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Step 2 CK > Preventative and EM MTB Chapters > Flashcards

Preventative and EM MTB Chapters Flashcards

1
Q

Ingestions of unknown substance– time window for lavage + when to avoid

A

first two hours

not for caustic ingestion or with altered mental status

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2
Q

Treatments that are almost always bad options for ingestion

A
  • diuretics
  • cathartics
  • whole bowel irrigation
  • ipecac (this is pre hospital)
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3
Q

Treatment that is is almost always a decent option in ingestion

A

charcoal

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4
Q

Most common causes of death by overdose nationwide

A

aspirin and acetaminophen LOL

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5
Q

Person with AMS of unclear etiology– first two steps

A

naloxone and dextrose (these do no harm)

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6
Q

Amount of acetaminophen that is dangerous? lethal?

A 
8-10 = danger 
12-15 = fatal
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7
Q

When is NAC safe for acetaminophen

A

first 24 hours

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8
Q

Metabolic disturbance in acetaminophen tox?

A

respiratory alkalosis and metabolic acidosis

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9
Q

Benefit of OD with BDZ + TCA

A

BDZ prevents seizing from TCA but if you give flumazenil all bets are off.

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10
Q

TCA EKG change

A

wide QT –> Torsades

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11
Q

TCA OD signs & tx

A

dry everything; sodium bicarb

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12
Q

Treatment caustic ingestion

A

endoscopy, flush with water

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13
Q

COD in CO poisoning

A

MI

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14
Q

Metabolic disturbance in CO poisoning

A

lactic acidosis

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15
Q

Lab to check first for CO poisoning

A

ABG (check for low pH 2/2 lactic acidosis…. low bicarb)

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16
Q

Two common drugs causing methemoglobinemia

A

anesthetics

nitrites

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17
Q

Treatment for methemoglobinemia

A

100% O2 and Methemoglobinemia

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18
Q

Color of blood in CO poisoning vs methemoglobinemia

A

CO- red

Met- brown

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19
Q

Nerve gas pathophys

A

blocks acetylcholinesterase …. ^ Ach ….^ secretions

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20
Q

COD in nerve gas + first step in treatment

A

bronchorhea –> bronchospasm –> respiratory arrest

*first give atropine

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21
Q

What predisposes to dig tox?

What lab is seen in dig tox

A 
hypokalemia = risk factor 
HYPER= lab finding (blocks Na/K ATPase and Dig competes with K+)
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22
Q

Dig tox symptom + tx

A

visual disturbance

Can give dig specific antibodies if CNS/ Cards Involvement

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23
Q

Specific signs of lead tox

A

ATN

wrist drop

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24
Q

Treatment lead tox

A

chelating agents (ie succimer, EDTA, dimercaprol)

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25
Q

Treatment of mercury tox

A

chelating agents (same as lead)

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26
Q

Methanol/ ethylene glycol tox treatment

A

fomepizole, dialysis

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27
Q

Tox metabolite in methanol/ethylene glycol tox?

A

methanol - formic acid

ethylene glycol- oxalate

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28
Q

Methanol/ethylene glycol organs effects

A

methanol -eyeballs

ethylene- kidneys

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29
Q

Osmolality equation

A

sosm= (2Na) + (BUN/2.8) + (Glu/18)

actual should = calculated else you have extra osmoles.

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30
Q

How do snake bites kill?

A

hemolysis/ DIC and respiratory paralysis

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31
Q

Treatment of snake bites

A

pressure, immobilization, antivenin PRN

32
Q

Lab finding in black widow bite?

A

hypocalcemia… can cause muscle/ abdominal pain

33
Q

Treatment black widow bite?

A

antivenin, calcium PRN

34
Q

Treatment brown recluse bite?

A

Dapsone, steroids, debride

35
Q

Abx for dog, cat, human bites?

A

augmentin for all.

36
Q

Concussion vs contusion management

A

observe contusion inpatient

37
Q

Indications for GI px

A

intubation
head trauma, burns
coagulopathy with respiratory failure

38
Q

Burns first two steps

A

assess airway –> give fluids

39
Q

Equation for fluid replacement in burns

A

4x % BSA X kg

40
Q

Rate and type of fluids for burns

A

normal saline 1/2 first 8 hours, 1/4 next 8, 1/4 next 8

41
Q

Equations for BSA burnt

A

arm and head are 9
leg chest and back are 18 each

*Hand width = 1%

42
Q

Common px abx in burns

A

topical (ie silver sulfadiazine)

43
Q

Difference between NMS and Malignant hyperthermia

A

both have high CPK/ Temp and can get dantrolene. But NMS is by antipsychotics and could also get a dopamine agonist. MHTN is from anesthetics

44
Q

Hypothermia cause of death

A

arrhythmia

45
Q

Cause of death in salt water vs fresh water drowning

A

salt- CHF

fresh- hemolysis (hypotonic fluid in vasculature, cells burst)

46
Q

Management of drowning

A

positive pressure ventilation

47
Q

What is basically never the right answer in cardiac arrest

A

precordial thump

48
Q

Which two rhythms can get unsynchronized cardioversion?

A

vfib, pulseless vtach

49
Q

Besides CPR, whats treatment of asystole?

A

epi

50
Q

Drugs for unstable vtach and vfib

A

epi/amio alternations

51
Q

Some common causes of pulseless electrical activity x4

A

TPTX
PE
tamponade
K+ disorder

52
Q

Unstable afib treatment

chronic stable afib treatment

A

unstable- Synch cardioversion

stable/chronic- rate control and either anticoagulate or asa if low risk

53
Q

Whats the CHADS score for afib anticoagulation?

A 
C-CHF/cardiomyopathy 
H- HTN
A-Age above 75 
D- DM
S- Stroke/ TIA = 2
54
Q

SVT treatment

A

vagal maneuvers –> adenosine –> BBer/CCB/Dig

55
Q

Least safe for anticoagulating in afib?

A

least safe is warfarin… can do dabigatran/rivaroxaban/apixaban

56
Q

Two drugs to avoid in WPW

A

dig and CCB

57
Q

Two antiarrythmics to use in WPW

A

procainamide or amio

58
Q

Cure for WPW

A

ablation

59
Q

EKG findings in WPW

A

short PR

Delta wave

60
Q

Vtach soon after MI… what do you need?

A

remove the clot

61
Q

how to assess risk for repeat ventricular arrhythmia?

A

echo

62
Q

Before you can implant defibrillator….. what type of ventricular arrhythmia must be present?

A

sustained.. can do EP studies to try and provoke sustained v tach.

63
Q

Cancer screen with largest mortality decrease-

A

mammo after 50

64
Q

How to benefit asx pt with many first degree relatives that have breast cx

A

SERMs- tamoxifen/raloxifene

65
Q

Age group for paps

A

21-65 every 3 years or q5 with cotest after 30

66
Q

Age group for chlamydia screening

A

15-25

67
Q

When is PSA the right answer?

A

patient asks for it

68
Q

Age for lipids in males vs females

A

males 35; females 45… or with CAD/equivalent… or DM, HTN etc.

69
Q

When to screen for DM

A

people with HTN, HLP

70
Q

Caveat to flu over age 50

A

has to be inactivated at 50 or with chronic disease

71
Q

Order of the two PNA vaccines

A

13 –> 23

72
Q

Who gets PNA vaccines before 65

A

chronic disease, CSF leak, cochlear implant, alcohol/tobacco, etc.

73
Q

When does someone get the PNA vaccines twive?

A

If their first dose was before 65… or if theyre immunocompromised. Wait at least 5 years before dosing again

74
Q

Who gets Hep A and B as adults

A

chronic liver disease; household contact; MSM; IVDU….

A: travelers
B: Health Care, DM, ESRD

75
Q

Age for DEXA/AAA screen

A

65

Step 2 CK (8 decks)

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