ERdeck2 Flashcards
at what hcg, is a gestational sac present?
typically 1500
Most common cause of acute nausea and vomiting?
viral gastroenteritis.
most common organism causing diarrhea
enterotoxigenic Escherichia coli (ETEC)
tx of travelers diarrhea?
loperamide, BRAT and fluids
how do you treat Crohn’s exacerbations?
Steroids. Possibly antibiotics if infectious
Does ulcerative colitis typically present with bloody diarrhea?
Yes
An ill appearing patient has a distended tender and Tympanic abdomen
Toxic megacolon
How do you treat a hypokalemic patient with EKG changes?
An ampule of calcium gluconate, 10 IV regular insulin and iv dextrose
How do you treat a hypokalemic patient without EKG changes?
10 IV insulin and 10 of IV dextrose
At what hemoglobin would you transfuse?
Nine
What is the most common cause of pancreatitis?
ETOH
How do you treat pancreatitis?
if mild - supportive
Otherwise IVF, NPO
What is Ranson’s criteria for?
It can assess for pancreatitis severity
What is the treatment for cholangitis?
Broad-spectrum antibiotics!! Volume replacement and emergent consult
What is the first line therapy for symptomatic gallstones?
Laparoscopic cholecystectomy
When is ERCP used?
For patients with common bile duct stones or dilated common bile ducts
What is the cause of hepatic encephalopathy? What is the treatment?
Elevated ammonia levels secondary to chronic hepatitis. lactulose.
If you’re working up a patient with known liver disease with ascites And they have abdominal pain and fever what should you consider
Spontaneous bacterial peritonitis
what is the mcc of SBO?
adhesions
What is the MCC of LBO?
malignancy
Which hernia: impairment of blood flow and exquisite pain.
strangulated
What imaging do you need for an anorectal abscess?
CT or ultra sound can differentiate it deeper or complicated
clue cells/ fishy odor
BV
frothy, malodorous discharge
trich
Before giving IV contrast, why are you looking at BUN:creatinine ratio
if greater than 1.2, it can cause ARF. Radiocontrast-induced nephropathy is a common cause of in-hospital ARF and can be provoked by imaging with an IV contrast agent in the ED.
MCC of rhabdo
alcohol and drugs followed by meds(statin)
pt presents with dark brown urine.
rhabdo. check CK. Give IVF
mcc of hematuria?
infections, nephrolithiasis and neoplasms
mcc of urinary retention?
BPH
What is Fournier’s gangrene?
necrotizing infection/gangrene usually of perineum
absent cremaster reflex?
testicular torsion. also negative prehns sign
Is preseptal cellulitis painful or non eye movements? and what are visual acuities like?
painless ocular movements, good visual acuity. typically from URI. tx PO augmentin
which is painful? preseptal or orbital cellulitis?
orbital cellulitis!!
preauricular adenopathy with conjunctivitis?
viral
flair cells in anterior chamber?
iritis
What condition should you Never give topical anesthetics to pt because it delays healing
corneal abrasion
tear drop pupil?
globe rupture
steamy cornea?
acute angle closure glaucoma. pressure 60-80 (normal 10-20)
Tx for mastoiditis?
vanco or nafcillin
hot potato voice
peritonsillar abcess
Wounds contaminated by fresh water and plantar puncture wounds through athletic shoes
should include Pseudomonas coverage.
What is important about Cyanoacrylate Tissue Adhesives
The adhesive should cover the entire wound and extend 5 to 10 mm on either side of the wound edges.
When should intraoral lacerations be sutured?
if they’re more than 2 cm
Is flexor tendon laceration urgent?
Urgent repair is important, as postinjury scarring and tendon retraction make flexor tendon repairs more difficult after 10 to 14 days.
Name some thing that are not visible on film?
Many common or highly reactive materials, such as wood, thorns, cactus spines, some fish bones, other organic matter, and most plastics
Name some thing that are visible on film?
Metal, mammalian bone, some types of fish bones (cod, haddock, grey mullet, red snapper, and sole), teeth, pencil graphite, certain plastics, glass, gravel, sand, and aluminum
When do myoglobin rise? CK-MB? troponin?
myoglobin - 1-2 h
CK-MB - 3-4 h
troponin - 3-6 h
What is contraindicated in cocaine associated chest pain?
beta blockers
from 1 to 6 weeks after myocardial infarction and consists of fever, pleuropericardial pain, malaise, and evidence of pleural and pericardial effusions.
Dressler’s syndrome
MCC of acute right sided heart failure?
PE
Most common valve in IVDA?
tricuspid by staph
endocarditis tx?
pen g or ceftriaxone +- vanco if MRSA suspected
tachycardia out of proportion to temperature?
myocarditis
Becks Triad
Cardiac tamponade….hypotension, Kussmals sign (JVD with inspiration), and Pulsus paradoxis (drop in pulse with inspiration)
“gold standard” for PE diagnosis?
pulmonary angiography
papilledema
malignant HTN
acute severe abdominal pain 30-60 min after eating, N/V/D may be present and this may all precede a presyncopal or syncopal episode, usually comes after a hypotensive episode
mesentaric ischemia
Virchow’s Triad
Thrombosis is thought to be caused by Virchow’s Triad which is
1) stasis of blood flow
2) endothelial injury
3) hypercoagulability
Tx for Pts. with acute DVT without PE
can be outpatient with Lovenox bridging with a Coumadin
T/F Corticosteroids and loop diuretics are commonly used
for SVC syndrome
True
pt has prodrome before syncope, what is the likely cause?
neuro or psychogenic
pt has no prodrome before syncope, what is the likely cause?
cardiogenic
women over 50, ESR over 50, unilateral sharp stabbing pain and temporal
temporal arteritis
MCC of A fib
HTN, valve disease
CHADS2 of what score get anticoag?
2 or greater. if 1 ASA or anticoag based on clinical judgement.
Wide tachy QRS
VT
