Inservice Deck 5 - rapid board review Flashcards
Where do aorta disruptions caused by blunt trauma occur?
distal to left subclavian artery at the ligamentum arteriosum
Where do majority of diaphragmatic injuries occur?
left side where no liver protection
Patients under 12, which cricothyroidotomy should you perform?
needle instead of surgical
All trauma patients who come in with GCS < 8…
need to be intubated
Findings of an uncal herniation? Which nerve?
oculomotor nerve, ipsilateral fixed and dilated pupil
equation for cerebral perfusion pressure?
MAP - ICP = CPP
how does a jefferson fracture (burst fx of C1) occur?
axial load
how does a hangman’s fx occur?
posterior C2 elements from severe hyperextension
what muscle is trapped in orbital floor fx? how does it present?
inferior rectus muscle
limited painful upward gaze with ipsilateral cheek and lip numbness with infraorbital nerve disruption
what organism is associated with human bite?
eikenella corrodens
what organism is associated with cat bite?
pasteurella multocida
what organism is associated with dog bite?
capnocytophaga canimorsus
most common organ injured in penetrating trauma?
liver
most common organ injured in blunt trauma?
spleen
most common traumatic cerebral bleed?
SAH
most common cause of coma following head injury?
diffuse axonal injury
tx of WPW? what do you avoid?
procainamide, cardioversion
avoid AV nodal blockers
side effect of thrombolysis?
accelerated idioventricular rhythm
best approach for transvenous pacer?
right internal jugular vein
EKG findings in pericardial tamponade?
electrical alternans
tachycardia
low voltage
tx of torsades?
mg or pacing in stable pt
cardioversion in unstable pt
murmur of HOCM?
crescendo-decrescendo murmur at left sternal border
increase with valsalva or standing, decrease with squatting or hand grip
most common cause of left sided endo? right sided endocarditis?
strep viridins
staph aureus
patient with chest pain and neuro findings?
thoracic aortic dissection
most common cause of esophageal rupture?
GI procedures
tx of patient with fever jaundice and RUQ pain?
ascending cholangitis
tx abx and surgical consultation
button battery lodged in esophagus? in stomach?
emergent removal
followed outpatient in stomach for 48 hours, if not through pylorus or GI sx remove endo
when is SBP indicated?
ascitic fluid with > 500 WBCs and with > 250 PMNs
most common cause of pancreatitis? second most common?
cholelithiasis, alcohol use
infection with diarrhea and pet turtle or iguana, sickle cell anemia, splenectomy, poultry or eggs with fecal WBCs?
salmonella
infection with diarrhea after abx use?
c diff
infection with diarrhea after potato salad or mayo?
staph aureus
infection with diarrhea after eating fried rice?
b cereus
infection with diarrhea after eating raw oysters?
vibrio cholera
infection with diarrhea after drinking from natural water sources?
giardia lamblia
infection with diarrhea and AIDS patient?
isosporo or cryptosporidium
what does e coli O157:H7 cause?
HUS in children
TTP in elderly
most common cause of lower GI bleeding in adults?
diverticulosis
organic causes of AMS?
AEIOU TIPS
alcohol epilepsy, endocrine, electrolytes insulin overdose, oxygen uremia trauma, temp, toxins infection psychosis, porphyria, poison stroke, shock, sepsis, lesion, SAH
back pain with bowel or bladder dysfunction?
cauda equina syndrome
back pain with upper back pain and syncope
thoracic aortic dissection
mid lower back pain with syncope?
AAA
sudden flank pain similar to ureterolithiasis in older patient
AAA
back pain worse at night?
malignancy
back pain with history of illicit IV drug use
paraspinal abscess
back pain with radicular sx/sciatica
disc herniation
tearing chest pain with upper back pain and HTN
aortic dissection
chest pain and neuro sx
type A aortic dissection
dyspnea with chest pain, worse lying down, relieved sitting forward
pericarditis
chest pressure with clenched fist on chest
acute cardiac ischemia
pleuritic chest pain with dyspnea and hemoptysis
PE
syncope with abd or back pain
AAA
syncope in first trimester of pregnancy
ectopic pregnancy
heart failure and syncope
aortic stenosis
worst headache of life, vomiting, syncope
SAH
syncope with palpitations
cardiac dysrhythmia
syncope with abnl EKG
herat block, long QT, WPW syndrome, brugada syndrome
syncope with chest pain/dyspnea
PE
sx of epiglottis?
droooling, dysphagia, distress
asthma red flags
systemic steroids sudden/severe exacerbations exacerbations requiring ICU admission 2 floor admissions in 1 year 2 ED visits in the year comorbid medical, psych, substance abuse problems
ventilator management for ARDS?
low tidal volumes and PEEP
ventilator management for asthma
low tidal volumes, low ventilation rate, permissive hypercapnia
patient with COPD exacerbation and mental status changes, think what?
hypercapnia
most common cause of CAP?
strep pneumo
h influenza
m pneumonia
PNA after flu?
staph aureus
PNA during pregnancy?
varicella
PNA with abd pain, vomiting diarrhea, hyponatremia, abnl liver function
legionella
PNA with bullous myringitis
mycoplasma
five Ts of congenital cyanotic heart disease
tetralogy of fallot transposition of great arteries tricuspid atresia truncus arteriosus total anomalous pulm venous return
- pulm atresia and hypoplastic left heart
non cyanotic cong heart lesions
VSD
PDA
endocardial cushion defect
poor feeding, diaphoresis with feeds, failure to thrive
PDA dependent lesions. Present? Tx?
sudden onset of cyanosis and shock
first week of life
tx with prostaglandin E1 infusion
side effect: apnea
infant with ambiguous genitalia and hyponatremia, hyperkalemia, and hypoglycemia?
congenital adrenal hyperplasia
tx: hydrocortisone
Association of gingivostomatitis in anterior mouth in pediatric?
herpes simplex virus
association of gingivostomatitis in posterior involvement
coxsackivirus (hand, foot, mouth)
high fever for 3-5 days in peds with diffuse lacy rash after fever?
roseola, human herpes virus 6
tx of kawasaki disease?
aspirin, IVIG
rule of 2s, what does it present with
meckel’s diverticulum
2% of population 45% of sx patients less than 2 2 cm wide 2 cm long 2 feet from iliocecal valve
abd pain, rash, edema, nephritis, arthralgias - diagnosis?
HSP
