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Clinical Disciplines- Emergency Medicine > Exam 3 - Study guide (MC) > Flashcards

Exam 3 - Study guide (MC) Flashcards

1
Q

Opiate toxidrome antidote

A

Naloxone (Narcan)

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2
Q

Valproate antidote (2)

A

Charcoal

L-carnitine

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3
Q

Methanol antidotes (3)

A

Fomepizole
Etoh
HD

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4
Q

Visine antidote

A

Atropine

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5
Q

Camphor antidotes (2)

A

Charcoal

Benzos

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6
Q

Cocaine antidote

A

Benzos

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7
Q

Iron poisoning tx (4)

A

Gastric lavage
Whole bowel irrigation
MOM
Deferoxamine

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8
Q

Cyanide toxicity tx (5)

A 
100% O2
Amyl nitrite
Sodium nitrite 
Sodium thiosulfate 
Hydroxocobalamin
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9
Q

Digoxin antidote? How often should you check levels? What should you avoid?

A
  • Digibind
  • Check level at least 6 hrs after last dose
  • Avoid Ca –> increased arrhythmias (“stone heart”)
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10
Q

CCB antidotes (4)

A

CaCl
Glucagon
Epi
Insulin

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11
Q

Acetaminophen antidote? At what time is it no longer beneficial? What are side effects of the antidote?

A

N-acetylcystine

  • No benefit if > 8hrs
  • N/V/D
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12
Q

Barbiturates antidotes (3)

A

Glucose
Narcan
Charcoal

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13
Q

Lithium antidote

A

Benzos for seizures

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14
Q

Isopropanol tx (2)

A

IVF

Ventilation

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15
Q

Ethylene glycol tx

A

Similar to methanol:
Fomepizole
Etoh
HD

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16
Q

Bath salts antidotes (4)

A

Cooling
IVF
Bicarb
Benzos

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17
Q

Amphetamines antidotes (3)

A

Benzos
Haldol
Cooling

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18
Q

MDMA (ecstacy) antidote

A

Benzos

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19
Q

Phenycyclidine (PCP) antidote

A

Benzos

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20
Q

Hydrofluoric acid antidote

A

Ca gluconate

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21
Q

Dystonic reactions antidotes (2)

A

Benadryl

Benzos

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22
Q

TCAs antidotes (2 categories)

A

For hypotension: fluids, bicarb, alpha agonists

For seizures: benzos, barbituates

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23
Q

TCAs + ________ = DEATH

A

Procainamide

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24
Q

BB antidote

A

Glucagon

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25
What increases osmolar gap?
ME DIE - Methanol - Ethylene glycol - Diuretics - Isopropyl alcohol - Etoh
26
What causes 1/4 of all trauma related deaths?
Blunt trauma
27
When should you provide ventilatory support to a trauma pt? (6)
- Upper airway obstruction - Flail chest - Multiple injuries - Comatose - Elderly - O2 < 50% on RA or < 80% on >40% O2
28
How do you dx sternal fx?
Serial EKGs q 8hrs for 24-36hrs | Echo
29
How do you tx scapular fx?
Sling Ice Analgesics Early ROM
30
When does a scapular fx require surgery?
If it involves glenoid &/or coracoid
31
When is mechanical ventilation required for flail chest?
- Shock - 3+ injuries - Head injury - Prior pulm disease - 8+ rib fractures - > 65yo
32
What occurs during pulmonary contusion?
Direct injury w/ no laceration --> hemorrhage & edema --> interstitial & intra-alveolar fluid collection
33
How do you dx pulmonary contusion?
pulmonary opacity within 6hrs of blunt trauma
34
How do you tx pulmonary contusion?
Ventilation | Pain & chest physiotherapy
35
When is mechanical ventilation for pulmonary contusion required?
When 1/4 lung volume involved or pre-existing pulmonary disease *May need to have uninjured lung down!
36
What is the clinical presentation of a basilar skull fx? (3)
- Raccoon eyes - Battle sign - Hemotympanum
37
What is the clinical presentation of transtentorial/uncal herniation?
- Oculomotor n compression --> ipsilateral dilated pupil | - Cerebral peduncle compression --> contralateral hemiparesis
38
What are warning signs of an orbital blow-out fx? (3)
- Infraorbital numbness - Enophthalmos - limited upward gaze w/ diplopia
39
How do you tx orbital blow-out fx?
Augmentin | Tetanus prophylaxis
40
What do you see w/ splenic rupture?
Kher's sign (L shoulder pain)
41
What is the MC blunt trauma of the abd? What is the MC penetrating?
``` Blunt = splenic Penetrating = liver ```
42
How do you dx renal injuries?
CT IVP Angiography
43
What causes renal injuries?
Direct impact or decelerating force
44
How is the pancreas injured? How do you dx?
Compression against spine CT *Amylase & DPL are NOT reliable
45
How do you dx bladder injuries?
Cystogram | CT w/ contrast
46
What are S/S of pneumomediastinum?
- Hamman's crunch | - SubQ emphysema in neck
47
What are S/S of cardiac tamponade? What is the triad?
- Becks triad: JVD, muffled heart sounds, hypotension - Pulsus paradox (10-15 drop in SBP during inspiration) - Kussmaul sign (increase in JVD & pressure during inspiration) - Electrical alternans
48
How do you tx cardiac tamponade?
Pericardiocentesis via paraxyphoid approach w/ 18 gauge & 20cc syringe, directed toward L scapular tip
49
What are characteristics of an aortic rupture? What is seen on CXR?
- Most commonly involves aortic isthmus - Retrosternal or interscapular pain (worse w/ increased BP) - CXR: mediastinal widening (MC), deviation of esophagus (most accurate sign), L pleural effusion, blurred aortic knob
50
What imaging do you use to dx aortic rupture?
TEE CT Aortography
51
How do you tx aortic rupture?
Avoid valsalva/vomiting Maintain SBP <120 Surgery
52
What is most associated w/ myocardial contusion? What is the main cause?
Sternum fx MVC
53
What indicated increased ICP? What is the triad?
Cushings triad: HTN, depressed respiratory, brady
54
How do you tx salicylate overdose? (5)
- Gastric lavage if within 1hr - Charcol - Normal saline - NaHCO3 - HD (if ESRD, CNS toxicity, serum>100, worsening, failure to alkalinize)
55
How do you tx barbiturate overdose? (4)
Glucose Narcan Charcoal Urinary alkalinization
56
What are sx of acetaminophen overdose? (3)
- Centrolobular necrosis - Vomiting (esp children) - Renal failure
57
What are the phases of acetaminophen overdose?
0-24 hrs = N/V, pallor, diaphoresis, malaise 24-48 hrs = RUQ pain, increased LFTs 72-96 hrs = LFTs peak, coagulopathy, encephalopathy 4-14 days = recover or die
58
What is the serotonin syndrome triad?
Myoclonus MS changes Shivering
59
What are other sx of sertonin syndrome?
``` "A2D2H2T" Agitation, ataxia Diarrhea, diaphoresis Hyperreflexia, hyperthermia Tremor ```
60
Antifreeze toxicity - what does the urine fluorescence reveal?
Ca oxalate crystals
61
Digoxin overdose - what is seen on EKG?
Atach w/ AV block
62
What is the triad seen w/ hypoglycemia?
Whipple's triad - Diaphoresis - Nausea - AMS
63
Iron toxicity - what is seen on labs?
Basophilic stippling & "vin rose" urine
64
What is the clinical presentation of dystonic rxns?
- Sudden onset abnormal posturing of head, neck, jaw - Contractures of lips, tongue, face, throat - Trismus, torticollis, tongue protrusions - Laryngeal, pharyngeal spasms - Fear, axiety - Oculogyric crisis (unable to move eyes in vertical plane, double vision)
65
How do you tx dystonic rxns?
- Benadryl 3-4 days to prevent recurrence | - Benzos
66
What are RFs for dystonic rxns?
``` Male Young Cocaine Hypocalcemia Neurodegenerative d/o ```
67
What is the clinical presentation of diverticulitis? (3)
Abrupt onset LLQ pain Fever Leukocytosis w/ left shift
68
How do you tx diverticulitis?
``` Levaquin Flagyl Zosyn If severe --> add vanco If abscess --> drain ```
69
How do you tx mesenteric ischemia?
Heparin | Abx
70
How do you tx H. pylori?
H2 blockers or PPI | Surgery
71
How do you tx urolithiasis?
<5mm = no tx (will pass) > 5mm: - Toradol - Morphine - Antiemetics - IVF - If infection --> abx, drain, admit
72
How do you tx pancreatitis?
"Place bowel at rest" - NPO - Fluids - Demerol - Antiemetics
73
How do you tx frostbite?
``` Elevate, splint Wrap in dry gauze Debride Tetanus Analgesics ```
74
How do you tx heat stroke? (4)
- IVF - Ice packs - Evaporative cooling* - Diazepam
75
How do you tx jellyfish sting? (3)
Vinegar Isopropyl alcohol Anesthetics (topical or oral)
76
How do you tx hymenoptera stings?
Antihistamines Epi (IM or auto-injector) Steroids Beta agonists
77
How do you tx black widow spider bite? (4)
Narcotics Benzos Antivenin Ca gluconate
78
How do you tx scabies?
``` Lindane (also used for lice) Elemite Calamine lotion Oral antipruritic agents Analgesics ```
79
How do you tx snake bites?
Elevate, constriction bands Antivenins: "polyvalent"
80
How do you tx scorpion sting?
cool compress | anascorp antivenin
81
How do you tx thermal burns?
``` Tetanus prophylaxis NG tube Narcotics Debride, steril dressings Ointment ```
82
What is the MC active enzyme of the brown recluse spider?
Sphingomyelinase D
83
What is the triad of heat stroke?
Hyperthermia >105 CNS dysfunction Anhydrosis
84
What is the MCC of pancreatitis? (3)
Alcoholism Cholelithiasis Hypertriglyeridemia
85
What is the clinical presentation of epididymitis?
- Gradual, bilateral pain - Fever - Phren's sign (relief w/ scrotal elevation) - Swelling - Worse w/ standing - 19-35yo
86
What is the clinical presentation of testicular torsion?
- Bell clapper deformity - Sudden, unilateral pain - Absent cremaster reflex - Vomiting common - Neonates, 12-15yo
87
What are sx of a barbiturate overdose?
CNS depression Hypothermia, hypoglycemia Urinary retention Aspiration pneumo*
88
What are characteristics & dx tests for appendicitis?
- Periumbilical, RLQ pain - Fever, N/V, anorexia - Rovsings sign: pain in RLQ w/ palpation of LLQ - Iliopsoas sign: pt supine, R knee extender & flex right hip - Obturator sign: pt supine, flex R knee to 90˚, internally/externally rotates hip - Alvarado score (10 pts total)
89
What are S/S of digoxin?
- N/V, weakness - Vision changes (yellow halos) - Syncope - MS changes - Hyperkalemia

Clinical Disciplines- Emergency Medicine (3 decks)

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