Random Medical Flashcards
Sepsis SO including criteria
O2 PRN, IV
Sepsis (2+) - 15 ml/kg max. 1 L
- RR > 20
-T > 100 F
- HR > 100
- SBP < 100
- AMS
Severe Sepsis (1) - 30 ml/kg max. 2 L
- RR > 30
- HR > 130
- SBP < 90
- EtCO2 ≤ 25 mm Hg
An extremely painful ischemic cutaneous lesion common in kidney disease patients.
Calciphylaxis
Which are associated with appendicitis (3)?
A. The pain begins in the epigastrium or periumbilical region, then shifts to the right lower quadrant.
B. Interrmitent and severe
C. Pain upon passive extension of the right leg with the patient in the left lateral decubitus position.
D. Dull and aching
A. The pain begins in the epigastrium or periumbilical region, then shifts to the right lower quadrant.
B. Interrmitent and severe
C. Pain upon passive extension of the right leg with the patient in the left lateral decubitus position.
Incomplete development of teeth, bones, and ligaments is the result of:
A. Congenital hip dysplasia
B. Duchenne’s muscular dystrophy
C. Osteogenesis imperfecta
D. Osteomyelitis
C. Osteogenesis imperfecta
Which of the following is TRUE about sickle cell disease (SCD) (check all that apply):
A. Sickle cell anemia (SCD) is an inherited disorder of the hemoglobin in blood.
B. Sickle cell anemia requires the inheritance of two sickle cell genes.
C. Sickle cell trait, which is the inheritance of one sickle gene, seldom causes problems.
D. Symptoms of sickle cell anemia are the result of the abnormally shaped sickled red blood cells obstructing the flow of blood.
E. Treatment of sickle cell anemia is focused on managing the individual Sx.
All are correct.
A child with hemophilia was involved in a bike accident and is bleeding from their leg. Which action(s) would you avoid?
A. Immobilizing the joint
B. Lowering the injured area
C. Applying cold to the area
D. Applying pressure
B. Lowering the injured area
During assessment, you note pitting edema of 6 mm which remains intended for several seconds with obvious swelling. You rate this as (Hint: # + pitting edema):
3 + pitting edema is represented by a deep pit (6 mm) that remains for several seconds after pressing with obvious skin swelling by general inspection.
1+ is slight (2 mm) with normal contours (interstitial fluid volume 30% above normal. 2+ 4 mm pit lasting longer than 1+ , 4+ deep pit, 8 mm, that remains for a prolonged period with frank swelling.
SO Gastrointestinal: Severe vomiting
- IV NS TKO
- 4 mg ondansetron SIVP/ 2 min.
-Repeat q 5 min.
-consider cardiac/ serious causes
Contraindicated- prolonged QT
How much D10 should you infuse in an adult patient?
What is the pediatric dose of D10?
How do you make D10 from D50?
-125 ml
- 0.5 g/kg or 5 ml/kg
- Dilute 4:1 (examples):
–replace 50 cc Ns from 250 IV bag and replace with 50 ml D50
OR
–remove 40 ml from D50 and replace with 40 ml NS
LE has detained a person who struck someone in the head with a machete. He is concerned about his dog and wants his cell phone to call a friend. LEOs have placed the phone in the trunk with their weapons. When the suspect lunges for his phone, he is tackled and thrown face down with several officers on his back. You notice the patient is no longer struggling, is flushed, and is diaphoretic. When you ask if he is ok, he states, “I …can’t… breathe”. You ask officers to sit the patient up and they comply. On the way to the ambulance, he becomes combative and is escalating despite your efforts.
- What SO should you follow?
- Write the SO.
Excited delirium/ Severe agitation
-Midazolam (Versed) 10 mg IN (5 mg/ml). May repeat q 15 min.
-IV, CM, SpO2, EtCO2, O2 as needed, BGL, T
-Midazolam 2 mg IV q 2 min. max 6 mg
-If midazolam unavailable:
– versed (Diazepam) 5 mg IV q 2 min. max 15 mg
–lorazepam (Ativan) 2 mg IV q 2 min. max 6 mg
SO for seizure:
Seizure lasting > 5 min or repeated with no return of consciousness between them.
-O2, BGL
-Midazolam (Versed) 10 mg IN (5 mg/ml) x 2 > if no resolution call fro orders. If not available:
-IV NS TKO (Valium) Diazepam 5 mg x 2 > 5 min- if no resolution call for orders.
-Lorazepam (Ativan) 2 mg IV x 2 > 5 min- if no resolution call for orders.
-Midazolam (Versed) 5 mg x 2 > 5 min- if no resolution call for orders.
- Avoid intubation if SpO2 can be maintained > 90%.
A patient reports black, tarry stools.
This is called:
You suspect:
melena
Lower GI bleed
A patient presents with rebound tenderness during abdominal palpation.
This is indicative of:
Provide (3) possible differential diagnosis:
peritonitis
appendicitis
ruptured bowel
infection of the perineum
cirrhosis
peritoneal dialysis infection
A middle-aged female reports severe RUQ abdominal pain radiating to the R shoulder and nausea after eating.
Cholecystitis
Early: periumbilical pain, nausea, vomiting, low grade fever
Ripe: pain in RLQ (McBurney’s point)
Rupture: decrease in pain and tenderness, rebound tenderness, generalized pain
Appendicitis
These are termed:
Cullen- (C around umbilicus)
Grey-Turner (2 words- 2 flanks)
