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Emergency Medicine > MTB 1 > Flashcards

MTB 1 Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Relationship bt Digoxin and Potassium

A

Both compete for biding at same site on Na/K ATPase

Hypokalemia predisposes to digoxin toxicity

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2
Q

Presentation of Digoxin Toxicity

A

GI probs: N/V/Abdominal Pain
Hyperkalemia
Confusion
Visual cahnges - yellow halos around objects
Arrhythmias - AV block, A tach, Bradycardia

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3
Q

Most accurate test for Digoxin Toxicity

A

Digoxin level

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4
Q

Best initial test for Digoxin Toxicity

A

K level

EKG

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5
Q

EKG of Digoxin Toxicity

A

Downsloping of ST segment in ALL leads

Atrial Tachycardia w variable AV block = MC

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6
Q

TX for Digoxin Toxicity

A

Control K+
Digoxin-specific Abs
-Esp if CNS and cardiac involvement

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7
Q

Presentation of Lead Poisoning

A 
Abdominal pain = lead colic
ATN
Anemia - Sideroblastic 
Peripheral neuropathy - wrist drop
CNS changes - memory loss and confusion
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8
Q

Most Accurate test for Lead poisoning

A

Lead Level

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9
Q

Best initial diagnostic test in lead poisoning

A

Increased level of free erythrocyte protoporphyrin

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10
Q

Most accurate test for Sideroblastic anemia

A

Prussian blue stain

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11
Q

TX for Lead Poisoning

A

Succimer - oral
Dimercaprol - parenteral
EDTA - parenteral

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12
Q

Presentation of Mercury Poisoning

A

Neuro problems - nervous, jittery, twitchy, hallucinations

Inhaled - Interstitial fibrosis

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13
Q

TX for Mercury Poisoning

A

Chelating agents

  • Dimercaprol
  • Succimer
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14
Q

Methanol and Ethylene glycol poisoning Presentation

A

Intoxication

Metabolic Acidosis with Increased AG

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15
Q

Cause of Methanol Toxicity

A

Wood Alcohol
Cleaning solutions
Paint thinner

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16
Q

Cause of Ethylene Glycol Toxicity

A

Antifreeze

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17
Q

Diff b/t Methanol and Ethylene glycol poisoning

A

Methanol - ocular toxicity

EG - Renal toxicity

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18
Q

Toxic metabolites of Methanol and Ethylene glycol poisoning

A

Methanol - Formic Acid/formaldehyde

EG - Oxalic acid/oxalate

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19
Q

How to calculate Osmolar GAp

A

Serum Osmolality = 2 x Sodium + BUN/2.8 + glucose/18

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20
Q

Best initial TX for toxicity for Methanol and Ethylene glycol poisoning

A

Fomepizole - inhibits alcohol DH

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21
Q

How do we effectively remove Methanol and Ethylene glycol from body

A

Dialysis - only this works

22
Q

TX for snake bite

A

Pressure
Immobilization decreases venom movement
Antivenin

23
Q

Presentation of Black widow spider bite

Labs

A

Abdominal pain
Muscle pain
Labs: Hypocalcemia

24
Q

Tx for Black widow spider bite

A

Calcium

Antivenin

25
Q

Presentation of Brown recluse spider bite

Labs

A

Local skin necrosis
Bullae
Blebs
No labs

26
Q

TX for brown recluse spider bite

A

Debridement
Steroids
Dapsone

27
Q

Management of Cat, Dog, Human bite

A

Amoxicillin/Clavulanate

Tetanus Vaccination booster if more than 5 yrs since last

28
Q

MCC of dog and cat bites

A

Pasturella

29
Q

MCC Human bite

A

Eikenella

30
Q

When do we admin the rabies vaccine

A

Animal has AMS/Bizarre behavior

Unprovoked attack by stray dog that cannot be observed

31
Q

Presentation of concussion
CT findings
TX

A

No focal neuro abnormalities
Normal CT
None. wait 24 hrs before going back to sports

32
Q

Presentation of Contusion
CT findings
TX

A

Sometimes has findings
Ecchymoses on CT
most - none. some surgical debridgement

33
Q

Presentation of rib fractures

A

Localized wall tenderness post trauma

Pain causes Hypoventilation -> Atelecstasis and Pneumonia

34
Q

Management of Rib Fx

A

Pain management - oral opiates, NSAIDs, intercostal nerve block
Respiratory support

35
Q

When do we see a lucid interval

A

Epidural hematoma

Subdural hematoma

36
Q

Do we need to hospitalize pts with concussion

A

No

37
Q

TX of subdural and epidural Hematoma

A 
Small - leave alone
Large
1. Intubation and hyperventilation 
2. Mannitol
3. Drainage
38
Q

Why do we hyperventilate pts with sub and epidural hematomas

A

Hyperventilation decreases pCO2 -> cerebral circulation constricts = decreasing pressure
- Bridge to therapy b/c slows herniation briefly

39
Q

MOA Mannitol in hematomas

A

Osmotic diuretic - decreases intravascular volume, decreases ICP

40
Q

CT of Subdural hematoma

A

Venous
Crescent
Concave

41
Q

CT of Epidural hematoma

A

Arterial

Biconvex or Lens-shaped

42
Q

When do we give stress ulcer PPX

A

Head Trauma
Burns
Endotracheal Intubation
Coagulopathy (platelets 1.5) w respiratory failure

43
Q

Best initial therapy for Burn pts

A

100% Oxygen to treat smoke inhalation and CO poisoning

44
Q

When do we intubate burn pts?

A

Stridor
Hoarseness
Wheezing
Burns inside nasopharynx or mouth

45
Q

What do use for fluid replacement in burn pts

A

Ringer lactate

46
Q

How do we calculate Fluid Replacement in burn pts

A 
Based on BSA 
Head = 9%
Legs = 18% front and back
Arms = 9% each
Chest/back = 18% Each
47
Q

How much and when do we give fluids in burn pts

A

First 1/2 = First 8 hours
1/4 = Second 8 hours
1/4 = Third 8 hours

48
Q

Fluid replacement Calculation

A

(4 mL) x (% BSA burned) x Wt in Kg

49
Q

How to calculate BSA in patchy burns

A

Use hand width = 1% BSA

Choose largest amount of Ringers or NS listed as answer

50
Q

MCC of death several days to weeks after a burn

How do we prevent

A

Infxn

Give PPX topical ABX - Silver sulfadiazine

Emergency Medicine (4 decks)

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