Emergency Medicine: Treatments [according to Master the Boards]

Question 1

Any head trauma resulting in sufficient injury to cause altered mental status or
loss of consciousness (LOC) is managed first with___________

Answer 1

a head CT.

without contrast

Question 2

Concussion CT findings

Answer 2

Normal CT scan

Question 3

Contusion: CT findings

Answer 3

(rarely) has focal findings. Ecchymoses found on CT (blood mixed in with brain parenchyma).

Question 4

Treatment of Concussion:

Answer 4

no specific therapy. Wait at least 24 hours before returning to
sports.
Those with concussion are safe to go home. Hospitalization is not
necessary. Observe at home for altered mental status.

Question 5

Treatment of Contusion:

Answer 5

vast majority need no specific treatment. Rarely need surgical
debridement.

Question 6

Treatment of Subdural and epidural hematoma:

Answer 6

based on size and signs of compression of the brain. Small ones are left alone. Large hematomas are
managed with:
Intubation and hyperventilation
Mannitol
Drainage

Question 7

Definition of a Large Intracranial Hemorrhage

Answer 7

• Compression of ventricles or sulci
• Herniation with abnormal breathing and unilateral dilation of the pupil
• Worsening mental status or focal findings

Question 8

The best initial therapy for those caught in a fire is __________

Answer 8

100% oxygen to treat

smoke inhalation and carbon monoxide poisoning.

Question 9

Fluid replacement formula is ______

Answer 9

(4 mL) × (%BSA burned) × weight in kg

Question 10

the Volume of Fluid Replacement is given in the following order

Answer 10

1/2 1°8h
1/4 2°8h
1/4 3° 8h
Give one-half in the first 8 hours, a quarter in the
second 8 hours, and a quarter in the third 8 hours.

Question 11

Treatment: Heat

cramps/exhaustion

Answer 11

Oral fluids and

electrolytes

Question 12

Treatment: Heatstroke

Answer 12

IV fluids;

evaporation

Question 13

Treatment: Neuroleptic
malignant
syndrome

Answer 13

Dantrolene or
dopamine
agonists:
bromocriptine,
cabergoline

Question 14

Treatment: Malignant

hyperthermia

Answer 14

Dantrolene

Question 15

Treatment: Drowning

Answer 15

Manage with airway and administer positive pressure ventilation.
Steroids and antibiotics are not beneficial.

Question 16

High Altitude Pulmonary Edema (HAPE) Treatment

Answer 16

oxygen, rapid descent, and steroids or nifedipine or sildenafil.

Question 17

Jellyfish Stings Treatment

Answer 17

Treat by removing nematocysts. Wash the wound with seawater to prevent
nematocysts from firing. Scrape off the stingers using a piece of hard plastic,
such as a credit card.

After tentacle removal use hot water on the wound, which inactivates the toxin.
Acetic acid (vinegar) may help prevent toxin release from the nematocyst of
these tentacles. Topical steroids and antihistamines relieve symptoms.