Medical Emergencies

Question 1

Kernig’s sign

Answer 1

Back, leg pain on knee extension-possible bacterial meningitis

Question 2

Brudzinski’s sign

Answer 2

Back, leg pain on neck flexion-possible bacterial meningitis or subarachnoid bleed

Question 3

Hamman’s sign

Answer 3

Crunching sound heard with auscultation over the anterior chest synchronized with heartbeat - tracheobronchial injury

Question 4

Normal urinary output

Answer 4

UO: 30-50 ml/hr (adult)
UO: 1-2 ml/kg/hr (peds)

Question 5

Normal blood volume

Answer 5

Blood volume: 70 ml/kg (adult)

Blood volume: 80 ml/kg (peds)

Question 6

Normal temperature
Mild hypothermia
Moderate hypothermia
Severe hypothermia

Answer 6

Normal:37.6/98.6
Mild:32-36 (decreasing HR)
Moderate: 29-32 (loss of shivering, ALOC)
Severe: 20-28(coma, VF common)

Question 7

Two major causes of heat loss?

Answer 7

Radiation, evaporation

Question 8

Thermoregulation ceases at?

Answer 8

28 degrees

Question 9

Order of how to assess the abdomen:

Answer 9

Inspect
Auscultation
Palpation
Percussion

Question 10

Environmental

1. Passive rewarming
2. Active rewarming
3. Warm and dead
4. Heat stroke

Answer 10

1. Mild hypothermia only. Up 1C/hr with blankets, heater
2. Apply heat to body
3. 32 C
4. Over 42 C

Question 11

Grey Turner’s sign

Answer 11

Flank bruising (retro peritoneal bleeding)

Question 12

Cooper Nail’s sign

Answer 12

Scrotum/labia (abdominal/pelvic bleeding)

Question 13

Halstead’s sign

Answer 13

Marbled abdomen (bleeding)

Question 14

Cullen’s sign

Answer 14

Umbilical discoloration (pancreatitis)

Question 15

Murphy’s sign

Answer 15

RUQ pain with inspiration (gallbladder)

Question 16

Levine’s sign

Answer 16

Fist to chest “clutching” (cardiac)

Question 17

Treat HTN when BP?

Answer 17

Over 220 systolic

MAP over 130

Question 18

Dehydration raises serium?

Answer 18

Sodium

Normal sodium: 135-145

Question 19

Objective data?

Answer 19

ABCs, neurological assessment, differential diagnosis for altered mental status: AEIOUTIPS

Question 20

Induction agent of choice with bronchospastic patients.

Answer 20

Ketamine(ketalar)

Question 21

Ativan: indication dose, max

Answer 21

Lorazepam, seizures, 1-2 mg, max 4 mg

Question 22

Mannitol dose

Answer 22

1-2 g/kg

Question 23

Drug choice for cyclic antidepressant OD

Answer 23

Sodium bicarbonate

Question 24

Drug choice for beta-blocker OD

Answer 24

Glucagon

Question 25

Fentanyl dose

Answer 25

Sublimate (3 mcg/kg)

Question 26

Treatment for malignant hyperthermia

Answer 26

Dantrium (dantrolene)

Question 27

Drug for GI bleeds

Answer 27

Sandostatin (octreotide)

Question 28

Normal potassium

Answer 28

3.5-5.5

Question 29

Normal sodium

Answer 29

135-145

Question 30

Normal chloride

Answer 30

95-105

Question 31

Normal calcium

Answer 31

8.5-10.5

Question 32

Metabolic acidosis elevates?

Answer 32

Potassium

Question 33

Mild hypertension

Answer 33

Mild:140-159/90-99

Question 34

Moderate hypertension

Answer 34

160-179/100-109

Question 35

Severe hypertension

Answer 35

Over 180/110

Question 36

Kehr’s sign

Answer 36

Referred left shoulder pain-possible splenic injury or ectopic pregnancy

Question 37

Anion gap

Answer 37

Na-(Cl + bicarbonate/CO2= AG
Normal 12+\-4
>16 indicates an underlying metabolic acidosis
Remember "MUDPILES"
-methanol
-uremia
-DKA
-Paraldehyde
-Ioniazide/Ion
-Lactate
-Ethylene glycol
-Salicylate