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ClinMed3 > ER-Final > Flashcards

ER-Final Flashcards

1
Q

body’s WBC enzymes lyse necrotic tissue

A

autolytic

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2
Q

topical exogenous, enzymatics, most selective but least damaging debridement for eschar ulcer?

A

chemical

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3
Q

most absorbent wound care?

A

foam

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4
Q

Tx for granulative ulcer that is clean with little exudate?

A

hydrocolloid

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5
Q

HCP exposed to ‘dirty’ bomb; at risk for?

A

alpha radiation

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6
Q

? is non-selective and substandard care in chronic wounds; aka?

A

wet to dry, mechanical

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7
Q

exudate- maintain ? (not wet, not dry)

A

moist

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8
Q

stable eschar - dont ?

eschar on heels - deride once eschar ?

A

debride

separates

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9
Q

infection: ? is most accurate but ? is MC

A

Bx, swab

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10
Q

? may injure periwound skin

A

Dakin’s solution

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11
Q

this antimicrobial reacts w/ cells DNA, prohibits repro

A

silver

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12
Q

all pts w/ maxillfacial trauma presumed to have ? until excluded

A

unstable cervical spine injury

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13
Q

GCS- moderate injury?

A

9-13

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14
Q

HM of brain insult of any cause

A

consciousness

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15
Q

severe head injury.. after ABCs?

A

ICE: IV access, cardiac monitor, elevate bed to 30 degrees

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16
Q

? occurs in 1/3 of head trauma pts

A

DIC

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17
Q

cerebral contusion has ? but concussion does NOT

A

structural injury

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18
Q

? and ? are linked to the severity of post concussive sequellae; ? is not

A

amnesia, seizures, postconcussive syndrome isn’t

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19
Q

MC cerebral herniation?

  • ? pupillary changes
  • ? motor weakness
A

uncal
ipsilateral
contralateral

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20
Q

subdural hematoma
MC in ? and ?
on CT scan?

A

elderly, alcoholics

crescent-shaped, high attenuation lesion

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21
Q

hyperdense, homogenous areas seen in ?

A

ICH- intracerebral hemorrhage

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22
Q

skull fx- clinically important? not important?

A

depressed, linear

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23
Q

MCC of penetrating head injury in US?

A

GSW

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24
Q

no rxn to bulbocavernous reflex =

A

s.c. injury

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25
Q

dec height with concavity of anterior vertebral body, STABLE injury (posterior intact)

A

simple wedge fx

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26
Q

wedge shaped fragment of anteroinferior vertebral body, causes quadriplegia and loss of ant column senses only

A

FLEXION teardrop fx

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27
Q

oblique fractures of base of spinous processes of lower cervical vertebra, stable injury, usually no neuro involvement

A

clay shoveler’s fx (flexion)

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28
Q

rupture of ligamentous complexes, possibly unstable if >50% override

A

subluxation

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29
Q

extremely unstable, high incidence of s.c. injury?

A

bilateral facet dislocation

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30
Q

only flexion rotation injury?

? views are helpful

A

unilateral facet dislocation

oblique

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31
Q

hyperextension, spondylosis of C2, unstable

A

hangman’s fx

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32
Q

may see ? syndrome in extension spinal injuries

A

central cord

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33
Q

extension injury- usually involves axis but can involve C5 and C7; stable in flexion/unstable in extension; DIVING ACCIDENTS

A

extension teardrop Fx

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34
Q

unstable injuries? 5

A

hangmans, extension teardrop, subluxation, bilateral facet dislocation, odontoid III

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35
Q

vertical compression fx

  • c spine and l spine, comminuted fx, stable
  • fx of C1 ring, axial loading injury, mechanically stable
A
  • burst fx

- jefferson/atlas C1 fx

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36
Q

complete spinal cord lesions: if sx are longer than 24h, 99% ?

A

do not have functional recovery

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37
Q

neurogenic shock triad?

A

hypotension, bradycardia, hypothermia

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38
Q

spinal shock has initial ? followed by ?

A

increase in BP, hypotension

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39
Q

anterior cord syndrome- anterior ? cord

  • complete ? paralysis
  • ? is preserved
A

2/3
motor
posterior column (spinothalamic)- propioception, vibration, crude touch

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40
Q

best for viewing maxilla? also zygomatic and other aspects of facial bones

A

water’s view

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41
Q

MC facial fx?

2nd MC?

A

nasal

zygomatic

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42
Q

don’t blow nose in? 2

A

zygomatic, orbital floor fx

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43
Q

hanging drop sign

A

orbital floor fx

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44
Q

most traumatized teeth are ?

A

maxillary teeth

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45
Q

w/ frontal sinus fx, MUST evaluate?

A

posterior wall

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46
Q

intra/postop MI assessment?

A

goldman cardiac risk assessment

47
Q

MC lab abn in pts

A

anemia

48
Q

young pt- transfuse when Hct is ?

A

18

49
Q 
OR= ?
field = ?
A

aseptic

sterile

50
Q

w/ surgical gown, most important is ?

A

impermeability to moisture (wet transmits bacteria ‘through’ gowns)

51
Q

gown:
surgery 2-4h?
>4h?

A

reinforced gown- double/triple layered

plastic and reinforced-impervious & hot

52
Q

? sterilization for instruments that might corrode (for moisture AND heat intolerant)

A

gas

53
Q

wound care for OA or laporoscopy?

A

gauze

54
Q

excellent at autolysis

A

transparent film

55
Q

can be used for heavy exudate w/ alginates, no endpoint for change

A

absorbent clear acrylic

56
Q

liquid impregnated gauze for minimal drainage, contain within wound edges

A

hydrogels

57
Q

fills dead space, for large amount of drainage?

A

alginates

58
Q

manage large amounts of exudate 20x their weight

A

absorbent wound fillers

59
Q

unique blend of cations, manages hard to heal wounds

A

tegaderm

60
Q

protect wound base from trauma during dressing changes

A

contact layers

61
Q

stimulate wound healing, from bovine/porcine/avian source; soak up wound fluid/highly absorptive

A

collagen dressings

62
Q

only available growth factor

A

Regranex

63
Q

signs of shock?

A

MACHO: metabolic acidosis, AMS, cool/clammy skin, hypotension, oliguria

64
Q
  • compensatory mech?

- when these fail… ?

A
  • inc CO, tachycardia, vasoconstriction

- change in VS and end organ dysfunction

65
Q

SIRS (need 2 of these)

  • body temp?
  • HR?
  • RR?
  • peripheral leuk count?
A

38C
>90
>20
>12,000 or >10%bands

66
Q

Txing shock:

-if little/no improvement w/ O2 delivery? 2

A

continue IV, give type O neg blood

67
Q

give calcium in massive ?

A

transfusion

68
Q

adult urine output?

A

> 50cc/hour

69
Q

MC cardiac rhythm

A

sinus tachycardia

70
Q

tx fractured ribs/sternum w/?

A

analgesics, nerve blocks

71
Q

MC esophageal injury? can lead to?

A

tears, mediastinitis

72
Q

MC fx:
shoulder
hip
knee

A

anterior
posterior
transverse

73
Q

hanging cast for?

A

humerus fx

74
Q

for first 48 hrs put colle’s Fx in a ?

A

sugar tong splint

75
Q

tibia fx- waddells triad?

A

knee/femur, chest, and c-spine injury

76
Q

ortho min 2 X-rays to order?

A

AP & lateral

77
Q

compartment syndrome- tx for CS and coagulopathy?

A

antivenom

78
Q

common pathogen of animal bites

A

pateurella multocida

79
Q

antihistamines for poison ivy

A

hydroxyzine, domeboro, calamine

80
Q

peritoneal Sx
extraperitoneal renal injury
intra

A

no

yes

81
Q

malignant htn has a DBP of ?

A

> 130

82
Q

malignant htn lab finding?

A

microangiopathic hemolytic anemia

83
Q

tx of rhabdomyolysis

A

hydration w/ IV isotonic saline
alkalinize w/ Na bicarb
forced diuresis (mannitol)

84
Q

tx of sea bather’s eruption

A

papain

85
Q

mc nonbacterial fish poisoning in USA; sx? tx?

A

ciguaterra
reversal of hot/cold perception
mannitol IV (<48h 60% reverse sx)

86
Q

MED average?

A

20 min at noon

87
Q

4 most imp predictors of CS/AMI?

A

DEER: diaphoresis, emesis, exertional CP, radiating CP

88
Q

MONA for MI even if on ? or ?

A

coumadin, plavix

89
Q

do not give BB, MS, or NTG w/ ? or ?

A

RVMI, hypotension

90
Q

dressler’s syn sx? tx?

A

post MI- fever, pleuritic CP, pericardial friction/rub; stop anticoags & give NSAIDs

91
Q

arteries:
inferior leads II, III, aVF?
septal/anterior aka V1,2/V3,4
lateral leads I, aVL, V5,6

A

RCA
LAD
Cx

92
Q

RVI: V1? V2?

A

v1 ste; v2 std

93
Q

IMI - may see ? before STe

A

TWI in aVL

94
Q

IWMI: always think about ? and ?

A

RVI, PWI

95
Q

tests in additional to tox screen to order separate?

A

TRIPLE A- acetaminophen, aspirin, alcohol

96
Q

CANT use charcoal? 5

A

hydrocarbons (gasoline, benzene, motor oil, etc), metals (lead, iron, mercury), ions (lithium), alc (ethanol, methanol), CAUSTICS (bleach, ammonia, household products, etc)

97
Q

isoniazid antidote?

A

pyridoxine

98
Q

organophosphate antidote? 2

A

atropine, pralidoxime- tx repeated until recovery

99
Q

check initial acetaminophen levels ? after ingestion

A

4 hours

100
Q

no dialysis and no antidote**

A

NSAIDs

101
Q
  • no antidote but tx w/ charcoal and atropine for bradycardia?
  • tx w/drawal s/e w/?
A

alpa 2 agonists (clonidine, methyldopa)

phentolamine, propanolol (hypertensive crisis)

102
Q

MAOI toxicity

  • EKG?
  • tx w/?
A 
sinus tachycardia (MC)
phentolamine or nitroprusside
103
Q

two that commonly use whole bowel irrigation w/ PEG?

A

iron, lithium (both = no charcoal)

104
Q

no lab tests are helpful with determining ? withdrawal; clinical sx present

A

opiod

105
Q

hallucinogen toxicity?

marijuana toxicity?

A
  • supportive, haldol for psychosis

- supportive- BZD for anxiety, seroquel (quetiapine) for hallucinations

106
Q
  • PCP OD labs will show elevated ?
  • plasma levels do not correlate well with ?
  • Tx?
A

CPK (muscle overactivity, violent behavior, seizures)
clinical findings
lavage/charcoal, BZD for agitation

107
Q
  • 2nd MC OD drug ER visit?
  • Tx OD w/ ?
  • CI? bc?
A
  • cocaine
  • BZD (htn)> fail then try phentolamine, NTG, or verapamil
  • BB, can cause MI
108
Q
  • seds/hypnotics number one choice in ?
  • MC findings?
  • besides lavage/charcoal, ? for ADULTS ONLY
A
  • suicide method
  • ataxia, slurred speech
  • sorbitol (CI children- diarrhea; opioid are anti-motility drugs)
109
Q

lithium toxicity:

  • acute Sx?
  • EKG changes? 3
  • Tx?
A
  • N/V/D
  • T wave flattening and inversion, U wave (hypokalemia- Li acts as Na sub), prolonged PR
  • PEG, hemodialysis
110
Q

carbon monoxide toxicity

  • lab?
  • tx?
  • MCC of ? death
  • consider in any pt w/ unexplained ? or exposure to ?
A
  • CO-Hb (pulseox and ABG may be falsely normal!)
  • 100% oxygen
  • toxin-induced
  • HA, fire/smoke
111
Q

caustics

  • bleach, ammonia, mouth ?, etc
  • sx?
  • tx?
A

mouth pipetting
mainly GI
endoscopy, NPO, possible esophagectomy

112
Q

carbamate insecticide (AchE inhibitor)- Tx ?

A

atropine

113
Q

tx of hydrocarbon toxicity?

A

supportive, ABCs

ClinMed3 (8 decks)

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