Review Cards Flashcards
Chest Utz findings most sensitive for pneumothorax
Absence of Comet Tail and Sliding Sign
Agent Contraindicated in Isopropanol Toxicity?
Fomepizole
Treatment for Carbon Monoxide Poisoning
100% inspire 02, HBOT, Methemoglobinemia, Methylene Blue
Most Common consideration in patients presenting with sterile pyuria?
C. Trachomatis Infection
Most common pulmonary fungal infection worldwide?
H. CAPSULATUM
Treatment of Benzodiazepine toxicity
Flumanezil 0.2mg IV max of 3mg in adult 0.01 to 0.02 mg/kg in pedia
A finding in chest radiograph that is dome shaped, dense opacification and is indicative of Pulmonary Embolism?
Hamptom Hump
Most sensitive indicator of adequate cardiopulmonary resuscitation in infants?
Increased Heart Rate
Thunderclap headache is associated with?
Intracerebral.aneurysmal Leak
Otogenic Brain abscess found in the temporal lobe or cerebellum are primarily cause by?
Bacteriodes
Fever, adenopathy, neurpathies (unilateral or bilateral facial never palsy),cardiac abnormalities, arthritis, and multiple annular/ target shaped skin lesion?
Lyme disease- earlt disseminated disease
Gold Standard imaging study for the diagnosis of bladder injury?
Retrograde Cystrogram
Downward vertical nystagmus is pathognomonic of what condition? What is the treatment?
Anterior Canal BPPV Treated: Deep Head Hanging Maneuver
The Gold standard for investigating penetrating neck injury?
Angiography
The Gold standard for non invasive imaging for abdominal injury?
Abdominopelvic CT with IV Contrast
Drug of choice for severe malaria?
IV artesunate
A strong H3 and H1 antagonist that increases cochlear blood flow and decrease peripheral vestibular inputs?
Betahistine
Treatment for cysticercosis
Albendazole and praziquantel
Most common cause of acute food poisoning in the US?
C. Perfringens
Triad of flashes, floaters and field deficits?
Retinal Detachment
Triad of fever, centripetal rash and tick bite?
Rocky Mountain Spotted Fever
Treatment for rodenticides ingesion?
If INR >2, start oral Vit K 20mg/d in adults (1-5 mg for children) up to 10 months
Most common cardiac rhythm in Pulmonary Embolism?
Normal SInus rhythm
Oral Medications causing severe esophageal irritation?
Potassium chloride Tetracycline Doxycycline Aspirin
Blast injury sustained as a result of being thrown from the blast site or structural collapse?
Tertiary Injuries
Treatment for Acute Chest Syndrome?
IV Fluids, O2, antibiotics and analgesics
Causes of genital herpes and resides in the sacral ganglia?
HSV-2
Chest pain, fever, and pleural/pericardial effusions 2-4 weeks after cardiac trauma (or surgery)
Pericardial Inflammation Syndrome
Congenital Long QT Syndromes May be associated with?
Deafness (Jervell-Lange- Nielsen Syndrome)
Most common type of sporotrichosis
Lymphocutaneous Type
Fracture of both pedicles of C2 with anterior displacement of C2 and C3
Hangman’s Fracture/ Traumatic Spondylisthesis
A common cause of stridor in children >6 months
Croup
Route of Exposure that poses the highest risk of transmission for bloodborne disease
Percutaneous exposure
Triad of jaundice, black, emesis, albuminuria
Yellow Fever
Most Common cause of non compressive focal neuropathy
Diabetic Peripheral Neuropathy
Most commmon symptom of blunt cardiac trauma?
Chest pain
Treatment for Idiopathic intracranial hypertension?
Oral acetazolamide
Eosinophilic intracellular lesions found within the cerebral neurons that is pathognomonic for rabies?
Negri bodies
Common cause of Hypomagnesemia in the ED?
Alcoholism
Causes the symptoms seen in scromboid fish poisoning?
Histidine to Histamine
A condition associated with increase endolymph within the cochlea and labyrinth?
Meniere’s Syndrome
What is the target arterial BP for patients who are candidates fro rTPA therapy?
SBP < or = 185 mmHg and DBP of < or = 110 mmHg
Presence of this reflex rules out testicular torsion
Cremasteric Reflex
Most common central cause of vertigo
Vestibular Migraine
Gold Standard for the diagnosis of Blunt cerebral vascular injury of the neck?
Digital Subtraction angiography
Most common tumor of the third ventricle?
Third Vertical Colloid Cysts
Most frequently injured abdominal organ
Liver
Most common affected structure in Thoracic Outlet Syndrome
Ulnar Nerve
What Iron Formulation has the most Ionic Iron Formulation?
Ferrous Fumarate
This agent cause pharmacobezoars in abdominal Radiographs?
Chloral Hydrate
Cranial Nerve involve with herpes zoster infection? (Shingles)
CN 7
Millian Ear Sign is diagnostic of?
Erysipelas
Vertical upward and rotatory nystagmus and a positive Dix-Hallpike test is diagnostic of___?
BPPV
Most sensitive clinical finding for placental abruption after trauma?
Uterine irritability
It is classically described as contralateral homonymous hemianopsia and unilateral cortical blindness
Basilar Artery Occlusion
Contraindicated agent in cardiac ischemia caused by Cocaine/ Methamphetamine toxicity?
B-blockers
Most common aortic blunt injury?
Proximal descending aorta
Treatment of opoid overdose
Naloxone 0.1-0.4 mg IV, SC, IM (adult) or 0.1mg/kg (pedia)
Most serious ocular oppurtunistic infection and is the leading cause of blindness in AIDS patients?
Cytomegalovirus retinitis
Treatment of Iron Toxicity
Deferoxamine
Type III Skin abscess is caused by?
Vibrio Vulnificus
Treatment for Beta blocker toxicity
Glucagon 3-10 mg IV Bolus
Standard fronline agent for Trigeminal Neuralgia
Carbamazepine
Most common artery involved in stroke
Middle Cerebral Artery
Most common STD in USA
C. Trachomatis
Romana sign and chagoma are associated with?
Chagas’ Disease
Treatment of Organosphosphate Poisoning
Atropine 1mg (adult)or 0.01-0.04 mg/kg (children) IV until tracheobronchial secretions stop Pralidoxime 1-2 g for adults or 20-40 mg/kg in children
Most common complication of lumbar puncture?
Post lumbar puncture headache
Presents with dysuria, purulent penile discharge, petechial or pustular acral skin leasions on an erythematous base, asymmetric arthralgias, tenosynovitirs or septic arthritis?
Disseminated gonococcal infection
Most common cultured agent in a shunt infection?
Staphyloccocus epididymis
Most common site for epidural abscess?
Thoracic and Lumbar Spine
Second most common death in young athletes?
Commotio cordis
Neuroblastoma is often associated with this syndrome presenting as acute ataxia with rapid chaotic eye movement?
Opsoclonus-myoclonus
Headache characterized as at least 5 episodes that are severe, unilateral, lasts 15-180 min and has a circadian/circannual pattern?
Cluster headache
Most common site of spinal injury in the elderly?
T12-L1 and T7-T8
Most common cardiac manifestation in Lyme disease
AV Block
Contraindicated agents in theophylline toxicity?
Cimetidine Phenytoin
Antidote for digoxin toxicity
Digi-Fab
Most common cause of ischemic stroke in children
Sickle Cell Disease
Treatment of Anticholinergic Toxicity
Supportive Therapy Activated charcoal in acute ingestion Antidysrhythmia Sodium Bicarbonate Physostigmine
Autoimmune disorder associated with fluctuating muscle weakness and fatigue in the proximal limb muscles among older men with history of cigarette smoking and lung cancer?
Lamber- Eaton Syndrome
Classic Presentation of paralysis of Upper extremities with lack of lower extremity, paralysis or weakness (cruciate paralysis) after a high energy impact?
Antlanto-occipital dissociation (AOD)
Heterophile NEGATIVE infectious mononucleosis without exudative pharyngitis, and mild lymphadenopathy
CMV Infection
Most common pelvic injury in elderly? Most common type of this injury?
Pubic ramus fracture, lateral compression
Treatment for Arsenic Poisoning?
Dimercaprol IM (BAL) Succimer PO- stable patients
Most common tick attachment?
Scalp
Single spinous process avulsion seen in the lower cervical and upper thoracic spine
“Clay-Shoveler”Fracture
Agent used to reverse heparin-induced coagulopathy?
Protamine 1mg per 100 U of Heparin used
Treatment for Methanol and Ethylene Glycol Toxicity?
Fomepizole 15mg/kg IV load then 10 mg/kg every 4 hours for 4 additional doses Ethanol 800 mg/kg/ IV load then 100mg/kg/h infusion IV dextrose Methanol: Folinic acid Ethylene glycol: pyridoxine Sodium Bicarb for significant met acidosis
Most commonly reported neurologic opportunistic infection in HIV patients
Toxoplasmosis Encephalitis
A systemic vasculitis involving medium sized- large arteries and may result to optic neuropathy and profound visual loss and contralateral ocular involvement?
Temporal Arteritis
Most common condition associated with Balanoposthisis?
Diabetes
Esophageal motility disorder that is due to failure of lower esophageal sphincter to relax and a complete absence of esophageal perilstasis
Achalasia
Most common thoracic spine fracture?
Simple wedge ( Compression) fracture- usually stable
Blast injury due to rapidly increasing then decreasing atmospheric pressure?
Primary Blast injury
Massive hemothorax is defined in the adult as a volume of at least?
>1500 mL
How much fluid collection can be seen on upright or decubitus chest radiograph?
>200-300 mL
Autoimmune disease characterized by muscle weakness and fatigue, made worse after repetitive use of voluntary muscles
Myasthenia Gravis
Treatment for Opoid withdrawal?
Clonidine 0.1-0.3 mg PO
Etiologic agent for Lyme Disease?
B.Burgdorferi
First line of abortive therapy for migraine at home?
Triptans
Characterized by painless primary chancre with an appearance of purplish blue unilateral inquinal lymphadenopathy noted on the overlying skin
Lymphogranuloma venereum
Treatment of TCA Toxicity?
Supportive Therapy Activated Charcoal Norepi or Epi Drip for Hypotension NaHCO3 for severe acidosis Magnesium Sulfate for Torsade Benzos for Seizure
Neuroleptic syndrome treatment?
Non depolarizing agent for muscle rigidity Dantrolene 0.5-2.5mg/kg
Most common case of subarachnoid hemorrhage?
Ruptured aneurysm (75%)
Common cause of traveler’s Diarrhea
Enterotoxic E. Coli
Treatment of Lead Poisonin?
Whole bowel irrigation using Polyethylene glycol BAL ( Dimercaprol) for chelation therapy
Most common causes of fever without obvious localizing findings in an HIV patient?
Pneumocystis Jirovecii
Most common form of an focal neuropathy and a common etiology us injury due to repetitive use
Median Mononeuropathy (Carpal Tunnel Syndrome)
Causative agent for painful genital ulcers and Lymphadenitis
Haemophilus ducreyi
Most common cardiac artery involved in cardiac traumatic injury?
Left anterior descending artey
Fallen Fragment sign is seen in fractures involving
Simple (unicameral) bone cyst
Causative agent of donovanosis?
Klebsiella granulomatis
Pediatric handle injuries are commonly associated with?
Pancreatic and orr Small Bowel Injuries
Causes orolabial lesions and resides in the trigeminal ganglia?
HSV-1
Acute headache with vestibular symptoms (vertigo or ataxia) indicates what condition?
Cerebellar hemorrhage
Which bone is dorsally dislocated in a perilunate dislocation?
Capitate
Most frequently injured intra-abdominal organ from sports accident?
Spleen
Which Bone is dorsally dislocated in a perilunate disloacation
Capitate
Which ventricle is at the greatest risk in cardiac injury due to its large anterior exposure?
Right Ventricle
Transient focal deficit that is unilateral following a simple or complex focal seizure
Todd’s paralysis
What nerve root is involve with suspected cubital tunnel syndrome, presence of neck pain and worsening of symptoms with neck flexion
C8 Entrapment
Bulging fissure sign on radiologic imaging is seen in?
Klebsiella Pneumonia Infection
Treatment of severe pain in rib fractures
Intercostal nerve block or serratus anterior plane block with bupivacaine
Often responsible for most cases of HSV Encaphilitis
HSV 1
Demyelinating disorder of the peripheral nerves that involves ascending symmetric weakness or paralysis and areflexia or hyporeflexia?
Guillain Barre-syndrome
Earliest indicator in acute radiation syndrome?
Decrease in Lymphocytic count
Frontotemporal headache, neck pain, facepain , partial Horner’s syndrome
Carotid Artery Dissection
Common pathogen using Endocarditis in IV Drug users
S. Aureus
Flexion Teardrop Fracture of the Spine is associated with what injury?
Anterior Spinal cord Syndrome
Occurs in the treatment of early syphilis and presents as headache and myalgias within 24h after treatment
Jarisch Herxheimer reaction
Most commonly injured area of the neck?
Zone II
Adult and Pediatric dose of INH toxicity
Pedia: 70 mg/kg IV Adult 5 g IV
Presents with malodorous thin watery discharge, vulvar irritation, pruritus, dysuria, dyspareunia, and occassionally low abdominal pain?
Trichomonas vaginalis
Most common cause of CNS infection globally and the leading cause of adult onset seizure worldwide?
Neurocysticercosis
What maneuver should be considered as first line treatment for Posterior canal BPPV?
EPLEY Maneuver
Treatment of Acetaminophen Toxicity
Acetylcysteine
Treatment of Acetaminophen Toxicity
Acetylcysteine
It is characterized by deafness, vertigo and facial nerve palsy cause by Herpes zoster oticus
Ramsay Hunt Syndrome
Most common central cause of vertigo?
Vestibular Migraine
Serum assay highly sensitive and specific for cerebrospinal fluid leakage
Serum Beta-2 transferrin
Most common sites for aspiration pneumonia after severe trauma?
Right and lower lung fields
What causes headache, transient visual obscurations, back pain, pulsatile tinnitus and papilledema with otherwise normal neuro exam?
Pseudomotor cerebri
Prosthetic valve endocarditis is mainly caused by?
Coagulase Negative Staphylococci
Treatment for Alchohol toxicity
IV Dextrose for Hypoglycemia Thiamine 100 mg IV or IM for Wernicke’s Encephalopathy
Pediatric handle injuries are commonly associated with?
Pancreatic and Small bowel injuries
Imaging study of choice for mandibular fracture
PANOREX ( Dental Panoramic X-ray
Most common cause of acute hemorrhagic fever in temperate climates?
Neisseria meningitides
Bladder volume of __ is a cause for concern in a neurogenic bladder?
>100 mL (200mL)
Treatment of Cyanide Poisoning
Cyanide kit: Amyl nitrite inhaler, Sodium Nitrite, Sodium Thiosulfate Hydrocobalamin
Most common GI manifestation of Sepsis?
Ileus
First line for refractory status epilepticus?
Propofol 2-10mg/k/h infusion
Second most common neurodegenerative disorder?
Dementia with Lewy Bodies
Blunt or penetrating injuries due to materials thrown from explosive casing
Secondary blast injuries
Most common cause of blunt neck trauma
Road traffic accidents
Most common cause of fungal meningitis?
Cryptococcus neoformans followed by Coccidiodes immitis
Diffuse CNS dysfunction with lack of focal physical examination findings to point to a specific region of brain dysfunction?
Toxic Metabolic Coma
A key component of a central cause of acute vestibular syndrome
acute nystagmus
Causative agent of pontiac fever?
Legionella
Treatment for CO and Cyanide poisoning specially for patients exposed to sever smoke inhalation during a fire
Sodium Thiosulfate AVOID Nitrites!
According to AHA guidelines, when to we give aspirin for stroke patients?
The current AHA/ASA guidelines recommend the adminis- tration of oral (or by rectum if swallowing impairment is pres- ent) aspirin within 24 to 48 hours after stroke onset unless thrombolytics have been given within the prior 24 hours.19 No antiplatelet agent (including aspirin) should be given within 24 hours of receiving thrombolytic therapy.
Type of anemia seen in P. Falciparum infection?
Normochromic, normocytic anemia
Most common symptom in pseudomotor cerebri
Headache
Weakest Link in disaster management?
Communication
This type/s of ambulance have physical access between the drivers and patient care compartments?
Type 2 and 3 ambulance
Most important factor in surviving cardiac arrest?
Early defibrillation
Contraindication for applying cervical collar in the field because of potential airway compromise?
Patients with mandibular or soft tissue neck injuries
What is a operational limitation for air medical transport?
Weather
Overriding condition for air transport?
Safety
What is the largest single non-trauma indication in most helicopter EMS programs?
Cardiac
Most common complaints in cruise ships?
Shortness of breath and injuries
First and very effective method for decontamination?
Disrobe, brush off solid dusts or powders, wash and dry face
The only natural disaster where more injury and death occur during the recovery period than in acute
Hurricane
Type of primary blast injury that involves lung parenchyma exploding into alveolar spaces ( dense to less dense medium)?
Spalling
In an isolated tympanic membrane rupture after a bomb blast, you should order____ as an adjunct diagnostic?
Chest radiography to rule out Pulmonary barotrauma
Normal muscle compartment pressure? At what pressure causes muscle ischemia, irreversible nerve and muscle damage?
< 10 mmHg, > 30mmHg
Most common and consistent finding in compartment syndrome?
Pain
Type of gas that interrupt pulmonary diffusion, with a pleasant odor of new mown hay?
Phosgene
Second most common hazardous material?
Ammonia
In acute radiation syndrome at what level will have GI Sydrome and death most likely?
> 6 Gy
What preparation is used in patients with suspected molluscum contagiosum and dermatophytic infections?
Potassium hydroxide
Used in establishing diagnosis of herpes infections?
Tzanck Smear
Presence of these cells are indicative of herpes infection?
Multinucleated Giant Cells
Most frequently used topical corticosteroid in the outpatient setting?
Hydrocortisone
Corticosteroids of moderate potency used in treating severely inflamed skin and thicker skin area?
Triamcinolone acetonide Fluocinolone acetonide
Refers to the decrease in responsiveness to a drug as result of enzyme- mediated events?
Tachyphylaxis
Non tender erythema with skin flaking and scaling, thickening of skin, patient often has preexisting eczema or psoriasis
Exfoliative erythoderma
The rate of erythema multiforme recurrence is high in children with this concomitant infection?
Herpes simplex infection
Slippage of the epidermis from the dermis when slight rubbing pressure is applied to the skin
Nikolsky sign
Major complications and leading causes of death in toxic epidermal necrolysis?
Infection Hypovolemia and electrolye disordersd
Generalized mucocutaneous, autoimmune blistering eruption with a grave prognosis characterized by intraepidermal acatholytic blistering
Pemphigus vulgaris
A severe adverse drug reaction that usually develops within 8 weeks of initiation of drug therapy?
Drug rash with eosinophilia and Systemic symptoms syndrome
Dermatologic triad of wide-spread ecchymoses, hemorrhagic bullae and epidermal necrosis
Purpura Fulminans
Side effects seen in higher potency topical corticosteroids on the face for more than a few days while treating sever seborrheic dermatitis
Perioral dermatitis or steroid rosacea
Causative agent of Tinea barbae? Treatment?
Tricophyton Treatment is Terbinafine 250mg PO daily 2-4 weeks
Results from reactivation of varicella zoster virsu in the genticulate ganglion and presents with ear pain, vesicles in the external auditory canal, facial nerve paralysis and vestibulocochlear dysfunction
Ramsay-Hunt syndrome
Etiologic agents that fluoresce from Wood’s lamp?
Nits Lice Microsporum Malassezia
Most common dermatophyte infection that can spread from involvement of the feet?
Tricophyton rubrum and tricophyton mentagophytes
Appears as short chopped hyphae and yeast forms termed “sphaghetti and meatballs” under potassium hydroxide preparation?
Malassezia infection
The 5 Ps hallmark of lichen planus?
Purple Polygonal Pruritic Planar Papules
Are fine white lacy reticulate lines that adhere to the papules and are pathognomonic of Lichen Planus?
Wickham striae
This condition is identical to lichen planus except they tend to be more generalized and photodistributed and there is a history of drug ingestion?
Lichenoid drug eruptions
May present as papular lesions 2-5 mm in, generalized and are reddish to copper in color with palmar-plantar involvement with a collarete scale?
Secondary syphilis- late stage
Treatment for Secondary Syphilis?
Benzathine Pen G 2.4 million U IM single dose
A vasvular leak in the superficial dermis of the skin characterized by transient pruritic wheals and welts
Urticaria
The presence of large edematous areas that involve the deeper dermis and the subcutaneous tisse?
Angioedema
An unusual allergy characterized by acute urticaria or anaphylaxis is allergy to meat (beef, lamb, pork) 4 hours after being bitten by a Lone Star tick bite?
Allergy to galactose-a- 1, 3 glactose
Idiopathic, intensely pruritic eruption that begins in the third trimester of pregnancy?
Polymorphic eruption of pregnancy
Treatment for Erythema Migrans in non-pregnant patients?
Doxycycline 200 mg PO-single dose
A symptom common with drug eruption but often absent in a viral exanthem?
Pruritus
Drug reaction that Occurs as a solitary or occasionally multiple, discrete, round to oval erythematous patches that turn dusky red or violaceous?
Fixed drug eruption
May occur within 3-5 days of initiation of warfarin and heparin that starts as a single painful area followerd by erythema that rapidly turns blue black with subsequent necrosis of the skin?
Anticoagulant necrosis
An infection after priamry exposure to varicella, the virus remains latent in the dorsal root ganglia until it later reactivates and spreads down the sensory to the skin
Herpes zoster
Most common autoimmune blistering disease in the elderly?
Bullous pemphigoid
Chemical produced by the “blister beetle”which when released after the insect is crush produces vesicles and blisters on the exposed areas?
Canthadrin
Common molluscum contagiosum seen in children? In HIV infections?
M. Contagiosum V1 in children, V2 in HIV infections
Causative agent for “Hot tub folliculitis”?
Pseudomonas aeruginosa
Causative agent for Kaposi’s sarcoma?
Human Herpesvirus 8
Treatment for Hidradenitis suppurativa?
Clindamycin 1% lotion twice daily and use of antibacterial soaps such as chlorhexidine, once to twice daily
Rapidly developing ulcer that begins as a pustule or erythematous nodule and has violaceous over hanging borders
Pyoderma Gangrenosum
Triad of diabetic foot ulcers?
Neuropathy Deformity Trauma
Third most common chronic mycobacterial infection in humans?
Buruli Ulcer caused by Mycobacterium ulcerans
Involves direct injury of the peripheral nerves of the foot sustained from prolonged cooling and accelerate by wet conditions?
Trench foot
Characterized by mild but uncomfortable inflammatory lesions of the skin caused by long-term intermittent exposure to damp, non-freezing ambient temperatures.
Chillblains aka pernio
Treatment for Chillblains?
Nifedipine Pentoxyfylline Limaprost
Mild necrosis of subcutaneous fat tissue that develops during prolonged exposure to temperatures just above freezing?
Panniculitis
At what skin temp does frostbite occur?
Skin temp is <0 C( <32 F)
Zone in frostbite injury that may benefit if the circulation in the frozen area can be restored
Zone of Stasis
Most susceptible tisse to frostbite injuries
Bone marrow
Frostbite injuries that involve tissue loss of entire thickness of the skin, hemorrhagic blisters
Third Degree
First definitive step of frostbite therapy and should be initiated as soon as the risk of refreezing injury can be avoided
Rapid rewarming @ 37C-39 C ( 98.6 to 102.2 F) for 20-30 minute
When should thrombolytic therapy be given as management of pulse deficits after rewarming of frostbite injury?
Within 24h
Involuntary drop in core temperature below 35 C (<95 F)?
Accidental hypothermia
Type of heat loss that occurs when a warm body makes direct contact with a cold object?
Conductive heat loss
A type of heat loss that occurs due to the energy required for water to phase change from a liquid to a gas?
Evaporative heat loss
Referred as the continuing drop fo core temp even after the patient is removed from the cold environment?
Afterdrop
Most common iatrogenic causes of hypothermia?
Massive transfusion and large volume crystalloid resuscitation
Used to describe cardiac arrest that can commonly occur during extrication, transport or treatment of a deeply hypothermic patient?
Rescue collapse
Expected dysrhythmias seen in hypothermic cardiac response?
Atrial fibrillation and flutter
Can be misdiagnosed as ST Elevation MI and usually occurs below 32 C?
Osborn J waves
The renal response to hypothermia?
Cold Diuresis
Preferred site for core temp measurement in an intubated patient as it closely measures cardiac temp?
24cm below the larynx or lower third of the esophagus
Type of heat injury that occurs during periods of high environmental stress, and over a period of hours to days?
Classic heat injury
Acute inflammation of the sweat ducts caused by blockage of the sweat pores by macerated stratum corneum
Prickly heat aka Lichen tropicus
Cardinal Symptoms of heat stroke?
Hyperthermia and altered mental status
What cross reacts with individuals sensitized to other hymenoptera stings?
Fire ant venom
Causes target lesions associated with immediate pinprick sensation, diffuse myalgias involving larger muscle groups after being bitten
Black widow bites
Only North american scorpion that produces systemic toxicity
Bark Scorpion ( Centruroides Sculpturatus)
Systemic ascending paralysis caused by tick borne illness
Tick paralysis
Initial bite of this insect is painless and linear, feed on blood of sleeping victims
Kissing Bugs and Bed Bugs (Hemiptera)
An absence of systemic symptoms or hematologic abnormalities after 8-12 hour after an unidentified snake bite indicate?
Dry bite
Treatment for Crotaline snakes or pit viper bite?
Crotalidae Immune Fab (Fab AV): 4-6 vials + 250 cc NSS over one hour then repeat dose of 4-6 vials if initials control is not achieved
Immediate cause of death after an Elapid snake bite?
Paralysis of respiratory muscles
Antibiotic for marine associated wound infections cause by vibrio Species Coverage
Fluoroquinolone
Treatment for jellyfish envenomation?
Irrigation with seawater and hot water immersion, Application of topical lidocaine
Characterized by mild local effects with localized pain and erythema. 20-30 minutes later, severe generalized pain in the abdomen, back chest head and limbs develop after being bitten by the Australian box jellyfish
Irukandji Syndrome
How many hours should a diver wait before flying after the last divibg exposure?
12 to 24h?
Absolutr contraindication to hyperbaric therapy?
Untreated pneumothorax
Factors associated with poor resuscitation prognosis in near drowning?
Need for bystander CPR at scene CPR in the ED Asystole at the ED after warming
Factors associated with poor resuscitation prognosis in near drowning?
Need for bystander CPR at scene CPR in the ED Asystole at the ED after warming
The critical driver of altitude illness
Sleeping altitude
A drug induces bicarbonate diuresis, greatly facilitates this process thru its inhibition of carbonic anhydrase, thus counteracting ascent-related respiratory alkalosis
Acetazolamide
Criteria for an unacclimitize persons become unconscious?
SaO2- 50-60% PaO2- <30mmHg JVPO2- < 15mmHg
A syndrome characterized by headache along with some combination of nausea or vomiting, dizziness, fatigue or sleep disturbance and occurs in the setting of more gradual and less severe hypoxic insult than acute hypoxia syndrome?
Acute Mountain Sickness
Side effects of high dose acetazolamide?
Peripheral Paresthesias Nausea Drowsiness
Defined by progressive neurologic deterioration or ataxia in individual who has recently ascended to high altitude?
High altitude cerebral edema
Highest priority in treatment of HACE?
Descent (Then O2 supplementation and steriod therapy)
Main etiology for High altitude PE?
High microvascular pressure
Hallmark of High altitude PE?
Progression of dyspnea with exertion to dyspnea t rest
Treatment of choice for HAPE?
Immediate descent
Prophylaxis for those who have previously experience HAPE
Nifedipine 20 mg every 8 hours while ascending
Blunts hypoxic pulmonary vasoconstriction thru generation of nitric oxide, prevents HAPE in susceptible individuals
Tadalafil > sildenafil
Characterized by excessive polycythemia for a given altitude which causes symptoms of headache, muddle thinking, difficulty of sleeping, impaired peripheral circulation, drowsiness and chest congestion
Monge’s disease or chronic mountain sickness
Two major asphyxiants?
Carbon monoxide and Hydrogen cyanide
Corner stone of initial treatment for chemical burn
Agressive large volume irrigation
Most important chemical burn feature that HCW may alter
Contact time
Use to remove or rinse phenol or carbolic acid injury?
isopropyl alcohol rinse is equivalent to polyethylene glycol
Most common orthopedic injury commonly seen in electrical injury
posterior shoulder dislocations
Neurologic/ msucular stunning associated with cardio respiratory arrest after a lightning injury
Keraunoparalysis
Pathognomonic for lightning strike injury, consist of a red superficial feathering or ferning patter
Lichtenberg figures
