EMERGENCY MEDICINE Flashcards by Bao Truong

Wound from dog bite

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

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

How well did you know this?

Not at all

Perfectly

Signs and symptoms of organophosphate poisoning? (7)

Treatment>

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.

How well did you know this?

Not at all

Perfectly

Management of ingestion of household cleaning agent

Observer for 12 hours then EGD

How well did you know this?

Not at all

Perfectly

Arrhythmia with heart block & prolonged QT, hypotension

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

Amitryptyline
(a TCA)

How well did you know this?

Not at all

Perfectly

Arrhythmia with heart block & prolonged QT, hypotension

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

Amitryptyline
(a TCA)

How well did you know this?

Not at all

Perfectly

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

What is going on? Treatment

Serotonin syndrome

Treat with cryoheptadine

How well did you know this?

Not at all

Perfectly

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

What is going on? Which drug can cause this?

Rhabdomyolysis
Can be caused phencyclidine (PCP)

How well did you know this?

Not at all

Perfectly

Faintly visible, lucent line crossing the right middistal tibia obliquely

What is fracture called? Mechanism of injury?

“Toddler’s fracture”

Twisting force from a fall

How well did you know this?

Not at all

Perfectly

Finding on urinalysis consistent with car radiator antifreeze ingestion

Calcium oxalate crystals

How well did you know this?

Not at all

Perfectly

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)

Basilar skull fracture

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

How well did you know this?

Not at all

Perfectly

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

Battle sign / postauricular ecchymosis - bruising over mastoid process

Basilar skull fracture

Racoon eye (bleeding around the orbit)

How well did you know this?

Not at all

Perfectly

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

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

Treatment = IV diphenhydramine

How well did you know this?

Not at all

Perfectly

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

What is the bite?

Brown spider bite

How well did you know this?

Not at all

Perfectly

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

What is the bite?

Black spider bite

How well did you know this?

Not at all

Perfectly

Hallmark of TCA toxicity?

Arrhythmia with prolonged QT/QRS

How well did you know this?

Not at all

Perfectly

Fluid management in burn

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

How well did you know this?

Not at all

Perfectly

What bite can cause hemolytic anemia?

Brown spider bite

How well did you know this?

Not at all

Perfectly

What kind of pain should raise concern for splenic rupture?

Left shoulder pain

How well did you know this?

Not at all

Perfectly

Most common sequela of hydrocarbon ingestion?

Aspiration pneumonitis

Widening of anterior portion of the physis, without bony fracture

Which Salter-Harris type ?

Type 1

Which Salter-Harris type ?

Type 2

Which Salter-Harris type ?

Type 3

Which Salter-Harris type?

Type 1

Which Salter-Harris type ?

Type 4

Which Salter-Harris type?

Type 5

XR show now fracture or displacement, but later has growth arrest Which Salter-Harris type ?

Type 5

What is the mnemonic to recognize Salter-Harris types?

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

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

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 **

Linear increase in the density of metaphyses What is going on?

Lead toxicity

Best first step of management of cardiogenic shock

A small fluid bolus (10cc/kg)

How to distinguish epiglotitis vs croup?

Croup: hoarseness + cough Epiglotitis: no viral prodrome

Wheezing with hyperinflation of right lung What's going on?

Foreign object aspiration

What is the treatment for exercise-induced asthma?

Leukotriene receptor agonist (ex montelukast)

What is a big side effect of leukotriene receptor agonist?

Neurobehavioral problem

Diffuse interstitial process in HIV patient What is it?

Lymphocytic interstitial pneumonitis (LIP)

Most common etiology of croup

Parainfluenza virus

What are nutritional deficiencies seen in CF?

Vitamin A, D, E, K deficiency

Telangiectasia on lips, tongue, palate. What is the genetic condition? Mode of inheritance? What is the patient at risk for?

Hereditary hemorrhagic telangiectasia Autosomal dominant At risk for pulmonary hemorrhage

What is seen here? What is going on ?

Broad based budding yeast Blastomycosis

Common electrolyte abnormality in CF?

Hyponatremia

Most common infectious triggers of Stevens Johnson Syndrome?

1 - Mycoplasma 2 - CMV

When Heliox is NOT indicated to treat severe asthma?

WHen patient needs FiO2 > 40%

Rectal prolapse is significantly more prevalent among which chronic illness?

Cystic fibrosis

What are these? What is the underlying condition?

Gotron papules Juvenile dermatomyositis

Fever, pharyngitis, cervical lymphadenopathy, aphthuous ulcer What is the condition? Treatment?

PFAPA Treatment = steroid