General Medical Emergencies

Question 1

Types of hemophilia that only men have

Answer 1

Hemophilia A (factor VIII) (most common)
Hemophilia B (fact IX)

Question 2

Type of hemophilia that both men and women can have

Answer 2

Von Willebrand (common)

Question 3

What common medications do patients with hemophilia have to avoid? (2)

Answer 3

Aspirin + NSAIDs

Question 4

If a hemophiliac has decreased LOC following a head injury, what must you obtain immediately?

Answer 4

Head CT

Question 5

What is the treatment for hemophiliacs following a traumatic injury of any kind?

Answer 5

-replace clotting factor
-administer cryo of FFP
-ice, compression, elevation, immobilization

Question 6

What is the treatment for lacerations in a hemophiliac?

Answer 6

-replace clotting factor
-topical thrombin
-observation for 4 hours post suturing

Question 7

How long do you need to hold pressure on a hemophiliac following IV insertion or phleb draw?

Answer 7

5 minutes manual pressure

Question 8

What are some common causes of DIC?

Answer 8

sepsis, trauma, pancreatitis, HELLP in OB

Question 9

S/s of DIC

Answer 9

bruising, petechia, purpura, hematuria, excessive bleeding, end-organ failure

Question 10

Dx of DIC (4)

Answer 10

-low hemoglobin, hematocrit, platelets, fibrinogen
-prologed coags

Question 11

Tx of DIC

Answer 11

-treat underlying cause
-control bleeding
-antifibrinolytic agents (Amicar + TXA)
-Transfuse platelets, FFP

Question 12

Causes of anemia

Answer 12

-blood loss
-low iron
-low vitamin B12
-low folic acid

Question 13

Tx for anemia

Answer 13

-stop blood loss
-oral iron replacement
-replace vitamin B12

Question 14

Side effects of oral iron replacement

Answer 14

-dark stools
-constipation

Question 15

What is polycythemia?

Answer 15

Excessive red blood cells

Question 16

What is secondary polycythemia?

Answer 16

increased RBC d/t high altitude or hypoxia seen in COPD

Question 17

Tx for polycythemia vera

Answer 17

phleb to remove whole blood and infuse saline
-chemotherapy to decrease blood cell production

Question 18

What is polycythemia vera?

Answer 18

Overactive bone marrow which results in a hematocrit over 55% and results in crease in RBC, WBC, and platelets

Question 19

What organs are potentially enlarged in polycythemia vera?

Answer 19

Spleen + liver

Question 20

What is sickle cell disease?

Answer 20

congenital hemolytic anemia causes sickilg of RBCs

Question 21

What is treatment for sickle cell anemia? How does it work?

Answer 21

Hydroxyurea | Works by decreasing sickling + producing more hemoglobin

Question 22

What should acute chest syndrome be triaged as?

Answer 22

ESI 2

Question 23

What is acute chest syndrome?

Answer 23

Chest pain and dyspnea, high mortality rate

Question 24

Why do sickle cell patients often have abdominal pain when in crisis?

Answer 24

Sequestration of cell in the spleen

Question 25

What is the most common s/s of vaso-occlusive crisis?

Answer 25

Priaprism

Question 26

What are common triggers for sickle cell disease?

Answer 26

-low 02 saturation -infection -dehydration -exposure to cold

Question 27

What kind of ischemia is seen in acute chest syndrome?

Answer 27

Cardiac

Question 28

Splenic ischemia in sickle cell crisis increases....

Answer 28

risk of infection

Question 29

Main s/s of sickle cell disease

Answer 29

Excruciating, sudden, exposive pain in abdomen, chest, back, and joints

Question 30

Dx of sickle cell anemia

Answer 30

CBC to detect infection, dehydration, reticuloyte count

Question 31

Tx for sickle cell crisis

Answer 31

-high flow 02 -IVF for rehydration -antibiotics for infection -opioids for pain -early stem cell transplantation is goal