Emergency Medicine_Selected Topics_RR Flashcards
Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms
Antipsychotic (neuroleptic malignant syndrome)
Side effects of corticosteroids
Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies
Treatment for delirium tremens
Benzodiazepines
Treatment for acetaminophen overdose
N-acetylcysteine
Treatment for opioid overdose
Naloxone
Treatment for benzodiazepine overdose
Flumazenil
Treatment for neuroleptic malignant syndrome and malignant hyperthermia
Dantrolene
Treatment for malignant hypertension
Nitroprusside
Treatment for atrial fibrillation
Rate control, rhythm conversion, and anticoagulation
Treatment of supraventricular tachycardia
If stable: rate control with carotid massage or other vagal stimulation;
If unsuccessful, consider amiodarone
Causes of drug-induced SLE.
Isoniazid, pencillamine, hydralazine, procainamide, chlorpromazine, methyldopa, quinidine
Macrocytic, megaloblastic anemia with neurologic symptoms
B12 deficiency
Macrocytic, megaloblastic anemia without neurologic symptoms
Folate deficiency
A burn patient presents with cherry-red, flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?
Treat CO poisoning with 100% O2 or with hyperbaric O2 if poisoning is severe or the patient is pregnant.
Blood in the urethral meatus or high-riding prostate.
Bladder rupture or urethral injury
Test to rule out urethral injury
Retrograde cystourethrogram
Radiographic evidence of aortic disruption or dissection
Widened mediastinum (>8cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus
Radiographic indications for surgery in patients with acute abdomen
Free air under the diaphragm, extravasation of contrast, severe bowel distention, space-occupying lesion (CT), mesenteric occlusion (angiography)
The most common organism in burn-related infections
Pseudomonas
Method of calculating fluid repletion in burn patients
Parkland formula:
24-hour fluids = 4 x kg x % body surface area
Acceptable urine output in a trauma patient
50 cc/hr
Acceptable urine output in a stable patient
30 cc/hr
Signs of neurogenic shock
Hypotension and bradycardia
Signs of increased intracranial pressure (Cushing’s triad)
Hypertension, bradycardia, and abnormal respirations
Decreased CO and PCWP
Increased peripheral vascular resistance (PVR)
Hypovolemic shock
Decreased CO
Increased PCWP and PVR
Cardiogenic (or obstructive) shock
Increased CO
Decreased PCWP and PVR
Septic or anaphylactic shock
Treatment of septic shock
Fluids and antibiotics
Treatment of cardiogenic shock
Identify cause; pressors (eg, dopamine)
Treatment of hypovolemic shock
Identify cause; fluid and blood repletion
Treatment of anaphylactic shock
Diphenhydramine or epinephrine 1:1000
Supportive treatment for ARDS.
Continuous positive airway pressure (CPAP)
Signs of air embolism
A patient with chest trauma who was previously stable suddenly dies
Signs of cardiac tamponade
Distended neck veins, hypotension, diminished heart sounds (Beck’s triad); pulsus paradoxus
Absent breath sounds, dullness to percussion, shock, flat neck veins
Massive hemothorax
Absent breath sounds, tracheal deviation, distended neck veins
Tension pneumothorax
Treatment for blunt or penetrating abdominal trauma in hemodynamically unstable patients
Immediate exploratory laparotomy
Increased intracranial pressure in alcoholics or the elderly following head trauma. Can be acute or chronic; crescent shape on CT
Subdural hematoma
Head trauma with immediate loss of consciousness followed by a lucid interval and then rapid deterioration. Convex shape on CT
Epidural hematoma
