ER Questions Flashcards
Components of glasgow coma score
Eye opening,motor, verbalizing
Dead patient has a GCS of
3
GCS score <_ is coma
8
Beck’s triad
muffles heart sounds, high neck veings, HoTN- cardiac tamponade
Pulse felt at radial means BP of atleast
90
Pulse felt at brachial means BP of atleast
80
Pulse felt at femoral means SBP of atleast
70
Pulse felt at carotid means SBP of atleast
60
What kind of shock occurs when the heart is not pumping well enough to push adequate volume to perfuse?
cardiogenic
what kind of shock occurs when there is not enough blood volume to perfuse?
hypovolemic
What kind of shock occurs when cardiac output increases, but vasculature is too dilated dt inflamm rxn causing insufficient pressure to perfuse?
septic
What kind of shock occurs when there is dilated vasculature dt spinal cord injury
neurogenic
Potential spaces for life threatening internal hemorrhage
Chest Pelvis Abdomen Femur Scalp
toxicology causes of HTN
CT SCAN: cocaine thyroid supplements sympathomimetics caffeine anticholinergics, amphetamines nicotine
toxicology causes of HoTN
CRASH: clonidine (CCBs) reserpine (and other BP meds) antidepressantes, aminophylline sedative hypnotics heroin and other opiates
toxicology caues of tachycardia
FAST: Freebase & other cocaine forms anticholinergics, amphetamine, antihistamines sympathomimetics, solvent abuse theophylline
toxicology causes of bradycardia
PACED: propranolol & BP meds anticholinesterases clonidine & CCBs ethanol & other alcohols digoxin
toxicology causes of tachypnea
PANT:
PCP, pneumonitis (chemical)
ASA, other salicylates
toxin induced metab acidosis
toxicology causes of slow respirations
SLOW: sedative hypnotics liquor opiates weed
toxicology causes of hyperthermia
NASA: neuroleptic malig syn, nicotine antihistamines salicylates, sympathomimetics anticholinergics, antidepressants
toxicology causes of hypothermia
COOLS: carbon monoxide opiates oral hypoglycemis, insulin liquor sedative hypnotics
vertical or rotary nystagmus
think PCP
toxicology causes of seizures
OTIS CAMPBELL: organophosphates tricyclic antidepressant isoniazid, insulin sympathomimetics cocaine, camphor amphetamines, anticholinergics methylxanthines (theophylline, caffeiene) PCP benzo withdrawal ethanol withdrawal lithium, lidocaine lead, lindane
Anticholinergic toxidrome
hyperthermia, flushed skin, dry skin, dilated pupils, delirium/halluc/szs
hot as hare, red as a beat, dry as a bone, blind as a bat, mad as a hatter
tachycardia, htn, urinary retention, decreased bs
cholinergic(organophosphates/insecticides) toxidrome
DUMBELS: diarrhea, diaphoresis urinar and/or fecal incontinence miosis bradycardia, bronchosecretions/spasms emesis lacrimation salvation
EKG showing diffuse T wave peaking
hyperkalemia
cholinergic(organophosphates/insecticides) toxidrome
contraleteral- left
tongue pointing to right/ deviating from left means stroke on which side of brain
points to contralateral- left brain
leg weakness on left means stroke on which side
contralateral- right brain
toxic dose of acetaminophen/tylenol
150 mg/kg
antidote for acetaminophen overdose
N-acetylcysteine
toxic and lethal dose of aspirin
toxic 160mg/kg lethatl 500mg/kg
treatment of aspirin OD
correct fluids and acid/base
lytes- k replacement, glucose
urine alkalinization via sodium bicarb if level >35mg/dL
what NSAID has 4 stages of OD
acetaminophen
“stepping out into a snowstorm” vision
methanol poisoning
Antibiotic for gonorrhea
Ceftriaxone 250mg IM
Antibiotic for chlamydia
Azithromycin 1g PO once
MC STI
chlamydia
Antibiotics for otupt PID
Ceftriaxone, Doxycycline, Flagyl
MP rash involving palms and soles with “copper penny” lesions
Syphilis
how to dx syphilis
VDRL for screening, FTA-ATBs is confirmatory
Antibiotic for syphilis
if allergy
Benzathine PCN-G (Bicillin)
Doxycycline
dx of herpes
Gold standard is tissue culture
tzank smear showing multinucleated giant cells
MC HPV types
6 & 11
MC HPV types for cervical dysplasia
16 & 18
causitive agent of chancroid
Haemophilus ducreyia
painful necrotizing genital ulcer with inguinal LAD
chancroid
antibiotcs for chancroid
azithromycin, ceftriaxone, cipro
tx for acute cystitis
Cephalexin
Cipro (no prego)
Nitrofuratoin (prego good)
Bactrim
tx acute pyelonephritis outpt
Cipro, Bactrim DS
tx acute bacterial prostatis outpt
Cipro x 21d
acute epididymitis <40 yo
Cef + Doxy
acute epididymitis >40 yo
Cipro or Bactrim
tx for varicocele
NSAID/ Naprosyn, scrotal support
buckle fracture occurs in what part of bone
metaphysis
PEDS ortho that are MC in females
nursemaids elbow, patellar dislocation, scoliosis, systemic lupus
changes in inferior leads (II, III, aVF)
inferior MI- RCA
changes in lateral leads ( I, aVL, V5, V6)
lateral MI- left circumflex
changes in precordial leads
anterior MI- LAD
changes in anterior lead (V1)
posterior MI- RCA
changes in precordial leads and I and aVL
anterolateral MI- left main artery
hyperkalemia leads to what arrhythmia
Vfib, death
what lyte distrubance and lead to torsades
hypocalcemia, hypomagnesemia
MC cardiomyopathy
dilated- enlargement of one or all chambers or heart, systolic dysfx
intraarticular fx of thumb
Bennett’s fx
comminuted thumb fx
Rolando’s fx
Gamekeeper’s fx involves
ulnar collateral lig of thumb (aka skier’s thumb)
mallet finger is
extensor tendon injury, from hyperflexion
MC injured carpal ligament
scapholunate ligament
varus stress of knee tests
LCL
valgus stress of knee tests
MCL
distal radial fx with dorsal displacement
colles fx
distal radial fx with palmar displacement
smiths fx
comminuted distal radius fx with articular surface involvement displaced fx ulnar styloid
bartons fx
fx proximal ulna, dislocation radial head
monteggia fx dislocation
fx proximal radius, dislocation of distal radioulnar joing
galeazzi fx dislocation
proximal fibula shaft fx with distal tibia fx
maisonneurve fx
transverse fx proximal 5th metacarpal
jones fx
fx/dislocation at tarsometatarsal joint with LATERAl subluxation of metatarsal
Lis franc fx
drooling, dysphagia, distress
epiglottitis (supraglottitis) ABCs ceftriaxone IV
hard, nontender swelling on eye lid with redness
chalazion, warm compress and lid scrubs
Bells Palsy affects CN
CN7
Bells palsy is caused by? tx..
HSV1 generally, acyclovir within 72hrs