PBL Quiz 1 Flashcards
All patients with ACS + ongoing pain should be treated with
FONAS
Fluids
Oxygen (<90)
Nitro
ASA 325
Statin
Tx for UA/NSTEMI
Dual + anticoagulant
BB
Nitro
Tx for STEMI
Dual + anticoagulant
BB
Reperfusion
ACEI for long-term
Tx for inferior/posterior wall MI
Dual + anticoagulant
Reperfusion
Avoid Morphine, nitro, CCB
Caution with BB
Tx for cocaine-induced or prinzmetal MI
Benzo (Lorazepam) or CCB
BB should be avoided
Standard HF treatment long-term
ACEI or ARB, BB, diuretic (Furosemide)
add spironolactone if needed
Acute tx for HF
IV furosemide
seated position
supplemental oxygen
mechanical ventilation
pericarditis tx
colchicine + NSAIDS
glucocorticoids instead of NSAIDs if contraindications
tx aortic stenosis
aortic valve replacement
intraaortic balloon pump and percutaneous aortic valvuloplasty until replacement
tx aortic regurgitation
after load reducers - ACEI, ARBs, Nifedipine, Hydralazine
replacement or repair
tx mitral stenosis
percutaneous balloon valvuloplasty - best in young w noncalcified valves
otherwise - do valve replacement
tx mitral regurg
after load reducers - ACEI, ARB, Hydralazine, Nifedipine)
repair > replacement
tx MVP
reassurance + BB
management pneumothorax (watered down)
first episode + small + stable - observation + supplemental oxygen w nonrebreather mask
large - needle or catheter aspiration - 2nd intercostal space midclavicular
unstable - chest tube thoracostomy - 5th intercostal space mid to anterior axillary line
how would you define stability for pneumothorax
RR < 24
HR < 120 and > 60
O2 > 90%
Normal BP
Able to speak in full sentences
how would you define a small pneumothorax
</= 3 cm at apex
</2 cm at hilum
MC cause SVC syndrome
small cell bronchogenic CA
sx SVC
facial, neck, upper extremity edema
facial plethora
chest pain
respiratory sx
neurologic sx
dyspnea (MC sx)
mc cause of Lambert eaten myasthenic syndrome
small cell lung CA
sx lambert eaten
proximal muscle weakness that improves w repeated use
dry mouth
postural hypoTN
erectile dysfunction
hyporeflexia
sluggish pupillary response
NO MUSCLE ATROPHY
MC cause superior sulcus (Pancoast) tumors
non-small cell lung CA
sx superior sulcus (Pancoast) tumors
shoulder and arm pain - may radiate to head and neck
weakness and atrophy of muscles of hand or arm
ulnar neuropathy
what is prominent in anterior shoulder dislocation
acromion
seizures - sodium channel blockers
phenytoin
carbamazepine
oxcarbazepine
eslicarbazepine
lamotrigine
lacosamide
rufinamide
seizures - GABA enhances
Barbiturates
benzos
tiagabine
vigabatrin
seizures - glutamate receptor blockers
perampanel
felbamate
seizures - drugs that interfere with/block calcium channels
ethosuximide - T type
Gabapentin, pregabalin
MOA Valproate
enhances GABA
inhibits glutamate and NMDA receptors
increases refractory period of voltage-gated sodium channels
first line for focal and secondarily generalized seizures
Lamotrigine
Carbamezpine
Oxcarbazepine
Levetiracetam
first line for primary generalized tonic clonic, atypical absence, myoclonic, atonic seizures
valproate
lamotrigine
levetiracetam
screening for lung CA
annual low dose CT between 50-80 if 20 pack year hx or quit within 15 years
