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Emergency Medicine > The End > Flashcards

The End Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Stroke of small vessels (penetrating branches)

A

Lacunar

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2
Q

CM lacunar stroke

A
  • Pure motor (MC)
  • Ataxic hemiparesis (leg > arm)
  • Dysarthria (clumsy hand syndrome)
  • Pure sensory loss
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3
Q

Tx lacunar stroke

A

ASA

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4
Q

Middle cerebral stroke CM

A
  • contralateral sensory/motor loss/hemiparesis greater in face, arm > leg/foot
  • Contralateral homonymous heminopsia, gaze preference toward lesion
  • D: broca (expressive), wernicke (sensory), math comprehension, agraphia
  • ND: spatial deficits, dysarrthria, left sided neglect, anosognois, aprexia
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5
Q

Anterior cerebral artery storke CM

A
  • contralateral sensory/motor loss/hemiparesis greater in leg/foot
  • face spared, speech preservation
  • Personality changes, confusion
  • Urinary incontince
  • Gaze preference toward lesion
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6
Q

Posterior cerebral stroke CM

A
  • Visual hallucinations
  • Contralateral homonymous hemianopsia
  • Ipsilateral CN deficts + contralatteral muscle weakness
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7
Q

Basillar stroke CM

A

cerebellar dysfunction

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8
Q

vertebral stroke CM

A

vertigo, nystagmus, N/V, diplopia

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9
Q

Ischemic stroke dx

A

non-con CT to r/o hemorrhage

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10
Q

Tx ischemic stroke

A

thrombolytics within 3 horus of onset

  • Alteplase only tpa effective in ischemic stroke
  • antiplatelet therapy: ASA after 3 hours and TPA not give; or at least 24 hours after thrombolytics
  • only lower BP if >185/110 for thrombo or >220/120 with no thrombo
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11
Q

Berry aneurysm MC location

A

circle of willis

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12
Q

Spinal injury MC after blowout vertebral body burst fracture

A

anterior cord

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13
Q

Anterior cord mneumonic

A

ANT couldn’t walk to the bathroom in the TeePee so he peeds his pants when his bladder busted into flex

(LE >UE)

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14
Q

Spinal injury MC after hyperextension injuries

A

central cord

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15
Q

MC incomplete cord syndrome

A

central cord

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16
Q

central cord mneumonic

A

because maleficicent developed frost bite when she extended her hand to touch the cold window pane, she couldn’t put her shawl on with her weak hands

-UE>LE
sensory “shaw distribution”

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17
Q

Posterior cord

A

loss of proprioception and vibratiory sense only

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18
Q

MC cord syndrome after penetrating trauma

A

Brown-Sequard

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19
Q

Brown sequard mneumonic

A

the MVP (motor, vib, prop) on the winning side was oblivious 2 (levels) the stabbing heat of pain (temp and pain) of defeat from the losing side

  • Ipsilateral motor, vibration, proprioception
  • Contralateral: pain, temp
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20
Q

optic neuritis tx

A

IV methylprednisolone followed by oral steroids

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21
Q

Most important step in chemical eye burns

A

irrigation

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22
Q

irrigate eye for how long?

A

30 minutes or >2 L until pH 7.0 - 7.3

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23
Q

Orbital cellulitis is most commonly secondary to

A

sinus infection (ethmoid)

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24
Q

Orbital cellulitis abx

A

vanco, clinda

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25
Q

erysipelas tx

A

IV PCN, vanco

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26
Q

cellulitis tx

A

cephalexin, dicloxacillin

MRSA: Iv vanc or linezolid

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27
Q

folliculiits tx

A

topical mupirocin, clinda, eryth

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28
Q

6th disease =

A

roseola

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29
Q

Only childhood exanthem that starts on trunk and spreads to face

A

Roseola

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30
Q

MC viral cause of pericarditis/ myocarditis

A

coxsackie

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31
Q

MCC of pancreatitis in children

A

mumps

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32
Q

Measles =

A

rubeola

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33
Q

Koplik spots

A

Rubeola

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34
Q

Koplik spots def

A

buccal mucosa

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35
Q

Rubeola CM

A

URI prodrome (cough, coryza, conjunctiviits) –> koplik spots –> morbilliform rash (bright red) at hairline –> extremities

36
Q

vitamin that reduces mortality in rubeola

A

A

37
Q

Rubella AKA

A

3 day rash

38
Q

Rubella CM

A

low grade fever/cough/anorexia/LN –> pink maculopapular rash on face –> extremities

39
Q

Forcheimer spots def:

A

soft palate

40
Q

Forcheimer spots

A

Rubella, Scarlet fever

41
Q

Fifth dz

A

Erythema infectuosum

42
Q

Slapped check rash

A

Erythema infectuosum

43
Q

Can cause aplastic crises in those with SCD or G6PD

A

erythema infectiuosom

44
Q

Childhood rash that spares palms/ soles

A

erythema infectuosom

45
Q

Posterior pituitary releases?

A

oxytocin and ADH

46
Q

SIADH is d/t

A

increased ADH (inappropriate)

47
Q

MC of SIADH

A

stroke

48
Q

Type of cancer that secrets ectopic ADH (resulting in SIADH)

A

SCLC

49
Q

patient usually only becomes symptomatic with SIADH when

A

increase oral free water intake

50
Q

Dx of SIADH

A

isovolemic hypotonic hyponatremia

51
Q

Tx SIADH

A

water restriction; demeclocycline in severe cases

-severe hyponatremia or intracranial bleed –> IV hypertonic saline with furosemide

52
Q

Diabetes insipidus d/t

A

1) ADH deficiency (central DI)

2) Insensitivity to ADH (nephrogenic) –> large amounts of dilute urine

53
Q

Nephrogenic DI often caused by what drug

A

lithium

54
Q

dx DI:

A
  • fluid deprivation test: continued production of dilute urine
  • desmopressin (ADH) stimulation test: differentiates nephrogenic from central
    • Central: reduction in urine output
    • nephrogenic: continued production of dilute urine
55
Q

Tx: central DI

A

desmopressin; carbamazepine

56
Q

Tx: nephrogenic DI

A

na/protein restriction –> HCTZ, indomethacin

57
Q

autonomic symptoms of hypoglyemica:

A

sweating, tremors, palpitations, nervousness, tachy

58
Q

CNS symptoms of hypoglycemia:

A

HA, lightheadedness, slurred pseech, confusion, dizziness

59
Q

Symptomatic hypoglycemic?

A

<60

60
Q

If <60 bs tx?

A

fast acting carb

61
Q

If <40 bs or LOC tx?

A

IV bolus D50 or inject glucagon SQ

62
Q

Gold standard for diagnosis DM

A

fasting >126 (at least 8 hours, two occasions)

63
Q

2 hr GTT =

A

> 200

64
Q

Gold standard for gestational DM testing

A

2 hr GTT

65
Q

HBA1c

A

6.5+

66
Q

random glucose

A

200+

67
Q

breathing associated with DKA?

A

kussmaul’s

68
Q

what type of acid/base is DKA?

A

high anion gap metabolic acidosis

69
Q

MCC of DKA/HSS?

A

infection

70
Q

Tx DKA/HSS?

A

IV fluids: isotonic 0.9% NS until hypotension resolves –> 0.45% NS

  • When glucose reaches 250, switch to DS 0.45 (1/2) NS to prevent hypoglycmia
  • Insulin
  • K+ correction –> 20-40 me1/L if <5.5
71
Q

Anion gap calculation

A

Na - (Cl + HC03)

72
Q

High anion gap if >

A

12

73
Q

pH of HHS

A

> 7.30

74
Q

pH of DKA

A

<7.30

75
Q

MC type of hyperparathyroidism?

A

primary

76
Q

MCC of primary hyperparathyroidism?

A

parathyroid adenoma

77
Q

Primary hyperparathryoidism is d/t

A

excess PTH production

78
Q

Hyperparathyroidism is common in people taking?

A

lithium

79
Q

MEN I:

A

HPT, pituitary tumors, pancreatic tumors

80
Q

MEN 2A:

A

HPT, pheo, medullary thyroid cancer

81
Q

Secondary hyperparathyroidism is d/t

A

increase PTH d/t hypocalcemia or vitamin D deficiency

82
Q

MCC of secondary hyperparathyroidism?

A

Chronic kidney failure

83
Q

Triad of hyperparathyroidism:

A

hypercalcemia, increased PTH, decrease phosphate

84
Q

Tx: primary hyperparathyroidism

A

parahtyroidectomy

85
Q

Tx: secondary hyperparathyroidism

A

vitamin D/calcium supplements

86
Q

Trousseu’s associte dwith

A

hypocalcemia

87
Q

Chvostek’s associated with

A

hypocalcemia

Emergency Medicine (7 decks)

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