Selected Topics in Emergency Medicine Flashcards
Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms
Antipsychotics (neuroleptic malignant syndrome)
Side effects of corticosteroids
Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies
Treatment for DTs
Benzodiazepenes
Treatment for acetaminophen overdose
N-acetylcysteine
Treatment for opioid overdose
Naloxone
Treatment for benzodiazepene overdose
Flumazenil (monitor for withdrawal and seizure)
Treatment for neuroleptic malignant syndrome and malignant hyperthermia
Dantrolene
Treatment for malignant hypertension
Nitroprusside
Treatment of atrial fibrillation.
Rate control, rhythm conversion, and anticoagulation
Treatment for supraventricular tachycardia
If stable, rate control with carotid massage or other vagal stimulation; if unsuccessful, consider adenosine
Causes of drug-induced SLE
Isoniazid, penicillamine, hydralazine, procainamide, chlorpromazine, methyldopa, quinidine
Macrocytic, megaloblastic anemia with neurologic symptoms
B12 deficiency
Macrocytic megaloblastic anemia without neurologic symptoms
Folate deficiency
A burn patient presents with cherry-red, flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?
Treat CO poisoning with 100% oxygen or with hyperbaric oxygen if poisoning is severe or the patient is pregnant
Blood in the urethral meatus or high-riding prostate
Urethral injury or bladder rupture
Test to rule out urethral injury
Retrograde cystourethrogram
Radiographic evidence of aortic dissection
Widened mediastinum (>8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus
Radiographic indications for surgery in patients with acute abdomen
Free air under the diaphragm Extravasation of contrast Severe bowel distension Space-occupying lesion on CT Mesenteric occlusion (angiography)
The most common organism in burn-related infections
Pseudomonas
Method of calculating fluid replacement in burn patients
Parkland formula: 24-hour fluids = 4 x wt (kg) x % body surface area affected
Acceptable urine output in a trauma patient
50 cc/hr
Acceptable urine output in a stable patient
30 cc/hr
Signs of neurogenic shock
Hypotension and bradycardia
Signs of increased ICP
Hypertension, bradycardia, and abnormal respirations (Cushing triad)
Shock with decreased CO, decreased PCWP, increased peripheral vascular resistance
Hypovolemic shock
Shock with decreased CO, increased PCWP, increased peripheral vascular resistance
Cardiogenic (or obstructive) shock
Shock with increased CO, decreased PCWP, decreased PVR
Distributive (e.g. septic or anaphylactic) shock
Treatment of septic shock
Fluids and antibiotics
Treatment of cardiogenic shock
Identify cause; inotropes (e.g. dopamine)
Treatment of hypovolemic shop
Identify cause; fluid and blood repletion
Treatment of anaphylactic shock
Epinephrine 1:1000 and diphenhydramine
Supportive treatment for ARDS
Low tidal volume ventilation
Signs of air embolism
A patient with chest trauma who was previously stable suddenly dies
Signs of cardiac tamponade
Distended neck veins, hypotension, diminished heart sounds (Beck triad). Pulsus paradoxis
Absent breath sounds, dullness to percussion, shock, flat neck veins
Massive hemothorax
Absent breath sounds, tracheal deviation, shock, distended neck veins
Tension pneumothorax
Treatment for blunt or penetrating abdominal trauma in hemodynamically unstable patients
Immediate exploratory laparotomy
Elevated ICP in alcoholics or the elderly following head trauma. Can be acute or chronic, crescent shape on CT.
Subdural hematoma
Head trauma with immediate loss of consciousness followed by a lucid interval and then rapid deterioration. Convex shape on CT.
Epidural hematoma
