Lecture 1 Office Emergencies Dr. Bennet

Question 1

What is the underlying cause of Syncope?

Answer 1

Temporary insufficiency of cerebral circulation.

Tx Trendellenberg.

Question 2

Pallor, Sweating, Yawning, faintness, light headed….

Answer 2

Signs and symptoms of syncope.

Question 3

Syncope of cardiac etiology will have what unique signs and symptoms?

Answer 3

Arrythmias/ Palpatations.

Can occur in a seated patient.

Question 4

Syncope of vasovagal origin have which unique symptoms?

Answer 4

Percipitated by an unpleasant physical or emotional stress.

Question 5

Treatment options for syncope?

Answer 5

Trendelenberg with legs elevated.

Inhalation of Ammonia.

O2 administration.

Question 6

Treatment for anaphylaxis?

Answer 6

Airway control
epinephrine 0.5cc IM or .2cc into site Q 15min.

CPR
Hypotension: Ephedrine
Bronchospasm: Aminophyline

Question 7

What is the pathophysiology of asthma?

Answer 7

Spasm of smooth muscle
Airway edema
Increased mucous 
Eosinophilic infiltrate
Injury/desquamation of epithelium.

Question 8

Emergency medications for asthma attacks (5)

Answer 8

Salbutamol
Epinephrine
Ipratropium
aminophylline
Corticosteroids

Question 9

Medical treatment for acute seizures

Answer 9

Valium 10-15 mg every 10-20 mins.

Dilantin 4mg/kg IV

Question 10

Hypertensive Crisis measurement?

Answer 10

180/110 mm Hg

Question 11

What is the medical goal when treating hypertensive crisis?

Answer 11

Lower the diastolic to 90-100 mm Hg over 15 mins.

Question 12

What is insulin shock?

Answer 12

Extreme hypoglycemia due to over-administration of insulin or insulin intake without food.

Question 13

What is the treatment for hypoglycemia in a conscious vs unconscious patient?

Answer 13

Conscious: Patient is able to swallow give oral sugar or orange juice.

Unconscious: Start IV 20-50 ml of D50 slowly with 1 mg glucagon.

Question 14

What are some of the signs and symptoms of epinephrine reactions?

Answer 14

Headaches, seizures, tachycardia, palpitations, SOB.

Question 15

Treatment for a local anesthetic reaction?

Answer 15

Thorazine 0-5 mg - 1 mg IV

Demerol 12.5 mg - 25 mg IV

Question 16

Polyuria
Pilydipsia
Polyphagia

Answer 16

All signs of diabetic ketoacidosis.

Dont forget the deep rapid respirations (Kussmaul’s respiration)

Question 17

Treatment for diabetic ketoacidosis.

Answer 17

Airway maintenance

IV lifeline with liter of normal saline.

Monitor Cardiac rhythm.

Question 18

What are the two golden rules when treating diabetics in an emergency situation?

Answer 18

Anyone in a coma of unknown etiology should receive glucose.

Diabetics need glucose when in doubt as it wont harm a hyperglycemic patient to have more glucose.