July '21 Flashcards
In a flexion-type (Smith) fx or a reverse Colles fx, where will swelling be apparent? What deformity?
What nerve is at risk for injury?
volar aspect of wrist
garden spade deformity
Median nerve is at risk for injury
Which artery is at risk in a Smith fx?
radial artery
What does pregnancy do to blood pressure?
Pregnancy results in a 5-15 mm Hg fall in systolic and diastolic pressures during the second trimester, but pressures return to near normal levels in the third trimester
What happens to hematocrit in pregnancy?
decreased
smaller increase in red cell volume relative to plasma volume
What happens to WBC in pregnancy?
increases, not uncommon to see between 15-20k
How is the pediatric airway different from adults?
The pediatric epiglottis is longer, narrower, and shaped differently (omega) than the adult epiglottis
narrowest portion of the pediatric airway
cricoid cartilage, below vocal cords
Risk of mainstem intubation higher in adult or peds?
peds, due to short trachea and bronchus
MCC of airway obstruction in children
tongue
Hard signs of Aerodigestive and Neurovascular Injury Following Penetrating Neck Trauma
airway obstruction/stridor
cerebral ischemia
major hemoptysis/hematemesis
decreased or absent radial pulse
expanding, pulsatile hematoma
fluid non responsive shock
severe acute bleeding
vascular bruit or thrill
FND
Soft signs penetrating neck trauma
chest tube air leak
dysphagia or dysphonia
dyspnea
minor hematemeis or hemoptysis
mediastinal emphysema
non expanding hematoma
subcutaneous emphysema
What is the most common congenital heart defect?
VSD
where can you hear the classic VSD murmur best?
holosystolic murmur best heard at the lower left sternal border
What syndrome is associated with a ventricular septal defect that results in R to L shunting?
Eisenmenger syndrome
progressive high pulmonary vascular pressure alters flow from L to R through the VSD to R to L, leading to cyanosis
What is the MCC of pediatric hypertension?
essential/primary HTN
Which incomplete spinal cord syndrome has the best prognosis of full recovery?
Brown sequard syndrome
Want to do intubation, but concern for C-spine, collar in place, next step?
remove cervical collar and maintain inline immobilization, establish a definitive airway
parkland formula
LR = 4mL x total body surface area of burn (%) x body weight kg
50% given in first 8 hours, remainder over 16 hours
peds ETtube sizing
3.5 + (age/4) in mm
in pts between 2 and 8 yo
MCC of neonatal hemorrhage?
failure to administer Vit K in the immediate postpartum period
What test differentiates fetal from maternal blood?
Apt test
When do Koplik spots occur in relation to the rash of measles?
prior to the onset of rash
What is a major risk with perioral electrical burns?
at risk for delayed bleeding 5-21 days after the injury
(labial artery)
What is a “kissing burn”?
burn at the flexor creases of the extremities. Due to current flowing across opposing surfaces and extremity forced into flexion by an electric shock