Emergency Medicine1 Flashcards
1
Q
Q001. ACEIs; Toxicity
A
A001. Cough; rash; proteinuria; angioedema; taste changes; teratogenic effects
2
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Q002. Amantadine; Toxicity
A
A002. Ataxia; livedo reticularis
3
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Q003. Aminoglycosides; Toxicity
A
A003. Ototoxicity; nephrotoxicity - ATN
4
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Q004. Amiodarone; Toxicity
A
A004. Pulmonary fibrosis; peripheral deposition => bluish discoloration,; arrhythmias,; hypo-/hyperthyroidism,; corneal deposition
5
Q
Q005. Amphotericin; Toxicity
A
A005. Fever/chills; nephrotoxicity; bone marrow suppression; anemia
6
Q
Q006. Antipsychotics; Toxicity
A
A006. Sedation; acute dystonic reaction; akathisia; parkinsonism; tardive dyskinesia; neuroleptic malignant syndrome
7
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Q007. Azoles (e.g., fluconazole); Toxicity
A
A007. Inhibition of P-450 enzymes
8
Q
Q008. AZT; Toxicity
A
A008. Thrombocytopenia; megaloblastic anemia
9
Q
Q009. β-blockers; Toxicity
A
A009. Asthma exacerbation; masking of hypoglycemia; impotence
10
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Q010. Benzodiazepines; Toxicity
A
A010. Sedation; dependence; respiratory depression
11
Q
Q011. Bile acid resins; Toxicity
A
A011. GI upset; malabsorption of vitamins; and medications
12
Q
Q012. Calcium channel blockers; Toxicity
A
A012. Peripheral edema; constipation; cardiac depression
13
Q
Q013. Carbamazepine; Toxicity
A
A013. Induction of P-450 enzymes; agranulocytosis; aplastic anemia
14
Q
Q014. Chloramphenicol; Toxicity
A
A014. Gray baby syndrome; aplastic anemia
15
Q
Q015. Cisplatin; Toxicity
A
A015. Nephrotoxicity; acoustic nerve damage
16
Q
Q016. Clonidine; Toxicity
A
A016. Dry mouth; severe rebound headache; hypertension
17
Q
Q017. Clozapine
A
A017. Agranulocytosis
18
Q
Q018. Corticosteroids; Toxicity
A
A018. Mania (acute) immunosuppression; bone mineral loss; thinning of skin; easy bruising; myopathy (chronic); cataracts
19
Q
Q019. Cyclophosphamide; Toxicity
A
A019. Myelosuppression; hemorrhagic cystitis
20
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Q020. Digoxin -; Toxicity
A
A020. GI disturbance; yellow-green visual changes; arrhythmias - junctional tachycardia or SVT,; varying amounts of AV node blocks
21
Q
Q021. Doxorubicin -; Toxicity
A
A021. Cardiotoxicity; (dilated cardiomyopathy)
22
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Q022. Ethyl alcohol -; Toxicity
A
A022. Renal dysfunction
23
Q
Q023. Fluoroquinolones; Toxicity
A
A023. Cartilage damage in children Achilles tendon rupture
24
Q
Q024. Furosemide; Toxicity
A
A024. Ototoxicity; hypokalemia; nephritis
25
Q025. Gemfibrozil; Toxicity
A025. Myositis; reversible Æ in LFTs
26
Q026. Halothane; Toxicity
A026. Hepatotoxicity; malignant hyperthermia
27
Q027. HCTZ; Toxicity
A027. Hypokalemia; hyperuricemia; hyperglycemia
28
Q028. HMG-CoA reductase inhibitors; Toxicity
A028. Myositis; reversible Æ in LFTs
29
Q029. Hydralazine; Toxicity
A029. Drug-induced SLE
30
Q030. Hydroxychloroquine; Toxicity
A030. Retinopathy
31
Q031. INH -; Toxicity
A031. Peripheral neuropathy - prevent with vitamin B6; hepatotoxicity; inhibition of P-450 enzymes; seizures with overdose
32
Q032. MAOIs -; Toxicity
A032. Hypertensive tyramine reaction; serotonin syndrome - with meperidine
33
Q033. Methanol; Toxicity
A033. Blindness
34
Q034. Methotrexate; Toxicity
A034. Hepatic fibrosis; pneumonitis; anemia
35
Q035. Methyldopa; Toxicity
A035. Pos. CoombsÀ test; drug-induced SLE
36
Q036. Metronidazole; Toxicity
A036. Disulfiram reaction; vestibular dysfunction; metallic taste
37
Q037. Niacin; Toxicity
A037. Cutaneous flushing
38
Q038. Nitroglycerin; Toxicity
A038. Hypotension; tachycardia; headache; tolerance
39
Q039. Penicillin/β-lactams ; Toxicity
A039. Hypersensitivity reactions
40
Q040. Penicillamine; Toxicity
A040. Drug-induced SLE
41
Q041. Phenytoin; Toxicity
A041. Nystagmus; diplopia; ataxia; gingival hyperplasia; hirsutism
42
Q042. Prazosin -; Toxicity
A042. First-dose hypotension
43
Q043. Procainamide; Toxicity
A043. Drug-induced SLE
44
Q044. Propylthiouracil; Toxicity
A044. Agranulocytosis
45
Q045. Quinidine; Toxicity
A045. Cinchonism -; (headache, tinnitus); thrombocytopenia; arrhythmias - torsades de pointes
46
Q046. Reserpine; Toxicity
A046. Depression
47
Q047. Rifampin; Toxicity
A047. Induction of P-450 enzymes; orange-red body secretions
48
Q048. Salicylates; Toxicity
A048. Fever; hyperventilation with; respiratory alkalosis; and metabolic acidosis; dehydration; diaphoresis; hemorrhagic gastritis
49
Q049. SSRIs; Toxicity
A049. Anxiety; sexual dysfunction
50
Q050. Succinylcholine; Toxicity
A050. Malignant hyperthermia
51
Q051. Tetracyclines; Toxicity
A051. Tooth discoloration; photosensitivity; FanconiÀs syndrome
52
Q052. TCAs; Toxicity
A052. Sedation; coma; anticholinergic effects; seizures; wide QRS; in severe cases - prolonged QT => torsade
53
Q053. Valproic acid; Toxicity
A053. Teratogenicity => neural tube defects
54
Q054. Vancomycin; Toxicity
A054. Nephrotoxicity; ototoxicity; Àred man syndromeÀ - histamine release, not an allergy
55
Q055. Vinblastine; Toxicity
A055. Severe myelosuppression
56
Q056. Vincristine; Toxicity
A056. Peripheral neuropathy
57
Q057. Acetaminophen; What is the Antidote
A057. N-acetylcysteine
58
Q058. Acid/alkali ingestion; What is the Antidote
A058. Upper endoscopy to evaluate for stricture
59
Q059. Anticholinesterases,; organophosphates; What is the Antidote
A059. Atropine; pralidoxime
60
Q060. Antimuscarinic/; anticholinergic agents; What is the Antidote
A060. Physostigmine
61
Q061. Arsenic, mercury, gold; What is the Antidote
A061. Succimer; dimercaprol
62
Q062. β-blockers; What is the Antidote
A062. Glucagon
63
Q063. Barbiturates (phenobarbital); What is the Antidote
A063. Urine alkalinization (bicarb); dialysis; activated charcoal
64
Q064. Benzodiazepines; What is the Antidote
A064. Flumazenil
65
Q065. Black widow bite -; What is the Antidote
A065. Calcium gluconate
66
Q066. Carbon monoxide -; What is the Antidote
A066. 100% O2; hyperbaric O2
67
Q067. Copper, arsenic, lead, gold -; What is the Antidote
A067. Penicillamine
68
Q068. Cyanide -; What is the Antidote
A068. Nitrite; sodium thiosulfate
69
Q069. Digitalis -; What is the Antidote
A069. Stop digitalis,; normalize K+,; lidocaine (for torsades), anti-digitalis Fab
70
Q070. Heparin -; What is the Antidote
A070. Protamine sulfate
71
Q071. Iron salts -; What is the Antidote
A071. Deferoxamine
72
Q072. Lead -; What is the Antidote
A072. Succimer; CaEDTA; dimercaprol
73
Q073. Methanol, ethylene glycol (antifreeze); What is the Antidote
A073. EtOH; fomepizole; dialysis
74
Q074. Methemoglobin; What is the Antidote
A074. Methylene blue
75
Q075. Opioids; What is the Antidote
A075. Naloxone
76
Q076. Phencyclidine hydrochloride (PCP); What is the Antidote
A076. NG suction
77
Q077. Salicylates -; What is the Antidote
A077. Urine alkalinization; dialysis; activated charcoal
78
Q078. TCAs; What is the Antidote
A078. Na bicarb - QRS prolongation; diazepam or lorazepam for Seizures; cardiac monitor for; arrhythmias
79
Q079. Theophylline; What is the Antidote
A079. Activated charcoal
80
Q080. tPA, streptokinase; What is the Antidote
A080. Aminocaproic acid
81
Q081. Warfarin; What is the Antidote
A081. Vitamin K, FFP
82
Q082. Cardiac Life Support; What are the Basic Principles
A082. Check if responsive; call for help; Patient on firm, flat surface ABCs; Airway open?; Breathing?; CPR; IV meds before intubate; CPR if alone - 2 breaths, check pulse - carotid or femoral, 15 compressions; CPR if have help - 2 breaths, 5 compressions
83
Q083. Burns; Hx/PE
A083. 2nd leading cause of death in kids; don't underestimate degree of nonvisible deep destruction- esp. with electrical burns thorough airway & lung exam; respiratory burn - patient may need early intubation before edema sets in
84
Q084. Burns; Dx; Rule of 9's
A084. ABCs; aware of possible À shock, inhalation injury, CO poisoning; evaluate % of BSA involved rule of 9's; BSA (Body Surface Area); head = 18%; front = 18%; back = 18%; each arm = 9%; each leg = 18%
85
Q085. Burns; Categories
A085. 1st degree - epidermis involved, area painful, no blisters, capillary refill intact; 2nd degree - epidermis & superficial dermis, area painful, blisters; 3rd degree - epidermis & dermis, area painless, white & charred
86
Q086. Burns; Tx
A086. Treatment supportive; freq. dressing changes; rehydrate; topical silver sulfadiazine and mafenide; circumferential burns - at risk for compartment syn, need early escharotomy; early skin graft - prevent contractures; fluid req. - in 1st 24 hrs. - BSA x wt(kg) x 4cc, give 1/2 in 1st 8 hrs, 1/4 in next 8 hrs, 1/4 in last 8 hrs; 1st choice - lactate ringers; 2nd choice - NS (0.9%); hydrate enough to maintain urine output at least 1cc/kg/hr
87
Q087. Burns; Complications
A087. Shock; superinfection - esp. Pseudomonas
88
Q088. CO Poisoning; What is it
A088. Hypoxemic poisoning syn causes; car exhaust; smoke inhalation; barbeque in poor ventilation; old appliances
89
Q089. CO Poisoning; HX/PE
A089. Cherry-red skin; confusion; headaches; if severe À coma, seizures chronic low-level exposure; flu-like Sxs; suspect smoke inhalation in - singed nose hairs; facial burns; hoarseness; wheezing; carbonaceous sputum
90
Q090. CO Poisoning; Dx
A090. ABG; normal serum carboxyHb level - < 5% in nonsmokers, < 10% in smokers; laryngoscopy; bronchoscopy; EKG - elderly; history of cardiac dis.
91
Q091. CO Poisoning; Tx
A091. 100 O2 hyperbaric O2:; pregnant; neuro Sxs; severely Æ carboxyHb; smoke inhalation - may need early intubation (before edema sets in)
92
Q092. Aortic Disruption; What is it
A092. Rapid deceleration injury most common causes; high speed MVAs; fall from great heights; ejection from vehicles complete; rapidly fatal; usually have contained hematoma within adventitia; laceration usually at lig. arteriosum
93
Q093. Aortic Disruption; Dx
A093. CXR immediately; wide mediastinum; loss of aortic knob; pleural cap; trachea deviation to right; left main stem bronchus depressed; aortography - gold standard; transesoph echo before OR; always suspect if sternal fractures or 1st & 2nd rib fractures
94
Q094. Aortic Disruption; Tx
A094. OR emergently
95
Q095. Aortic Dissection; What is it; Risk Factors
A095. Surging of blood through tear in aortic intima; seperation of intima & media => false lumen; Stanford type A: ascending aorta; type B: - desc. thoracic aorta (distal to lt. subclavian) risk factors:; HTN; trauma; coarctation of aorta; syphilis; pregnancy; Ehlers-Danlos; Marfan's
96
Q096. Aortic Dissection; Hx/PE
A096. Acute onset; severe tearing chest pain radiates to back => syncope, stroke, MI; asymm or decreased periph pulses; paraplegia; shock - as worsens; type A - aortic regurgitation with diastolic murmur
97
Q097. Aortic Dissection; Dx
A097. CXR; CT with IV contrast; transesoph echo or; MRI/MRA or; angiography - gold standard; EKG
98
Q098. Aortic Dissection; Tx
A098. Stabilize HBP or low HBP; IV nitrates; B blockers; goal - systolic < 120, HR < 70; type A - emergent surgery; type B - med management
99
Q099. Aortic Dissection; Complications
A099. MI; CHF; cardiac tamponade; postop hemorrhage; future dissection; future aneurysm; death
100
Q100. Postop Fever; What is it Caused By; (What are the 6 W's)
A100. Wind - atelectasis, pneumonia; Water - UTI; Wound - abscess; Walk- DVT; Wonderdrug - drug reaction; Wire - catheter
101
Q101. Postop Fever; How to Decrease Risk
A101. Incentive spirometry; short-term foley use; early ambulation; DVT prophylaxis; pre- & post-op ABx; fevers before POD3: probably not infectious unless Clostridium or B-hemolytic strep
102
Q102. Acute Abdomen; What is it
A102. Abdom Sxs so severe; surgery should be considered; primary Sx - acute abdom pain
103
Q103. Acute Abdomen; Hx/PE
A103. OPQRST: Onset, Precip factors, Quality, Radiation, Sxs, Temporal quality; Treatment modalities; full GYN Hx; LMP; STD Sxs; pelvic exam; pregnancy test - rule out PID, ectopic pregnancy,; ovarian torsion
104
Q104. Acute Abdomen; Character of Pain
A104. Sharp - parietal (peritoneal); dull, diffuse - visceral (organ); perforation - sudden onset of diffuse, severe pain; obstruction - acute onset of colicky; inflammation - gradual onset over 10-12 hrs, constant, ill- defined
105
Q105. Acute Abdomen; Dx
A105. Assess stability; emergent surgery & exploratory lap - peritoneal signs, impending shock, shock; if stable À PE, pelvic exam (women), CBC with diff, electrolytes, LFTs, amylase, lipase, urine B-hCG, UA, KUB, US; no contrast studies - if suspect complete LBO
106
Q106. Acute Abdomen; Tx
A106. Hemodynamically unstable - emergent exploratory lap; stable - expectant management; vitals; NPO; NG tube; IV fluids; serial abdom exams; serial labs; type & cross; Foley - monitor urine output; monitor fluid status
107
Q107. Appendicitis; What is it
A107. Always consider in patient with acute abdomen; MC - teens & 20's; causes - no. 1 - lumen obstructed by lymphoid tissue hyperplasia; no. 2 À fecalith, foreign body, tumor (carcinoid), parasite; obstruction => overdistention, increased pressure, ischemia & necrosis
108
Q108. Appendicitis; Hx/PE
A108. Dull, vague pain orig. at umbilicus, lasts 1-12 hrs. pain then followed by n/v, anorexia, ("hamburger sign"); may have mild fever; sharper pain => RLQ at McBurney's point, psoas sign, obturator sign, rovsing's sign; if perforated - pain decreased, peritoneal sigs will dev. atypical À elderly, kids, pregnant, retrocecal appendices
109
Q109. Appendicitis; Dx
A109. Clinical - if classic signs & Sxs, mild leukocytosis & left shift; UA - a few RBCs or WBCs; KUB À fecalith, loss of psoas shadow; US - rule out gyn abnorm; abdom CT - rule out abscesses
110
Q110. Appendicitis; Tx
A110. strong suspicion - immed open or lap appendectomy; 15-20% false pos. acceptable; if no appendicitis found - complete exploration of abdo; before surgery À NPO, IV fluids, ABx for anaerobes - 24 hrs. if perforation - cont. ABx until afebrile & WBC count normalizes, close wound by delayed primary closure on POD5; if abscess - broad-spectrum ABx, abscess percutaneously drained, elective appendectomy 6-8 wks
111
Q111. Appendicitis; Complications
A111. Risk of perforation & mortality increased with amt of time have appendicitis; (at 48 hrs - 75% risk)
112
Q112. Acute Management of Trauma Patient; "ABCDE"; What is "A"
A112. Airway - airway patency & adeq ventilation; take precedence over other Tx; conscious - nasal cannula or face mask; unconscious - chin lift or jaw thrust to reposition tongue; early intubation À apnea, decreased mental status, impending airway compromise, severe closed head injuries, failed bag mask ventilation; cricothyroidectomy - can't be intubated, signif maxillofacial trauma, keep cervical spine stable, never let this concern delay airway management
113
Q113. Acute Management of Trauma Patient; "ABCDE"; What is "B"
A113. Breathing 5 thoracic causes of immed. death must not be missed:; tension pneumothorax; cardiac tamponade; open pneumothorax; massive hemothorax; airway obstruction
114
Q114. Acute Management of Trauma Patient; "ABCDE"; What is "C"
A114. Circulation; 2 16-gauge IVs; fluid bolus of 1-2L (adults); vitals rechecked; replete fluid per fluid status; LR or NS - isotonic; replete 3:1 (fluid to blood)
115
Q115. Acute Management of Trauma Patient; "ABCDE"; What is "D"
A115. Disability; evaluate CNS dysfunction via Glasgow Coma Scale
116
Q116. Acute Management of Trauma Patient; "ABCDE"; What is "E"
A116. Extra; check temperature status; foley catheter - after rule out urethral injury; secondary survey - full exam; additional XRs - trauma series: AP chest, AP pelvis, AP/lat C-spine, T1
117
Q117. Pelvic Fractures; What are they
A117. MC after trauma such as a MVA; needs immediate attention by orthopedist; potentially life-threatening
118
Q118. Pelvic Fractures; Hx/PE
A118. ABCDE trauma survey; secondary survey - may reveal unstable pelvis; AP pelvic XR; when stable - CT; if hypotension & shock - hemorrhage likely; can be assoc with urethral injury - check for blood at urethral meatus; check high-riding, "ballotable" prostate; check for lack of prostate; retrograde urethrogram, rule out injury before Foley; serial H&H; never explore pelvic or retroperitoneal hematoma
119
Q119. Pelvic Fractures; Tx
A119. Embolize bleeding vessels; emergent external pelvic fixation; internal fixation if hemodynamically stable
120
Q120. acute dystonia
A120. involuntary muscle cont/spasm - torticollis, oculogyric crisis; Rx: anticholinergic (benztropine) or diphenhydramine; Prevent: prophylatic benztropine
121
Q121. akathisia
A121. subjective/objective restlessness; Rx: reduce neuroleptic, βblocker (propranolol), +/- benzos, anticholinergics
122
Q122. dyskinesia
A122. pseudoparkinsonism Rx:; anticholinergic (benztropine); or DA agonist (amantidine); reduce/stop neuroleptic or d/c
123
Q123. tardive dyskinesia
A123. stereotypic oral-facial movements; likely d/t DA receptor sensitization; 50% irreversible Rx:; reduce/stop neuroleptic or d/c or change drugs; giving anticholinergics or Æneuroleptic may initially WORSEN TD
124
Q124. Neuroleptic Malignant syndrome
A124. fever; muscle rigidity; autonomic instability; clouded consciousness; ÆCPK, WBCs Rx:; stop neuroleptic; dantrolene/bromocriptine; IV fluids
125
Q125. Evolution of EPS
A125. 4 hours: acute dystonia; 4 days: akathisia; 4 weeks: akathisia; 4 months: tardive dyskinesia
126
Q126. EtOH withdrawal syndrome
A126. Mild withdrawal (6-24h from last drink): tremor, anxiety, N/V, insomnia; Major Withdrawal (10-72h): visual/auditory hallucinations, whole body tremor, vomiting, diaphoresis,ÆBP; Withdrawl seizures - 6-48hrs; DTs - 2-7d, severe autonomic instability/hyperactivity (ÆHR, BP), delerium, confusion, agitation, hallucinations, fever, positional nystagmus, death - mortality 15-20%
127
Q127. EtOH withdrawal Rx including DTs
A127. benzos* (DOC); haloperidol for hallucinations; clonidine, BBs for hyperadrenergic state; thiamine, folate, vitamens; replace lytes; IV fluids
128
Q128. Barbituate withdrawal
A128. anxiety; seizures; delerium; tremor; cardiac & respiratory depression; Rx: benzos
129
Q129. Benzodiazepine withdrawal
A129. rebound anxiety; seizures; tremor; instability; Rx: benzos
130
Q130. Cocaine/amphetamine withdrawal
A130. depression; hyperphagia; hypersomnolence; Rx: supportive, avoid BBs (results in excess uninhibited cardiac activation)
131
Q131. Opioid withdrawal
A131. anxiety; insomnina; flu-like symptoms*; sweating; piloerection; fever; rhinorrhea; stomach cramps; diarrhea; mydriasis; Rx: clonidine +/or buprenorphine for mod withdrawal, methadone for severe, naltrexone in pts drug-free for 7-10d
132
Q132. Aortic disruption CXR
A132. widened mediastinum; pleural cap; loss of aortic knob; deviation of trachea to R; depression of L main stem bronchus; Always suspect with R1-2#s; aortography - gold standard
133
Q133. Arrhythmia Rx:; asystole
A133. epi; atropine
134
Q134. Arrhythmia Rx:; Vfib
A134. desynchronized shock --> epi or vasopressin --> shock --> lido or amio --> shock --> procainamide or Mg
135
Q135. Arrhythmia Rx:; VTach
A135. if unstable/pulseless - desynchronized shock; if stable - lido or amio
136
Q136. Arrhythmia Rx:; PEA
A136. identify & Rx underlying; +/- epi +/or atropine
137
Q137. Arrhythmia Rx:; Afib/flutter
A137. if unstable shock at 100J; If stable, control rate (CCB, dig, BB); +/- rhythm conversion; anticoagulate
138
Q138. Arrhythmia Rx:; SVT
A138. Control rate; valsalva, carotid sinus massage, cold stimulation; adenosine (procainamide)
139
Q139. Arrhythmia Rx:; bradycardia
A139. if symptomatic consider atropine; if Mobitz II/AVB pace; Acutely, unstable - atropine/dopamine/dobutamine or transvenous pacing
140
Q140. hypovolemic shock
A140. ÆCO; ÆPCWP; ÆPVR
141
Q141. cardiogenic shock
A141. Causes:; tension PTX; cardiac tamponade; arrhythmia; structural hrt dz; MI; ÆCO; ÆPCWP; ÆPVR
142
Q142. Septic shock
A142. ÆCO; ÆPCWP; ÆPVR
143
Q143. anaphylactic shock
A143. ÆCO; ÆPCWP; ÆPVR
144
Q144. Rx for malignant HTN
A144. nitroprusside
145
Q145. test to rule out urethral injury
A145. retrograde cystourethrogram
146
Q146. Radiographic indications for Sx in pts with acute abd
A146. free air under diaphragm; extravasation of contrast; severe bowel distension; SOL; mesenteric occlusion (angiography)
147
Q147. Cannon a waves
A147. complete AVB
148
Q148. signs of neurogenic shock
A148. hypotension; bradycardia
149
Q149. Cushing's triad
A149. Signs of ÆICP; HTN; bradycardia; abnormal respirations
150
Q150. Signs of air embolism
A150. pt with chest truma previously stable suddenly dies
151
Q151. Organims/Rx of strep pharyngitis
A151. Org: GAS, S. pneumo Rx:; Pen V; Amoxicillin; erythromycin
152
Q152. Organisms causing sinusitis
A152. S. pneumo; H. flu; M. catarrhalis; GAS; anaerobes; S. aureus
153
Q153. Rx for sinusitis
A153. 1st line À Amoxicillin (TMP-SMX if pen allergic); 2nd line - Amox/clav; 3rd line clarithromycin
154
Q154. Acute OM pathogens
A154. Viral; S. pneumo; H. flu; M. catarrhalis
155
Q155. The nasopharyngeal airway can be used in which types of patients?
A155. breathing semiconscious patients and when an oropharyngeal airway is technically challenging
156
Q156. Prolonged use of a bag valve can lead to..?
A156. Distention of the stomach increasing the chance of an aspiration event
157
Q157. What are the steps of successful intubation?
A157. 5P's Preparation, preoxygenation, pretreatment, paralysis, and placement
158
Q158. How do you prepare for successful intubation?
A158. IV access, monitors, suction, appropriate sized ET tube, and meds for rapid sequence intubation
159
Q159. What pretreatment may be necessary in small children prior to intubation and why?
A159. Atropine, to blunt the bradycardia induced by succinocholine
160
Q160. What pretreatment prior to intubation may be used in adults with reactive airway disease? What about in adults where there is a concern about increased ICP?
A160. Reactive airway disease - lidocaine 1.5mg/kg; Pancuronium 0.01mg/kg
161
Q161. What sedative agent is used prior to paralysis for intubation?
A161. Etomidate 0.3mg/kg
162
Q162. volar =?
A162. palmar
163
Q163. Physical Exam of emergency ortho...?
A163. ROM; Palpation for subtle deformities well beyond the area of subjective pain; Neurovascular assessment
164
Q164. Ulnar nerve palsy causes..?
A164. Claw hand
165
Q165. Inability to extend the knee could be caused by paralysis of which nerve?
A165. Femoral nerve
166
Q166. Early treatment of ortho emergencies?
A166. NSAIDs; RICE (rest ice compression elevation); NPO; Reduction of long bone deformities
167
Q167. Don't forget to give _____ for open fractures?
A167. Tetanus
168
Q168. In children with trauma to a joint, what is important to consider on imaging?
A168. Comparison to the opposite extremity - difficult to tell the difference between a fracture and an epiphyseal growth plate
169
Q169. Compartment syndrome defined?
A169. When the pressure in a compartment exceeds the arterial perfusion pressure
170
Q170. Most reliable sign of compartment syndrome?
A170. Paresthesia
171
Q171. ARDS, neuro involvement, and thrombocytopenia post- closed fractures in leg..?
A171. Fat embolism
172
Q172. If you land directly on your shoulder, and hit hurts to reach across your body, what is the injury?
A172. Acromioclavicular joint separation
173
Q173. when does Acromioclavicular joint separation require surgery?
A173. type iv or higher (when the clavicle is displaced into surrounding areas)
174
Q174. 96% of shoulder dislocations are...?
A174. Anterior shoulder dislocations
175
Q175. how does the patient with an Anterior shoulder dislocation appear?
A175. holding arm in slight abduction and external rotation
176
Q176. What is the most common fracture in Aneterior shoulder dislocations? what nerve should be tested?
A176. Hill-Sachs deformity - fracture of the posterolateral aspect of the humeral head; Test the axillary nerve
177
Q177. Posterior dislocations are caused by...? always associated with...?
A177. fall on outstretched hand, convulsive seizure. Associated with Hill Sachs deformity
178
Q178. Most common mechanism of acute rotator cuff tear? This injury impairs which movement?
A178. Forced abduction. Impairs arm abduction to 30 degrees
179
Q179. What important structures travel with the humerus?
A179. The deep brachial artery and the radial nerve
180
Q180. Who gets supracondylar fractures? how?
A180. Kids < 15. Falling backwards on an outstretched hand
181
Q181. Posterior fat pad sign indicates?
A181. In adults - radial head fracture; In kids - supracondylar fracture
182
Q182. What is fracture of the proximal 1/3 of the ulna with radial head dislocation called?
A182. Monteggia fracture
183
Q183. What is fracture of the distal 1/3 of radius with dislocation of the distal radioulnar joint called?
A183. Galeazzi
184
Q184. Causes of carpal tunnel?
A184. RA, hypothyroid, DM, collagen vascular diseases
185
Q185. Phalen's test?
A185. Fully flex the wrists for 60 seconds
186
Q186. Tinel's sign?
A186. Light tapping over the median nerve produces pain or paresthesias
187
Q187. Most common carpal injury..?; High risk of..?
A187. Fracture of the scaphoid. AVN
188
Q188. Smith's fracture?
A188. Like colles, but distal fragment is displaced in the volar direction
189
Q189. neurogenic shock?
A189. state of vasomotor instability resulting from impairment of the descending sympathetic pathways in the spinal cord, or just a loss of sympathetic tone
190
Q190. does spinal shock signify permanent spinal cord damage?
A190. often times no
191
Q191. anterior cord syndrome results in loss of which tracts?
A191. spinothalamic and corticospinal tract
192
Q192. Central cord syndrome can be caused by? Affects?
A192. Hyper-extension injuries. Nerves that cross over at that level
193
Q193. if a penetrating spinal injury is diagnosed, begin treatment with..?
A193. High dose methylprednisolone
194
Q194. if suspecting a c-spine fracture, what xrays should be ordered?
A194. lateral, AP, and odontoid view
195
Q195. C1 burst fracture is called? Caused by...?
A195. Jefferson fracture. Caused by axial loading - someone falls on their head, or something falls on their head
196
Q196. Odontoid fractures are caused by..?
A196. Flexion
197
Q197. Hangman's fracture?
A197. Fracture of both pedicles of C2 - hyperextension mechanism
198
Q198. Stable or unstable?; atlanto-occipital dislocation; burst fracture of C5 with intact ligaments... simple wedge fracture; odontoid fracture; flexion teardrop fracture; extension teardrop fracture
A198. atl - unstable; burst c5 - stable; simple wedge - stable; odontoid - unstable; flexion teardrop - unstable; extension teardrop - stable
199
Q199. flexion teardrop fracture is associated with...?
A199. tearing of the posterior complex
