that crosses suture margins
EDH: lens shaped that does not cross sutures

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15
Q

Treatment of cluster HA

A

100% oxygen

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16
Q

1st line medication for actively seizing patient

A

Lorazapam (Ativan)

give thiamine before glucose if alcoholic

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17
Q

Peripheral vertigo

A

Causes: BPPV, vestibular neuritis, herpes zoster, meniere’s, labyrinthitis, acoustic neuroma, OM
S/Sx: N/V, HORIZONTAL nystagmus, tinnitus, vision changes

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18
Q

Central vertigo

A

Causes: Migraine, brainstem ischemia, CVA

S/Sx: Gait disturbance, Vertical nystagmus, NO tinnitus, no vision changes

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19
Q

Myasthenic Crisis

A

severe enough bulbar weakness to produce dysphagia and aspiration that may lead to respiratory failure.
Patient has generalized weakness.
Tx intubation and IVIG

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20
Q

***Where do 90% of nose bleeds arise?

A

Keisselbach’s plexus

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21
Q

Peritonsillar abscess

A

Severe pain, “hot potato voice”, drooling, dysphagia, uvular deviates away
CT of neck
OR for I&D
start IV abx pcn, augmentin or clindamycin

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22
Q

Ludwig’s angina

A

Hx of recent dental procedure or poor dental hygeine
cellulitis of sub lingual area
pain, swelling, trismus, dysphagia, “bull’s neck”

23
Q

Painless unilateral vision loss, suspect…

A

CRAO

PE: pallor of optic disc, cherry red fovea (macula), boxcar segmentation of retinal veins

24
Q

Painless vision loss with a curtain across visual field suspect…

A

Retinal detachment
IOP is normal or low, pupil exam unremarkable
retina appears gray with white folds

25
Q

Cremasteric reflex and Phren’s sign absent in…

A

Testicular torsion (present’s with high riding teste, swelling, tenderness)

26
Q

Epididymitis

A

tender posterior and lateral to testes
positive phren’s sign (elevate testicle and pain relieved)
etiology: 35 prsotatitis (Doxy)

27
Q

Blue dot sign seen in

A

torsion of appendicieal testes (7-14)

28
Q

Paraphimosis

A

Foreskin is retracted behind glans and cannot be returned to normal position
Can be from foley that didn’t have foreskin replaced after

29
Q

White cell casts seen in

A

Pyelonephritis (tx IV ceftriaxone, PO FQ)

30
Q

Imaging if suspect nephrolithiasis

A

NON contrast CT

31
Q

Opiod/Narcotic Intoxication overdose (heroin, oxy, morphine)

A

CNS depression
miosis
respiratory depression
Treat with Narcan

32
Q

Activated charcoal does not bind

A

Potassium
Alcohol
Iron
Lithium (PAIL)

33
Q

Anticholinergic antidote

A

Physostigmine

34
Q

***Benzo antidote

A

Flumazenil

35
Q

Methanol/Polyethylene glycol antidote

A

Alcohol, because it has a higher binding affinity

36
Q

Acetominophen toxicity

A

toxic dose is >140 mg/kg
Treat with acetylcystine (mucomist)
Best level is 4 hours after ingestion

37
Q

Stimulants (Cocaine/amphetamine) overdose

A

dilated pupils, hypertension, euphoria
treat with Benzos
DO NOT GIVE BB (unopposed alpha)

38
Q

***Cyanide toxicity

A

bitter almonds

39
Q

**Arsenic toxicity

A

Garlic odor breath

40
Q

Menengitis Triad

A

Fever, nuchal rigidity, mental status changes

(also petichial rash

41
Q

LP of bacterial meningitis

A 
(DO NOT perform if papilledema)
WBC: 1000-10,000
Neuts: >80%
Glucose: Low
Protein: High
Gram Stain: +
(TREAT with Rocephin)
42
Q

LP of Fungal Meningitis

A

WBC:

43
Q

LP of viral meningitis

A

WBC:

44
Q

Impetigo causative agent

A

Strep (Rarely staph)

small vesicles with honey colored crusts

45
Q

Botulism characteristics

A

Cranial neuropathy with descending weakness
Gram positive, rod-shaped spore-forming anaerobe
absence of fever

46
Q

Leading cause of death in children under 5

A

Drowning

47
Q

Difference between heat exhaustion and heat stroke

A

Heat exhaustion has normal mental status and heat stroke does not Heat stroke= core temp above 105 F( 40.5 C), Heat exhaustion is

48
Q

neuroleptic malignant syndrome treatment

A

SE of anti psychotic drugs
See intense rigidity, hyperthermia and mental status changes
Treat with DANTROLENE

49
Q

Difference between primary and secondary adrenal insufficiency

A

Primary= addison’s from autoimmune destruction or dysfunction of renal cortex (hyperpigmentation, low aldosterone, hyponatremia, hyperkalemia, decreased BP)
Secondary=stimulation of adrenal cortex by ACTH from exogenous steroids or pituitary tumor

50
Q

Adrenal crisis

A

life threatening
presents with flank/abdominal pain hypotension that is resistant to catecholamine and IV fluid administration
need to replace missing cortisol with IV glucocorticoids
seen in elderly with chronic disease or post operation

51
Q

Pheochromocytoma

A

tumor of neural crest cells which release catecholamines
cause EPISODIC palpitations, sweating, syncope and hypertension
Tumor of renal medulla

52
Q

Myxedema coma

A

presents in elderly with hypothyroidism, hypothermia and confusion
EKG with sinus brady, and possible QT prolongation
Treat with levothyroxine and glucocorticoids

53
Q

Pericardial Tamponade EKG

A

low voltage sinus tachy, PR depression, electrical alternans, height of QRS changes

PANCE Questions (10 decks)

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