ROSH Flashcards
(151 cards)
1
Q
-Patient with a history of a motor vehicle accident, fall or playing sports -Complaining of severe foot pain and an inability to bear weight
A
Lisfranc Injuries
2
Q
-PE will show: -respiratory depression -sedation -miosis -hyporeflexia -bradycardia -hypotension -hypothermia -Diagnostics may show prolonged QTc interval
A
Opioid Toxicity
3
Q
PE will show hypotension, bradycardia, and heart block
A
Beta-Blocker Toxicity
4
Q
Poison: seretonin Reuptake Inhibitors what is the antidote?
A
cyproheptadine
5
Q
Carbon Monoxide (CO) Poisoning treatment
A
100% oxygen, hyperbaric oxygen
6
Q
Labs will show: -normocytic -hypochromic anemia -basophilic stippling on peripheral smear
A
Lead Poisoning
7
Q
A
complete cord transection
8
Q
Ventricular Fibrillation tx
A
defibrillation
9
Q
-Patient will be a child -Complaining of a sudden episode of coughing, wheezing, or stridor
A
Foreign Body Aspiration
10
Q
Poison: Anticholinergics what is the antidote?
A
physostigmine
11
Q
Poison: heparin what is the antidote?
A
protamine
12
Q
-Respiratory alkalosis + -anion gap metabolic acidosis
A
Salicylate Toxicity
13
Q
Symptoms caused by the accumulation of the toxic byproduct OXALIC ACID
A
Ethylene Glycol Intoxication
14
Q
-Aspirin -wintergreen -bismuth subsalicylate can lead to what kind of toxicity?
A
Salicylate Toxicity
15
Q
-“Mad as a hatter” (AMS) -“blind as a bat” (mydraisis) -“red as a beet” (flushed skin) -“hot as a hare” (anhydrosis) -“dry as a bone” (dehydration)
A
Anticholinergic Toxidrome
16
Q
PE shows: leg Internally rotated, sciatic nerve injury
A
Posterior hip dislocation
17
Q
What is the treatment for an ethmoid bone fracture?
A
-Analgesia -systemic antibiotic -avoidance of sneezing and blowing of the nose.
18
Q
PE will show: -hyperthermia -tachycardia -mydriasis -dry skin
A
Anticholinergic Toxidrome
19
Q
pH: > 7.45; PaCO2: < 35; HCO3: Normal
A
Respiratory Alkalosis
20
Q
Poison: anticoagulants what is the antidote?
A
vitamin K FFP
21
Q
-Patient with a history of blunt or penetrating trauma -Complaining of blurry vision
A
Hyphema
22
Q
Acute Mountain Sickness Treatment
A
halt ascent, acetazolamide
23
Q
Stable patient + negative FAST –>
A
observation
24
Q
Brown-Séquard Syndrome Patient with a history of
A
penetrating trauma
25
Inquire about number of vomiting episodes Patients without vomiting six hours after exposure will not have major toxicity GI necrosis/hemorrhage
Iron Toxicity
26
Hyphema Treatment is with eye protection, limitation of activity, and
head elevation of 30–45 degrees
27
Pneumothorax
28
Poison: iron what is the antidote?
deferoxamine
29
What is the best radiologic view for diagnosing a bilateral facet dislocation?
Lateral view.
30
Anterior Cord Syndrome
31
Poison: opioids what is the antidote?
nalaxone
32
Poison: isoniazid what is the antidote?
pyridoxine
33
Salicylate Toxicity
Rx: activated charcoal (if \< 1 hour from ingestion), urine alkalinization, K+
34
Poison: methanol what is the antidote?
ethanol
35
-Patient will be an adult with a history of fall on an outstretched hand -PE will show localized swelling, tenderness, and decreased motion
Radial Head Fracture
36
-Patient with a history of chest trauma -PE will show diminished or absent breath sounds, tracheal deviation away from the side of the injury, hypotension, jugular venous distension
Tension Pneumothorax
37
Poison: CCBs what is the antidote?
calcium glucagon insulin
38
Black Widow Spider treatment
-Opioids -benzodiazepines -antivenin (only if severe sx)
39
Opioid Toxicity Treatment is
stabilization, naloxone
40
FAST
Ultrasound: Focused Assessment with Sonography for Trauma
41
Chance Fracture Evaluate for
intra-abdominal injury
42
-Facial trauma -Purple/bluish swelling of septum
Septal Hematoma
43
Acetaminophen Toxicity tx
Treatment is N-acetylcysteine (restores glutathione)
44
tracheal deviation away from the side of the injury,
Tension Pneumothorax
45
Diagnosis is made by non-contrast CT, will appear as crescent-shaped hematoma
Subdural Hematoma
46
Unstable patient + negative FAST --\>
repeat FAST or DPL
47
What other medication is an acceptable alternative to amiodarone in refractory ventricular fibrillation?
Lidocaine
48
Patient will be a child Complaining of: -sudden episode of coughing -wheezing -stridor
Foreign Body Aspiration
49
Subdural Hematoma
50
Killer B's: -Bradycardia -Bronchorrhea -Bronchospasm
Cholinergic Toxicity
51
Stable patient + positive FAST --\>
CT
52
Poison: insulin what is the antidote?
glucose
53
- fall on an outstretched hand (FOOSH) -Complaining of dorsal radial wrist pain with decreased range of motion -PE will show anatomical snuffbox tenderness
Scaphoid Fracture
54
Scaphoid Fracture Treatment is
thumb spica splint
55
Lead Poisoning tx
Treatment is oral succimer or IV EDTA (calcium disodium edetate, given after dimercaprol)
56
PE shows: leg EXTERNALLY rotated, femoral artery/vein/nerve injury
Anterior hip dislocation
57
- Fifth metatarsal diaphysis fracture ≥ 1.5 cm distal to base -Malunion/nonunion -Rx: cast/splint, non weight-bearing
Jones fracture
58
Opioid Overdose
59
PE will show tenderness of the tarsometatarsal joint
Lisfranc Injuries
60
what kind of toxicity? -Aspirin, wintergreen, bismuth subsalicylate -Respiratory alkalosis + anion gap metabolic acidosis -Hypoglycemia -Tinnitus
Salicylate Toxicity
61
62
transverse fracture through the base of the 5th metatarsal
jones fracture
63
Salter-Harris Fractures
I: S (Slipped epiphysis) II: A (fracture Above physis), most common III: L (fracture beLow physis) IV: T (fracture Through physis) V: ER (ERasure of the growth plate)
64
Brown-Séquard Syndrome Most commonly caused by
spinal cord hemisection
65
Patient with \_\_\_\_\_\_\_\_\_\_poisoning will be complaining of: -headache -nausea -dizziness
Carbon Monoxide (CO) Poisoning
66
Patient with a history of exposure to raccoons, bats, or skunks
Rabies
67
Rabies tx
Treatment is wound care (scrubbing), rabies immune globulin at wound site (if indicated), vaccination
68
pH: \< 7.35; PaCO2: Normal; HCO3: \< 22
Metabolic Acidosis
69
Classes of medications with\_\_\_\_\_\_\_properties include: -antihistamines -tricyclic antidepressants -sleep aids
anticholinergic
70
Jefferson/Burst Fracture
71
PE will show: -unequal pupils -injected conjunctiva/sclera blood in anterior chamber
Hyphema
72
\_\_\_\_\_\_\_\_\_\_\_is the definitive way to diagnose and clear a cervical spine injury on patients of all ages
cervical spine MRI scan
73
-Fifth metatarsal base avulsion fracture -Bulky dressing or hard sole shoe
Pseudo-Jones
74
Poison: cyanide what is the antidote?
hydroxycobalamin amyl nitrite sodium thiosulfate
75
Patient with a history of direct trauma to the orbit Complaining of limitation of upward gaze, infraorbital anesthesia
Orbital Blowout Fracture
76
-PE will show cherry-red skin (post-mortem finding) -Labs will show carboxyhemoglobin
Carbon Monoxide (CO) Poisoning
77
Unstable patient + positive FAST --\>
laparotomy
78
Hip Dislocation treatment
Treatment is emergent reduction under conscious sedation
79
Poison: sulfonylurea what is the antidote?
octreotide glucose
80
what is the orientation of this fracture?
segmental
81
What is the most common long bone fracture?
Tibia.
82
Poison: digoxin what is the antidote?
digoxin FAB
83
-Most commonly caused by flexion injury -Comments: proprioception and vibration intact
Anterior Cord Syndrome
84
Foreign Body Aspiration most common site is the\_\_\_\_\_\_main bronchus
right
85
Cat Bite Most commonly caused by
Pasteurella multocida
86
Ethylene Glycol Intoxication clinical presentation
-flank pain -hematuria, - oliguria
87
Associated with patients with ischemic heart disease & ventricular dysfunction Notable feature: uncoordinated, disorganized electrical activity
Ventricular Fibrillation
88
Tension pneumothorax
89
Chance Fracture
90
Patient with a history of ingestion of: -antifreeze -solvents -windshield wiper fluid -cleaners -fuels -de-icing solutions
Ethylene Glycol Intoxication
91
what level does the spinal cord terminate in adults?
L1-L2
92
Cat Bite Treatment is irrigate, leave the wound open,
amoxicillin - clavulanate
93
Chance Fracture Imaging shows fracture through all \_\_\_\_\_\_\_\_\_\_\_
three columns
94
X-ray will show fat pad ‘sail sign’
Radial Head Fracture
95
Proximal Humerus Fracture
96
CT will show teardrop sign
Orbital Blowout Fracture
97
PE will show loss of motor, pain, and temperature below injury
Anterior Cord Syndrome
98
-PE will show arm abducted, externally rotated. Apprehension test positive. -X-ray will show humeral head displaced inferiorly and medially
Anterior Shoulder Dislocation
99
Mandible Fracture tx
-Treat open fracture with antibiotics, update tetanus -Monitor airway
100
Poison: beta blockers what is the antidote?
glucagon insulin
101
Dog Bites Treatment is
amoxicillin/clavulanate.
102
Tension Pneumothorax treatment
Treatment is needle decompression of the chest in the second intercostal space in the midclavicular line or fifth intercostal space in the midaxillary line followed by chest tube insertion
103
PE will show anatomical snuffbox tenderness
Scaphoid Fracture
104
Preexisting IgE antibodies → mast cell degranulation → shock, airway compromise
Anaphylaxis
105
Radial Head Fracture
106
Anticholinergic Toxidrome
Treatment is supportive care alone or in combination with antidotal therapy with \_\_\_\_\_\_\_\_\_\_\_\_
107
Jones Fracture
108
Anterior Shoulder Dislocation
109
Orbital Blowout Fracture
110
Labs will show: -anion gap metabolic acidosis -↑ osmol gap -hypocalcemia -acute renal failure -enveloped (or Maltese cross) shaped crystals in urine -fluorescent urine under Wood lamp
Ethylene Glycol Intoxication
111
Associated with seatbelt, often not positioned correctly
Chance Fracture
112
-Patient will be a football player or diver -With a history of trauma via axial loading -Most commonly caused by burst fracture of C1 -Treatment is a halo
Jefferson/Burst Fracture
113
Lisfranc Injuries
114
pH: \> 7.45; PaCO2: Normal; HCO3: \> 26
Metabolic Alkalosis
115
pH: \< 7.35; PaCO2: \> 45; HCO3: Normal
Respiratory Acidosis
116
SLUDGE: -Salivation/Sweating -Lacrimation -Urination -Defecation -Gastrointestinal distress -Emesis
Cholinergic Toxicity
117
Poison: Acetaminophen what is the antidote?
N-acetylcysteine
118
\_\_\_\_\_\_\_\_\_\_\_\_\_ Toxicity will show: Patient will be complaining of abdominal pain, nausea, vomiting, and diaphoresis PE will show RUQ tenderness Labs will show elevated AST and ALT
Acetaminophen Toxicity
119
Indications: -Serum Fe level \> 500 mcg/dL or severe signs and symptoms such as metabolic acidosis: -repetitive vomiting -toxic appearance -lethargy -hypotension -signs of shock
Chelating agents: -Deferasirox -deferoxamine -deferiprone
120
Acetaminophen Toxicity PE will show
RUQ tenderness
121
-Patient will be a young, tall, thin, man -PE will show decreased breath sounds, decreased fremitus, hyperresonance to percussion
Spontaneous Pneumothorax
122
Poison: cholinergics what is the antidote?
atropine pralidoxime (2-PAM)
123
Poison: carbon monoxide what is the antidote?
oxygen
124
-Likely due to trauma -Pain, swelling, facial asymmetry, bruising
Mandible Fracture
125
Labs will show anion gap metabolic acidosis, ↑ osmol gap, hypocalcemia, acute renal failure, enveloped (or Maltese cross) shaped crystals in urine, fluorescent urine under Wood lamp
Ethylene Glycol Intoxication
126
Loss of thermoregulatory mechanisms: -Dry skin -AMS -Abnormal LFTs
Heat Stroke
127
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Toxicity Labs will show elevated AST and ALT
Acetaminophen
128
Foreign Body Aspiration
129
Mechanism: -block reuptake of biogenic amines (nrepinephrine, serotonin) -anticholinergic (dilated pupils, tachycardia, dry, hot, urinary retention) -sodium channel blockade (wide QRS complex) -alpha-1 adrenergic receptor blockade (vasodilation, hypotension) antihistamine effects (contributes to sedation) -GABA receptor antagonism (may contribute to seizures)
Tricyclic antidepressants TCA
130
Poison: heavy metals: arsenic copper lead mercury what is the antidote?
dimercaprol EDTA Penicillamine Succimer (DMSA)
131
Poison: benzodiazepines what is the antidote?
flumazenil
132
Beta-Blocker Toxicity Treatment is
glucagon, high dose insulin
133
-Patient will be a complaining of headache, joint pain, and constipation -X-ray will show hyperdense lines at metaphyses ("lead lines")
Lead Poisoning
134
Beta-Blocker Toxicity Labs will show
hypoglycemia
135
Dog Bites Sepsis most commonly caused by
C. canimorsus
136
Complaining of hydrophobia, agitation, spasms
Rabies
137
Poison: Tricyclic Antidepressant what is the antidote?
sodium bicarbonate
138
Poison: methemoglobin what is the antidote?
methylene blue
139
Nexus Criteria
Clears patients from cervical spine fracture clinically without imaging if all the following criteria met: -No midline cervical tenderness -No focal neurologic deficits -Normal alertness - No intoxication -No painful distracting injury
140
Septal Hematoma tx
Rx: drainage followed by packing
141
Poison: hydrofluoric Acid what is the antidote?
calcium gluconate
142
PE will show inferior rectus entrapment, enophthalmos
Orbital Blowout Fracture
143
PE will show: -ipsilateral loss of motor -position and vibration -contralateral loss of pain and temperature
Brown-Séquard Syndrome
144
Anticholinergic Toxidrome
145
Metronidazole (Flagyl) Avoid ________ when taking this medication
alcohol
146
Jefferson/Burst Fracture Most commonly caused by burst fracture of \_\_\_\_\_\_\_
C1
147
Normal ABG values
pH:7.35 – 7.45; PaCO2: 35 – 45; HCO3: 22 – 26
148
Hypertension, bradycardia, irregular respirations
Cushing Triad
149
Poison: aspirin what is the antidote?
sodium bicarbonate
150
Poison: ethylene glycol what is the antidote?
fomepizole ethanol
151
Subdural Hematoma Most commonly caused by
rupture of the bridging veins
