Emergency medicine Flashcards
What core temp is considered mild hypothermia
34-36
What core temp is severe hypothermia
<30 C
symptoms of severe hypothermia
fixed dilated pupils, v-fib
at what temp does a person lose their shivering reflex, have mild alterlations in consciousness, bradycardia
30-34
Treatment for hypothermia
warming blankets, warm IV fluids, heated O2,
Gold standard for severe hypothermia
extracorpeal blood rewarming
Tx for forstbite
rewarm, hyperbaric oxygen, surgical debridement
Alterations in mental status, multiorgan dysfunction, core temp >104, HA, seizures
heat stroke
symptoms of high altuitude sickness
HA, nausea, fatigue, weakness, insomnia
Tx for high altitude sickness
descent, oxygen, antiemetics,
Tx for high altitude sickness is descent isn’t possible
dexamethasone or acetazolamide
What are the 2 main classes of poisonous snakes?
pit vipers and elapids
what type snakes are elapids?
coral snakes, cobras
spider bite with severe pain, muscle spasms of abdomen and trunk, severe HTN, tachycardia
black widow spider
TX for black widow spider bite
narcotic analgesics, local ice, antivenom only for seriously ill
What does a brown recluse spider look like?
dark, violin shaped area on its back
What does the cytotoxic venom from a borwn recluse spider cause?
tissue necrosis and hemolysis
Tx for brown recluse spider bite
dapsone
antidote for anticholinergic poisoning
physostigmine
tx for anticholinesterase poisoning (physostigmine, organophosphates)
atropine
Tx for benzo OD
flumazenil
Tx for beta blocker OD
glucagon
Tx for CCB OD
calcium
Tx for carbon monoxide poisoning
100% oxygen
Tx for cyanide poisoning
sodium nitrite
tx for digoxin OD
Digibind
Tx for iron OD
deferoxamine
Tx for lead OD
EDTA
Tx for arsenic/ mercury OD
penicillamine
Tx for heparin OD
protamine
T for isonizid OD
pyridoxine (vitamin B6)
Tx for methanol, ethylene glycol OD
Ethanol
Tx for narcotics OD
naloxone
Tx for tricyclic antidepressant OD
sodium bicarb
tx for warfarin OD
Vitamin K
Tx for hypovolemic shock
20 cc fluids/kg, blood +/- surgery
Tx for cardiogenic shock
MI treatments, vasopressors, IABP (intraaortic balloon pump)
Tx for anaphylactic shock
0.3-0.5 SQ einephrine, albuterol, steroids
Presents with fever, tachypnea, leukocytosis, HPOTN, decreased systemic vascular resistance
septic shock
Signs of neurogenic shock
spinal cord injury, HPOTN due to loss of vascular tone, warm flushed skin
how long does it take 2nd degree (partial thickness) burns to heal?
14-21 days
Do third degree burns heal on their own?
No
will third degree burns have any sensation?
no
For the rules of 9s , what body parts are worth “nine”
head/neck
Right arm
Left arm
For the rules of 9s which body parts are work 18?
torso front
torso back
Right leg
left leg
Tx for hypernatremia
hypotnoic solution (D5W)
Causes of hypokalemia
diuretics, vomiting, diarrhea, Cushign syndrome, Mag depletion, poor intake
S/S for hypokalemia
weakness, paralytic ileus, a/v tach, v fib
what will EKG show with hypokalemia
decreased T wave amplitude, T wave inversion, ST depression, U wave, prolonged QT< v-tach, torsades
Causes of hyperkalemia
renal failure, ACEI, spironolactone, digoxin, Addison’s, oral potassium excess
ECG findings with hyperkalemia
peaked T waves, QRS widening, v-fib
Tx for hyperkalemia
IV calcium, IV lasix, glucose, insulin, kayexalate, albuterol, dialysis
causes of hypercalcemia
hyperparathyroidism
malignancies (bone, lyphoma, leukemia, multiple myeloma)
drugs that can cause hypercalcemia
tamoxifen, thiazides, VIt A, VIt D
presents with lethargy, depression, atatxis, psychosis, neuromuscular weakness, renal stones, decreased GFR
hypercalcemia
what will you see in the eye with hypercalcemia?
bank keratopathy
Tx for hypercalcemia
hydration with normal saline, loop ciuretic, calcitonin, IV bisphosphonates
what is the most common cause of hypocalcemia?
chronic kidney disease
WHat are other causes of hypocalcemia?
hypoalbuminemia, hypoparathyroidism, VItamin D deficiency, magnesium depletion
S/S of hypocalcemia
tetany, paresthesias in fingers and mouth, carpopedal spasm
sign that is contraction of the facial muscle in response to tapping the facial nerve
Chvostek’s sign (hypocalcemia)
carpal spasm occuring with BP cuff inflation
Trousseau’s sign (hypocalcemia)
what will happen to the QT interval with hypocalcemia?
prolongation of the QT interval
Tx for hypocalcemia
Calcium chloride, calcium gluconate
Tx for acute asthma attack
oxygen, Beta agonists (repeated) IV magnesium, BiPAP, intubation, systemic steroids
diagnosis of an acute pulmonary embolism
pulmonary angiogram
Tx for acute pulmonary embolism
oygen, anticoagulation, thrombolytic therapy
S/S of PE
acute dyspnea, pleuritic chest pain, tachpnea, tachycardia, hypoxia
causes of respiratory acidosis
COPD, narcotics, airway obstruction, pneumonia
Tx for respiratory acidosis
BIpAP, intubation (reverse underlying process)
what is MUDPILES (metabolic acidosis)
methanol uremia diabetic ketoacidosis Paraladehyde Ibuprofen/ INH/ Iron Lactic acidosis Ethylene glycol Salicylates (aspiring)
causes of metabolic alkalosis
vomiting, volume depletion (diuretics), primary aldosteronism
Tx for metabolic alkalosis
acetazolamide
caues of respiratory alkalosis (pH>7.45 pCO2<350
hyperventlation, early shock, CVA, anxiety, pulmonary disease
S/S of respiratory alkalosis
circumoral and digitial paresthesias, carpopedeal spasm, dizziness, confusion
