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EMERGENCY MEDICINE > ROSH > Flashcards

ROSH Flashcards

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Royal College: Emergency Medicine flashcards
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

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2
Q

-PE will show: -respiratory depression -sedation -miosis -hyporeflexia -bradycardia -hypotension -hypothermia -Diagnostics may show prolonged QTc interval

A

Opioid Toxicity

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3
Q

PE will show hypotension, bradycardia, and heart block

A

Beta-Blocker Toxicity

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4
Q

Poison: seretonin Reuptake Inhibitors what is the antidote?

A

cyproheptadine

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5
Q

Carbon Monoxide (CO) Poisoning treatment

A

100% oxygen, hyperbaric oxygen

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6
Q

Labs will show: -normocytic -hypochromic anemia -basophilic stippling on peripheral smear

A

Lead Poisoning

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7
Q
A

complete cord transection

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8
Q

Ventricular Fibrillation tx

A

defibrillation

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9
Q

-Patient will be a child -Complaining of a sudden episode of coughing, wheezing, or stridor

A

Foreign Body Aspiration

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10
Q

Poison: Anticholinergics what is the antidote?

A

physostigmine

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11
Q

Poison: heparin what is the antidote?

A

protamine

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12
Q

-Respiratory alkalosis + -anion gap metabolic acidosis

A

Salicylate Toxicity

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13
Q

Symptoms caused by the accumulation of the toxic byproduct OXALIC ACID

A

Ethylene Glycol Intoxication

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14
Q

-Aspirin -wintergreen -bismuth subsalicylate can lead to what kind of toxicity?

A

Salicylate Toxicity

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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

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16
Q

PE shows: leg Internally rotated, sciatic nerve injury

A

Posterior hip dislocation

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17
Q

What is the treatment for an ethmoid bone fracture?

A

-Analgesia -systemic antibiotic -avoidance of sneezing and blowing of the nose.

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18
Q

PE will show: -hyperthermia -tachycardia -mydriasis -dry skin

A

Anticholinergic Toxidrome

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19
Q

pH: > 7.45; PaCO2: < 35; HCO3: Normal

A

Respiratory Alkalosis

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20
Q

Poison: anticoagulants what is the antidote?

A

vitamin K FFP

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21
Q

-Patient with a history of blunt or penetrating trauma -Complaining of blurry vision

A

Hyphema

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22
Q

Acute Mountain Sickness Treatment

A

halt ascent, acetazolamide

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23
Q

Stable patient + negative FAST –>

A

observation

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24
Q

Brown-Séquard Syndrome Patient with a history of

A

penetrating trauma

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25
Q

Inquire about number of vomiting episodes Patients without vomiting six hours after exposure will not have major toxicity GI necrosis/hemorrhage

A

Iron Toxicity

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26
Q

Hyphema Treatment is with eye protection, limitation of activity, and

A

head elevation of 30–45 degrees

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27
Q
A

Pneumothorax

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28
Q

Poison: iron what is the antidote?

A

deferoxamine

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29
Q

What is the best radiologic view for diagnosing a bilateral facet dislocation?

A

Lateral view.

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30
Q
A

Anterior Cord Syndrome

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31
Q

Poison: opioids what is the antidote?

A

nalaxone

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32
Q

Poison: isoniazid what is the antidote?

A

pyridoxine

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33
Q

Salicylate Toxicity

A

Rx: activated charcoal (if < 1 hour from ingestion), urine alkalinization, K+

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34
Q

Poison: methanol what is the antidote?

A

ethanol

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35
Q

-Patient will be an adult with a history of fall on an outstretched hand -PE will show localized swelling, tenderness, and decreased motion

A

Radial Head Fracture

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36
Q

-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

A

Tension Pneumothorax

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37
Q

Poison: CCBs what is the antidote?

A

calcium glucagon insulin

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38
Q

Black Widow Spider treatment

A

-Opioids -benzodiazepines -antivenin (only if severe sx)

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39
Q

Opioid Toxicity Treatment is

A

stabilization, naloxone

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40
Q

FAST

A

Ultrasound: Focused Assessment with Sonography for Trauma

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41
Q

Chance Fracture Evaluate for

A

intra-abdominal injury

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42
Q

-Facial trauma -Purple/bluish swelling of septum

A

Septal Hematoma

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43
Q

Acetaminophen Toxicity tx

A

Treatment is N-acetylcysteine (restores glutathione)

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44
Q

tracheal deviation away from the side of the injury,

A

Tension Pneumothorax

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45
Q

Diagnosis is made by non-contrast CT, will appear as crescent-shaped hematoma

A

Subdural Hematoma

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46
Q

Unstable patient + negative FAST –>

A

repeat FAST or DPL

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47
Q

What other medication is an acceptable alternative to amiodarone in refractory ventricular fibrillation?

A

Lidocaine

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48
Q

Patient will be a child Complaining of: -sudden episode of coughing -wheezing -stridor

A

Foreign Body Aspiration

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49
Q
A

Subdural Hematoma

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50
Q

Killer B’s: -Bradycardia -Bronchorrhea -Bronchospasm

A

Cholinergic Toxicity

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51
Q

Stable patient + positive FAST –>

A

CT

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52
Q

Poison: insulin what is the antidote?

A

glucose

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53
Q
  • fall on an outstretched hand (FOOSH) -Complaining of dorsal radial wrist pain with decreased range of motion -PE will show anatomical snuffbox tenderness
A

Scaphoid Fracture

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54
Q

Scaphoid Fracture Treatment is

A

thumb spica splint

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55
Q

Lead Poisoning tx

A

Treatment is oral succimer or IV EDTA (calcium disodium edetate, given after dimercaprol)

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56
Q

PE shows: leg EXTERNALLY rotated, femoral artery/vein/nerve injury

A

Anterior hip dislocation

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57
Q
  • Fifth metatarsal diaphysis fracture ≥ 1.5 cm distal to base -Malunion/nonunion -Rx: cast/splint, non weight-bearing
A

Jones fracture

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58
Q
A

Opioid Overdose

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59
Q

PE will show tenderness of the tarsometatarsal joint

A

Lisfranc Injuries

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60
Q

what kind of toxicity? -Aspirin, wintergreen, bismuth subsalicylate -Respiratory alkalosis + anion gap metabolic acidosis -Hypoglycemia -Tinnitus

A

Salicylate Toxicity

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61
Q
A
62
Q

transverse fracture through the base of the 5th metatarsal

A

jones fracture

63
Q

Salter-Harris Fractures

A

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
Q

Brown-Séquard Syndrome Most commonly caused by

A

spinal cord hemisection

65
Q

Patient with __________poisoning will be complaining of: -headache -nausea -dizziness

A

Carbon Monoxide (CO) Poisoning

66
Q

Patient with a history of exposure to raccoons, bats, or skunks

A

Rabies

67
Q

Rabies tx

A

Treatment is wound care (scrubbing), rabies immune globulin at wound site (if indicated), vaccination

68
Q

pH: < 7.35; PaCO2: Normal; HCO3: < 22

A

Metabolic Acidosis

69
Q

Classes of medications with_______properties include: -antihistamines -tricyclic antidepressants -sleep aids

A

anticholinergic

70
Q
A

Jefferson/Burst Fracture

71
Q

PE will show: -unequal pupils -injected conjunctiva/sclera blood in anterior chamber

A

Hyphema

72
Q

___________is the definitive way to diagnose and clear a cervical spine injury on patients of all ages

A

cervical spine MRI scan

73
Q

-Fifth metatarsal base avulsion fracture -Bulky dressing or hard sole shoe

A

Pseudo-Jones

74
Q

Poison: cyanide what is the antidote?

A

hydroxycobalamin amyl nitrite sodium thiosulfate

75
Q

Patient with a history of direct trauma to the orbit Complaining of limitation of upward gaze, infraorbital anesthesia

A

Orbital Blowout Fracture

76
Q

-PE will show cherry-red skin (post-mortem finding) -Labs will show carboxyhemoglobin

A

Carbon Monoxide (CO) Poisoning

77
Q

Unstable patient + positive FAST –>

A

laparotomy

78
Q

Hip Dislocation treatment

A

Treatment is emergent reduction under conscious sedation

79
Q

Poison: sulfonylurea what is the antidote?

A

octreotide glucose

80
Q

what is the orientation of this fracture?

A

segmental

81
Q

What is the most common long bone fracture?

A

Tibia.

82
Q

Poison: digoxin what is the antidote?

A

digoxin FAB

83
Q

-Most commonly caused by flexion injury -Comments: proprioception and vibration intact

A

Anterior Cord Syndrome

84
Q

Foreign Body Aspiration most common site is the______main bronchus

A

right

85
Q

Cat Bite Most commonly caused by

A

Pasteurella multocida

86
Q

Ethylene Glycol Intoxication clinical presentation

A

-flank pain -hematuria, - oliguria

87
Q

Associated with patients with ischemic heart disease & ventricular dysfunction Notable feature: uncoordinated, disorganized electrical activity

A

Ventricular Fibrillation

88
Q
A

Tension pneumothorax

89
Q
A

Chance Fracture

90
Q

Patient with a history of ingestion of: -antifreeze -solvents -windshield wiper fluid -cleaners -fuels -de-icing solutions

A

Ethylene Glycol Intoxication

91
Q

what level does the spinal cord terminate in adults?

A

L1-L2

92
Q

Cat Bite Treatment is irrigate, leave the wound open,

A

amoxicillin - clavulanate

93
Q

Chance Fracture Imaging shows fracture through all ___________

A

three columns

94
Q

X-ray will show fat pad ‘sail sign’

A

Radial Head Fracture

95
Q
A

Proximal Humerus Fracture

96
Q

CT will show teardrop sign

A

Orbital Blowout Fracture

97
Q

PE will show loss of motor, pain, and temperature below injury

A

Anterior Cord Syndrome

98
Q

-PE will show arm abducted, externally rotated. Apprehension test positive. -X-ray will show humeral head displaced inferiorly and medially

A

Anterior Shoulder Dislocation

99
Q

Mandible Fracture tx

A

-Treat open fracture with antibiotics, update tetanus -Monitor airway

100
Q

Poison: beta blockers what is the antidote?

A

glucagon insulin

101
Q

Dog Bites Treatment is

A

amoxicillin/clavulanate.

102
Q

Tension Pneumothorax treatment

A

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
Q

PE will show anatomical snuffbox tenderness

A

Scaphoid Fracture

104
Q

Preexisting IgE antibodies → mast cell degranulation → shock, airway compromise

A

Anaphylaxis

105
Q
A

Radial Head Fracture

106
Q

Anticholinergic Toxidrome

A

Treatment is supportive care alone or in combination with antidotal therapy with ____________

107
Q
A

Jones Fracture

108
Q
A

Anterior Shoulder Dislocation

109
Q
A

Orbital Blowout Fracture

110
Q

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

A

Ethylene Glycol Intoxication

111
Q

Associated with seatbelt, often not positioned correctly

A

Chance Fracture

112
Q

-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

A

Jefferson/Burst Fracture

113
Q
A

Lisfranc Injuries

114
Q

pH: > 7.45; PaCO2: Normal; HCO3: > 26

A

Metabolic Alkalosis

115
Q

pH: < 7.35; PaCO2: > 45; HCO3: Normal

A

Respiratory Acidosis

116
Q

SLUDGE: -Salivation/Sweating -Lacrimation -Urination -Defecation -Gastrointestinal distress -Emesis

A

Cholinergic Toxicity

117
Q

Poison: Acetaminophen what is the antidote?

A

N-acetylcysteine

118
Q

_____________ 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

A

Acetaminophen Toxicity

119
Q

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

A

Chelating agents: -Deferasirox -deferoxamine -deferiprone

120
Q

Acetaminophen Toxicity PE will show

A

RUQ tenderness

121
Q

-Patient will be a young, tall, thin, man -PE will show decreased breath sounds, decreased fremitus, hyperresonance to percussion

A

Spontaneous Pneumothorax

122
Q

Poison: cholinergics what is the antidote?

A

atropine pralidoxime (2-PAM)

123
Q

Poison: carbon monoxide what is the antidote?

A

oxygen

124
Q

-Likely due to trauma -Pain, swelling, facial asymmetry, bruising

A

Mandible Fracture

125
Q

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

A

Ethylene Glycol Intoxication

126
Q

Loss of thermoregulatory mechanisms: -Dry skin -AMS -Abnormal LFTs

A

Heat Stroke

127
Q

______________ Toxicity Labs will show elevated AST and ALT

A

Acetaminophen

128
Q
A

Foreign Body Aspiration

129
Q

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)

A

Tricyclic antidepressants TCA

130
Q

Poison: heavy metals: arsenic copper lead mercury what is the antidote?

A

dimercaprol EDTA Penicillamine Succimer (DMSA)

131
Q

Poison: benzodiazepines what is the antidote?

A

flumazenil

132
Q

Beta-Blocker Toxicity Treatment is

A

glucagon, high dose insulin

133
Q

-Patient will be a complaining of headache, joint pain, and constipation -X-ray will show hyperdense lines at metaphyses (“lead lines”)

A

Lead Poisoning

134
Q

Beta-Blocker Toxicity Labs will show

A

hypoglycemia

135
Q

Dog Bites Sepsis most commonly caused by

A

C. canimorsus

136
Q

Complaining of hydrophobia, agitation, spasms

A

Rabies

137
Q

Poison: Tricyclic Antidepressant what is the antidote?

A

sodium bicarbonate

138
Q

Poison: methemoglobin what is the antidote?

A

methylene blue

139
Q

Nexus Criteria

A

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
Q

Septal Hematoma tx

A

Rx: drainage followed by packing

141
Q

Poison: hydrofluoric Acid what is the antidote?

A

calcium gluconate

142
Q

PE will show inferior rectus entrapment, enophthalmos

A

Orbital Blowout Fracture

143
Q

PE will show: -ipsilateral loss of motor -position and vibration -contralateral loss of pain and temperature

A

Brown-Séquard Syndrome

144
Q
A

Anticholinergic Toxidrome

145
Q

Metronidazole (Flagyl) Avoid ________ when taking this medication

A

alcohol

146
Q

Jefferson/Burst Fracture Most commonly caused by burst fracture of _______

A

C1

147
Q

Normal ABG values

A

pH:7.35 – 7.45; PaCO2: 35 – 45; HCO3: 22 – 26

148
Q

Hypertension, bradycardia, irregular respirations

A

Cushing Triad

149
Q

Poison: aspirin what is the antidote?

A

sodium bicarbonate

150
Q

Poison: ethylene glycol what is the antidote?

A

fomepizole ethanol

151
Q

Subdural Hematoma Most commonly caused by

A

rupture of the bridging veins

EMERGENCY MEDICINE (2 decks)

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