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EM Quick Facts > FA EM Clerkship > Flashcards

FA EM Clerkship Flashcards

1
Q

What is the drug therapy in ACLS?

A

Epinephrine 1mg q 3-5 min

Vasopressin 40mg can be used in 2nd dose of Epi

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2
Q

VFib and VTach should be defibrillated (shocked) with how many joules?

A

360 mono

150-200 biphasic

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3
Q

VFib or VTach what meds to give?

A

1mg Epi

Then 300mg Amiodarone or 1-1.5 mg/kg Lidocaine

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4
Q

Tx for unstable bradycardia?

A

Atropine .5mg IV bolus q3-5 min, max dose 3mg
Transcutaneous pacing
Dopamine 5-20 mcg/kg
Epi 2-10 mcg/min

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5
Q

What makes bradycardia unstable?

A

LOC, Dec BP, CHF, ischemic chest pain

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6
Q

AFib/Aflutter tx algorithm?

A

Diltiazem .25 mg/kg IV over 2 minutes, then inc to .35 mg/kg, then infuse 5-15 mg/h IV
If no result try beta blockers:
Metoprolol 5mg IV q 5min
Esmolol 500 mcg/kg IV over 1 minute, then 50-200 mcg/kg
Atenolol 2.5-5 mg IV

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7
Q

Adenosine is contraindicated in what pts?

A

Asthma pt

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8
Q

What do you pretreat with during RSI in peds?

In head injury pt? Why?

A

Atropine - prevent Brady

Lidocaine - prevent Dec intracranial pressure

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9
Q

What is the mnemonic for normal AG metabolic acidosis?

A

HARD UP

HyperPTH
AI, anhydrase inhibitors
RTA
Diarrhea
Ureteroenteric fistula
Pancreatic fistula
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10
Q

What is a normal QRS interval?

Prolonged could mean what?

A

< .12 ms

IV conduction delay or Left or Right BB block

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11
Q

CXR that shows loss of costophrenic angle indicates what?

A

250cc of fluid at least

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12
Q

How to describe a fracture?

A 
BLT RATS
Bone
Location
Type of fracture
Rotation 
Angulation
Transposition 
Shortening
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13
Q

What are the 4 sites in a FAST exam?

A

Hepatorenal interface (Morrison’s pouch)
Splenic-renal interface
Pericardial sac
Bladder (pouch of Douglas)

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14
Q

AFib/Aflutter and unstable, what energy used for synchronized cardioversion?

A

120-200J biphasic or 200J monophonic

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15
Q

VTach w/pulse and stable, what meds?

A

Procainamide 20-50 mg/min IV, do not use in CHF

Amiodarone 150mg IV bolus over 10 minutes, can repeat 1x, then infuse 1 mg/min for 6 hours

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16
Q

Succinylcholine RSI dose?

Duration of action? Onset?

Do not use in whom?

A

1.5 mg/kg

5-10 minute, 45-60s

HyperK, crush injury, NMJ disease

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17
Q

A reduction of 0.3 mEq/L suggests total body deficit of what?

1 mEq/L dec in serum K equals about ___ mEq/L?

A

100 mEq

350

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18
Q

Hyponatremia subdivided how?

What are they?

A

Volume status

Hyper - CHF, cirrhosis, nephrotic syndrome, RF
Eu - SIADH, psychogenic polydipsia
Hypo - Diuretics, V/D, burns, 3rd spacing, RF w/excretion of free water

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19
Q

Pathologic Q waves described how?

A

> 40ms wide and 1/4 of R wave in same lead

Does not count in aVr, III, V1

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20
Q

Pregnant pt w/suspected PE, what is the best test?

Why?

A

CT

More radiation but V/Q scan radioisotope collects in bladder so there is more radiation exposure to the FETUS

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21
Q

What CN runs along the tentorium cerebelli?

MC site?

A

3

Uncal herniation

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22
Q

What is Cushing reflex?

Why does this happen?

A

HTN, bradycardia, dec respirations in setting of Increased ICP

Attempt to maintain the cerebral perfusion pressure
CPP = MAP - ICP

23
Q

How to test for CSF in setting of rhinorrhea?

A

Double ring sign
Glucose in fluid
B2-transferrin has highest sensitivity/specificity

24
Q

Basilar skull fracture, what should be started?

A

ABx

25
Q

What sign is indicative of a severe MOI in neck trauma?

A

Fracture of hyoid bone

26
Q

What is the MCly injured organ associated w/penetrating trauma?

Blunt trauma?

A

1 - liver, #2 - small bowel

27
Q

How to view Subxyphoid?

RUQ view?

LUQ view?

Pelvic?

A

Indicator facing pt’s right, transverse

Indicator to pt’s head, Midaxillary line

Indicator to pt’s head, Midaxillary line

Probe in suprapubic area

28
Q

GU trauma MC in what situation?

A

Straddle injury
Penetrating injury to lower ABD
Fall from height

29
Q

ET tube size for peds?

Depth?

A

(Age + 16) / 4

(Age + 12) / 2

30
Q

Extensor posture indicates lesion where?

A

Below red nucleus

31
Q

What orders for w/u of delirium?

What’s in a coma cocktail for resuscitation?

A

Head CT, CBC, CMP, CXR, EKG, UA, UDS

B1, glucose, Narcan, O2

32
Q

What are the causes of AMS?

A 
AEIOU TIPS
Alcohol
Encephalopathy - endocrine
Insulin diabetes
Opiates, O2 deprivation
Uremia
Trauma, Temp
Infection
Psychosis
Space-occupying lesion, SAH, stroke
33
Q

What are the contraindications to tPA?

A

SBP > 180
Hx of hemorrhagic stroke
Active bleeding
Aortic dissection

34
Q

tPA can be given up to what time now?

Except for who?

A

4.5 hours

> 80 y/o
pt anticoagulated
NIHSS > 25
DM or stroke pmhx

35
Q

Key landmarks for SAH?

A

Blood in perimesencephalic cisterns (star or crab), along the falx, or in the Sylvian fissure

36
Q

What is the major complication of SAH?
What else?

Treat how?

A

Vasospasm
Seizures

Nimodipine 60mg PO q4 hours, start w/in 96 hours
Phenytoin

37
Q

What history should you obtain in cases of seizures?

A 
Loss of bladder
Partial vs general
1st seizure or known history 
Recent hx of trauma 
Syncope?
38
Q

Definition of status epilepticus?

A

Continuous seizure > 10 minutes or 2 or more seizures occurring w/out full recovery between attacks

39
Q

What is Ludwig’s Angina?

What causes it?

A

Cellulitis of b/l submandibular spaces and lingual space

Bacteroides - anaerobe

40
Q

What is the treatment for CHF in the ED?

A 
Nitro
O2
BiPAP
Lasix
ASA
Maybe a Benzo
41
Q

PERC score what are the age and vital requirements to PERC out?

What is included the necessary history?

A

< 50 y/o, HR < 100, O2 sat > 95%

PMHx DVT, recent surgery/trauma, hemoptysis, HORMONE therapy, u/l leg swelling

42
Q

What is Light’s criteria?

A

Exudate:
LDH > 200
Fluid:serum LDH > .6
Fluid:serum protein > .5

43
Q

Treatment of COPD in the ED?

A

O2
Nebulized ipratropium/albuterol
IV steroids
Abx if underlying PNA

44
Q

TV for a pt on ventilator is normally what?

If ARDS?

A

6-10 mL/kg

4-6

45
Q

Pt w/suspected ACS, how much nitro should be given and how often?

A

.4mg q5 minutes up to 3 total doses

46
Q

MC cause of 3rd degree AV block?

A

IPF

47
Q

What to look for in LBBB?

A

Large wide R waves in I, aVL, V5, V6

48
Q

What to look for in RBBB?

What is MC?

A

Wide S waves in I, aVL, V5, V6

Rabbit ears RSR in V1, V2

49
Q

What is the difference bw MAT and wandering atrial pacemaker?

Sx?

A

Wandering atrial pacemaker has HR bw 60-100

Palpitations or anxiety

50
Q

Unstable SVT, how much synchronized cardioversion energy?

Meds?

A

50J

Adenosine 6mg, then 12, 12
Cardizem .25 mg/kg IV or Verapamil .15 mg/kg IV

51
Q

Cardinal features of WPW on EKG?

A

Short PR
Wide QRS
Delta wave = slurring of QRS

52
Q

Pt w/acute pulmonary edema in ESRD can benefit from what?

A

Sublingual captopril

53
Q

CHF exacerbation, what is the treatment?

A

BiPAP
ASA
Nitro .4 mg q5min
Lasix (40-80 mg IV)

54
Q

What is HTN urgency?

A

> 180/110 w/no End organ damage

EM Quick Facts (6 decks)

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