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GEN PEDS > EMERGENCY MEDICINE > Flashcards

EMERGENCY MEDICINE Flashcards

1
Q

Wound from dog bite

Antibiotics to prevent infection? (First line and second line)

A

First line: Amoxicillin/Clavulanate
Second line: Bactrim + Clindamycin

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2
Q

Signs and symptoms of organophosphate poisoning? (7)

Treatment>

A

DUMBELS: (cholinergic effects)
1 - Defecation
2 - Urination
3 - Miosis
4 - Bronchorrhea/Bronchospasm/Bradycardia
5 - Emesis
6 - Lacrimation
7 - Salivation

Giving atropine at increasing doses until pulmonary secretions are dried.

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3
Q

Management of ingestion of household cleaning agent

A

Observer for 12 hours then EGD

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4
Q

Arrhythmia with heart block & prolonged QT, hypotension

What is the ingested medication? What class of med is this?

A

Amitryptyline
(a TCA)

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5
Q

Arrhythmia with heart block & prolonged QT, hypotension

What is the ingested medication? What class of med is this?

A

Amitryptyline
(a TCA)

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6
Q

Agitated, combative, hallucination, sweating profusely, high temperature, high heart rate, hypertension, hyperreflexia / clonus

What is going on? Treatment

A

Serotonin syndrome

Treat with cryoheptadine

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7
Q

Urinalysis positive for blood but no RBCs on microscopy, pain, agitation

What is going on? Which drug can cause this?

A

Rhabdomyolysis
Can be caused phencyclidine (PCP)

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8
Q

Faintly visible, lucent line crossing the right middistal tibia obliquely

What is fracture called? Mechanism of injury?

A

“Toddler’s fracture”

Twisting force from a fall

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9
Q

Finding on urinalysis consistent with car radiator antifreeze ingestion

A

Calcium oxalate crystals

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10
Q

Hearing loss after a fall, then see clear discharge from both nares

What is going on? What are associated exam findings that would be noted the next few days? (2)

A

Basilar skull fracture

1 - Postauricular ecchymosis (Battle sign - bruising over mastoid process)
2 - Racoon eyes (bleeding around the orbit)

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11
Q

What is this finding ? What is likely going on? What is another associated finding in this situation?

A

Battle sign / postauricular ecchymosis - bruising over mastoid process

Basilar skull fracture

Racoon eye (bleeding around the orbit)

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12
Q

A few hours after taking a medication, a patient develops anxiety, agitation, torticollis, muscle rigidity, eye deviation, trismus. Mental status and vitals are normal

What is going on ? Treatment

A

Dystonic reaction
(likely from antipsychotic, antiemetic, or antiseizure med)

Treatment = IV diphenhydramine

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13
Q

Severe necrosis surrounding the site of a bite, associated with formation of a large eschat.

What is the bite?

A

Brown spider bite

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14
Q

Several generalized cramping pain within 30-60 minutes of the bite

What is the bite?

A

Black spider bite

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15
Q

Hallmark of TCA toxicity?

A

Arrhythmia with prolonged QT/QRS

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16
Q

Fluid management in burn

A

3mL/kg of LR for every 1% body surface area.
Half of the total given over first 8 hours, half over the next 16 hours

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17
Q

What bite can cause hemolytic anemia?

A

Brown spider bite

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18
Q

What kind of pain should raise concern for splenic rupture?

A

Left shoulder pain

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19
Q

Most common sequela of hydrocarbon ingestion?

A

Aspiration pneumonitis

20
Q

Widening of anterior portion of the physis, without bony fracture

Which Salter-Harris type ?

A

Type 1

21
Q

Which Salter-Harris type ?

A

Type 2

22
Q

Which Salter-Harris type ?

A

Type 3

23
Q

Which Salter-Harris type?

A

Type 1

24
Q

Which Salter-Harris type ?

A

Type 4

25
Q

Which Salter-Harris type?

A

Type 5

26
Q

XR show now fracture or displacement, but later has growth arrest

Which Salter-Harris type ?

A

Type 5

27
Q

What is the mnemonic to recognize Salter-Harris types?

A

SALTeR

1 - Straight across
2 - Above
3 - Lower
4 - Through
5 - Rammed together

28
Q

Rule of 9s to calculate burn BSA (6 components)
Limitation of this approach

A

1 - Head & neck - 9%
2 - Each upper limb - 9%
3 - Thorax and abdomen - front - 18%
4 - Thorax and abdomen - back - 18%
5 - Perineum - 1%
6 - Each lower limb - 18%

** not reliable for < 14 years old **

29
Q

Linear increase in the density of metaphyses

What is going on?

A

Lead toxicity

30
Q

Best first step of management of cardiogenic shock

A

A small fluid bolus (10cc/kg)

31
Q

How to distinguish epiglotitis vs croup?

A

Croup: hoarseness + cough
Epiglotitis: no viral prodrome

32
Q

Wheezing with hyperinflation of right lung

What’s going on?

A

Foreign object aspiration

33
Q

What is the treatment for exercise-induced asthma?

A

Leukotriene receptor agonist

(ex montelukast)

34
Q

What is a big side effect of leukotriene receptor agonist?

A

Neurobehavioral problem

35
Q

Diffuse interstitial process in HIV patient

What is it?

A

Lymphocytic interstitial pneumonitis (LIP)

36
Q

Most common etiology of croup

A

Parainfluenza virus

37
Q

What are nutritional deficiencies seen in CF?

A

Vitamin A, D, E, K deficiency

38
Q

Telangiectasia on lips, tongue, palate.

What is the genetic condition? Mode of inheritance? What is the patient at risk for?

A

Hereditary hemorrhagic telangiectasia

Autosomal dominant

At risk for pulmonary hemorrhage

39
Q

What is seen here? What is going on ?

A

Broad based budding yeast

Blastomycosis

40
Q

Common electrolyte abnormality in CF?

A

Hyponatremia

41
Q

Most common infectious triggers of Stevens Johnson Syndrome?

A

1 - Mycoplasma
2 - CMV

42
Q

When Heliox is NOT indicated to treat severe asthma?

A

WHen patient needs FiO2 > 40%

43
Q

Rectal prolapse is significantly more prevalent among which chronic illness?

A

Cystic fibrosis

44
Q

What are these? What is the underlying condition?

A

Gotron papules

Juvenile dermatomyositis

45
Q

Fever, pharyngitis, cervical lymphadenopathy, aphthuous ulcer

What is the condition? Treatment?

A

PFAPA

Treatment = steroid

GEN PEDS (16 decks)

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