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Emergency Medicine > Exam 1 Reverse > Flashcards

Exam 1 Reverse Flashcards

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1
Q

Jaw thrust

A

Pt comes in with neck trauma, how do you open their airway?

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2
Q

Oropharyngeal

A

What type of airway do you use in an obtunded Pt?

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3
Q

(Age + 16)/4

A

How do you determine size of orotracheal tube in a kid?

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4
Q

Uses paralysis + sedation to intubate ptDON’T use if difficult/distorted airway

A

What is rapid sequence intubation?

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5
Q

Ketamine - relaxes bronchial smooth muscle

A

You need to RSI, & Pt is an asthatic, which sedation should you use?

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6
Q
  1. Fentanyl2. Midazolam3. Etomidate4. Propofol5. Ketamine - good for asthma
A

Sedation meds

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7
Q
  1. Succinylcholine2. Vecuronium
A

Paralysis meds

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8
Q
  1. Mechanical failure2. Tension pneumo3. ARDS4. CHF
A

Causes of failure to oxygenate/ventilate?

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9
Q

> 80

A

If you can palpate a radial pulse, what must SBP at least be?

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10
Q

> 70

A

If you can palpate a femoral pulse, what must SBP at least be?

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11
Q

> 60

A

If you can palpate a carotid pulse, what must SBP at least be?

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12
Q

25-30%

A

How much cardiac output does chest compressions provide?

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13
Q

Defibrillation

A

What is the only intervention consistently proven to improve outcome in cardiac arrest?

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14
Q
  1. Refractory tachycardia2. Torsades3. Unstable bradycardia
A

When do you use electrical pacing?

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15
Q

CAD - MI

A

MCC sudden cardiac death?

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16
Q

Morning MC in winter, home, males 50-75Beta-blockers protective

A

When does sudden cardiac death usually occur?

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17
Q

Pulseless VT or VF

A

Which arrhythmias usually cause sudden cardiac death?

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18
Q
  1. Witnessed collapse2. Prompt CPR3. Early defibrillation4. Younger 5. Arrest occurring away from home6. Initial rhythm was VF/VT
A

What factors inc. your chance of survival if you go into VF?

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19
Q

Vent rate <60 &/or periods of asystole Rarely survives

A

What is bradyasystole?

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20
Q

Bradycardia or asystole

A

The SA node experienced ischemia/infarction…what rhythm would you typically see?

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21
Q

AV block

A

The AV node experienced ischemia/infarction…what rhythm would you typically see?

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22
Q
  1. Age2. Male3. CAD4. Cardiomegaly w/ LVH5. Impaired LV function, EF<30%, CHF6. Long QT7. Vent. arrhythmias
A

Risk factors for sudden cardiac death in adults >35y/o

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23
Q

Coarse

A

Is coarse or fine VF better?

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24
Q

Circulatory insufficiency that creates imbalance btwn tissue Ox supply & demand Causes anaerobic metabolism which creates lactic acid

A

What is shock?

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25
Q
  1. Inc. oxygen demand - Status epilepticus2. Impaired tissue Ox use - septic shock, postresuscitation phase of cardiac arrest
A

Causes of lactic acidosis

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26
Q

Systemic Infammatory Response Syndrome - from shock Need 2 or more1. Temp >100.4 or 90bpm3. RR >20 4. WBC >12 or <4 or 10% immature forms or bands

A

Dx SIRS

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27
Q
  1. Hypovolemic2. Cardiogenic3. Obstructive4. Distributive
A

Classification of shock

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28
Q

AirwayBreathingCirculationDelivery of OxEnd points of resuscitation

A

Tx shock

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29
Q

When volume resuscitation not adequate or contraindicated (cardiogenic shock)1. Dopamine2. NE3. Phenylephrine4. Vasopressin5. Epi6. Dobutamine

A

When do you use vasopressors & name them

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30
Q
  1. Maternal age2. Inc. live birth order3. Lack of prenatal care4. Unwed mother
A

Risk factors for maternal death

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31
Q
  1. PE2. Hemorrhage3. Pregnancy-induced HTN4. Infection
A

What are the leading causes of maternal death?

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32
Q

> 20 wksUterus compresses IVC

A

When shouldn’t you use a femoral vein for IV access in a pregnant woman?

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33
Q

Supine but elevate R hip to prevent vascular compression

A

What position should a pregnant lady be in if you’re intubating?

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34
Q

22-26 wks

A

When is the fetus viable?

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35
Q

Tilt PtC-section if baby >20wks after 5 minOpen chest CPR after 15 min

A

If a pregnant lady goes into cardiac arrest, what should you do?

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36
Q

CT b/c D-dimer inc. w/ pregnancyTx w/ Heparin

A

Pregnant lady gets PE, what tests should you do?

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37
Q

VF/VT

A

What is the MCC of global brain ischemia in adults?

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38
Q

Asphyxia

A

What is the MCC of global brain ischemia in kids?

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39
Q

Pts who remain in coma after resuscitation from arrest 1. Reduces neuronal cell death2. Beneficial to heart, lungs, kidneys & intestines ROSC 34 C

A

When should you induce therapeutic hypothermia?

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40
Q
  1. Trauma2. Sepsis3. Advanced dementia4. Active bleeding5. CA w/ brain mets6. DNR
A

Contraindications of therapeutic hypothermia

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41
Q

33 C Cool for 24h then rewarm over 24h

A

What temp do you cool Pt to in therapeutic hypothermia?

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42
Q
  1. Morphine2. Hydromorphone3. Fentanyl4. Meperidine5. Oxycodone6. Hydrocodone7. Codeine8. Tramadol
A

Name some opiates

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43
Q
  1. Buprenorphine2. Butorphanol3. Nalbuphine4. Pentazocine
A

Name some opiate agonists-antagonists

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44
Q

Egg or soy protein allergy

A

Contraindications to propofol

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45
Q

Etomidate - amnestic not analgesic

A

Which sedative has a risk of myoclonic jerking?

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46
Q

Sensation from heart, blood vessels, pericardium, lungs & esophagus Pain poorly localized, dull, heavy or achy

A

Visceral pain fibers

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47
Q

Sensation from pleura, peritoneum, muscle, skeleton & skinPain well localized & sharp

A

Somatic pain fibers

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48
Q

Visceral pain signals perceived in somatic structures - arms, neck & jaw

A

Referred pain

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49
Q
  1. Radiation to R arm/shoulder***2. Radiation to both arms/shoulders3. Worse w/ exertion4. Radiation to L arm5. Diaphoresis6. N&V7. Worse than previous angina/similar to previous MI8. Pressure
A

Factors that inc. likelihood of acute MI

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50
Q
  1. Pleuritic2. Positional3. Sharp4. Reproducible w/ palpation5. Inframammary location6. Not exertional
A

Factors that dec. likelihood of acute MI

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51
Q

Inflammation of costal cartilage Sharp, dull &/or worse w/ breathing

A

What is costochondritis & S/S?

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52
Q

Sharp pain at xyphoid

A

What is xiphodynia?

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53
Q
  1. Tachyarrhythmias2. LVH3. Myocarditis4. Pericarditis5. Cardiac contusion6. HF7. PE8. Sepsis
A

Troponin is elevated, but no MI, what could it be?

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54
Q

Duration of diastolic relaxation of the heart, coronary vascular resistance

A

What influences coronary artery blood flow?

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55
Q

PCI w/in 90mins or Fibrinolysis w/in 30 minAntiplatelets, antithrombins, beta-agonists, nitrates

A

Tx STEMI

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56
Q
  1. Prior intracranial hemorrhage2. Known structural cerebral vascular lesion (ex. AV malformation)3. Known intracranial CA4. Ischemic stroke w/in 3 mo5. Active internal bleeding6. Suspected aortic dissection/pericarditis
A

Absolute contraindications to fibrinolytics

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57
Q

with PCI 1. Abciximab2. Eptifibatide3. Tirofiban

A

When would you use a glycoprotein IIb/IIIa inhibitor with an MI?

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58
Q

Inferior MI - nitrates dec. preload & may cause HOTN due to RV involvement Do not use w/in 24h of Viagra or 48h of tadalafil use

A

When should you use caution with nitrates?

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59
Q
  1. Signs of HF2. Low cardiac output3. Inc. risk for cardiogenic shock4. Prolonged PR, 2/3rd degree heart block, active asthma, reactive airway disease
A

You should start oral beta-blockers in MI Pts unless…

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60
Q

Get EKG, Troponin1. Aspirin2. Nitrates3. Benzos4. PCIDO NOT use beta-blockers - will inc. BP

A

STEMI from crack…what is the Tx?

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61
Q

Dec. cardiac output leading to inadequate tissue perfusion despite adequate or excessive circulating volume (pump problem)

A

Define cardiogenic shock

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62
Q
  1. Old2. Female3. Acute/prior ischemic event4. PMH5. CHF6. Diabetes
A

Risk factors for cardiogenic shock

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63
Q

Large MI

A

MCC of cardiogenic shock?

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64
Q

Hypoperfusion1. AMS2. Dec. urine output3. Ashen/cyanotic, cool skin, mottled extremities, weak pulses4. Weak pulses due to sympathetic nervous system 5. HOTN6. Sinus tachycardia7. Tachypnea8. JVD9. Rales10. Loud/new systolic murmur11. Cardiac PMI moved

A

S/S Cardiogenic shock

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65
Q
  1. PCI usually 2. Correct hypoxia, hypovolemia, rhythm disturbances, electrolyte abnormalities, acid base abnormalities3. Foley-cath to monitor output
A

Tx cardiogenic shock

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66
Q

Tx same way as w/o shock except1. No NTG if SBP <902. No beta-blockers for Pts in shock or at risk for shock

A

Tx cardiogenic shock + MI

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67
Q
  1. Myocardial ischemia2. Cardiomyopathy3. HTN4. Cardiac dysrhythmias 5. Noncompliance
A

MCC HF & Pulmonary edema

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68
Q

60%

A

What is normal ejection fraction?

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69
Q
  1. EF <40%2. Impaired contractility - difficulty ejecting blood3. Leads to inc. intracardiac volumes & pressures, pulm. congestion & edema
A

Describe systolic dysfunction

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70
Q
  1. EF normal/higher2. Impaired vent relaxation - difficulty receiving blood3. Atrial pressures inc. inc. w/ age, womenOften due to chronic HTN & LVH, sometimes CAD
A

Describe diastolic dysfunction

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71
Q
  1. Cardiomegaly2. Interstitial edema3. Effusions4. Kerley B lines5. Cephalization6. Bat wing pattern
A

CXR - L-sided CHF

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72
Q

always inc. - but change of 40% from baseline = acute exacerbation

A

BNP in chronic HF?

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73
Q
  1. Noncompliance - excess salt, meds2. Raid AFib3. Acute MI4. Renal failure
A

MC precipitants of acute HF syndrome

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74
Q
  1. O2, SL NTG2. BP >150/100 - add IV NTG/nitroprusside3. IV diuretic - furosemide4. If severe dyspnea - begin BiPAPAdmit PRN
A

Tx HTN HF

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75
Q
  1. RV infarction2. Aortic stenosis3. Volume depletion4. Hypertrophic cardiomyopathy
A

When should you avoid nitrates w/ HF?

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76
Q

SBP<901. Inotrope - dobutamine/dopamine until SBP 90-100Admit - may need vasodilator

A

Tx HOTN HF

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77
Q
  1. CCB 2. NSAIDs3. Antiarrythmics - quinidine, procainamide
A

Drugs to avoid in HF

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78
Q

Only Tx if hypoperfusion or risk of AV block1. TransQ pacing at 100 May need sedation w/ narcotics/benzos

A

Tx bradyarrhythmias

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79
Q
  1. Vagal maneuvers2. Adenosine Tx underlying cause
A

Tx regular stable narrow tachyarrhythmias

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80
Q
  1. Control rate - diltiazem or beta-blockersTx underlying cause
A

Tx irregular stable narrow tachyarrhythmias

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81
Q

If VT - amiodaroneConsider synch. cardioversion SVT - adenosine

A

Tx regular stable wide tachyarrhythmias

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82
Q

If WPW w/ AF - amiodarone/procainamideIf Torsades - MgIf VT - synch. cardioversion

A

Tx irregular stable wide tachyarrythmias

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83
Q

4

A

If defibrillator Pt is in cardiac arrest, how many shocks have they already had?

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84
Q

60-80 mins

A

When a Pt presents to the ED, at what time are their BP measurements most representative?

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85
Q

Noncompliance w/ meds

A

MCC hypertensive urgencies?

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86
Q

Reduce BP w/in 24-48h Commonly use Clonidine

A

Tx hypertensive urgency

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87
Q

Elevated BP w/ papilledema

A

What is malignant HTN?

88
Q
  1. HA2. N/V3. Visual complaints4. AMS - encephalopathy - cardiac Sx, confusion, lethargy, coma 5. Eyes - hemorrhages, exudates, papilledema6. Acute CHF
A

S/S hypertensive emergency

89
Q

NonspecificUsually HA

A

S/S hypertensive urgency

90
Q

Lower MAP ASAP by 20-25% Use Labetalol/Metoprolol/Esmolol Nicardipine/NTG/sodium nitroprusside Benzos

A

Tx hypertensive emergency

91
Q

Esmolol - short acting

A

If a Pt has asthma & presents w/ hypertensive emergency, what should you use to lower BP?

92
Q

goal SBP <140-110Morphine Labetalol

A

Tx aortic dissection w/ HTN emergency?

93
Q

NTG then diuretics

A

Tx pulm edema w/ HTN emergency

94
Q

NTGbeta-blockers

A

Tx acute MI w/ HTN emergency

95
Q

BenzosDO NOT use beta-blockers

A

Tx cocaine intox. w/ HTN emergency

96
Q

LabetalolNicardipine

A

Tx eclampsia w/ HTN emergency

97
Q

Nicardipine/Labetalol

A

Tx HTN encephalopathy w/ HTN emergency

98
Q

Labetalol/Nicardipine Oral nimodipine

A

Tx SAH w/ HTN emergency

99
Q

LabetalolNicardipine

A

Tx intracranial hemorrhage w/ HTN emergency

100
Q

Labetalol

A

Tx acute ischemic stroke w/ HTN emergency

101
Q

Tx pain & anxiety firstNicardipine/Labetalol

A

Tx acute postop HTN

102
Q

Labetaol & Nicardipine

A

When in doubt w/ HTN emergency on test, use what??

103
Q

If significantly elevated but no S/S - start meds & arrange follow upHCTZ or Lisinopril

A

Do you treat ED identified HTN?

104
Q

Unknown - have inc. risk of death

A

MCC syncope

105
Q

Cardiac 1. Structural Old people? Aortic stenosis2. Dysrhythmias - usually no prodrome

A

What is the most dangerous type of syncope?

106
Q

Brief tonic clonic mvmts may occur w/ syncope

A

Why are seizures usually confused with syncope?

107
Q

CV risk

A

What is a good predictor of syncope in old people?

108
Q

Cardiac & neuro

A

Which types of syncope need admitted?

109
Q
  1. Sharp, stabbing, severe retrosternal CP2. Sudden/gradual onset3. Worse w/ inspiration or mvmt4. Referred to back/trapezius5. Worst when supine, better when leaning forward6. Fever, malaise, dyspnea, dysphagia 7. Pericardial friction rub
A

S/S pericarditis & pericardial effusion

110
Q
  1. Diffuse ST elevation2. PR depression (II, aVF, V4-V6)3. Later see T wave inversion & ST normalization4. ST to T amplitude >0.25CXR usually normal
A

EKG changes w/ pericarditis & CXR

111
Q

Low QRS - pulsus alternans CXR - enlarged heart w/ water bottle appearance

A

EKG changes w/ pericardial effusion & CXR

112
Q

EchoTx - pericardiocentesis Treat underlying cause

A

How do you diagnose pericardial effusion & Tx?

113
Q

TraumaMetastatic effusion MC non-traumatic cause

A

MCC tamponade in ED?

114
Q
  1. Dyspnea at rest2. Fatigue3. Beck’s triad - neck vein distention, HOTN, muffled heart sounds4. Tachycardia5. Pulsus paradoxus
A

S/S tamponade

115
Q

Echo -DxRA compression, RV diastolic collapse, hyperdynamic heartEKG - low voltage, electrical alternansCXR - may be normal

A

Dx tamponade

116
Q
  1. Neck vein distention2. HOTN3. Muffled heart soundsseen w/ tamponade
A

What is Beck’s triad & when is it seen?

117
Q
  1. IV fluids2. Dobutamine3. PericardiocentesisTraumatic - surgery
A

Tx tamponade

118
Q

Pericardium becomes thickened & scarred preventing diastolic filling1. Trauma w/ intrapericardial hemorrhage2. Pericardiotomy3. Chronic renal failure4. Fungal/TB pericarditis5. Idiopathic

A

What is constrictive pericarditis & when is it seen?

119
Q
  1. DOE, orthopnea2. Fatigue, weakness3. JVD4. Inspiratory neck vein distension - Kussmaul sign5. Paradoxical pulse6. Pericardial knock7. Hepatomegaly8. Ascites
A

S/S constrictive pericarditis

120
Q

Constrictive pericarditisEarly diastolic sound just after S2

A

What is a pericardial knock & when is it seen?

121
Q

EKG - low voltage QRS, inverted T wavesCXR - pericardial calcification on lateral**Doppler echo, CT or MRI preferred

A

Dx constrictive pericarditis

122
Q
  1. Fluid restriction & diuretics2. Pericardiectomy
A

Tx constrictive pericarditis

123
Q
  1. Fever2. Fatigue3. Myalgias4. HA 5. CP6. Palpitations7. Dyspnea
A

S/S myocarditis

124
Q

Labs - inc. WBC, ESR & troponinMay need nuclear imaging/Bx

A

Dx myocarditis

125
Q

Supportive

A

Tx myocarditis

126
Q
  1. Dilated - Most common 2. Hypertrophic3. Restrictive
A

Types of cardiomyopathies

127
Q

Dilated cardiomyopathydeath w/in 2 years w/o transplant

A

What is the main indication for heart transplantation?

128
Q
  1. DOE2. Orthopnea3. PND4. Bibasilar rales5. Dependent edema6. CP
A

S/S dilated cardiomyopathy

129
Q

CXR - CMG, pulm congestionEKG - LVH, LAE, Afib, AV conduction abnormalities, vent. arrhythmiasEcho - Chamber enlargement, dec. vent. function

A

Dx dilated cardiomyopathy

130
Q
  1. Nitrates, diuretics2. Anticoagulation3. Antiarrhythmics PRN
A

Tx dilated cardiomyopathy

131
Q

& diminished vent. contractile force - low CO & HFDilated

A

Which cardiomyopathy shows systolic & diastolic dysfunction?

132
Q

HypertrophicMuscular hypertrophy of nondilated LV - muscle becomes stiffRestricted vent. filling

A

Which cardiomyopathy shows diastolic dysfunction?

133
Q

EKG - LVH, LAE, deep septal Q wavesEcho*** - disproportionate septal hypertrophy

A

Dx hypertrophic cardiomyopathy

134
Q

Emergent? Beta-blockers for CPArrhythmias? AmiodaroneDO NOT give digoxin, nitrates, diuretics or beta-agonists

A

Tx hypertrophic cardiomyopathy

135
Q

Restrictive May be from amyloidosis, sarcoidosis, hemochromatosis, scleroderma

A

Which cardiomyopathy shows elevated venous pressures?

136
Q

Mitral Then aortic, tricuspid then pulmonic

A

Which valve is most often infected w/ endocarditis?

137
Q

a - S. aureus High fever, systemic toxicity s - Strep. ViridansGradual onset

A

MCC endocarditis acute & subacute

138
Q

EndocarditisO - painful nodules on pads of digitsJ - nontender hemorrhagic plaques on palms/solesBacteria seeds & heart spits out little clots

A

When are Osler nodes & Janesway lesions seen?

139
Q
  1. Cultures - 3 diff sites 2. Inc. ESR, CRP 3. UA - hematuria, proteinura, pyuria 4. EKG - conduction abnormalities5. Echo 6. TEE better - can rule in but not out Dx 7. Duke criteria
A

Dx endocarditis

140
Q
  1. ABCs2. Abx Sick - Nafcillin + GentamicinSubacute - PCN + GentamicinProsthetic valve - Vanco + Gentamicin + Rifampin
A

Tx endocarditis

141
Q

NO mammary glands

A

Should you anticoagulate an endocarditis Pt?

142
Q

you die

A

During aortic dissection, what happens if the blood dissects through the adventitia?

143
Q

HTNPrego MCC women <40

A

MCC thoracic aortic dissection?

144
Q

A - ascending, surgeryB - below, medical mgmt

A

Type A vs. B aortic dissections

145
Q
  1. Abrupt severe onset CP that radiates to back/abdomen2. Ripping/tearing3. Diaphoresis, N/V4. FH5. Migratory findings6. SBP diff. >15mm btwn each arm 7. Unilat pulse deficit/absent8. Diastolic murmur9. Neuro deficits10. Neuro deficits/dysphagia, Horner syndrome
A

S/S aortic dissection

146
Q

CXR - mediastinal widening, obliteration of aortic knob, tracheal displacement to the R, Pleural effusion to LCT

A

Dx aortic dissection

147
Q

Tx HTNBeta-blockers - Labetalol, EsmololNitroprusside

A

Tx aortic dissection

148
Q

Thrombotic occlusion

A

MCC acute limb ischemia?

149
Q

Heart

A

Where do most emboli from arterial occlusion come from?

150
Q

Lower extremities at the bifurcation of the common femoral arteryThen poplitealArm - brachial artery

A

MC locations for arterial occlusion

151
Q
  1. Pain 2. Pallor3. Paralysis4. Pulselessness5. Paresthesias6. Poikilothermia
A

S/S arterial occlusion

152
Q

ABI 30mm = obstructionUS - most accurate above knee CT angio

A

Dx acute arterial occlusion

153
Q

Supportive1. Aspirin2. Heparin3. Analgesia4. Fluids Revascularization1. Thrombolytics2. Embolectomy3. PTCA4. Bypass graft5. Amputation

A

Tx arterial occlusion

154
Q

Stasis & endothelial injury

A

What does dysfunction of venous valves cause?

155
Q

Not really

A

Are distal DVTs bad?

156
Q

Iliofemoral thrombosis causing edema of extremityPale, cool, possible limb loss

A

Define phlegmasia alba dolens

157
Q

Iliofemoral thrombosis that inclues all collateral veins of extermityArterial ischemia & cyanosis, possible limb loss

A

Define phlegmasia cerulea dolens

158
Q
  1. Pain, tenderness, swelling2. Upper extremity - hand swelling3. Swelling, edema, tenderness in calves & thighs4. Arm - distended superficial veins that don’t collapse when arm is raised5. Measure - diff. >2 cm6. Homan’s sign7. US - better above knee
A

Dx DVT

159
Q
  1. Heparin/Lovenox then switch to POContraindicated? IVC filter/umbrella2. Thrombolytic therapySuperficial thrombophlebitis - NSAID, warm compressesCalf vein? Watch
A

Tx DVT

160
Q

SystolicDiastolic not good

A

What murmurs do you usually hear with prosthetic aortic valves?

161
Q

Loud holosystolic murmur

A

What murmurs should you worry about with prosthetic mitral valves?

162
Q

S. epidermidis

A

MC organism for prosthetic valve endocarditis?

163
Q

Men commit 4x more but women attempt 4x more

A

Who commits more suicides, men or women?

164
Q

SexAgeDepressionPrevious attemptEthanol useRational thinking lossSocial supports lackingOrganized planNo spouseSickness>5 = high risk

A

Screening for suicide

165
Q
  1. Diabetes2. Thyroid disorders3. Intoxications4. Withdrawal5. AIDS6. Head injury
A

What medical conditions can cause mental status changes?

166
Q

Sleep disturbanceInterestGuiltEnergyConcentrationAppetitePsychomotor slowingSuicidal thoughtsMood 5or+ = major depression

A

Screening for depression

167
Q

school year

A

When are there more psych emergencies for kids?

168
Q

Afib

A

MCC CHF

169
Q

Oxygen

A

What is the best Tx for COPD to extend life?

170
Q

CO2Ox in COPD Pts

A

What is your drive for breathing?

171
Q

Thorazine

A

Tx hiccups

172
Q

p >0.5 L >0.6

A

Exudate - protein & LDH levels

173
Q

Exudative - amiodarone

A

What drug commonly causes pleural effusions?

174
Q
  1. +/- dyspnea2. Dullness to percussion & dec. breath sounds3. CXR4. Thoracentesis
A

Dx pleural effusion

175
Q
  1. Diuretics 2. Thoracentesis if <1-1.5L
A

Tx pleural effusion

176
Q

Bronchitis

A

MCC hemoptysis?

177
Q
  1. CXR2. Bronchoscopy if >600mL3. CT
A

Dx hemoptysis

178
Q

Late evenings & early mornings

A

When is asthma worse during the day?

179
Q

Smokinggggggggggnext is asthma

A

MCC COPD

180
Q
  1. Asthma2. Emphysema3. Bronchitis
A

3 diseases of COPD

181
Q

FEV1

A

How is staging of COPD determined?

182
Q
  1. Exertional dyspnea2. Chronic productive cough3. Minor hemoptysis4. Tachypnea, accessory muscle use5. Pursed lip breathing6. Wheezing7. Prolonged expiratory time 8. Crackles/rhonchi9. Barrel chest/reduced diagphragmatic motion10. Displacement of PMI - R HF & R axis dev. 11. Dec. breath sounds
A

S/S COPD

183
Q
  1. Distended neck veins2. Passive hepatic congestion3. Peripheral edema
A

S/S pulm. HTN/Cor Pulmonale

184
Q
  1. Confusion2. Tremor3. Plethora4. Stupor5. Hypopnea/apnea
A

S/S hypercarbia

185
Q
  1. Dyspnea2. Pleuritic CP worsened w/ cough/breathing 3. Referred pain4. Neuro Sx5. Tachypnea6. Hypoxia7. LCTA usually 8. R vent. S3 or split S2
A

S/S PE

186
Q
  1. S1Q3T3 - McGinn White sign 2. Sinus tachycardia MC** w/ R axis dev.
A

EKG PE

187
Q
  1. Ox<93%2. Dec. end tidal CO23. CXR - westermark, CMG, Hampton, Fleischner4. Sinus tach, S1Q3T3 5. CT angio6. V/Q scan7. Pulm. angiography***gold std
A

Dx PE

188
Q

PEPeripheral dome shaped dense opacification on CXR

A

When is Hampton’s hump sign seen?

189
Q

PElocal widening of artery at site of occlusion on CXR

A

When is Fleischner’s sign seen?

190
Q

PEWedge shaped oligemia on CXR

A

When is Westermark sign seen?

191
Q

Pulm angioBut you’ll prob get CT angio

A

Gold Std for Dx PE?

192
Q
  1. UFH/LMWH2. Coumadin3. +/- fibrinolytics
A

Tx PE

193
Q
  1. Massive - BP t give fibrinolytics
A

3 categories of PE

194
Q

Pneumococcus

A

MCC PNA

195
Q
  1. Cough2. Fatigue3. Fever4. Dyspnea5. Sputum6. Pleuritic CP
A

S/S PNA

196
Q
  1. Sudden onset w/ fever2. Rigor3. Dyspnea4. Hemoptysis5. CP6. Tachycardia7. Tachypnea8. Abnormal lung sounds
A

Classic S/S Pneumococcus PNA

197
Q

KlebsiellaPulm. abscess common CXR - necrotizing lobar PNA

A

Currant jelly sputum?

198
Q

Bullous myringits from Mycoplasm Tx - Azithromycin (Macrolide) common in young adults confirm w/ cold agglutinin

A

PNA w/ ear problems?

199
Q
  1. Bronchial breath sounds2. Egophony3. Inc. tactile & vocal fremitus4. Pleuritic friction rubs5. Cyanosis & jaundice6. Abdominal distention
A

S/S consolidation

200
Q

Immunocompromised & unvaccinatedCXR - patchy infiltrates

A

Who gets H. flu PNA?

201
Q
  1. CF2. Hospitalized3. Central venous catheters4. Burn wounds5. Bronchiectasis6. HIV
A

Who should you consider pseudomonas PNA in?

202
Q

After viral illnessIVDU, hospitalized Pts, debilitated

A

Who usually gets Staph PNA?

203
Q

Chlamydia psittaci

A

PNA & contact w/ pigeons?

204
Q

Legionella

A

Old person w/ PNA, GI Sx & bradycardia?

205
Q

Azithromycin

A

Tx PNA in healthy PT

206
Q

Levaquin

A

Tx PNA w/ comorbidites

207
Q

No - wait 24-48h

A

If Pt aspirates - should you give abx?

208
Q

S. aureus

A

MCC empyema

209
Q
  1. Thoracentesis2. Fluid w/ +GS/culture3. Glucose 1000
A

Dx empyema

210
Q

Aspiration

A

MCC lung abscess

211
Q

Several weeks of 1. Cough2. Fever3. Pleuritic CP4. Wt loss5. Night sweats

A

S/S lung abscess

212
Q

CXR - dense consolidation w/ air-fluid level inside thick walled cavitary lesion

A

Dx lung abscess

213
Q

Clindamycin + FlagylMight need bronchoscopic drainage/surgery

A

Tx lung abscess

214
Q

AsymptomaticActive1. Fever2. Malaise3. Wt loss4. CP Reactivation has same Sx w/ extrapulm - Lymph MC

A

Primary TB S/S

215
Q

Culture

A

Gold Std for Dx TB?

Emergency Medicine (5 decks)

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