Test 27 - IM Flashcards
What is electromyography used for?
Distinguishing between nerve and muscle disease
Symptoms of spinal cord compression
isolated, symmetric lower extremity symptoms, including loss of sensation and signs of upper motor neuron disease (hyperreflexia and +babinski).
Difference in presentation between Guilllain-Barre and spinal cord compresson.
Both have symmetric LE weakness and loss sensation
GB: no UMN signs
SCC: Upper motor neuron signs
In adult tachycardia algorithm, what are signs that synchronized cardioversion is necessary?
Hypotension Altered Mental Status Signs of shock Ischemic chest discomfort Acute heart failure
Hyperactive deep tendon reflexes suggest what electrolyte imbalance? Why?
Ca2+ is needed for muscle relaxation. Without the ability to relax quickly the reflexes become hyperactive.
What is the primary manifestation of low potassium?
Muscle weakness and cramps. U waves on EKG.
What is the primary manifestation of high potassium?
muscle weakness, flaccid paralysis. Asystole with severe hyperkalemia.
What is the primary manifestation of mild and severe hypermagnesemia?
Mild - decreased DTRs
Severe - loss DTRs, muscle paralysis, apnea, cardiac arrest
What is naloxone used for?
Opiate intoxication : pinpoint pupils, respiratory depression
Patient comes in with abnormal gait, confusion, high bp, dilated pupils. Not oriented X 3. What is the possible differential?
intoxication, infection, vitamin deficiency, endocrine disturbances, hypoglycemia, post-octal state (altered mental status after seizure), hypertensive encephalopathy, CNS hypoxia
Patient comes in with abnormal gait, confusion, high bp, dilated pupils. Not oriented X 3. What do you treat for immediately?
Potentially preventable causes of the confusion: Thiamine: for Wernicke's Dextrose: for hypoglycemia O2: for hypoxia Naloxone: opiate overdose
Why is it important for malnourished patients to get thiamine before dextrose?
If they have wernicke’s encephalopathy, sugars can worsen Wernicke’s
What are the 2 causes of hypertrophic cardiomyopathy?
- Hypertrophied intraventricular septum
2. Abnormal motion of mitral valve leaflets (SAM - systolic anterior motion)
What is Hypertrophic Osteoarthropathy (HOA)?
Digital clubbing accompanied by sudden arthropathy commonly affecting the wrist and hand joints. If caused by underlying lung disease, like smoking, it’s called Hypertrophic pulmonary Osteoarthropathy (HPOA).
