ER

Question 1

primary survey

Answer 1

A airway
B breathing
C circulation with hemorrhage control
D disability (neurologic deficit)
E exposure (maintain warm environment, expose patient)

Question 2

secondary survey

Answer 2

head to toe assessment to prioritize care

Question 3

most common ped surgical emergency

Answer 3

appendicitis

Question 4

most common cause of shock in children

Answer 4

hypovolemia (NOT cardiac)

Question 5

kids who show up in cardiopulmonary arrest usually have what

Answer 5

primary respiratory arrest

Question 6

Pulmonary system is unable to maintain adequate gas exchange to meet metabolic demands

Answer 6

respiratory failure

Question 7

reversible small airway obstruction that is refractory to sympathomimetic and inti-inflammatory agents and that may progress to respiratory failure without prompt and aggressive intervention

Answer 7

status asthmaticus

Question 8

ARDS four features of dx

Answer 8

Underlying disease that predisposes to ARDS
Bilateral infiltrates on CXR
Absence of evidence of heart failure ( esp LVF)
Severe hypoxemic respiratory failure

Question 9

most common precipitant ARDS

Answer 9

infection

Question 10

increased anion gap

Answer 10

metabolic acidosis-accumulation of acid

• lactic acidosis
• ketoacidosis
• exogenous acids

Question 11

normal anion gap

Answer 11

metabolic acidosis- loss of base
renal bicarb loss
loss of bicarb from gut
decreased renal hydrogen ion secretion

Question 12

metabolic alkalosis

Answer 12

Hydrogen ion loss: vomiting, renal loss, diuretics, hypokalemia, low Cl states
Bicarb gain: sodium bicarb administration, citrate administration

Question 13

respiratory acidosis

Answer 13

Airway obstruction, pneumonia, ARDS, PE
Respiratory muscle weakness
Trauma
Respiratory depression

Question 14

respiratory alkalosis

Answer 14

High levels of anxiety or pain
Altitude
Excessive mechanical ventilation
Respiratory stimulants/salicylate overdose
Pulmonary embolism, asthma, edema

Question 15

1 week old in ER with shock

Answer 15

sepsis
cardiac
IEM

Question 16

Failure of cardiovascular system to deliver oxygenated blood and substrates to tissues, and to remove toxic metabolites. –> anaerobic metabolism in cells –> cell damage

Answer 16

shock

Question 17

hypovolemic shock

Answer 17

dehydration, burn, hemorrhage

Question 18

distributive shock

Answer 18

septic, anaphylaxis, spinal

Question 19

cardiogenic shock

Answer 19

myocarditis, dysrhythmia

Question 20

obstructive shock

Answer 20

tamponade, pneumothorax

Question 21

compensated shock

Answer 21

organ perfusion maintained

Question 22

uncompensated shock

Answer 22

circ failure with end organ dysfunction

Question 23

irreversible shock

Answer 23

irreparable loss of essential organs

Question 24

Weakness, fatigue, headache, pallor, disorientation,thirst, N/V, occ muscle cramps

Answer 24

heat exhaustion

Question 25

life threatening failure of thermoregulation. Rectal temp over 40.6. Sxs of CNS dysfunction

Answer 25

heat stroke

Question 26

heat stroke effects

Answer 26

Cellular hypoxia, enzyme dysfunction, disrupted cell membranes -> global end organ derangements
rhabdomylosis, ATN, renal failure, ARDS, DIC

Question 27

most common cause of burns in children

Answer 27

scalding

Question 28

dry, red, hypersensitive (sunburn)

Heal 5-7 days, no scarring

Answer 28

superficial, first degree

Question 29

deep- white and dry, skin blanches, decreased pain, can blister

Answer 29

partial thickness, superficial or deep 2nd degree burn

Question 30

all epidermal and dermal elements

Answer 30

full thickness

Question 31

most common poisoning

Answer 31

tylenol

Question 32

antidote tylenol poisoning

Answer 32

acetylcysteine

Question 33

should you suture a wound

Answer 33

no

Question 34

bugs for human bites

Answer 34

Strep, staph, anaerobes, and Eikenella Corrodens

Question 35

bugs for dog and cat bites

Answer 35

Pasteurella multocida, strep , staph and anaerobes