PREP:EM Questions Flashcards

1
Q

mild vs moderate vs severe hypothermia

definitions and treatment

A

mild 32-35: active external warming
moderate 28-32: +active core (bladder, gastric lavage)
severe < 28: ECMO, pleural lavage

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2
Q

treatment of shivering

A

BDZs

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3
Q

atropine dose

A

0.02mg/kg (minimum dose of 0.1mg)

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4
Q

What’s a normal ankle-brachial index?

A

> 0.9

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5
Q

disorder with mousy/musty odor

A

PKU

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6
Q

fishy odor

A

trimethylaminuria

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7
Q

sweaty feet smell

A

isovaleric acidemia

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8
Q

SIRS criteria

A

Core temp < 36 or >38.5
tachycardia or bradycardia
tachypnea
leukocytosis, lymphopenia, or 10%+ bandemia

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9
Q

Septic shock definition

A

sepsis + SIRS + continued cardiovascular dysfxn after 40ml/kg fluids

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10
Q

refractory septic shock definitions

A

fluid refractory: after 60ml/kg fluids

catecholamine refractory: after 10 mcg/kg/min of dopa, epi, or norepi

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11
Q

severe sepsis definition

A

when associated with:
ARDS
cardiovascular dysfxn
dysfxn of 2 or more organ systems

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12
Q

what is hydrogen sulfide

A

mustard gas

causes superficial skin burns, eye irritation, and resp tract irritation

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13
Q

What are the classifications of neutropenia

A

severe < 500
moderate 500-1000
mild 1000-1500

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14
Q

What is the discriminatory zone with HCG?

A

transvaginal US- 1,500 mIU/mL

transabdominal US- 6,000 mIU/mL

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15
Q

symptoms of carbemazepine toxicity

A

can cause resp compromise, altered mental status, vomiting, drowsiness, slurred speech, nystagmus, hallucinations, hypotension, coma, dystonic reactions, seizures
has some anticholinergic properties
false positive for TCAs on UDS

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16
Q

expected compensation for acute resp acidosis

A

increase in serum bicarb 0.1 meq for each 1 mmHg PCO2

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17
Q

expected compensation for acute metabolic acidosis

A

decrease in PCO2 1.2 mmHgfor each 1 meq of bicarb

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18
Q

expected compensation for acute resp alkalosis

A

decrease in serum bicarb 0.2 meq for each 1mmHg PCO2

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19
Q

expected compensation for acute metabolic alkalosis

A

increase in PCO2 0.6 mmHg for each 1meq of bicarb

20
Q

how frequently can you repeat epi in anaphylaxis?

A

3-4 times every 5-15 minutes

21
Q

what is the pathophys of staph scalded skin syndrome?

A

hematogenous spread of epidermolytic or exfoliative toxin; children are more affected that adults due to inefficient renal clearance

22
Q

most common nerve injury in supracondylar fracture

A

median nerve

23
Q

most common artery injury in supracondylar fracture

A

brachial artery

24
Q

treatment of DUB

A

combo pills or progestin only pill taper

25
risk factors for patellar dislocation
patella alta genu valgum increased femoral anteversion ligamentous laxity
26
sites for IO access
``` proximal tibia distal tibia distal femur proximal humerus sternum in adults ```
27
MUDPILES
``` methanol/metabolic defects uremia DKA, alcoholic ketoacidosis, starvation paraldehyde iron and INH lactic acidosis ethylene glycol salicylates * also CO, cyanid, hydrogen sulfide, metformin, phenformin, sulfur, theophyllin, and toulene! ```
28
normal CSF opening pressure
< 20 cm H2O
29
LR +
= (positive test/presence of disease) / (positive test/absence of disease) = sensitivity / (1 - specificity)
30
LR -
= (negative test/presence of disease) / (negative test/absence of disease) = (1 - sensitivity) / specificity
31
How do you use LRs?
You have to convert the pretest probability to odds This is pretest probability / (1 - pretest probability) Then you multiply by the LR Finally, you convert the odds BACK to the probability!
32
What are clinically significant LRs?
LR + > 10 | LR - < 0.1
33
Amanita phalloides ingestion
white mushroom that can kill. classically: stage I: 6-24hrs of no sxs II: V/D 12-24hrs III: seeming recovery IV: 2-4d later with liver and renal failure
34
typical murmur for HOCM
midsystolic harsh ejection murmur
35
Brown Sequard syndrome
hemisection of the spinal cord loss of contralateral pain and temperature loss of ipsilateral motor
36
loss of contralateral pain and temperature | loss of ipsilateral motor
Brown Sequard syndrome | hemisection of the spinal cord
37
Anterior cord syndrome
disruption of the anterior spinal artery loss of motor and pain sensation preserved temp and proprioception
38
loss of motor and pain sensation | preserved temp and proprioception
Anterior cord syndrome | disruption of the anterior spinal artery
39
Central cord syndrome
upper extremities affected more than lower extremities
40
upper extremities affected more than lower extremities
central cord syndrome
41
Posterior cord syndrome
loss of proprioception and pain sensation
42
loss of proprioception and pain sensation
posterior cord syndrome
43
ectasy/MDMA intoxication
hyponatremia, concentrated urine, altered mental status | may see serotonin syndrome
44
formula for odds ratio?
(AxD)/(BxC) in standard 2x2 table
45
what's the difference between odds ratio and relative risk?
relative risk is used when patients are followed over time. | odds ratio is used when patients already have the outcome and you look back retrospectively at an exposure of interest