Last Go Round Flashcards
Outside Hx with redness and pustule and pain in localized area
think bee sting or ant bite
- Local=ice/Nsaids
- think anaphyalxis
- if 1 week out from it= serum sickness!
anterior cord syndrome?
Motor and pain/temp
Lymes ppx
1x dose of Doxy 200
10 year old with abnormal vitals and SVT firs tTx? Adenosine fluids or shock?
Shock (adenosine if stable)
Sudden hadache, visual stuff, Hyperdensity in sella?
Pituitary apoplexy - sudden hemorrhag or inafractin of th epituitary gland likely in the setting of a mass
Can TTP be acquired? What are the cuases?
Yes Preggos Drugs (tacro, anti-immunes) Auto immune disorders Bacterial illness AIDS
What is TTP Pentad
Fever Anemia Thrombocytopenia Renal AMS needs staroids, big line for PLEX
Order of Thyroid meds?
Propanolol, PTU
Iodine
Steroids
Neg FAST, GSW to abdomen/flank - next step
Ex lap
Kid IV access= No IOs in the lower extremities due to fractures. hem shock so no EJ an dno IV in the arms - next place for resuscitation…
Femoral Vein
ph 7.3 but CO2 10 — gotta think
Slaicylate posioning - CO2 should be 30 so now we have a resp alk on top of it
What is brpnchiloitis oliterans?
submucosal lymphocytic inflammation can disrupt the epithelium of the small airways followed by an ingrowth of fibromyxoid granulation tissue into the airway lumen, which can lead to obliteration of the airway lumen
Usually chornic lung transplant rejection
Always chack what is preg VB? What and hwo much do you give?
Mom is Rh Neg = 300 mcg rhogam if under 20 weeks
if > 20 weeks need the KB test to see how much rhgam to give
remember if she is Rh(-), there is a risk for Ab to be formed to the ag and risk for subsequent pregnancies
Rh(-) mom, rh + dad and then a Rh + baby later= Ab cros splaenta and attack and fetal hemolysis
Difference in CCB vs BB overdose?
clonidine?
HypoG is BB
pinpoint pupils is clonidine (the other is big pupils)
infant with bilious emesis - KUB or gi series , VS nomral
GI sereis for malroation
VS abnromal = X ray
outpatient fight bite meds- PCN allergy
doxy clinda
kidney stne 2 mm, UTI, VS normal- can you DC?
ROsh says yes. Urology follow up, abx, flomax. If there is obstruction (significant), fever than inpatient admission
figure 3 sign chest x ray
aortic coaractaion
look for rib notching
labrythinitis tx
steroids
severe sepsis out of favor
now septic shock
sepsis is used for SOFA scoring
+ romberg test means
Vestibular system is out
- msk proprioception
- Vestibular
- vision
- PNS + 5. CNS sytheszing the info
rapid ascent diving SOB
PTX
cold and feet
Damp, non freezing- red and burning
wet, non freezing
freezing
pernio or chilblains
trenchfoot
frostbite
ingown toenail tx
partial nail removal near the edge with digital block
PLacental abrption is painful or not
painful. +/- bleeding depdning on where tje placenta is
Salicylate txicity
ABG, tx
met acid, resp alk - low bicarb, hyprevent and low co2. alinlize the serum. lactic acidosis too
Low Co2, low bicarb!
acute chest tx
fludis, abx, transfusion therpay
high risk laryngospasm for ketamine
<3 months
URI in a kid
ear hematoma tx
ID at bottom of it, compressive dressing
ID after 48 hours or big >2 cm
Needle apsiration if <48 <2 cm
Nasal bone fx, packing, abx decision
Pack it, no abx (controversial) take packing out in 3 days and follow up ENt 1 week
preggo, hypotensive, LUQ pain
Splenic artery aneyrusm rupture (MC in preggos)
Ketosis w.out acidosis
Isopropyl
Elevated osmol gap
no role for fomepizole- supportive
Tx for eye chlamydia infant
Or erythromycin
Not topical
Refractory htn, alkalosis, hypok
Renal artery stenosis
Soilled teacup
Lunate
If upright it is capitate
Nms tx
Benzo
ascending paralysis, hyporeflexia, intact sensation…
tick paralysis
what suture should you do on the volar aspact of the hand?
Horizontal (straight line) mattress - reduces skin necrosis
what bite or sting? oral secretions + nystagmus
scorpion
How to treat CAP -
no more HCAP
go off of risk factors
give tamiflu to old lady hospitlaized after 3 days of symptoms?
yes
Where do you put abx for periotneal dialysis infection
intraperiotneal
diving
Ascent:
Air embolus- 100% oxygen
decomrpession sickness- bends- hours
Descent:
nitrgne narocsis 100 ft
barotisis 30 ft
Recent C section with foul semlling and pain= Tx
Cervicitis tx
Clinda gent endometritis
Azithr CFTX
hyperoxia test, symptoms improve with ___ problems
Lung
if not, its heart and give PGE1
oral or topical acycolivr for herpes eye?
Oral + topical steroids
ischemic stokre < 3 months ago tp a conteaidicitaion?
yes
flail chest tx
basically jus tpain control
stipid heme
PV= phleboomty PLasmaphereisis= MM and proteins leukaphroeis= AML
conreal ulcer vs abrasion looks
sharply demarcated with grey ring around it
All ICDs are also..
Ventricular pacemakers
MAgnet = Pacing mode and defbrillator off
atrial myxoma associated with what disease?
raynauds
what is hellp and how do you treat
Form of severe Pre-E- Abd pain/SOB/blurry vision +
PLts/LFts/Anemia
Mg + Labetalol + Delivery
obvious urethral injury - suprapubic cath or Uroloy consult for repair
suprapbuic cath - they repair these weeks after injury
rash around dickhole without getting better on abx and now spreading?
think SJS!
BIpap in COPD
Remember fio2 and pep is oxygen
so put the diriving pressure up and go 12/4 and allows less PEEP (the 4) and more time to exhale
CT head or give factor first in a truama?
Give factor, you would do that in head trauma and a neg ct anyway
osler weber syndrome?
AVMs, epistaxis, Telangiesctaisa on the mouth
Minimal VB in first trimester pregnant bleeding- give rohgam
controversial but Guidleines say yes
the Ab portion of the test actually looks at Anti duffy Ab
Give if Rh negative
lidocaine dosing in a code?
1.5 mg/kg - then half
What is rhematic fever
what is scaret fever
JONES after strep
Big rash during strep
If stable on trauma go to CT scanner first
peds svt dsing adenosine
electricity
.1 mg/kg > .2 mg/kg
0.5J/kg then 2x it
what physical exam do you do for costochondritis
hands behind head and posterior retractionog elbows
bells palsy tx
Steroids
+/- anitvirals
predicotrs for head bleed
loss of consciousness, seizure prior to the injury, advanced age (age greater than 60 years), amnesia after the event, intoxication, or a coagulopathy.
SSS vs NMS
SSS is quickly after a change (hyper/clonus)
NMS is after a long time on psych meds (rigidity, autonomic instabiltiy, fever)
Tx for a hearald patchand then rash
Pit rose
no tx
Lunate dislocation next step
transfer for ortho hand reduciton
Lunate is spilled
mEDIAN NERVE PALSY!
lata vs accuminata difference
lata is flat and pale (secondary syhp and)painless
Accumiante is pink and much more beefy - warts HPV
erythemas!
Nodosum= SLE, sarcoid, malignancy Multiforme: EM from drugs or infections Infectioisum: Pervo Migrans: lymes Marginatum: Rheamtic fever (JONES)
HSV eye tx
Trifluridine
or acyclovir
topcial
scarelt fever
is associated WITH phayrhngitis (still jsut abx not other tx)
Rhemuatic fever- AFTER infection
light bulub sign (there is rotatio nwhere you dont see greater tuberoisty)
posterio shoulder dislocation
elli0s 2/3
clina or augmention + calcium or znic sealant
tx brugada
ICD
afib wpw tx
procain
NOT BB- it uses accessory pathway
MVC with a horizontal SPine fx- associated injury?
Bowel injury
unstable fx- spine Chance fx
tx kawasaki
high dose aspirin
IVIG
admit
shock
Class 1- Pulse pressure 15 class 2- tachycardia 30 class 330-40 BP class 4-40
pterygium tx
nothing unless covers pupil
optho
osms
NA x2
Glucose / 2
BUN/ 2.8
218 218
Jones and stuff
Jones (worse and more distal and bigger)
psuedojoens is avulsin fx and walking boot
Lisfranc- WB, 2nd metatarsal
triads
cushings
alveolar osteotis (dry socket)
Clove oil-Eugenol
digoxin stuff
Dig effect- scooped st depressin (not toxic)
Toxicity is VT, arrythmia, PVC stuuff
Jesserson
hangman
clay shoverelver
Jeff- axial load c 1 (you would see dens to see c1)
hanfman- bilateral c2 fx
clay shovel- stabel c7 SP fx
Neck zones
1- bottom up to cric (trach one finer in)
2- cric to madible (cric someone)
3- mandible and up (bag someone with three fingers)
airway peds
get it in OR not ED
saline soaked gauze for a tooth and transfer them
toth avulsion
Ccb and bb OD tx
Calcium Glucagon (imaptied gluconeogenesis and pressorh in heart adenylate cyclase myocarial, bypasses BB recepotr and works in minutes- first line) High dose insulin (positivr inotrope) Fluids Pressors Lipid emulsion
Spironolactone can cause…
HyperK
LP spot for infants??
L45
Lower for yiung infants
First thiing that shows in 3 weeker with meningitis?
Pradoxical irritability
Cries when you pick it up
Ehat does extenral validlity also mean
Is the study geneaizable
Hyoothermia tezt iok answer- sklwiing warming in eztenral- nezt sept
Intebtla re wamring.
