Medical Flashcards
S/S of resp difficulty
grunting, nasal flaring, accessory muscle use, tracheal tugging, intercostal retractions, difficulty speaking, color change
COPD
relies on hypoxic drive, when arterial O2 level low
emphysema
pink puffer, pursed lips, barrel chest, damaged alveoli, wheezing
Chronic bronchitis
blue bloater, cough mucus, overweight, cyanotic, rhonchi
Asthma s/s
wheezing - 1st expiratory, 2nd inspiratory, last silent
Asthma tx
O2, epi, beta 2 agonist (albuterol, preventol, theophlyn)
Pneumonia s/s & tx
sob, fever sudden onset, rhonchi, O2 and breathing tx
Pulmonary embolus s/s
shock and resp distress, acute/sudden onset chest pain, sob, cyanotic from nipple line up
Pulmonary embolus risk factors
female, birth control pills, recent surgery or delivery, dvt, bed ridden, cellulitis of the leg, long trips
Hyperventilation
resp alkalosis, slow breathing or treat underlying cause
upright p wave
sinus rhythm
Inverted P wave
junctional rhythm (AV Node)
No P wave
junctional rhythm (bundle of his)
Sinus rhythm
SA node in RA, 60-100
Accelerated junctional rhythm
AV node, 40-60
Junctional rhythm
bundle of his, below 40
Ventricle rhythm
purkinje fibers, below 20 wide complex
Reentry
may cause PVCs or tachydysrhythmias
Layers of heart muscle out - in
epicardium(pericardium), myocardium, endocardium
Cardiac output
stroke volume X heart rate
Stroke volume
amount ejected with each contraction 80-100ml
Starling’s law
the bigger the stretch the bigger the contraction
Electrode placement for leads I,II,III
V-tach
regular, rapid, wide give amiodarone or lido
A-fib
irregular, no P wave, narrow complex
Sudden death from MI usually occurs within
1 hr of symptoms from dysrhythmias
Cardiogenic shock
pump problem, treat with dopamine
ST elevation in II, III AvF
inferior wall
ST elevation in I, AvL, V5,V6
lateral wall
St elevation in V1,V2
septal(anterior)
ST elevation in V3,V4
anterior wall
Pulmonary edema
L heart failure, blood backs into capilaries
resp distress, rales/crackles, pink frothy sputum
O2, lasix, nitro morphine(vasodilation) CPAP
Cor pulmonale
R heart failure, blood backs into venous system
JVD, pedal or sacral edmea
Checking responsiveness
C - circulation
A - airway
B - breathing
D - defibrillation
Assessment ABCs
LOC: if unresponsive do CAB
if responsive do
ABCD(disability loc)E(extremities)
ACLS secondary survey
A - adv airway (ET,LMA,etc)
B - breathing (assessed, assured, & secured, O2)
C - Circ interventions (IV, EKG)
D - differential diagnosis
Differntial Diagnosis for cardiac arrest
5 Hs & Ts
Hypovolemia Thromboemboli (pulm & coronary)
Hypothermia Trauma
Hypoxia Tension pneumo
Hydrgen ion (acidosis) Tamponade
Hyper/hypo kalemia Toxins (OD)
Most likely reversible cause of PEA
hypovolemia
Abd aortic aneurysm
Lumbar back/abd pain, tearing pain, hx of htn, pulsating mass
unequal pulses in lower ext
Hypertension
crisis - headache, photophobia, epistaxis
200/100
Joules settings for v-fib
1st - 200j
2nd - 300j
3rd - 360j
How much valium for seizure
5 - 10 mg IV
Statis epilepticus
2 or more seizures without consciousness or a prolonged seizure
Absence/petit mal seizures
children have many a day, may or may not lose consciousness
Focal motor seizures
only one specific area is seizing
S/S of stroke
visual disturbances, speech disturbance, may have loc change, hemiparesis, dizzy
Causes of AMS
hypoperfusion, hypoglycemia, heat stroke
AEIOU-TIPS
alcohol, epilepsy, insulin, od, underdose
trauma, infection, psychosis, stroke
Pituitary gland
master gland
pea-shaped in brain
releases oxytocin and ACTH
Adrenal gland
superior portion of kidneys
releases epi and norepi
Islets of langerhans
in pancreas produces insulin
glucagon
produced in pancreas, sent to liver where stored as glycogen
DKA
metabolic acidosis resp alkalosis
kussmaul’s, polyuria, polydyspsia, polyphagia
Insulin shock
(hypoglycemia)
sudden onset, cold clammy, headache weak dizzy
IM glucagon
Epi doses for allergic reaction
adult - 0.3 mg
pedi - 0.15 mg
Upper GI hemorrhage
black tarry stool(melena), vomiting blood/coffee ground
colored(hematemesis) may be bleeding ulcer
Lower GI bleed
bright red or wine colored stool (hematochezia)
Appendicitis
RLQ pain, N/V, no appetite, may start periumbilical
low fever unless ruptured, constipation
Cholecystitis
RUQ pain, yellow/green bile vomit
Cystitis
most common cause of UTI
Abd pain pt usually more comfortable in what position
lateral recumbent with knees bent (fetal position)
Poison control number
1-800-222-1222
Tricyclic antidepressants
(tofranil, elavil)
treat with sodium bicarb
Aspirin OD
hyperventilation, tachycardia, fever, sweating
tinnitus
Pit viper bite VS coral snake
necrotoxin
neurotoxin
Marine animal
(coelenterates)
salt water, meat tenderizer, vinegar, hot water
Stings
do not rub or use cold water
Cocaine/speed OD
dilated pupils, tahcycardia, v-tach, seizures, agitated/restless
benzo is antidote
Benzo OD
romazicon
delirium tremens
48-72 hrs after last drink
Organophosphate poisoning
SLUDGE
salivation, lacrimation, urination, diarrhea, GI, emesis
constricted pupils, slow pulse
give atropine large frequent doses
Heat exhaustion
sodium/water loss
tachycardic and sweating
Heat stroke
true medical emergency temp 105-106 stops sweating
rapid cooling, IV
salt water VS fresh water drowning
salt - pulm edema
fresh - hemodilution
Radiation
alpha, beta, gamma
alpha - 6 in clothes protect
beta - 1-2 ft
gamma - unlimited distance
Meningitis
fever, nucal rigidity, AMS, headache
question: present @ football games fever, stiff neck for days
Hepatitis
RUQ pain(murphy’s sign), dark urine, clay stools, sick for days or weeks
TB
more common in HIV pt
Most common cause of PID
gonorrhea
Psychotic VS neurotic
psychotic worse not in touch with reality
Restrain pt in what position
on back(supine) or side
prefer 5 people
placenta
gas exchange, nutrients, wastes, heat, hormone production
Stages of labor
1st - start of labor - complete dilation
2nd - complete dilation - delivery of baby
3rd - delivery of baby - delivery of placenta
Ectopic pregnancy
1 sided lower abd pain, blood spotting
kehr’s sign - referred pain to shoulders
Supine hypotensive syndrome
syncope, dizzy
put on left side
Hypertensive syndrome
preeclampsia
toxemia
htn, protein in urine, swelling, epigastric pain, hyper reflexes
first mag sulfate if seizing the valium if it continues
