PREP:EM Questions Flashcards
mild vs moderate vs severe hypothermia
definitions and treatment
mild 32-35: active external warming
moderate 28-32: +active core (bladder, gastric lavage)
severe < 28: ECMO, pleural lavage
treatment of shivering
BDZs
atropine dose
0.02mg/kg (minimum dose of 0.1mg)
What’s a normal ankle-brachial index?
> 0.9
disorder with mousy/musty odor
PKU
fishy odor
trimethylaminuria
sweaty feet smell
isovaleric acidemia
SIRS criteria
Core temp < 36 or >38.5
tachycardia or bradycardia
tachypnea
leukocytosis, lymphopenia, or 10%+ bandemia
Septic shock definition
sepsis + SIRS + continued cardiovascular dysfxn after 40ml/kg fluids
refractory septic shock definitions
fluid refractory: after 60ml/kg fluids
catecholamine refractory: after 10 mcg/kg/min of dopa, epi, or norepi
severe sepsis definition
when associated with:
ARDS
cardiovascular dysfxn
dysfxn of 2 or more organ systems
what is hydrogen sulfide
mustard gas
causes superficial skin burns, eye irritation, and resp tract irritation
What are the classifications of neutropenia
severe < 500
moderate 500-1000
mild 1000-1500
What is the discriminatory zone with HCG?
transvaginal US- 1,500 mIU/mL
transabdominal US- 6,000 mIU/mL
symptoms of carbemazepine toxicity
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
expected compensation for acute resp acidosis
increase in serum bicarb 0.1 meq for each 1 mmHg PCO2
expected compensation for acute metabolic acidosis
decrease in PCO2 1.2 mmHgfor each 1 meq of bicarb
expected compensation for acute resp alkalosis
decrease in serum bicarb 0.2 meq for each 1mmHg PCO2
expected compensation for acute metabolic alkalosis
increase in PCO2 0.6 mmHg for each 1meq of bicarb
how frequently can you repeat epi in anaphylaxis?
3-4 times every 5-15 minutes
what is the pathophys of staph scalded skin syndrome?
hematogenous spread of epidermolytic or exfoliative toxin; children are more affected that adults due to inefficient renal clearance
most common nerve injury in supracondylar fracture
median nerve
most common artery injury in supracondylar fracture
brachial artery
treatment of DUB
combo pills or progestin only pill taper
risk factors for patellar dislocation
patella alta
genu valgum
increased femoral anteversion
ligamentous laxity
sites for IO access
proximal tibia distal tibia distal femur proximal humerus sternum in adults
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!
normal CSF opening pressure
< 20 cm H2O
LR +
= (positive test/presence of disease) / (positive test/absence of disease)
= sensitivity / (1 - specificity)
LR -
= (negative test/presence of disease) / (negative test/absence of disease)
= (1 - sensitivity) / specificity
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!
What are clinically significant LRs?
LR + > 10
LR - < 0.1
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
typical murmur for HOCM
midsystolic harsh ejection murmur
Brown Sequard syndrome
hemisection of the spinal cord
loss of contralateral pain and temperature
loss of ipsilateral motor
loss of contralateral pain and temperature
loss of ipsilateral motor
Brown Sequard syndrome
hemisection of the spinal cord
Anterior cord syndrome
disruption of the anterior spinal artery
loss of motor and pain sensation
preserved temp and proprioception
loss of motor and pain sensation
preserved temp and proprioception
Anterior cord syndrome
disruption of the anterior spinal artery
Central cord syndrome
upper extremities affected more than lower extremities
upper extremities affected more than lower extremities
central cord syndrome
Posterior cord syndrome
loss of proprioception and pain sensation
loss of proprioception and pain sensation
posterior cord syndrome
ectasy/MDMA intoxication
hyponatremia, concentrated urine, altered mental status
may see serotonin syndrome
formula for odds ratio?
(AxD)/(BxC) in standard 2x2 table
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
