Part 6 Flashcards
What coagulation values should be checked to anticipate the need for blood products?
PT, PTT, INR
Prothrombin Time (PT), Partial Thromboplastin Time (PTT), and International Normalized Ratio (INR) are key tests for evaluating coagulation status.
What is the purpose of a Sengstaken Blakemore tube?
Provides direct pressure on bleeding
This intervention is often used in cases of variceal hemorrhage.
True or False: A nasogastric tube can be safely inserted in cases of esophageal varices.
False
Inserting a nasogastric tube can cause lethal rupture of varices.
What is a common cause of Mallory Weiss tears?
Chronic forceful vomiting
Conditions like alcoholism and bulimia are often implicated.
What is the gold standard for diagnosing a rupture of the esophagus?
EGD (Esophagogastroduodenoscopy)
This procedure allows direct visualization of the esophagus.
What are the classic symptoms of Hyperthyroidism/Grave’s Disease?
Weight loss, palpitations, nervousness, heat intolerance
Exophthalmos (bulging eyes) is also a common presentation.
What is the first treatment step in a Thyroid Storm?
Give IV fluids first
Other treatments include beta blockers and steroids.
What characterizes hypothyroidism or myxedema coma?
Fatigue, cold intolerance, weight gain, puffy eyelids
It primarily occurs in women, especially during winter.
What is the treatment for Myxedema Coma?
IV Levothyroxine (T4) or Triostat (T3)
Levothyroxine is commonly known as Synthroid.
What are the common signs of Cushing’s Syndrome?
Buffalo hump, moon face, purple striae
It can be caused by excessive corticosteroid use or adrenal tumors.
What is Addison’s Disease also known as?
Adrenal Insufficiency / Adrenal Crisis
Patients may present with depression, malaise, and salt craving.
What lab finding indicates liver failure?
INR > 1.5
This indicates decreased albumin and coagulation factor production.
What is the primary treatment for hepatic encephalopathy?
Lactulose
It helps remove ammonia from the body.
What are the symptoms of septic shock?
Hypotension with normal heart rate, refractory to fluids
Patients often need IV fluid therapy and vasopressors.
What is the hallmark sign of pancreatitis?
Pain in the upper abdomen that radiates to the back
Increased lipase levels (usually >3 times normal) confirm diagnosis.
What signs indicate hemorrhagic pancreatitis?
Grey-Turner’s Sign, Cullen’s Sign
These are flank and periumbilical ecchymosis, respectively.
What is the main symptom of hyperkalemia?
Tall, tented, or peaked T-waves on EKG
Symptoms may include abdominal cramps, nausea, and bradycardia.
What is the treatment for hypokalemia?
Oral potassium 60 mEq
If severe, IV potassium can be given but never as a bolus.
What is Chvostek’s Sign?
Cheek muscle spasms when the facial nerve is tapped
It indicates hypocalcemia.
What are the components of Virchow’s Triad?
- Loss of vein integrity
- Stasis
- Hypercoagulable state
These factors contribute to the development of Deep Venous Thrombosis (DVT).
What is the classic presentation of arterial occlusion?
Claudication, cold limb, 6 P’s
The 6 P’s include Pain, Pallor, Paresthesia, Poikilothermia, Pulselessness, Paralysis.
What is the treatment for high altitude pulmonary edema (HAPE)?
Descend, Acetazolamide, Dexamethasone
Nifedipine may also be used for pulmonary vasodilation.
What are the symptoms of acute mountain sickness (AMS)?
Headache, nausea, vomiting, lassitude
Symptoms typically resolve with descent and hydration.
What is Rhabdomyolysis?
Breakdown of muscle fibers releasing myoglobin into the bloodstream
It can be caused by crush injuries, hyperthermia, and excessive exercise.
What are the symptoms of ASA (Aspirin) poisoning?
- Nausea
- Vomiting
- Tinnitus
It can lead to respiratory alkalosis and metabolic acidosis.
What type of diuretic is Lasix?
Loop diuretic
What type of diuretic is Mannitol?
Osmotic diuretic
What are the initial symptoms of Acetylsalicylic Acid (ASA) poisoning?
Nausea, vomiting, ringing in the ears (Tinnitus)
True or False: ASA poisoning can lead to respiratory alkalosis.
True
What serious condition can ASA poisoning cause in children?
Reye’s syndrome
What is the treatment for ASA poisoning?
Bicarb and dialysis can be helpful
What are the four stages of Tylenol poisoning?
- Stage I – Flu symptoms begin
- Stage II – Flu symptoms stop, liver failure occurs
- Stage III – Peak liver enzymes, RUQ pain, Flu symptoms resume
- Stage IV – Resolution period
What is the antidote for Tylenol poisoning?
N-acetylcysteine (Mucomyst, Acetadote)
What symptoms can Dilantin (Phenytoin) overdose cause?
- Supraventricular Tachycardia (SVT)
- Ventricular dysrhythmias
- Coma
- Confusion
- Tremors
What is the antidote for Iron overdose?
Deferoxamine
What does pink urine indicate in the context of Iron overdose treatment?
Therapeutic level of Deferoxamine
Which drugs are commonly associated with Beta Blocker overdose?
- Labetolol
- Carvidolol
- Esmolol
What is the antidote for Beta Blocker overdose?
Glucagon
What are the symptoms of Calcium Channel Blocker overdose?
- Hypotension
- Bradycardia
- Conduction delays
What is the antidote for Calcium Channel Blocker overdose?
Calcium Gluconate
What are the symptoms of Digitalis toxicity?
- Flu-like symptoms
- Visual disturbances
- Yellow/Green halos
What is the treatment for Digitalis toxicity?
Digibind (Digoxin Immune Fab)
What is the primary treatment for Tricyclic Antidepressant (TCA) overdose?
Bicarb
What is the antidote for Anticholinergic Poisoning?
Physostigmine
True or False: Romazicon (Flumazenil) can lead to seizures if pushed too fast.
True
What are common symptoms of Alcohol Poisoning?
- Hypoglycemia
- Seizures (from withdrawals)
What is a treatment for Ethylene Glycol or Methanol poisoning?
IV ethanol (ETOH) or Fomepizole (Antizol)
What is the treatment for Organophosphate Toxicity?
- Atropine
- 2-Pam Chloride
What does SLUDGE stand for in relation to Cholinergic Poisoning?
- Salivation
- Lacrimation
- Urination
- Defecation
- Gastroenteritis
- Emesis
What are the symptoms of Cyanide Toxicity?
- Coma
- Seizures
- Cherry red skin
- Apnea
- Cardiac arrest
What is the first agent used in the standard cyanide antidote kit?
Amyl nitrate
What is the antidote for Cocaine overdose?
Benzodiazepines (Valium, Ativan, Versed)
What is the antidote for Opioid overdose?
Naloxone (Narcan)
Fill in the blank: The treatment for Alkalis poisoning is _______.
Copious Water
What is the antidote for Benzodiazepines overdose?
Flumazenil (Romazicon)
