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HJ S2RR > Emergency Medicine > Flashcards

Emergency Medicine Flashcards

1
Q

Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, extrapyramidal symptoms?

A

Antipsychotic (neuroleptic malignant syndrome)

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2
Q

Side effects of corticosteroids

A

Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies

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3
Q

Treatment of DTs

A

Benzodiazepines

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4
Q

Treatment for acetaminophen overdose

A

N-acetylcysteine

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5
Q

Treatment for opioid overdose

A

Naloxone

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6
Q

Treatment for benzodiazepine overdose

A

Flumazenil (monitor for withdrawal and seizures)

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7
Q

Treatment for neuroleptic malignant syndrome & malignant hyperthermia

A

Nitroprusside

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8
Q

Treatment for atrial fibrillation

A

Rate control, rhythm conversion & anti coagulation

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9
Q

Treatment for SVT

A

Stable –> carotid massage (rate control), other vagal stimulation

Unsuccessful –> consider adenosine

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10
Q

Causes of drug induced SLE

A

INH, penicillamine,hydralazine, procainamide, chlorpromazine, methyl dopa, quinidine

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11
Q

Macrocytic,megaloblastic anaemia with neurological symptoms

A

B12 deficiency

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12
Q

Microcytic, megaloblastic anaemia without neurological symptoms

A

Folate deficiency

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13
Q

A burn patient presents with cherry red, flushed skin & coma. SaO2 normal, but carboxyHb is elevated. Treatment?

A

CO poisoning –> 100% O2, or hyperbaric O2 if severe poisoning or pregnant

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14
Q

Blood in the urethral meatus or high riding prostate

A

Bladder rupture or urethral injury

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15
Q

Test to rule out urethral injury

A

Retrograde cystourethrogram

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16
Q

Radiographic evidence of aortic disruption or dissection

A 
Widened mediastinum (>8cm), 
Loss of aortic knob
Pleural cap
Tracheal deviation to the right
Depression of left main bronchus
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17
Q

Radiographic indications for surgery in acute abdomen

A 
Free air under diaphragm 
Extravasation of contrast 
Severe bowel distension
Space occupying lesion (on CT)
Mesenteric occlusion (angiography)
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18
Q

Most common organism in burns related infections

A

Pseudomonas

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19
Q

Method of calculating fluid repletion in burn patients

A

Parkland formula:

24hr fluids = 4 x kg x %BSA

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20
Q

Acceptable urine output in trauma patient

A

50cc/hr

21
Q

Acceptable urine output in a stable patient

A

30cc/hr

22
Q

Signs of neurogenic shock

A

Hypotension & bradycardia

23
Q

Cushings triad (signs of raised ICP)

A

HTN, bradycardia & abnormal respirations

24
Q

Low cardiac output
Low PCWP
High peripheral vascular resistance

A

Hypovolaemic shock

25
Q

Low cardiac output
High PCWP
High PVR

A

Cardiogenic (or obstructive) shock

26
Q

High cardiac output
Low PCWP
Low PVR

A

Distributive (e.g. septic or anaphylactic) shock

27
Q

Treatment of septic shock

A

Fluid & antibiotics

28
Q

Treatment of cardiogenic shock

A

Identify cause –> inotropes (e.g. Dopamine)

29
Q

Treatment of hypovolaemic shock

A

Identify cause –> fluid and blood repletion

30
Q

Treatment of anaphylactic shock

A

Epinephrine 1:1000 & diphenhydramine

31
Q

Supportive treatment for ARDS

A

Low tidal volume ventilation

32
Q

Signs of air embolism

A

A patient with chest trauma who was previously stable suddenly dies

33
Q

Signs of cardiac tamponade

A

Beck triad:

  • distended neck veins
  • hypotension
  • diminishes heart sounds

Pulsus paradoxus

34
Q

Absent breath sounds, dullness to percussion, shock, flat neck veins

A

Massive haemothorax

35
Q

Absent breath sounds, tracheal deviation, shock, distended neck veins

A

Tension pneumothorax

36
Q

Treatment for blunt or penetrating abdominal trauma in haemodynamically unstable patients

A

Immediate exploratory laparotomy

37
Q

Raised ICP in alcoholics or the elderly following heat trauma. Can be acute or chronic

Crescent shape on CT

A

Subdural haematoma

38
Q

Head trauma with immediate LOC followed by lucid interval and then rapid deterioration

Convex shape on CT

A

Extradural (epidural) haematoma

39
Q

Patient with singed nasal hairs, facial burns, hoarseness, wheezing, soot in posterior oropharynx or carbonaceous sputum. Suspect?

A

Thermal or inhalational injury to the airway

40
Q

When to intubate?

A

GCS < 8 = intubate!

41
Q

Immediately evaluate trauma patients for? (6)

A 
Open pneumothorax
Tension pneumothorax
Flail chest
Massive haemothorax
Cardiac tamponade
Airway obstruction
42
Q

ABCDE assessment airways

A
  • ability to speak
  • look for airway obstruction
  • give O2

Intubate if compromised airway (jaw thrust or cricothyroidotomy)

43
Q

ABCDE breathing assessment

A
  • auscultation breath sounds
  • if suspect tension pneumo —> needle decompression
  • CXR (rule out trauma)
  • if suspect pneumo or haemo —> chest drain
44
Q

ABCDE circulation assessment

A
  • assess pulses
  • control active bleeding ; splint long-bone deformity/fractures
  • secure IV access
  • fluids & bloods if unstable
45
Q

ABCDE disability assessment

A
  • GCS

- gross motor/sensory function in extremities

46
Q

ABCDE assessment exposure

A
  • disrobe & inspect for more injuries

- cover patient to prevent hypothermia

47
Q

19 yo man gunshot wound to chest bp 60/30, no BS on left, raised JVP, tracheal deviation to right. Management?

A
  • IV 14G cannula to 2nd ICS MCL

- chest drain

48
Q

Syndrome associated with weak aortic wall

A

Marfans
Syphillis
Ehlers Danlos

49
Q

25yo man stabbed in neck, calm and vital signs stable.
O/E cut extends through platysma muscle.
Management?

A

Admit for surgical exploration of wound

All penetrating trauma that violates the platysma muscle mandates admission and surgical consultation for surgery or further diagnostic evaluation

HJ S2RR (16 decks)

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