Emergency medicine Flashcards

1
Q

deal with painOPQRST

A
OPQRST
Onset
Percipitating factor
Quality
Radiation
Symptoms
Temporal course/Treatment modalities
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2
Q

in case of abdominal pain if the patient remebers the exact time of the pain onset what to think

A

perforation

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3
Q

Management of female patient with an acute abdomen(4)

A

pelvic exam
pregnancy test
ectopic pregnancy
ovarian torsion

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4
Q

localisation of Mc burney point

A

2/3 of the distance from the anterior superior illiac spine to the umbilicus

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5
Q

Hamburger sign in appendicitis

A

if the patient wants to eat it’s not appendicitis

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6
Q

psoas sign in appendicitis

A

passive extensionof the hip elicits RLQ pain

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7
Q

obturator sign in appendicitis

A

passive rotation of the hip elicits RLQ pain

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8
Q

rovsing sign

A

dep palpation of the LLQ elicits RLQ pain

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9
Q

what to rule out in case of second and first rib /sternal fracture

A

aortic disruption

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10
Q

rule of 9 (4)

A

head and each arm 9%
back and chest 18%
each leg 18%
perineum 1%

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11
Q

Packland formula

A

4poids en Kg% BSA

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12
Q

how to give fluid in burns(2)

A

50 % determine par packland formula during first 8 hours

50 % sur 16 hrs

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13
Q

second leading cause of death in kids

A

burns

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14
Q

Management of asystole(2)

A

epinephrine

atropine

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15
Q

management of VFIB

A

desinchronised shock with 200,300 and 360 joules

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16
Q

failure with external shock in VFIB(2)

A

epinephrine
or
vasopressin

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17
Q

failure with epinephrine or vasopressin in VFIB(2)

A

lidocaine or

amiodarone

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18
Q

failure with lidocaine or amiodarone in VFIB(2)

A

procainamide or

magnesium

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19
Q

stable VTAC(2)

A

lidocaine
or
amiodarone

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20
Q

unstable and pulseless VTAC

A

desynchronised shock

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21
Q

rx of PEA(2)

A

epinephrine
or
atropine

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22
Q

AFIB /flutter unstable

A

shock starting at 100j

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23
Q

stable AFIB/flutter < 48 h(5)

A
control rate
Calcium blocker
digoxin
b blocker
plus rythm   conversion
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24
Q

stable afib/flutter > 48 h(5)

A
control rate
Calcium blocker
digoxin
b blocker
anticoagulateor perform TEE before rythm conversion
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25
Q

management of supraventricular tachycardia(SVT)

A

rate control

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26
Q

Means to control rate in SVT(3)

A

valsalva
carotid sinus massage
cold stimulus

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27
Q

resistant SVT to rate control next step

A

adenosine

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28
Q

bradycardia in mobitx 2 or 3 degree AV block

A

transvenous pacemaker

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29
Q

zone 1 du cou

A

en dessous du cartilage cricoide

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30
Q

zone 2 du cou

A

situe entre le cartilage cricoide et une ligne joignant les deux gognons

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31
Q

zone 3 du cou

A

situe au dessus de la ligne joignant les 2 gognons

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32
Q

trauma in zone 1 next step

A

aortography

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33
Q

trauma in zone 2 next step

A

surgical exploration if platysma is penetrated

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34
Q

trauma in zone 3 du cou next step

A

aotography and triple endoscopy

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35
Q

previuosly patient with chest trauma dies suddenly next step

A

air embolism

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36
Q

cuases of post op fever 5 W

A
Wind: Atelectasis,
pneumonia
Water: UTI
Walking: DVT
Wounds: Wound
infection, abscess
Wonder drugs: Drug
reaction
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37
Q

clue for carbon monoxyde poisonning(3)

A

cherry red skin
headaches
hypoxemia

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38
Q

when to suspect smoke inhalation in burns(5)

A
singed nose hairs
facial burns
hoarseness
wheezing
carbonaceous sputum
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39
Q

Induction of P-450 enzymes(4)

A

enzymes Barbiturates
phenytoin
carbamazepine
rifampin.

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40
Q

Inhibition of P-450 enzymes(3)

A

Cimetidine
ketoconazole
INH.

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41
Q

Metabolism by P-450 enzymes(11)

A
Benzodiazepines
amide anesthetics
metoprolol
propranolol
nifedipine
phenytoin,
quinidine
theophylline
warfarin
barbiturates.
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42
Q

↑ risk of digoxin toxicity(4)

A

Quinidine
cimetidine
amiodarone
calcium channel blockers

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43
Q

Competition for albumin-binding sites(3)

A

Warfarin
ASA
phenytoin

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44
Q

Blood dyscrasias (4)

A

Ibuprofen
quinidine
methyldopa
chemotherapeutic agents.

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45
Q

Hemolysis in G6PD-deficient patients (6)

A
Sulfonamides
INH
ASA
ibuprofen
nitrofurantoin
primaquine
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46
Q

Gynecomastia (3)

A

Cimetidine
ketoconazole
spironolactone

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47
Q

Stevens-Johnson syndrome(2)

A

Ethosuximide

sulfonamides.

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48
Q

Photosensitivity(3)

A

Tetracycline
amiodarone
sulfonamides.

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49
Q

Drug-induced SLE(4)

A

Procainamide
hydralazine
INH
penicillamine.

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50
Q

antidote of Acetaminophen

A

N-acetylcysteine

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51
Q

management of Acid/alkali ingestion

A

Upper endoscopy to evaluate for stricture

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52
Q

Anticholinesterases, organophosphates antidote

A

Atropine

pralidoxime.

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53
Q

Antimuscarinic/anticholinergic agents

A

Physostigmine.

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54
Q

Arsenic, mercury, gold antidote (2)

A

Succimer

dimercaprol.

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55
Q

β-blockers antidote

A

β-blockers Glucagon

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56
Q

Barbiturates (phenobarbital) antidote (3)

A

Urine alkalinization
dialysis
activated charcoal.

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57
Q

Benzodiazepines antidote

A

Flumazenil

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58
Q

Black widow bite antidote

A

Calcium gluconate.

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59
Q

Carbon monoxide antidote(2)

A

100% O2

hyperbaric O2.

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60
Q

Copper, arsenic, lead, gold antidote

A

Penicillamine.

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61
Q

Cyanide Nitrite

A

sodium thiosulfate

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62
Q

Digitalis antidote(4)

A

Stop digitalis
normalize K+,
lidocaine (for torsades),
anti-digitalis Fab.

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63
Q

Heparin antidote

A

Protamine sulfate.

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64
Q

Iron salts antidote

A

Deferoxamine.

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65
Q

Lead antidote(3)

A

Succimer
CaEDTA
dimercaprol.

66
Q

Methanol, ethylene glycol (antifreeze) antidote (3)

A

EtOH
fomepizole
dialysis.

67
Q

Methemoglobin antidote

A

Methylene blue.

68
Q

Opioids antidote

A

Opioids Naloxone.

69
Q

Phencyclidine hydrochloride (PCP) rx

A

NG suction.

70
Q

Salicylates antidote(3)

A

Urine alkalinization
dialysis
activated charcoal

71
Q

TCAs antidote(3)

A

Sodium bicarbonate for QRS prolongation
diazepam or lorazepam for seizures
cardiac monitor for arrhythmias.

72
Q

Theophylline antidote

A

Activated charcoal.

73
Q

tPA, streptokinase antidote

A

Aminocaproic acid.

74
Q

Warfarin antidote(2)

A

Vitamin K

FFP.

75
Q

ACEIs side effect(6)

A
Cough
 rash
proteinuria
angioedema
taste changes
teratogenic effects.
76
Q

Amantadine side effect(2)

A

Ataxia

livedo reticularis

77
Q

Aminoglycosides side effect(2)

A

Ototoxicity

nephrotoxicity (acute tubular necrosis).

78
Q

Amiodarone side effect(4)

A

Pulmonary fibrosis
peripheral deposition → bluish discoloration, arrhythmias,
hypo-/hyperthyroidism
corneal deposition

79
Q

Amphotericin side effect(4)

A

Fever/chills
nephrotoxicity
bone marrow suppression
anemia

80
Q

Antipsychotics side effect(6)

A
Sedation
 acute dystonic reaction
akathisia
parkinsonism
tardive dyskinesia,
neuroleptic malignant syndrome.
81
Q

Azoles (e.g., fluconazole) side effect

A

Inhibition of P-450 enzymes.

82
Q

AZT side effect(2)

A

Thrombocytopenia

megaloblastic anemia

83
Q

β-blockers side effect (3)

A

Asthma exacerbation,
masking of hypoglycemia
impotence.

84
Q

Benzodiazepines side effect(3)

A

Sedation,
dependence
respiratory depression.

85
Q

Bile acid resins side effect(2)

A

GI upset

malabsorption of vitamins and medications.

86
Q

Calcium channel blockers side effect(3)

A

Peripheral edema
constipation
cardiac depression.

87
Q

Carbamazepine side effect(3)

A

agranulocytosis
Induction of P-450 enzymes
aplastic anemia

88
Q

Chloramphenicol side effect(2)

A

Gray baby syndrome

aplastic anemia.

89
Q

Cisplatin side effect(2)

A

Nephrotoxicity

acoustic nerve damage.

90
Q

Clonidine side effect (3)

A

Dry mouth
severe rebound headache
hypertension

91
Q

Clozapine side effect

A

Agranulocytosis

92
Q

Corticosteroids side effect(7)

A
Mania (acute)
immunosuppression
bone mineral loss
 thinning of skin
easy bruising,
myopathy (chronic)
 cataracts.
93
Q

Cyclophosphamide side effect(2)

A

Myelosuppression

hemorrhagic cystitis.

94
Q

Digoxin side effect(3)

A

disturbance
yellow visual changes
arrhythmias

95
Q

arythmias in digoxin(2)

A

junctional tachycardia

SVT

96
Q

Doxorubicin side effect

A

Cardiotoxicity (cardiomyopathy).

97
Q

Ethyl alcohol side effect

A

Renal dysfunction

98
Q

Fluoroquinolones side effect

A

Cartilage damage in children

Achilles tendon rupture in adults.

99
Q

Furosemide side effect(3)

A

Ototoxicity
hypokalemia
nephritis.

100
Q

Gemfibrozil side effect(2)

A

Myositis

reversible ↑ in LFTs.

101
Q

Halothane side effect(2)

A

Hepatotoxicity

malignant hyperthermia.

102
Q

HCTZ side effect(3)

A

Hypokalemia
hyperuricemia
hyperglycemia.

103
Q

HMG-CoA reductase inhibitors side effect(2)

A

Myositis

reversible ↑ in LFTs.

104
Q

Hydralazine side effect

A

Drug-induced SLE.

105
Q

Hydroxychloroquine

A

Retinopathy

106
Q

INH side effect(4)

A

Peripheral neuropathy
hepatotoxicity
inhibition of P-450 enzyme
seizures with overdose.

107
Q

prevention of neuropathy in INH

A

B6

108
Q

MAOIs side effect(2)

A
Hypertensive tyramine reaction
 serotonin syndrome (with meperidine).
109
Q

Methanol side effect

A

Blindness.

110
Q

Methotrexate side effect(3)

A

Hepatic fibrosis
pneumonitis
anemia.

111
Q

Methyldopa side effect(2)

A

Coombs’ test

drug-induced SLE.

112
Q

Metronidazole side effect(3)

A

Disulfiram reaction
vestibular dysfunction
metallic taste.

113
Q

Niacin side effect

A

Cutaneous flushing.

114
Q

Nitroglycerin side effect(4)

A

Hypotension
tachycardia
headache
tolerance.

115
Q

Penicillin/β-lactams side effect

A

Hypersensitivity reactions

116
Q

Penicillamine side effect

A

Drug-induced SLE

117
Q

Phenytoin side effect(4)

A

Nystagmus
diplopia
ataxia,
gingival hyperplasia, hirsutism.

118
Q

Prazosin first dose side effect

A

hypotension.

119
Q

Procainamide side effect

A

Drug-induced SLE.

120
Q

Propylthiouracil effect

A

Agranulocytosis.

121
Q

Quinidine effect

A

Cinchonism
thrombocytopenia
arrhythmias

122
Q

arrythmia in quinidine

A

torsades de pointes

123
Q

cinchonism quid(2)

A

headache

tinnitus

124
Q

Reserpine side effect

A

Depression.

125
Q

Rifampin side effect(2)

A

Induction of P-450 enzymes

orange-red body secretions

126
Q

Salicylates side effect (6)

A
Fever
 hyperventilation with respiratory alkalosis and metabolic acidosis
dehydration,
diaphoresis
hemorrhagic gastritis.
127
Q

SSRIs side effect(2)

A

Anxiety

sexual dysfunction.

128
Q

Succinylcholine side effect

A

Malignant hyperthermia.

129
Q

Tetracyclines side effect(3)

A

Tooth discoloration
photosensitivity
Fanconi’s syndrome

130
Q

TCAs side effect(5)

A
Sedation
coma
 anticholinergic effects
 seizures 
 arrhythmias.
131
Q

Valproic acid side effect

A

Teratogenicity → neural tube defects.

132
Q

Vancomycin side effect(3)

A

Nephrotoxicity
ototoxicity
“red man syndrome

133
Q

quid of redman syndrome(2)

A

caused by histamine release

not allergy

134
Q

Vinblastine side effect

A

Severe myelosuppression

135
Q

Vincristine side effect

A

Peripheral neuropathy

136
Q

why avoid Beta blockers in cocaine intox

A

unopposed @ activity causes HTA

137
Q

quid of opiods withdrawal rx moderate symptoms(2)

A

clonidine

buprenorphine

138
Q

severe symptoms for opiods withdrawal rx

A

methadone

139
Q

indication for rx opiods iitox who are drug free 7-10 days

A

naltrexone

140
Q

Vitamin A(2)

A

Night blindness

dry skin.

141
Q

Vitamin B1 (thiamine)

A

Beriberi

142
Q

symptom in beriberi (5)

A
polyneuritis
 dilated cardiomyopathy
high-output CHF
edema
 Wernicke-Korsakoff syndrom
143
Q

Vitamin B2 (riboflavin)(3)

A

Angular stomatitis
cheilosis
corneal vascularization

144
Q

Vitamin B3 (niacin)

A

Pellagra

145
Q

Pellagra(3)

A

diarrhea,
dermatitis
dementia.

146
Q

Vitamin B5 (pantothenate)(4)

A

Dermatitis
enteritis
alopecia
adrenal insufficiency

147
Q

Vitamin B6 (pyridoxine)(3)

A

Convulsions
hyper irritability
required during administration of INH.

148
Q

Vitamin B12 (cobalamin)(4)

A

Macrocytic,
megaloblastic anemia
neurologic symptom
glossitis.

149
Q

neurologic symptom in B12(3)

A

optic neuropathy
subacute combined degeneration
paresthesia

150
Q

Vitamin C deficiency

A

Scurvy

151
Q

quid of scurvy(4)

A

swollen gums
bruising
anemia
poor wound healing

152
Q

Vitamin D deficiency (3)

A

Rickets in children
(bending bones),
osteomalacia in adults (soft bones),
hypocalcemic tetany.

153
Q

Vitamin E deficiency

A

Vitamin E ↑ fragility of RBCs.

154
Q

Vitamin K

A

Neonatal hemorrhage
↑ PT and aPTT
normal BT.

155
Q

Biotin deficiency(2)

A

Dermatitis

enteritis

156
Q

cause of biotin deficiency

A

ingestion of raw eggs

157
Q

The most common vitamin deficiency in the United States.

A

Folic acid

158
Q

disease causing folic acid deficiency

A

sprue

159
Q

symptom in folic acid deficiency(3)

A

macrocytic
megaloblastic
anemia without neurologic symptoms

160
Q

Magnesium deficiency(5)

A
Weakness
 muscle cramps
 exacerbation of hypocalcemic tetany,
 CNS hyperirritability → tremors,
choreoathetoid movement,
161
Q

Selenium deficiency

A

keshan disease (cardiomyopathy).