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Emergency Medicine > Emergency Medicine1 > Flashcards

Emergency Medicine1 Flashcards

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1
Q

Q001. ACEIs; Toxicity

A

A001. Cough; rash; proteinuria; angioedema; taste changes; teratogenic effects

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2
Q

Q002. Amantadine; Toxicity

A

A002. Ataxia; livedo reticularis

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3
Q

Q003. Aminoglycosides; Toxicity

A

A003. Ototoxicity; nephrotoxicity - ATN

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4
Q

Q004. Amiodarone; Toxicity

A

A004. Pulmonary fibrosis; peripheral deposition => bluish discoloration,; arrhythmias,; hypo-/hyperthyroidism,; corneal deposition

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5
Q

Q005. Amphotericin; Toxicity

A

A005. Fever/chills; nephrotoxicity; bone marrow suppression; anemia

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6
Q

Q006. Antipsychotics; Toxicity

A

A006. Sedation; acute dystonic reaction; akathisia; parkinsonism; tardive dyskinesia; neuroleptic malignant syndrome

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7
Q

Q007. Azoles (e.g., fluconazole); Toxicity

A

A007. Inhibition of P-450 enzymes

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8
Q

Q008. AZT; Toxicity

A

A008. Thrombocytopenia; megaloblastic anemia

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9
Q

Q009. β-blockers; Toxicity

A

A009. Asthma exacerbation; masking of hypoglycemia; impotence

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10
Q

Q010. Benzodiazepines; Toxicity

A

A010. Sedation; dependence; respiratory depression

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11
Q

Q011. Bile acid resins; Toxicity

A

A011. GI upset; malabsorption of vitamins; and medications

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12
Q

Q012. Calcium channel blockers; Toxicity

A

A012. Peripheral edema; constipation; cardiac depression

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13
Q

Q013. Carbamazepine; Toxicity

A

A013. Induction of P-450 enzymes; agranulocytosis; aplastic anemia

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14
Q

Q014. Chloramphenicol; Toxicity

A

A014. Gray baby syndrome; aplastic anemia

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15
Q

Q015. Cisplatin; Toxicity

A

A015. Nephrotoxicity; acoustic nerve damage

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16
Q

Q016. Clonidine; Toxicity

A

A016. Dry mouth; severe rebound headache; hypertension

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17
Q

Q017. Clozapine

A

A017. Agranulocytosis

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18
Q

Q018. Corticosteroids; Toxicity

A

A018. Mania (acute) immunosuppression; bone mineral loss; thinning of skin; easy bruising; myopathy (chronic); cataracts

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19
Q

Q019. Cyclophosphamide; Toxicity

A

A019. Myelosuppression; hemorrhagic cystitis

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20
Q

Q020. Digoxin -; Toxicity

A

A020. GI disturbance; yellow-green visual changes; arrhythmias - junctional tachycardia or SVT,; varying amounts of AV node blocks

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21
Q

Q021. Doxorubicin -; Toxicity

A

A021. Cardiotoxicity; (dilated cardiomyopathy)

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22
Q

Q022. Ethyl alcohol -; Toxicity

A

A022. Renal dysfunction

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23
Q

Q023. Fluoroquinolones; Toxicity

A

A023. Cartilage damage in children Achilles tendon rupture

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24
Q

Q024. Furosemide; Toxicity

A

A024. Ototoxicity; hypokalemia; nephritis

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25
Q

Q025. Gemfibrozil; Toxicity

A

A025. Myositis; reversible Ƒ in LFTs

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26
Q

Q026. Halothane; Toxicity

A

A026. Hepatotoxicity; malignant hyperthermia

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27
Q

Q027. HCTZ; Toxicity

A

A027. Hypokalemia; hyperuricemia; hyperglycemia

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28
Q

Q028. HMG-CoA reductase inhibitors; Toxicity

A

A028. Myositis; reversible Ƒ in LFTs

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29
Q

Q029. Hydralazine; Toxicity

A

A029. Drug-induced SLE

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30
Q

Q030. Hydroxychloroquine; Toxicity

A

A030. Retinopathy

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31
Q

Q031. INH -; Toxicity

A

A031. Peripheral neuropathy - prevent with vitamin B6; hepatotoxicity; inhibition of P-450 enzymes; seizures with overdose

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32
Q

Q032. MAOIs -; Toxicity

A

A032. Hypertensive tyramine reaction; serotonin syndrome - with meperidine

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33
Q

Q033. Methanol; Toxicity

A

A033. Blindness

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34
Q

Q034. Methotrexate; Toxicity

A

A034. Hepatic fibrosis; pneumonitis; anemia

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35
Q

Q035. Methyldopa; Toxicity

A

A035. Pos. CoombsÀ™ test; drug-induced SLE

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36
Q

Q036. Metronidazole; Toxicity

A

A036. Disulfiram reaction; vestibular dysfunction; metallic taste

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37
Q

Q037. Niacin; Toxicity

A

A037. Cutaneous flushing

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38
Q

Q038. Nitroglycerin; Toxicity

A

A038. Hypotension; tachycardia; headache; tolerance

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39
Q

Q039. Penicillin/β-lactams ; Toxicity

A

A039. Hypersensitivity reactions

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40
Q

Q040. Penicillamine; Toxicity

A

A040. Drug-induced SLE

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41
Q

Q041. Phenytoin; Toxicity

A

A041. Nystagmus; diplopia; ataxia; gingival hyperplasia; hirsutism

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42
Q

Q042. Prazosin -; Toxicity

A

A042. First-dose hypotension

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43
Q

Q043. Procainamide; Toxicity

A

A043. Drug-induced SLE

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44
Q

Q044. Propylthiouracil; Toxicity

A

A044. Agranulocytosis

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45
Q

Q045. Quinidine; Toxicity

A

A045. Cinchonism -; (headache, tinnitus); thrombocytopenia; arrhythmias - torsades de pointes

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46
Q

Q046. Reserpine; Toxicity

A

A046. Depression

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47
Q

Q047. Rifampin; Toxicity

A

A047. Induction of P-450 enzymes; orange-red body secretions

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48
Q

Q048. Salicylates; Toxicity

A

A048. Fever; hyperventilation with; respiratory alkalosis; and metabolic acidosis; dehydration; diaphoresis; hemorrhagic gastritis

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49
Q

Q049. SSRIs; Toxicity

A

A049. Anxiety; sexual dysfunction

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50
Q

Q050. Succinylcholine; Toxicity

A

A050. Malignant hyperthermia

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51
Q

Q051. Tetracyclines; Toxicity

A

A051. Tooth discoloration; photosensitivity; Fanconi˪s syndrome

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52
Q

Q052. TCAs; Toxicity

A

A052. Sedation; coma; anticholinergic effects; seizures; wide QRS; in severe cases - prolonged QT => torsade

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53
Q

Q053. Valproic acid; Toxicity

A

A053. Teratogenicity => neural tube defects

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54
Q

Q054. Vancomycin; Toxicity

A

A054. Nephrotoxicity; ototoxicity; Àœred man syndromeÀ - histamine release, not an allergy

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55
Q

Q055. Vinblastine; Toxicity

A

A055. Severe myelosuppression

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56
Q

Q056. Vincristine; Toxicity

A

A056. Peripheral neuropathy

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57
Q

Q057. Acetaminophen; What is the Antidote

A

A057. N-acetylcysteine

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58
Q

Q058. Acid/alkali ingestion; What is the Antidote

A

A058. Upper endoscopy to evaluate for stricture

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59
Q

Q059. Anticholinesterases,; organophosphates; What is the Antidote

A

A059. Atropine; pralidoxime

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60
Q

Q060. Antimuscarinic/; anticholinergic agents; What is the Antidote

A

A060. Physostigmine

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61
Q

Q061. Arsenic, mercury, gold; What is the Antidote

A

A061. Succimer; dimercaprol

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62
Q

Q062. β-blockers; What is the Antidote

A

A062. Glucagon

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63
Q

Q063. Barbiturates (phenobarbital); What is the Antidote

A

A063. Urine alkalinization (bicarb); dialysis; activated charcoal

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64
Q

Q064. Benzodiazepines; What is the Antidote

A

A064. Flumazenil

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65
Q

Q065. Black widow bite -; What is the Antidote

A

A065. Calcium gluconate

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66
Q

Q066. Carbon monoxide -; What is the Antidote

A

A066. 100% O2; hyperbaric O2

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67
Q

Q067. Copper, arsenic, lead, gold -; What is the Antidote

A

A067. Penicillamine

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68
Q

Q068. Cyanide -; What is the Antidote

A

A068. Nitrite; sodium thiosulfate

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69
Q

Q069. Digitalis -; What is the Antidote

A

A069. Stop digitalis,; normalize K+,; lidocaine (for torsades), anti-digitalis Fab

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70
Q

Q070. Heparin -; What is the Antidote

A

A070. Protamine sulfate

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71
Q

Q071. Iron salts -; What is the Antidote

A

A071. Deferoxamine

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72
Q

Q072. Lead -; What is the Antidote

A

A072. Succimer; CaEDTA; dimercaprol

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73
Q

Q073. Methanol, ethylene glycol (antifreeze); What is the Antidote

A

A073. EtOH; fomepizole; dialysis

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74
Q

Q074. Methemoglobin; What is the Antidote

A

A074. Methylene blue

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75
Q

Q075. Opioids; What is the Antidote

A

A075. Naloxone

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76
Q

Q076. Phencyclidine hydrochloride (PCP); What is the Antidote

A

A076. NG suction

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77
Q

Q077. Salicylates -; What is the Antidote

A

A077. Urine alkalinization; dialysis; activated charcoal

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78
Q

Q078. TCAs; What is the Antidote

A

A078. Na bicarb - QRS prolongation; diazepam or lorazepam for Seizures; cardiac monitor for; arrhythmias

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79
Q

Q079. Theophylline; What is the Antidote

A

A079. Activated charcoal

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80
Q

Q080. tPA, streptokinase; What is the Antidote

A

A080. Aminocaproic acid

81
Q

Q081. Warfarin; What is the Antidote

A

A081. Vitamin K, FFP

82
Q

Q082. Cardiac Life Support; What are the Basic Principles

A

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
Q

Q083. Burns; Hx/PE

A

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
Q

Q084. Burns; Dx; Rule of 9’s

A

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
Q

Q085. Burns; Categories

A

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
Q

Q086. Burns; Tx

A

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
Q

Q087. Burns; Complications

A

A087. Shock; superinfection - esp. Pseudomonas

88
Q

Q088. CO Poisoning; What is it

A

A088. Hypoxemic poisoning syn causes; car exhaust; smoke inhalation; barbeque in poor ventilation; old appliances

89
Q

Q089. CO Poisoning; HX/PE

A

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
Q

Q090. CO Poisoning; Dx

A

A090. ABG; normal serum carboxyHb level - < 5% in nonsmokers, < 10% in smokers; laryngoscopy; bronchoscopy; EKG - elderly; history of cardiac dis.

91
Q

Q091. CO Poisoning; Tx

A

A091. 100 O2 hyperbaric O2:; pregnant; neuro Sxs; severely Ƒ carboxyHb; smoke inhalation - may need early intubation (before edema sets in)

92
Q

Q092. Aortic Disruption; What is it

A

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
Q

Q093. Aortic Disruption; Dx

A

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
Q

Q094. Aortic Disruption; Tx

A

A094. OR emergently

95
Q

Q095. Aortic Dissection; What is it; Risk Factors

A

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
Q

Q096. Aortic Dissection; Hx/PE

A

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
Q

Q097. Aortic Dissection; Dx

A

A097. CXR; CT with IV contrast; transesoph echo or; MRI/MRA or; angiography - gold standard; EKG

98
Q

Q098. Aortic Dissection; Tx

A

A098. Stabilize HBP or low HBP; IV nitrates; B blockers; goal - systolic < 120, HR < 70; type A - emergent surgery; type B - med management

99
Q

Q099. Aortic Dissection; Complications

A

A099. MI; CHF; cardiac tamponade; postop hemorrhage; future dissection; future aneurysm; death

100
Q

Q100. Postop Fever; What is it Caused By; (What are the 6 W’s)

A

A100. Wind - atelectasis, pneumonia; Water - UTI; Wound - abscess; Walk- DVT; Wonderdrug - drug reaction; Wire - catheter

101
Q

Q101. Postop Fever; How to Decrease Risk

A

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
Q

Q102. Acute Abdomen; What is it

A

A102. Abdom Sxs so severe; surgery should be considered; primary Sx - acute abdom pain

103
Q

Q103. Acute Abdomen; Hx/PE

A

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
Q

Q104. Acute Abdomen; Character of Pain

A

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
Q

Q105. Acute Abdomen; Dx

A

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
Q

Q106. Acute Abdomen; Tx

A

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
Q

Q107. Appendicitis; What is it

A

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
Q

Q108. Appendicitis; Hx/PE

A

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
Q

Q109. Appendicitis; Dx

A

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
Q

Q110. Appendicitis; Tx

A

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
Q

Q111. Appendicitis; Complications

A

A111. Risk of perforation & mortality increased with amt of time have appendicitis; (at 48 hrs - 75% risk)

112
Q

Q112. Acute Management of Trauma Patient; “ABCDE”; What is “A”

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
Q

Q113. Acute Management of Trauma Patient; “ABCDE”; What is “B”

A

A113. Breathing 5 thoracic causes of immed. death must not be missed:; tension pneumothorax; cardiac tamponade; open pneumothorax; massive hemothorax; airway obstruction

114
Q

Q114. Acute Management of Trauma Patient; “ABCDE”; What is “C”

A

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
Q

Q115. Acute Management of Trauma Patient; “ABCDE”; What is “D”

A

A115. Disability; evaluate CNS dysfunction via Glasgow Coma Scale

116
Q

Q116. Acute Management of Trauma Patient; “ABCDE”; What is “E”

A

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
Q

Q117. Pelvic Fractures; What are they

A

A117. MC after trauma such as a MVA; needs immediate attention by orthopedist; potentially life-threatening

118
Q

Q118. Pelvic Fractures; Hx/PE

A

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
Q

Q119. Pelvic Fractures; Tx

A

A119. Embolize bleeding vessels; emergent external pelvic fixation; internal fixation if hemodynamically stable

120
Q

Q120. acute dystonia

A

A120. involuntary muscle cont/spasm - torticollis, oculogyric crisis; Rx: anticholinergic (benztropine) or diphenhydramine; Prevent: prophylatic benztropine

121
Q

Q121. akathisia

A

A121. subjective/objective restlessness; Rx: reduce neuroleptic, βblocker (propranolol), +/- benzos, anticholinergics

122
Q

Q122. dyskinesia

A

A122. pseudoparkinsonism Rx:; anticholinergic (benztropine); or DA agonist (amantidine); reduce/stop neuroleptic or d/c

123
Q

Q123. tardive dyskinesia

A

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 Ɠneuroleptic may initially WORSEN TD

124
Q

Q124. Neuroleptic Malignant syndrome

A

A124. fever; muscle rigidity; autonomic instability; clouded consciousness; ƑCPK, WBCs Rx:; stop neuroleptic; dantrolene/bromocriptine; IV fluids

125
Q

Q125. Evolution of EPS

A

A125. 4 hours: acute dystonia; 4 days: akathisia; 4 weeks: akathisia; 4 months: tardive dyskinesia

126
Q

Q126. EtOH withdrawal syndrome

A

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,ƑBP; Withdrawl seizures - 6-48hrs; DTs - 2-7d, severe autonomic instability/hyperactivity (ƑHR, BP), delerium, confusion, agitation, hallucinations, fever, positional nystagmus, death - mortality 15-20%

127
Q

Q127. EtOH withdrawal Rx including DTs

A

A127. benzos* (DOC); haloperidol for hallucinations; clonidine, BBs for hyperadrenergic state; thiamine, folate, vitamens; replace lytes; IV fluids

128
Q

Q128. Barbituate withdrawal

A

A128. anxiety; seizures; delerium; tremor; cardiac & respiratory depression; Rx: benzos

129
Q

Q129. Benzodiazepine withdrawal

A

A129. rebound anxiety; seizures; tremor; instability; Rx: benzos

130
Q

Q130. Cocaine/amphetamine withdrawal

A

A130. depression; hyperphagia; hypersomnolence; Rx: supportive, avoid BBs (results in excess uninhibited cardiac activation)

131
Q

Q131. Opioid withdrawal

A

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
Q

Q132. Aortic disruption CXR

A

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
Q

Q133. Arrhythmia Rx:; asystole

A

A133. epi; atropine

134
Q

Q134. Arrhythmia Rx:; Vfib

A

A134. desynchronized shock –> epi or vasopressin –> shock –> lido or amio –> shock –> procainamide or Mg

135
Q

Q135. Arrhythmia Rx:; VTach

A

A135. if unstable/pulseless - desynchronized shock; if stable - lido or amio

136
Q

Q136. Arrhythmia Rx:; PEA

A

A136. identify & Rx underlying; +/- epi +/or atropine

137
Q

Q137. Arrhythmia Rx:; Afib/flutter

A

A137. if unstable shock at 100J; If stable, control rate (CCB, dig, BB); +/- rhythm conversion; anticoagulate

138
Q

Q138. Arrhythmia Rx:; SVT

A

A138. Control rate; valsalva, carotid sinus massage, cold stimulation; adenosine (procainamide)

139
Q

Q139. Arrhythmia Rx:; bradycardia

A

A139. if symptomatic consider atropine; if Mobitz II/AVB pace; Acutely, unstable - atropine/dopamine/dobutamine or transvenous pacing

140
Q

Q140. hypovolemic shock

A

A140. ƓCO; ƓPCWP; ƑPVR

141
Q

Q141. cardiogenic shock

A

A141. Causes:; tension PTX; cardiac tamponade; arrhythmia; structural hrt dz; MI; ƓCO; ƑPCWP; ƑPVR

142
Q

Q142. Septic shock

A

A142. ƑCO; ƓPCWP; ƓPVR

143
Q

Q143. anaphylactic shock

A

A143. ƑCO; ƓPCWP; ƓPVR

144
Q

Q144. Rx for malignant HTN

A

A144. nitroprusside

145
Q

Q145. test to rule out urethral injury

A

A145. retrograde cystourethrogram

146
Q

Q146. Radiographic indications for Sx in pts with acute abd

A

A146. free air under diaphragm; extravasation of contrast; severe bowel distension; SOL; mesenteric occlusion (angiography)

147
Q

Q147. Cannon a waves

A

A147. complete AVB

148
Q

Q148. signs of neurogenic shock

A

A148. hypotension; bradycardia

149
Q

Q149. Cushing’s triad

A

A149. Signs of ƑICP; HTN; bradycardia; abnormal respirations

150
Q

Q150. Signs of air embolism

A

A150. pt with chest truma previously stable suddenly dies

151
Q

Q151. Organims/Rx of strep pharyngitis

A

A151. Org: GAS, S. pneumo Rx:; Pen V; Amoxicillin; erythromycin

152
Q

Q152. Organisms causing sinusitis

A

A152. S. pneumo; H. flu; M. catarrhalis; GAS; anaerobes; S. aureus

153
Q

Q153. Rx for sinusitis

A

A153. 1st line À“ Amoxicillin (TMP-SMX if pen allergic); 2nd line - Amox/clav; 3rd line clarithromycin

154
Q

Q154. Acute OM pathogens

A

A154. Viral; S. pneumo; H. flu; M. catarrhalis

155
Q

Q155. The nasopharyngeal airway can be used in which types of patients?

A

A155. breathing semiconscious patients and when an oropharyngeal airway is technically challenging

156
Q

Q156. Prolonged use of a bag valve can lead to..?

A

A156. Distention of the stomach increasing the chance of an aspiration event

157
Q

Q157. What are the steps of successful intubation?

A

A157. 5P’s Preparation, preoxygenation, pretreatment, paralysis, and placement

158
Q

Q158. How do you prepare for successful intubation?

A

A158. IV access, monitors, suction, appropriate sized ET tube, and meds for rapid sequence intubation

159
Q

Q159. What pretreatment may be necessary in small children prior to intubation and why?

A

A159. Atropine, to blunt the bradycardia induced by succinocholine

160
Q

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?

A

A160. Reactive airway disease - lidocaine 1.5mg/kg; Pancuronium 0.01mg/kg

161
Q

Q161. What sedative agent is used prior to paralysis for intubation?

A

A161. Etomidate 0.3mg/kg

162
Q

Q162. volar =?

A

A162. palmar

163
Q

Q163. Physical Exam of emergency ortho…?

A

A163. ROM; Palpation for subtle deformities well beyond the area of subjective pain; Neurovascular assessment

164
Q

Q164. Ulnar nerve palsy causes..?

A

A164. Claw hand

165
Q

Q165. Inability to extend the knee could be caused by paralysis of which nerve?

A

A165. Femoral nerve

166
Q

Q166. Early treatment of ortho emergencies?

A

A166. NSAIDs; RICE (rest ice compression elevation); NPO; Reduction of long bone deformities

167
Q

Q167. Don’t forget to give _____ for open fractures?

A

A167. Tetanus

168
Q

Q168. In children with trauma to a joint, what is important to consider on imaging?

A

A168. Comparison to the opposite extremity - difficult to tell the difference between a fracture and an epiphyseal growth plate

169
Q

Q169. Compartment syndrome defined?

A

A169. When the pressure in a compartment exceeds the arterial perfusion pressure

170
Q

Q170. Most reliable sign of compartment syndrome?

A

A170. Paresthesia

171
Q

Q171. ARDS, neuro involvement, and thrombocytopenia post- closed fractures in leg..?

A

A171. Fat embolism

172
Q

Q172. If you land directly on your shoulder, and hit hurts to reach across your body, what is the injury?

A

A172. Acromioclavicular joint separation

173
Q

Q173. when does Acromioclavicular joint separation require surgery?

A

A173. type iv or higher (when the clavicle is displaced into surrounding areas)

174
Q

Q174. 96% of shoulder dislocations are…?

A

A174. Anterior shoulder dislocations

175
Q

Q175. how does the patient with an Anterior shoulder dislocation appear?

A

A175. holding arm in slight abduction and external rotation

176
Q

Q176. What is the most common fracture in Aneterior shoulder dislocations? what nerve should be tested?

A

A176. Hill-Sachs deformity - fracture of the posterolateral aspect of the humeral head; Test the axillary nerve

177
Q

Q177. Posterior dislocations are caused by…? always associated with…?

A

A177. fall on outstretched hand, convulsive seizure. Associated with Hill Sachs deformity

178
Q

Q178. Most common mechanism of acute rotator cuff tear? This injury impairs which movement?

A

A178. Forced abduction. Impairs arm abduction to 30 degrees

179
Q

Q179. What important structures travel with the humerus?

A

A179. The deep brachial artery and the radial nerve

180
Q

Q180. Who gets supracondylar fractures? how?

A

A180. Kids < 15. Falling backwards on an outstretched hand

181
Q

Q181. Posterior fat pad sign indicates?

A

A181. In adults - radial head fracture; In kids - supracondylar fracture

182
Q

Q182. What is fracture of the proximal 1/3 of the ulna with radial head dislocation called?

A

A182. Monteggia fracture

183
Q

Q183. What is fracture of the distal 1/3 of radius with dislocation of the distal radioulnar joint called?

A

A183. Galeazzi

184
Q

Q184. Causes of carpal tunnel?

A

A184. RA, hypothyroid, DM, collagen vascular diseases

185
Q

Q185. Phalen’s test?

A

A185. Fully flex the wrists for 60 seconds

186
Q

Q186. Tinel’s sign?

A

A186. Light tapping over the median nerve produces pain or paresthesias

187
Q

Q187. Most common carpal injury..?; High risk of..?

A

A187. Fracture of the scaphoid. AVN

188
Q

Q188. Smith’s fracture?

A

A188. Like colles, but distal fragment is displaced in the volar direction

189
Q

Q189. neurogenic shock?

A

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
Q

Q190. does spinal shock signify permanent spinal cord damage?

A

A190. often times no

191
Q

Q191. anterior cord syndrome results in loss of which tracts?

A

A191. spinothalamic and corticospinal tract

192
Q

Q192. Central cord syndrome can be caused by? Affects?

A

A192. Hyper-extension injuries. Nerves that cross over at that level

193
Q

Q193. if a penetrating spinal injury is diagnosed, begin treatment with..?

A

A193. High dose methylprednisolone

194
Q

Q194. if suspecting a c-spine fracture, what xrays should be ordered?

A

A194. lateral, AP, and odontoid view

195
Q

Q195. C1 burst fracture is called? Caused by…?

A

A195. Jefferson fracture. Caused by axial loading - someone falls on their head, or something falls on their head

196
Q

Q196. Odontoid fractures are caused by..?

A

A196. Flexion

197
Q

Q197. Hangman’s fracture?

A

A197. Fracture of both pedicles of C2 - hyperextension mechanism

198
Q

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

A

A198. atl - unstable; burst c5 - stable; simple wedge - stable; odontoid - unstable; flexion teardrop - unstable; extension teardrop - stable

199
Q

Q199. flexion teardrop fracture is associated with…?

A

A199. tearing of the posterior complex

Emergency Medicine (3 decks)

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