the ants go marching Flashcards
____________ are all complications of shock
DIC, ARDS, ATN, and high-output CHF
Fever in a child less than 30 days can be a marker for bacteremia, sepsis, and meningitis. Clinical findings are notoriously unreliable in this age group. The work up is?
Blood culture, urine culture and LP are required.
acute myocardial infarction is defined by two of
- clinical history of chest pain of at least 20 minutes duration
- EKG changes
- positive myocardial enzyme testing.
MI drugs fxn
- O2, nitroglycerin and morphine will increase O2 delivery to the heart
- beta blocker will decrease the work of the heart
- aspirin will inhibit platelets.
- heparin if no contraindication
- glycoprotein IIb/IIIa-inhibitor should also be administered
Fibrinolytic therapy is indicated for patients with STEMI (as a reperfusion option) if ?
- time to treatment is <6 to 12 hours from symptom onset
- ECG has at least 1-mm ST-segment elevation in two or more contiguous leads.”
____________ is the best means to diagnose right ventricular infarction with the ECG.
“Application of “right-sided” precordial leads
Aortic dissection rx
Sodium nitroprusside- blood pressure control in dissections as it is an easily titratable antihypertensive
nitroprusside increases heart rate –> may increase shearing forces, beta blocker should be started before (or concurrently with) it.
Unstable angina
angina at rest
stable angina
angina w/ exertion
Rx for dresslers syndrome
NSAIDs
Mobitz type 2
constant long PR always
Dropped beats
malignant htn is aka
htn emergency
htn crisis
*elevated BP w/ optic edema
Westermark sign
sign that represents a focus of oligemia (hypovolemia) (leading to collapse of vessel) seen distal to a pulmonary embolism (PE).
seen in 2% of PE
In the face of an AMI, the risks of complete heart block are much greater when new or preexisting bi- or trifascicular conduction blocks are present. In this setting, ____________ is indicated
prophylactic placement of a ventricular demand pacemaker
In SAD CAGES is a screening mnemonic for ?
symptoms- not causes- of major depression.
Interferon alfa has been associated with?
CNS side effects, including anhedonia, fatigue, anorexia, impaired concentration, sleep disturbance, and suicidal ideation.
*Pretreatment with SSRIs appears to be an effective strategy to minimize depression induced by interferon alfa.
Suicide risk among men shows a bimodal distribution with increased risk between the ages of?
15 and 24 and after age 65
Suicide risk among women peaks after age?
60
Most people who commit suicide suffer from ?
alcoholism or 15-20% major depression 10% schizophrenia 40% panic disorder also PTSD
“SAD PERSONS” scale is used to determine ?
suicide risk
S: Male sex → 1
A: Age 15-25 or 59+ years → 1
D: Depression or hopelessness → 2
P: Previous suicidal attempts or psychiatric care → 1
E: Excessive ethanol or drug use → 1
R: Rational thinking loss (psychotic or organic illness) → 2
S: Single, widowed or divorced → 1
O: Organized or serious attempt → 2
N: No social support → 1
S: Stated future intent (determined to repeat or ambivalent) → 2
Silent Suicide
an act of slowly killing oneself by nonviolent means, such as starvation or non-compliance with essential medical treatment
most common in elderly patients and frequently goes unrecognized. Such patients may present to the emergency department repeatedly because of non-compliance with treatment of their medical disorders
Occult Suicide
applied to self-destructive acts disguised as accidents and should be suspected in those who have “accidental” self-inflicted gun shot wounds, and in those who “unintentionally” overdose, or who fall from a height.
Chronic Suicidal Behavior
consists of recurrent self-destructive acts
Parasuicide
attempted suicide, which is seen more as a gesture than a serious act.
