Floor Notes Flashcards
differential diagnostic tool for atrial fibrilation?
PIRATES
Pulmonary (PE, COPD, congestion) Iatrogenic and infection Rheumatic heart dx Atherosclerosis and alcohol TSH (hypo or hyper) Electrolytes Sick sinus syndrome and sepsis
can a-fib cause a cardiomyopathy within months?
yes
cardiac enzymes are?
tropinin I
- most sensitive and specific to myocardial dmg, released from cytosol of dead myocytes
- lvls measurable in 2-4 hours (not before), normalizes in 7 days
CK (creatine kinase)
- normalizes in 3 days
define malingering
exaggerating or to feign illness to escape duty
Cardizem is?
diltiazem, a CCB (vasodilator) used for severe HTN
- should NOT be taken w/ BB
- SE: constipation, peripheral edema, lupus-like rash
what happens to WBC count during an infarct?
WBC increases d/t inflammation
CTA is?
CT (computed tomography) angiogram, a vascular study that uses iodine-rich contrast
- also involves radiation
what is the anti-coag cocktail?
Plavix (Clopidogrel), ASA, statin
what is the MOA of Clopidogrel? what’s the main risk?
adenosine-diphosphate R inh > dec platelet aggregation
bleeding
what does DAPT stand for?
dual anti-platelet therapy = ADP R inh + ASA
can PVD cause skin color changes?
yes
what should you ask from a patient when checking lung sounds?
take deep breaths with their mouth open
define munchausen syndrome
psychiatric illness where a person attempts to fake an illness to receive medical care
GI bleed from Italy that taxi’d from GB to Mani only to not enter the hospital and ditch the taxi fare.
what does fib stand for?
fucking Illinois bastard
what’s ordered to test for polycythemia vera?
JAK2 mutation
myotonic dystrophy
multisystem disorder d/t trinucleotide expansion (CTG) on c19
what can high BP limit in the kidneys?
perfusion and thus urine creation
alternative to furosemide? advantage?
bumetanide (bumex), easier on kidneys
dobutamine
b1 agonist (sympathomimetic), inc heart contractility and thus CO
mobilizing fluid causes what?
lots of urination
can the heart rebuild itself from heart failure?
yes
broken heart syndrome
takotsubo syndrome, LV becomes stunned causing acute heart failure
takotsubo = fishing pot for trapping octopus
INR can increase due to?
antibiotics, 4-5 days without significant vit K, illness
one can’t do what over the phone?
read body language
regarding blood pressure medication, what should be noted in plan section?
hold guidelines for when systolics get too low
what’s protocol for chronic steroid doses in post-op pts?
double the dose to avoid adrenal insufficiency
one ounce of prevention equals..
one pound of cure
instant patient, just..
add water
what do steroids do?
bump WBC count
FFP is..
fresh frozen plasma
VRE is..
vancomycin resistant enterococci
pronator drift
UMN dysfunction, eyes closed and arms out, palms drift towards pronation/away from supination
no such thing as bad weather, only..
bad clothing
at what point has a stress test provided adequate information?
9 minutes for treadmill, normal at this time = good prognosis
what should be added to patient charts post-op ortho?
blood loss anemia
what’s included in an ABG?
pH: 7.35 - 7.45
pCO2: 35 - 45
HCO3: 22 - 26
pO2: 80 - 200
LDH
lactate dehydrogenase, enzyme found in most cells that when found in serum suggests cell damage and death is occurring somewhere
ear infections can lead to..
disequilibrium, vertigo, light-headedness (feeling like one might faint)
what class of drugs carries risk of strokes in elderly pts with dementia?
second gen antipsychotics
if a pt is cognitively impaired and isn’t eating, what’s that mean?
red flag! figure it out
don’t prescribe what to females?
inserts
RVR
rapid ventricular rate, seen in a-fib
ivf
intravenous fluids
fluctulance
wave-like feeling to palpation
induration
increase in fibrous elements in tissue, associated with inflammation and loss of elasticity
Zosyn
Pipercillin + Tazobactam
Levaquin benefits
G- and G+ coverage, lacks psuedomonal coverage though
Phlegmasia cerulea dolens
painful leg swelling that turns the LE blue
SIRS criteria
fever > 100.4F, hypthermic 96.8
WBC > 12000 or > 10% bands
tachy (HR > 90)
hypervent (> 20 bpm) or PaCO2 < 32mmHg
what can cause hypercalcemia?
bone cancer, or metastasis to the bone, all d/t bone breakdown
