Emergency medicine Flashcards
deal with painOPQRST
OPQRST Onset Percipitating factor Quality Radiation Symptoms Temporal course/Treatment modalities
in case of abdominal pain if the patient remebers the exact time of the pain onset what to think
perforation
Management of female patient with an acute abdomen(4)
pelvic exam
pregnancy test
ectopic pregnancy
ovarian torsion
localisation of Mc burney point
2/3 of the distance from the anterior superior illiac spine to the umbilicus
Hamburger sign in appendicitis
if the patient wants to eat it’s not appendicitis
psoas sign in appendicitis
passive extensionof the hip elicits RLQ pain
obturator sign in appendicitis
passive rotation of the hip elicits RLQ pain
rovsing sign
dep palpation of the LLQ elicits RLQ pain
what to rule out in case of second and first rib /sternal fracture
aortic disruption
rule of 9 (4)
head and each arm 9%
back and chest 18%
each leg 18%
perineum 1%
Packland formula
4poids en Kg% BSA
how to give fluid in burns(2)
50 % determine par packland formula during first 8 hours
50 % sur 16 hrs
second leading cause of death in kids
burns
Management of asystole(2)
epinephrine
atropine
management of VFIB
desinchronised shock with 200,300 and 360 joules
failure with external shock in VFIB(2)
epinephrine
or
vasopressin
failure with epinephrine or vasopressin in VFIB(2)
lidocaine or
amiodarone
failure with lidocaine or amiodarone in VFIB(2)
procainamide or
magnesium
stable VTAC(2)
lidocaine
or
amiodarone
unstable and pulseless VTAC
desynchronised shock
rx of PEA(2)
epinephrine
or
atropine
AFIB /flutter unstable
shock starting at 100j
stable AFIB/flutter < 48 h(5)
control rate Calcium blocker digoxin b blocker plus rythm conversion
stable afib/flutter > 48 h(5)
control rate Calcium blocker digoxin b blocker anticoagulateor perform TEE before rythm conversion
management of supraventricular tachycardia(SVT)
rate control
Means to control rate in SVT(3)
valsalva
carotid sinus massage
cold stimulus
resistant SVT to rate control next step
adenosine
bradycardia in mobitx 2 or 3 degree AV block
transvenous pacemaker
zone 1 du cou
en dessous du cartilage cricoide
zone 2 du cou
situe entre le cartilage cricoide et une ligne joignant les deux gognons
zone 3 du cou
situe au dessus de la ligne joignant les 2 gognons
trauma in zone 1 next step
aortography
trauma in zone 2 next step
surgical exploration if platysma is penetrated
trauma in zone 3 du cou next step
aotography and triple endoscopy
previuosly patient with chest trauma dies suddenly next step
air embolism
cuases of post op fever 5 W
Wind: Atelectasis, pneumonia Water: UTI Walking: DVT Wounds: Wound infection, abscess Wonder drugs: Drug reaction
clue for carbon monoxyde poisonning(3)
cherry red skin
headaches
hypoxemia
when to suspect smoke inhalation in burns(5)
singed nose hairs facial burns hoarseness wheezing carbonaceous sputum
Induction of P-450 enzymes(4)
enzymes Barbiturates
phenytoin
carbamazepine
rifampin.
Inhibition of P-450 enzymes(3)
Cimetidine
ketoconazole
INH.
Metabolism by P-450 enzymes(11)
Benzodiazepines amide anesthetics metoprolol propranolol nifedipine phenytoin, quinidine theophylline warfarin barbiturates.
↑ risk of digoxin toxicity(4)
Quinidine
cimetidine
amiodarone
calcium channel blockers
Competition for albumin-binding sites(3)
Warfarin
ASA
phenytoin
Blood dyscrasias (4)
Ibuprofen
quinidine
methyldopa
chemotherapeutic agents.
Hemolysis in G6PD-deficient patients (6)
Sulfonamides INH ASA ibuprofen nitrofurantoin primaquine
Gynecomastia (3)
Cimetidine
ketoconazole
spironolactone
Stevens-Johnson syndrome(2)
Ethosuximide
sulfonamides.
Photosensitivity(3)
Tetracycline
amiodarone
sulfonamides.
Drug-induced SLE(4)
Procainamide
hydralazine
INH
penicillamine.
antidote of Acetaminophen
N-acetylcysteine
management of Acid/alkali ingestion
Upper endoscopy to evaluate for stricture
Anticholinesterases, organophosphates antidote
Atropine
pralidoxime.
Antimuscarinic/anticholinergic agents
Physostigmine.
Arsenic, mercury, gold antidote (2)
Succimer
dimercaprol.
β-blockers antidote
β-blockers Glucagon
Barbiturates (phenobarbital) antidote (3)
Urine alkalinization
dialysis
activated charcoal.
Benzodiazepines antidote
Flumazenil
Black widow bite antidote
Calcium gluconate.
Carbon monoxide antidote(2)
100% O2
hyperbaric O2.
Copper, arsenic, lead, gold antidote
Penicillamine.
Cyanide Nitrite
sodium thiosulfate
Digitalis antidote(4)
Stop digitalis
normalize K+,
lidocaine (for torsades),
anti-digitalis Fab.
Heparin antidote
Protamine sulfate.
Iron salts antidote
Deferoxamine.