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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?

25
What sign is indicative of a severe MOI in neck trauma?
Fracture of hyoid bone
26
What is the MCly injured organ associated w/penetrating trauma? Blunt trauma?
#1 - liver, #2 - small bowel #1 - spleen, #2 - liver
27
How to view Subxyphoid? RUQ view? LUQ view? Pelvic?
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
GU trauma MC in what situation?
Straddle injury Penetrating injury to lower ABD Fall from height
29
ET tube size for peds? Depth?
(Age + 16) / 4 (Age + 12) / 2
30
Extensor posture indicates lesion where?
Below red nucleus
31
What orders for w/u of delirium? What’s in a coma cocktail for resuscitation?
Head CT, CBC, CMP, CXR, EKG, UA, UDS B1, glucose, Narcan, O2
32
What are the causes of AMS?
``` AEIOU TIPS Alcohol Encephalopathy - endocrine Insulin diabetes Opiates, O2 deprivation Uremia Trauma, Temp Infection Psychosis Space-occupying lesion, SAH, stroke ```
33
What are the contraindications to tPA?
SBP > 180 Hx of hemorrhagic stroke Active bleeding Aortic dissection
34
tPA can be given up to what time now? Except for who?
4.5 hours > 80 y/o pt anticoagulated NIHSS > 25 DM or stroke pmhx
35
Key landmarks for SAH?
Blood in perimesencephalic cisterns (star or crab), along the falx, or in the Sylvian fissure
36
What is the major complication of SAH? What else? Treat how?
Vasospasm Seizures Nimodipine 60mg PO q4 hours, start w/in 96 hours Phenytoin
37
What history should you obtain in cases of seizures?
``` Loss of bladder Partial vs general 1st seizure or known history Recent hx of trauma Syncope? ```
38
Definition of status epilepticus?
Continuous seizure > 10 minutes or 2 or more seizures occurring w/out full recovery between attacks
39
What is Ludwig’s Angina? What causes it?
Cellulitis of b/l submandibular spaces and lingual space Bacteroides - anaerobe
40
What is the treatment for CHF in the ED?
``` Nitro O2 BiPAP Lasix ASA Maybe a Benzo ```
41
PERC score what are the age and vital requirements to PERC out? What is included the necessary history?
< 50 y/o, HR < 100, O2 sat > 95% PMHx DVT, recent surgery/trauma, hemoptysis, HORMONE therapy, u/l leg swelling
42
What is Light’s criteria?
Exudate: LDH > 200 Fluid:serum LDH > .6 Fluid:serum protein > .5
43
Treatment of COPD in the ED?
O2 Nebulized ipratropium/albuterol IV steroids Abx if underlying PNA
44
TV for a pt on ventilator is normally what? If ARDS?
6-10 mL/kg 4-6
45
Pt w/suspected ACS, how much nitro should be given and how often?
.4mg q5 minutes up to 3 total doses
46
MC cause of 3rd degree AV block?
IPF
47
What to look for in LBBB?
Large wide R waves in I, aVL, V5, V6
48
What to look for in RBBB? What is MC?
Wide S waves in I, aVL, V5, V6 Rabbit ears RSR in V1, V2
49
What is the difference bw MAT and wandering atrial pacemaker? Sx?
Wandering atrial pacemaker has HR bw 60-100 Palpitations or anxiety
50
Unstable SVT, how much synchronized cardioversion energy? Meds?
50J Adenosine 6mg, then 12, 12 Cardizem .25 mg/kg IV or Verapamil .15 mg/kg IV
51
Cardinal features of WPW on EKG?
Short PR Wide QRS Delta wave = slurring of QRS
52
Pt w/acute pulmonary edema in ESRD can benefit from what?
Sublingual captopril
53
CHF exacerbation, what is the treatment?
BiPAP ASA Nitro .4 mg q5min Lasix (40-80 mg IV)
54
What is HTN urgency?
> 180/110 w/no End organ damage

EM Quick Facts (6 decks)

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