Medical Emergencies Flashcards
Causes of Seizures: Neonatal
A severe infection that spreads throughout the body:
Sepsis
Causes of Seizures: Neonatal
Elevated body temperature:
Fever
Causes of Seizures: Neonatal
Low blood sugar:
Hypoglycemia
Causes of Seizures: Neonatal
Brain damage due to lack of oxygen:
Hypoxic-Ischemic Encephalopathy
Causes of Seizures: Neonatal
Imbalances in body chemistry:
Metabolic Disturbances
Causes of Seizures: Neonatal
Infection of the protective membranes covering the brain and spinal cord:
Meningitis
Causes of Seizures: Neonatal
Issues in brain development:
Developmental Abnormalities
Causes of Seizures: Neonatal
Symptoms occurring after stopping drug use:
Drug withdrawal
Causes of Seizures: Pediatric
Often leading to febrile seizures:
Fever
Causes of Seizures: Pediatric
Lack of oxygen:
Hypoxia
Causes of Seizures: Pediatric
Various infections can trigger seizures:
Infections
Causes of Seizures: Pediatric
Seizures with no known cause:
Idiopathic Epilepsy
Causes of Seizures: Pediatric
Imbalances in mineral in the body:
Electrolyte disturbances
Causes of Seizures: Pediatric
Injury to the head:
Head Trauma
Causes of Seizures: Pediatric
Low Blood Sugar:
Hypoglycemia
Causes of Seizures: Pediactic
Poisoning or exposure to harmful substances:
Toxic Ingestions or Exposure
Causes of Seizures: Pediatric
Growths in the brain:
Tumors
Causes of Seizures: Pediatric
Structural abnormalities in the central nervous system:
CNS Malformations
Causes of Seizures: General
Lack of oxygen:
Hypoxia
Causes of Seizures: General
Sudden drop in blood sugar levels:
Rapid Lowering of Blood Sugar
Causes of Seizures: General
Tumors, head trauma, toxic eclampsia, and vascular disorders:
Structural Brain Diseases
Causes of Seizures: General
Seizures without a known cause:
Idiopathic Epilepsy
What is the most common TYPE of seizure?
Grand Mal Seizure
_____ Phase: initial phase involves continuous muscle tension and contraction, leading to rigidity.
Tonic Phase
_____ phase: follows tonic phase and marked by rhythmic jerking movement of the extremities.
Clonic Phase
_____ seizure typically starts without warning phase (aura) and progresses through tonic and clonic phases, ending with period of recovery.
General Tonic - Clonic (Grand Mal)
2 types of Procedures to treat Hemorrhagic Stroke:
Endovascular Procedure
Neurosurgical Prodedures
Hemorrhagic Stroke Treatment: Endovascular Procedure
_____ Interventions: Catheter is inserted through an artery in the leg or arm and advanced to the hemorrhage site. Mechanical agents like coils can be placed to prevent further bleeding.
Catheter Based Interventions
Hemorrhagic Stroke Treatment: Neurosurgical Procedures
_____ Interventions: Severe cases, or when endovascular therapy is not feasible, neurosurgery may be necessary to remove the blood and repair the damaged vessels
Surgical Interventions
2 Types of Treatment for Ischemic Stroke:
Fibrinolytic Therapy
Mechanical Clot Removal
Treatment for Ischemic Stroke: Fibrinolytic Therapy
Goal:
Common Drug:
Other Drugs:
Timing:
Goal: Restore blood flow by dissolving the clot
Common Drug: Recombinant Tissue Plasminogen Activator (r-tPA)
Other Drugs: Tenecteplase, Retaplase, Streptokinase, Anistreplase
Timing: Most effective with first 4.5 hours after symptom onset.
Treatment for Ischemic Stroke: Mechanical Clot Removal (Mechanical Thrombectomy)
Procedure:
Timing:
Combination:
Procedure: Wire-Cage device is threaded through catheter to the blocked artery in the brain to remove the clot.
Timing: Ideally within 6 hours of symptom onset, but can be beneficial up to 24 hours in select pt.
Combination: Can be used alongside r-tPA in eligible patients
Treatment for Transient Ischemic Attack (TIA): Immediate Care
Early Recognition:
Airway Management:
Stroke Assessment:
Transport
Early recognition - rapid identification & supportive measures are crucial
Airway Management - ensure an adequate airway and provide oxygen if needed
Stroke Assessment - perform a stroke assessment and establish the time when the pt was last seen normal
Transport - NEarest stroke center & alert stroke team
_____ Strokes: due to blood flow to an artery in the brain is interrupted by a narrowing or blockage. Often due to a clot.
Ischemic Stroke
_____ Strokes: Occur when an artery in the brain leaks blood or ruptures. Due to high blood pressure, aneurysms or arteriovenous malformations.
Hemorrhagic Stroke
_____ : Temporary Sudden interruption of blood flow to the brain. SS identical to stroke. Typically resolves within 24 hours and DO NOT cause permanent damage. Can be a warning sign of future stroke.
Transient Ischemic Attack
8 D’s of Stroke Care:
Detection
Dispatch
Delivery
Door
Data
Decision
Drug
Disposition
_____: Conditions where the thyroid gland insufficient thyroid hormones.
SS-Decreased metabolic rate, weight gain, fatigue, bradycardia, myxedema (puffy face)
Hypothyroidism
_____: condition where the thyroid gland produces excessive thyroid hormones.
SS- Tachycardia, hypertension, hyperthermia, nervousness, insomnia, increased metabolic rate, weight loss and severe cases of exophthalmus (protrusion of the eyeballs).
Hyperthyroidism
Key Differences in Hypo VS Hyper Thyroidism:
Hormones Levels:
Metabolic Rate:
Common Cause:
Hormones:
Hypo- Low levels of thyroid hormones
Hyper- High levels
Metabolic Rate:
Hypo- Decreases
Hyper- Increases
Common Causes:
Hypo- Hashimotos disease
Hyper- Graves’ disease
SS of Opiate OD
Classic Triad of Opioid Toxicity
- Respiratory Depression, Miosis, Bradycardia
Hypothermia
What is the treatment for Opiate OD?
Naloxone (Narcan) = Opioid Antagonist
-Dose: .4-2mg every 2-3 minutes MAX 2mg
Disorder caused by high levels of cortisol in the blood.
Can result form long-term use of Glucocorticoid medication (prednisone) or from tumors on the pituitary gland.
Typically affects middle-aged individuals with women affected more than them.
Cushing Syndrome
SS of _____ include:
Weight gain (especially around trunk, face and neck)
Moon face
Buffalo hump
Skin changes
Emotional instability
Cardiovascular issues (hypertension and cardiac hypertrophy)
Metabolic changes (diabetes, osteoporosis and muscle wasting.
Cushing Syndrome
Most Likely treatment for Cushing’s Syndrome:
Surgical Treatment - Tumor Removal
Pharmacological Treatment - Antihypertensives and anti-adrenal mediations.
Patient with _____ require careful monitoring due to their increased risk of cardiovascular disease, skin fragility and susceptibility to infections.
Cushing’s Syndrome
_____: Predictable and often minor reactions that occur in addition to the desired therapeutic effect of medication. eg. Nausea, headache, dizziness, mild gastrointestinal discomfort.
Common Drug Side Effects
_____: Unintended and harmful reactions that occur at normal doses used for prophylaxis, diagnosis or therapy. e.g. allergic reactions, gastrointestinal bleeding, significant increases in blood glucose levels.
Adverse Effects
_____ pain: originates from the internal organs, specifically the walls of hollow organs.
Visceral Pain
_____ Pain: Sharp, well-defined pain that travels along specific neural routes, known as dermatology, to the spinal column.
Solid Organ
Somatic Pain
_____ Pain: Pain that is felt in a location different from its site of origin.
Referred Pain
Pain from an MI often referred to _____, _____, _____ or _____. (Locations)
Left arm, neck, jaw or back.
Visceral pain = _____
Hollow Organ Pain
Somatic Pain = _____
Pain from Solid Organs
Why do we use Inhaler with Patients?
Metered Dose Inhalers
Used to deliver medication directly to lungs.
Delivers a specific amount.
MDI’s are portable and easy to use.
Spacers can be added to accommodate pt who may have difficulty timing coordinating.
SS of Diverticulitis:
LLQ Pain
Fever
Elevated WBC
Nausea/Vomiting
Tenderness on palpation
Colicky Pain
Hematochezia (bright red bloody feces)
Perception of Incomplete Defecation
Complications of Diverticulitis:
Hemorrhage
Peritonitis
Prevention of Diverticulitis:
High Fibre Diet
Stay Hydrated
Regular Exercise
Avoid Straining
Avoid seeds/nuts
Pre-hospital care for diverticulitis:
Primarily supportive care; Monitor airway; IV fluids
SS of TIA:
Fuck With Shit, Via Con Dios
Facial Drooping
Weakness or numbness
Speech difficulties
Vision problems
Confusion
Dizziness
_____ Coronary Artery: supplies blood to a portion of the Right Atrium, Right ventricle and upper portion of the heart’s conduction system.
Right Coronary Artery
_____ Coronary Artery: Supplies the Left ventricle, interventricular septum, part of the right ventricle and lower conduction system.
Left Coronary Artery
_____ Bundle Branch Block can result from acute MI, medication use, electrolyte abnormalities and age related deterioration of the cardiac conduction system.
Right Bundle Branch Block
When _____ Bundle Branch is blocked, impulse travels down the LBB and spread through the interventricular septum to the RV, causing a delay in the right ventricle depolarization.
Right Bundle Branch
_____ Bundle Branch Block: Seen as Prolonged QRS in V1 upwards from the isometric line
Right Bundle Branch
_____ Bundle Branch Blocks: Significant myocardial disease, MI, medications, electrolyte abnormalities & degenerative disease of the conduction system
Left Bundle Branch Block
_____ Bundle Branch Block: Left Ventricle cannot depolarize normally. Impulse travels from the right ventricle through the interventricular septum to the left ventricle, causing a delay in the Left Ventricular Depolarization
Left Bundle Branch Block
_____ bundle branch block is seen as a prolonged QRS in V1 downwards from the Isometric line.
Left Bundle Branch Block
______: Severe & potentially fatal condition that begins with an infection in the bloodstream (septicemia)
Septic Shock
SS of Septic Shock: Increased Cardiac Output
Which One:
-Early Stages
-Progressive Symptoms
-Late Stages
Early Stages
SS of Septic Shock: Fever
Which One:
-Early Stages
-Progressive Symptoms
-Late Stages
Progressive Symptom
SS of Septic Shock: Skin Changes
Which One:
-Early Stages
-Progressive Symptoms
-Late Stages
Progressive Symptom
SS of Septic Shock: Respiratory Issues
Which One:
-Early Stages
-Progressive Symptoms
-Late Stages
Progressive Symptom
SS of Septic Shock: Altered Mental Status
Which One:
-Early Stages
-Progressive Symptoms
-Late Stages
Progressive Symptom
SS of Septic Shock: Severe Hypotension
Which One:
-Early Stages
-Progressive Symptoms
-Late Stages
Late Stages
SS of Septic Shock: Organ Dysfuncion
Which One:
-Early Stages
-Progressive Symptoms
-Late Stages
Late Stages
_____: Type of peptic ulcer that occurs in the proximal portion of the duodenum.
Duodenal Ulcer
Causes of Duodenal Ulcers:
_____ is found in over 80% of duodenal ulcers.
Helicobacter Pylori Bacteria
Causes of Duodenal Ulcers:
Medications like _____ can damage the mucosal lining.
Nonsteroidal Anti-Inflammatory Drugs: aspirin, ibuprofen and naproxen
Causes of Duodenal Ulcers:
Products like alcohol and nicotine.
Acid-Stimulating Products
Causes of Duodenal Ulcers:
_____ prevents neutralization of stomach acid in the duodenum.
Obstructed Pancreatic Duct
Causes of Duodenal Ulcers:
_____ a rare condition where an acid-secreting tumor causes ulcers.
So rare that in a list from A-Z its Z.
Zollinger-Ellison Syndrome
Pain from _____ often occurs at night or when the stomach is empty. May be relieved by drinking milk.
Duodenal Ulcers
Bleeding from _____ can cause anemia, hematemesis (vomiting blood) or melena (black, tarry stools).
Duodenal Ulcers
N/V caused by _____ is due to irritation of the mucosa.
Duodenal Ulcers
Medications for _____ include antacids, antibiotics, H2 histamine blockers, and proton-pump inhibitors.
Duodenal Ulcers
_____: progressive and debilitating condition characterized by chronic airflow obstruction. Included a combination of emphysema, chronic bronchitis and asthma.
Chronic Obstructive Pulmonary Disease (COPD)
Common Symptoms of _____:
Dyspnea, Cough, Increase Sputum Production, Wheezing, Tachypnea, Pleuritic Chest Pain, Accessory Muscle Use, Pursed Lip Breathing, Tripod Positioning.
Chronic Obstructive Pulmonary Disease
Severe Symptoms of _____:
Confusion and Agitation, Somnolence (excessive sleepiness), 1-2 word dyspnea
Chronic Obstructive Pulmonary Disease
Physical Exam Findings of _____:
Barrel Chest, Clubbing of Fingers, Jugular Vein Distention, Peripheral Edema
Chronic Obstructive Pulmonary Disease
SPO2 should be ___-___ % for COPD patients.
90-95%
COPD patients work on _____ drive.
Hypoxic drive.
Transport for COPD patient in what position?
Position of comfort and ensure airway stays patent.
2 things to not give too much of in COPD patients:
Oxygen - Hypoxic Drive
Fluids - Can cause flash pulmonary edema
_____ can prevent the need for intubation in COPD patients.
CPAP
CPAP should be ___-___cm H2O.
5-10
_____ and _____ can be used early in the management of COPD patients.
Albuterol and Corticosteroids
_____: Inflammation of the vermiform appendix, small tube like structure to the large intestine at the ileocecal junction.
Appendicitis
_____ is usually caused by an obstruction of the appendiceal lumen by fecal material, food particles or tumor.
Appendicitis
Symptoms of _____ include:
Diffuse, colicky pain; N/V with low grade fever; Pain often starts in the periumbilical region and later localizes to the RLQ (McBurney’s Point)
Appendicitis
Fever and stiff neck:
Meningitis
_____: Inflammation of the gallbladder, often caused by gallstones.
Cholecystitis
Primary cause of cholecystitis in 90% of cases is _____.
Gallstones
Symptoms of _____ include:
Severe pain in RUQ radiating to the right shoulder; pain occurs after a high-fat meal; N/V and tenderness in the right subcoastal region.
Cholecystitis
_____ forms when bile, produced by the liver to remove cholesterol, becomes super saturated and forms stone like masses; stones can obstruct the cystic duct; leading to inflammation.
Gallstones (Cholecystitis)
Risk Factors for _____:
Obese middle-aged women with multiple children as well as Pima Indians and Scandinavian.
Cholecystitis.
_____: inflammation of the exocrine Pancreas.
Pancreatitis
Causes of Pancreatitis:
Metabolic: _____ is a major cause, accounting for about 80% of cases in the US.
Alcoholism
_____ Phase: After seizures; PT may experience confusion drowsiness or coma.
Postictal
Causes of Pancreatitis:
Mechanical: _____ or elevated serum lipids can obstruct the pancreatic duct.
Gallstones
Causes of Pancreatitis:
Vascular: _____ or shock can lead to vascular injuries.
Thromboemboliss
Causes of Pancreatitis:
_____: Certain infections can cause pancreatitis.
Infectious
_____: Often caused by gallstones blocking pancreatic duct, leading to enzyme backup and inflammation.
SS: Severe abdominal pain (LUQ/Radiating back/Epigastric region), NV, Ecchymosis and swelling.
High Mortality Rate 30-40% due to sepsis and shock.
Acute Pancreatitis
_____: Chronic alcohol intake can leak to acinar tissue destruction, causing enzyme backup and autodigestion of the pancreas.
SS: intense abdominal pain, NV and SS of hemorrhage (ecchymosis).
Chronic Pancreatitis
_____: Inflammation of the liver.
Hepatitis
Most common cause of Hepatitis:
Viral Infection
SS of _____: Headache, fever, weakness, joint pain, anorexia, NV & RUQ pain.
Prolonged Sympoms: Jaundice, darkened urine & gray colored stools.
Hepatitis
Hepatitis ___:
Fecal-Oral Route; often through contaminated food or water.
Fatigue, nausea, stomach pain & jaundice.
Does not cause chronic illness.
Vaccines are available and effective.
Hepatitis A
Hepatitis ___:
Bloodborne; through blood, semen, or other body fluids
Fatigue, poor appetite, stomach pain, N & jaundice
Can become chronic, leading to cirrhosis or liver cancer
Vaccines are available & effective
Hepatitis B
Hepatitis ___:
Bloodborne, primarily through sharing needles
Asymptomatic, can lead to serious live disease
More than half of infection become chronic
No vaccines available, but curative treatments exist
Hepatitis C
Hepatitis ___:
Bloodborne, requires co-infection w/HBV
Severe, can lead to lifelong liver damage
Can be chronic
No specific vaccine, but HBV vaccine provides protection
Hepatitis D
Hepatitis ___:
Fecal-Oral Route, often through contaminated Water
Fatigue, poor appetite, stomach pain, nausea & jaundice
Does not cause Chronic Illness
No vaccines available in the USA
Hepatitis E
Pre-Hospital Treatment of Patient with Hepatitis: (4)
Position of comfort
Manage Airway
Avoid giving anything by mouth in case immediate surgery
Analgesic and antibiotics may be required
What should you expect if the patient has fever, headache, stiff neck and blurred vision?
Meningitis
_____: infection of the meninges (protective coverings membranes of the brain and spinal cord).
Meningitis
_____ Gland: Small organ located in the mediastinum; behind the sternum.
Plays a crucial role in the immune system, especially during childhood
Larger in children & shrinks with age; becoming mostly fat & fibrous tissue in adults
Promotes maturation of the T lymphocytes essential for cell-mediated immunity
Thymus
_____: can lead to SS like cough, chest pain and difficulty breathing.
Thymomas
_____ Gland: located in the neck
Regulates metabolism by secreting thyroxine (T4) & triiodothyronine (T3); influences growth & development
Secretes Calcitonin; which lowers blood calcium level by inhibiting bone resorption
Thyroid Gland
_____: excess thyroid hormones in the blood.
Hyperthyroidism
_____: Inadequate thyroid hormones in the blood
Hypothyroidism
_____: Autoimmune disorder caused by hyperthyroidism.
Graves Disease
_____ Glands: Posterior lateral surfaces of the Thyroid
Regulates calcium levels in the blood
Secretes parathyroid hormone (PTH) which increases blood calcium levels
Bone: Releases calcium into the blood
Intestines: Converts Vitamin D to its active form, increasing calcium absorption
Kidneys: Increase calcium reabsorption
Parathyroid Glands
_____: High levels of calcium, often due to tumors.
Hyperparathyroidism
_____: Decreased level of calcium and vitamin D.
Hypoparathyroidism
_____ Gland: Center of the lower forehead.
Regulates sleep-wake cycles
Secretes melatonin
Pineal gland
How to manage and actively seizing patient:
Do not restrain them; protect them form objects within the environment.
Attempt to maintain the airway.
Stop the seizure
Give Meds
3 Drugs to give for seizure and dosages:
Diazepam (Valium): 5-10mg
Lorazepam (Activan): .1mg/kg (mag 4m) q 4 mins
Midazolam (Versed): 10mg IM
5 things to do for patient in Postictal state:
Manage Airway
Position in Left Lateral Recumbant
Monitor Continuously
Monitor/Maintain Temp if needed
Communicate with PT if you can to ensure they’re recovering. Be aware of things around them that could hurt them.
What part of the distal end of the gastrointestinal system is voluntary control?
The anus.
_____: Severe elevation in blood pressure (>180/120) that is accompanied by evidence of impending progressive target organ dysfunction.
Hypertensive Emergencies
_____: Acute or subacute consequence of severe hypertension. Characterized by a sudden & severe increase in blood pressure that leads to changes in brain functions. Requires immediate treatment to lower the BP.
Hypertensive Encephalopathy
How to manage hypertensive seizures:
Look for headaches, N/V, blurred vision, SOB, chest pain, dizziness.
Pregnant PT: check for edema of hands/face, headache, preeclampsia. Place PT on left side to prevent supine hypotension.
_____: Initial phase after infection where the host cannot transmit the infectious agents to others.
Latent Period
_____: Period when host can exhibit signs of clinical disease and can transmit the infectious agent to other host.
Communicable Period
_____: Time between exposure to an infectious disease & appearance of symptoms. Can vary greatly, from a few days to months or years.
Incubation Period
_____: Period between exposure to the disease & seroconversion (when antibodies become detectable). Person can test negative even though they are infected.
Window Phase
_____: Duration from the onset of SS until the resolution of symptoms or death. Resolution of symptoms does not necessarily mean the infectious agent has been eradicated.
Disease Phase
Most common causes of rectal foreign body obstruction: (2)
Intentional Insertion: sexual gratification or psychosis.
Swallowed Objects: Some objects get stuck in rectum.
_____: Abnormally low sodium level in the blood, affects water balance and nerve function.
Can lead to headache, confusion & seizures.
Hyponatremia
Treatment for Hyponatremia: (2)
Hypotonic Solution
Isotonic Solution
_____: Abnormally high calcium levels in the blood, impacts muscle & nerve function.
Can cause muscle weakness, kidney stones & abnormal heart rhythms.
Hypercalcemia
Treatment for Hypercalcemia: (4)
Hydration: IV Fluids
Medications: Calcitonin & Glucocorticoids
Monitor ECG
Definitive Care: Severe cases dialysis
_____: Abnormally low potassium levels in the blood, affects heart rhythms.
Can cause muscle weakness, cramps, ECG changes like flattened T waves & prominent U waves.
Hypokalemia
Treatment for Hypokalemia: (2)
Oral Supplements: Potassium Chloride
IV Potassium: Must be done cautiously to avoid complications.
_____ Poisoning:
Low - Intermediate Exposure: Headache, Vertigo, N/V
High Exposure: AMS, seizures, increased respirations.
Very High Exposure: Abrupt loss of consciousness, respiratory depression, cardiac arrest.
Hydrogen Cyanide Poisoning
Treatment for Hydrogen cyanide Poisoning: (think fire victims)
Hydroxocobalamin (cynokit)
Antidote binds cyanid, forms cyanocobalamin which is secreted by the kidneys.
_____ Poisoning: Odorless, tasteless & colorless gas produced from the incomplete burning of fossil fuels & other carbon containing compounds.
It combines to hemoglobin with an affinity rate of 200-500 greater that O2.
Prevents hemoglobin from transporting O2 leading to cellular hypoxia and metabolic acidosis.
Carbon Monoxide
Carbon Monoxide Poisoning:
(COHb <15-20%) - Headache, N/V, dizziness & blurred vision. Which of the following:
Mild
Moderate
Severe
Fatal
Mild
Carbon Monoxide Poisoning: (COHb 21-40%) - Confusion, syncope, CP dyspnea, tachycardia, tachypnea & weakness. Which of the following:
Mild
Moderate
Severe
Fatal
Moderate
Carbon Monoxide Poisoning: (COHb 41-59%) - Dysrhythmias, hypotension cardiac ischemia, palpitations, respiratory arrest, pulmonary edema, seizures, coma, cardiac arrest. Which of the following:
Mild
Moderate
Severe
Fatal
Severe
Carbon Monoxide Poisoning: (COHb >60%) - Death. Which of the following:
Mild
Moderate
Severe
Fatal
Fatal
Treatment for Carbon Monoxide Poisoning:
Remove patient from environment, maintain the airway, administer high flow O2.
_____ Poisoning: chemicals found in insectisides, herbicides & chemical weapons. They exhibit acetylcholinesterase (AChE); enzyme responsible for breaking down acetylcholine.
Organophosphate Poisoning
SS of Organophosphate Poisoning:
Salivation
Lacrimation
Urination
Defecation
Gastric Motility
Emesis
Treatment for Organophosphate Poisoning:
Atropine
Pralidoxime
SS of Renal Calculi (Kidney Stone):
Pain: Visceral pain in one flank
Bladder Symptoms: Increased need to urinate
Hematuria: Blood in urine.
Physical Exam Findings: Uncomfortable, pain, cool, pale, clammy.
How to treat Altered Mental Status: (3)
Manage ABC’s
IV & Blood Glucose
Medications
Medications for AMS:
_____: for suspected Narcotic OD
Naloxone (Narcan)
Medications for AMS:
_____: for suspected Bensodiazepine OD
Flumazenil
Medications for AMS:
_____: for suspected Barbituates OD
Benzodiazepines
Medications for AMS:
_____: for suspected tricyclic antidepressants OD
Sodium Bicarb
Medications for AMS:
_____: for suspected Beta Blocker OD
Glucagon
Medications for AMS:
_____: for suspected alcoholic PT to prevent complications of Thiamine deficiency.
Thiamine
Medications for AMS:
_____, _____, _____: for active seizures or status epilepticus.
Versed, Valium, Ativan
Medications for AMS:
_____: for kidney failure, trauma & infection.
Fluids
Medications for AMS:
_____/____: for sepsis.
Levophed/Vasopressors
Medications for AMS:
_____/_____ for Neurogenic/Cardiogenic.
Dopamine/Vasopressors
Medications for AMS:
_____: for poison.
Activated Charcoal
AEIOUTIPS:
Alcohol; Epilepsy; Insulin; Overdose; Uremia; Trauma; Infection; Psychiatric; Stroke
What medication can be used for hyperthyroidism? (3)
Radioactive Iodine Therapy
Propylthiouracil (PTU)
Surgery
What is the most common cause of hyperthyroidism?
Graves Disease
_____: bacterial infection that primarily affects the lungs but can also impact other body parts.
Transmitted through airborne droplets from coughing or sneezing.
SS- Chills, fever, fatigue, weight loss, night sweats, chronic cough, hemoptysis.
Tuberculosis
_____: infection of the lungs that can present with a variety of SS.
SS include chills, fever, fatigue, malaise, cough, dyspnea, pleuritic chest pain, tachypnea, crackles, wheezing or rhonchi, decreased air movement in infected area.
Physical Examination: fluid in the lungs
Pneumonia
_____: Often from hyperextension injuries, causing motor weakness more in the upper extremities & loss of bladder control
Central Cord Syndrome
_____: Hemitransection causing motor & sensory loss on the same side as the injury & pain/temperature loss on the opposite side
Brown-Sequard Syndrome
_____: Compression of nerve roots at the lower end of the spinal cord, leading to bowel/bladder incontinence & lower extremity weakness
Cause Equina Syndrome
_____: Temporary loss of all spinal cord functions below the injury, including paralysis, loss of sensation & bowel/bladder control
Spinal Shock
_____: Total severing of the Spinal Cord leading to quadriplegia or paraplegia, loss of reflexes & autonomic dysfunction
Complete Cord Transection
_____ is widespread blunt trauma to the head; high chance of death; damages entire axons in the brain
Diffuse Axon
How to handle sexual assault victim: (8)
Listen don’t judge.
Consider the victim a crime scene.
Do not allow victim to change clothes.
Carefully explain the process to the PT.
Assess the physical injuries, not the actual event.
Provide a safe environment.
Nonjudgemental.
Preserve physical evidence.
Universal Blood Recipient:
Type AB (Specifically AB+)
Universal Blood Donor:
Type O-
_____ Aneurysm: Occurs below the diaphragm. Affects the abdomen, femoral & distal pulses. Often the PT feels a sudden & urgent need to defecate.
Abdominal Aortic Aneurysm
_____ Aneurysm: Occurs above the diaphragm. Affects the thoracic cavity, upper arms & typically shows a difference BP’s left from right.
Thoracic Aortic Aneurysm
For any internal hemorrhage, control the BP to a systolic of ___:
80
SS of _____ OD: N/V, Diarrhea (sometimes with blood), liver necrosis, pain on swallowing, unusual breath odors, excessive salivation.
Acetaminophen (Tylenol)
How to treat Acetaminophen (Tylenol) OD:
Primary: Acetylcysteine (mucomyst)
If identified early, activated charcoal.
SS of _____ OD: CNS depression; profound drowsiness; stupor or coma; respiratory depression; hypotension; ataxia.
Benzodiazepines OD
How to treat benzodiazepines OD:
Flumazenil. Benzodiazepine antagonist can reverse CNS & respiratory depression.
_____ should be used with caution with patient with chronic benzodiazapene due to risk of seizures.
Flumazenil
_____: small masses of swollen veins located in the anus or rectum.
Hemorrhoids
_____: An abnormal connection between the epithelialized surface of the anal canal & the perianal skin
Fistulas
_____ result from pregnancy, portal hypertension, lifting heavy objects, straining during defecation low-fiber diet
Hehorrhoids
_____ often result from an abscess in anal glands that fails to heal properly, leading to a persistent, abnormal connection
Fistulas
What 2 OD’s is Sodium Bicarb used for?
Tricyclic Antidepressant; Salicylate
_____: life-threatening medical condition; usually bacterial that leads to a whole-body inflammatory state called systemic inflammatory response syndrome (SIRS).
SS: Fever, chills, tachycardia, RD, AMS, hypoperfusion & increased or decrease BGL
Septicemia (sepsis BB)
_____: condition where the body’s core temperature drops below 95F (35C); can result from inadequate heat production, excessive cold exposure or both
Hypothermia
_____ Hypothermia: 90-95*F
Shivering, tachycardia, vasoconstriction, tachypnea, fatigue, impaired judgment.
Mild Hypothermia
_____ Hypothermia: 82-90F
Condition where the body’s core temperature drops below 95F; can result from inadequate heat production, excessive cold exposure or both.
Moderate Hypothermia
_____ Hypothermia: <82*F
Coma, apnea, ventricular arrhythmia or asystole, loss of voluntary muscle control, hypotension, undetectable pulse & respirations.
Severe Hypothermia
_____: abnormally low concentration of glucose in the blood.
BGL <70
Hypoglycemia
_____: Condition characterized by an abnormally high concentration of glucose.
Typically >200 mg/dL
Hyperglycemia
SS of _____: AMS; seizures, lethargy, RD, out of character behavior, confusion & outburst of anger.
Hypoglycemia
SS of _____: Early- Increased thirst, urination and weight loss.
Late- Weakness, abdominal pain, generalized pain, generalized aches, loss of appetite, N/V, dehydration, fruity breath, tachypnea, hyperventilation, tachycardia.
Hyperglycemia
What is the number 1 SS associated with endocrinological emergencies?
Altered Mental Status
Which endocrinological emergency would we want to give fluids to?
DKA and HHNS
3 Main Causes of Physiological Seizures:
Metabolic
Drug Related Causes
Trauma/Injury/Vascular Issues/Infectious Causes
4 Main Types of Idiopathic Seizures:
Genetic Predisposition
Primary Epilepsy Syndroms
Development Abnormalities
Unknown Causes
Textbook says the most common cause of Seizure is _____:
Idiopathic Epilepsy
_____: serious condition where the intestines are blocked, preventing normal movement of content through the digestive tract. Can be acute or chronic.
SS: Diffuse abdominal pain; bloating and tenderness; N/V; Distended abdomen; signs of shock.
Bowel Obstruction
_____: serious condition that involves bleeding in the Upper Part of the digestive tract; including the esophagus, stomach & duodenum.
SS: Abdominal discomfort; N/V; Hematemesis & Melena; Signs of Shock; Orthostatic Hypotension.
Upper GI Bleed
_____: occur in the GI tract distal to the Ligament of Treitz; including small intestine, colon, rectum & anus & often associated w/chronic conditions.
SS: Cramping Pain; N/V; Changes in stools; abdominal findings; signs of shock; hemodynamic instability.
Lower GI Bleed
_____: Indicates a slow GI bleed
Melanotic Stool
_____: (Hematochezia) Suggest a large hemorrhage or bleeding in the distal colon; possible due to hemorrhoids or rectal fissures.
Bright Red Blood in Stool
_____ Abdomen: May indicate significant hemorrhage
Distended
_____: Bruising on the abdomen can be a signs of severe bleeding
Ecchymosis
_____: Feeling of incomplete evacuation/urge to defecate (seen in rectal or colonic lesions).
Tenesmus
_____: Condition often awakens the pt from sleep & is typically associated w/heart conditions like CHF.
Sudden SOB at night & often causes the patient to wake up from sleep.
Paroxysmal Nocturnal Dyspnea (PND)
_____: Difficulty breathing while lying flat; patient typically sleep with pillows.
Orthopnea
_____: Condition where the heart’s reduced stroke volume leads to fluid overload in the body’s tissues.
Congestive Heart Failure (CHF)
Treatment for Congestive Heart Failure is:
CPAP, Nitro, Morphine, Lasix
If BP is <90, treat right sided first with fluids to get pressure above 90. Then treat the left sided failure with drugs.
Right sided Heart Failure gets _____.
Left sided Heart Failure gets _____.
Fluids
Nitro (drugs)
In the field, what is the least useful technique for inspecting the abdomen?
Percussion.
Which type of Diabetes accounts for 90% of of diabetic patient?
Type 2
_____ Diabetes Mellitus
Autoimmune destruction of beta cells in the pancreas, leading to little or no insulin production.
Typically diagnosed in children & young adults; also called “juvenile onset” diabetes.
Patients require regular insulin injections to manage blood glucose levels.
Accounts for approx 5% of diabetes cases
DKA: Diabetic Ketoacidosis
Higher chance of becoming hypoglycemic
Type 1 Diabetes Mellitus
_____ Diabetes Mellitus:
Decreased responsiveness to insulin and insufficient insulin production.
Typically begins after 40 & often associated with obesity.
Patients usually do not depend on insulin replacement initially, managed with lifestyle changes & oral medications.
Often less S/S of Type 1 with lower levels of hyperglycemia & fewer major signs of metabolic disruption.
Accounts for over 90% of diabetes cases.
Type 2 Diabetes Mellitus
Treatment of right sided MI:
Maintain preload; Dobutamine; reduce afterload; early re-perfusion.
SS of Right sided MI: (3)
Distended Neck Veins
Clear Lung Fields
Hypotension
*Elevation in Leads II, III and avF
How many times does carbon monoxide bind to hemoglobin compared to oxygen?
200-250 x more
Elderly female having upper abdominal pain and what to do for her?
Silent MI - Run 12 Lead
Any form of chest pain, run 12 Lead.
_____:
Atrial Rate: 350-370 (cannot be counted)
Ventricular Rate: Varies greatly
Rhythm: Irregularly irregular
No PRI and the QRS is normal
AFIB
Parasite
_____: contracted from undercooked pork, causing GI disturbances and potentially severe complications.
Trichinosis
Parasite:
_____: causes epigastric pains and anemia.
Hookworms
Parasite:
_____: common in children, causing anal itching.
Pinworms
Parasite:
_____: causes abdominal cramping, fever and cough.
Roundworms
_____ Degree AV Block: Delay in impulse transmission from atria to ventricles.
ECG Indicator: PR interval longer than 0.20 seconds.
Impact: No complete blockage, just a slowing of the impulse.
First
_____ Degree AV Block (Mobitz __): Progressive delay of impulses until one is completely blocked.
Cycle: After a dropped beat, the cycle repeats.
Impact: Can cause syncope and angina if frequent.
Second Degree AV Block Mobitz I
_____ Degree AV Block (Mobitz ___): Intermittent block where some impulses are conducted and others are not.
Pattern: Often a recognized pattern.
Impact: More serious than Mobitz I, can lead to full AV block.
Second-Degree AV Block (Mobitz II)
_____ Degree AV Block: No impulses from atria are conducted to ventricles.
Impact: Severe bradycardia, heart failure, and potential cardiac arrest.
Third Degree AV Block
How do you position a stroke patient? (4)
Supine
Recovery position
Opposite side of stroke signs
If PT has medical history, transport in semi fowlers
Low amplitude, bradycardia, thin hair and doughy skin, is it a thyroid disorder or adrenal gland disorder?
Thyroid - Hypothyroidism
If a patient is taking atrovent, metaproterenol and betamethasone, what underlying disease or disorder would you expect them to have?
Asthma or COPD
COPD PT have a tendency to produce polycythemia. What is this? And why?
Abnormally high heatocrit due to excess production of RBC’s.
Chronic Hypoxia leads to decreased O2 - body then produces more red blood cells.
Rhonchi - Upper or Lower? Fluid or Congestion?
Snoring - Upper of Lower? Fluid or Congestion?
Strider - Upper or Lower? Fluid or Congestion?
Crackles - Upper or Lower? Fluid or Congestion?
Rhonchi - Lower / Fluid
Snoring - Upper / Congestion
Stridor - Upper / Obstruction
Crackles - Lower / Fluid
Ketones are a bybroduct of _____.
Fat metabolism (considered a form of catabolism)
What is the number 1 cause of coronary artery disease (CAD) or Angina?
Atherosclerosis
What happens when the external pacemaker fails?
The underlying rhythm returns.
What body part separates a lower and upper GI tract bleed?
Ligament of Treitz
Which is more common, Stroke, Epilepsy or Parkinson’s?
Stroke
Parkinson’s
Epilepsy
_____: inflammation of the stomach and intestines.
Gastroenteritis
_____: inflammation of the stomach.
Gastritis
_____: Chroninc inflammatory disease affecting any part of the GI tract.
Crohns
What percentage of the population has appendicitis?
10-20%
What is a substance that induces an immune response?
Immunogenicity
Pt complaining of severe headache; what do we watch them for? And prevent aspiration.
Intracranial pressure
What is ST Elevation?
STEMI
What is Tall Peaked T-Waves?
Hyperkalemia
MI
Early indication of Torsades
Number 1 Cause of Hemorrhoids:
Idiopathic
Straining in Defecation
Low Fiber
Pregnancy
Heavy Lifting
Portal Hypertension
_____: known as adrenal insufficiency, occurs when the adrenal glands do not produce enough steroid hormones.
SS - Progressive weakness/fatigue, hypotension, most likely in AFIB w/ RVR.
Addison’s Disease
_____: genetic disorder affecting red blood cells.
SS - Chronic anemia, vasooclussive crisis, hematologic crisis, infectious crisis.
Sickle Cell
