Tintinellis EMED Ph 2 Flashcards by brandon lovin

Cardiogenic Shock MC results from ?

These are more likely to occur from ? type of injury

What causes coronary artery hypoperfusion to occur

LV infarct induced pump failure leading to decreased tissue perfusion despite adequate volume avail in circulation

STEMI- leading cause of death in PTs w/ AMI

Lack of systemic resistance= dec DBP

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Why does pulmonary edema occur during cardiogenic shock

Augmenting ? can improve coronary artery perfusion

What is the risk of this augmentation

Inc after load/dysfunction increases LV end diastolic pressure

Vasoconstriction

Dec CO

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Why does cardiogenic shock induce systemic vasodilation

Euvolemic cardiogenic shock occurs subacutely in ? Pts

Finding of diaphoresis on these Pts indicates ?

Triggers systemic inflammatory response= inc NO w/ negative inotropic effects

Heart failure

Activation of sympathetic nervous system

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Shock is indicated by SBP <90 or a MAP below ?

? type of view on E-FAST is used for suspected tamponades/effusions

Pericardial effusion and aortic root bigger than ? suggest ascending aortic dissection

<65mmHg

Sub-costal 4 chamber view

> 3cm

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? is the most important definitive intervention for acute ischemia related cardiogenic shock

Add O2 to keep sats above ?

What issue happens after intubation w/ pos-pressure ventilation and how is this countered

Emergent revascularization via PCI/CABG

> 91%

Dec preload and CO= worsened HOTN;
Fluid bolus

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How is HOTN during cardiogenic shock Tx

How is congestion w/out HOTN Tx

What is the nest step if these meds fail to correct the shock

Vasopressor- Dopamine, NorEpi

Inotrope- Dobutamine: inc contractility; if SBP <70: NorEpi

Intra-aortic balloon pump/assist device

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Pts taking BBs and suffering from cardiogenic shock may not have appropriate response to dobuatmine, in which case ? med is used

Acute HF management is improved by ? therapies

? new medication is FDA approved for use but does not improve outcomes

Milrinone- selective phosphodiesterase 3 inhibitor

BB ACEI Resynch therapy Spironolactone

Nesiritide

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What are the 3 cardinal Sxs of HF

MI induced reduction of CO causes the neurohormonal release of ?

What are the counter-regulatory responses to this activation

SOB Edema Fatigue

NorEpi Endothlin ADH TNF-a: activate RAAS/Symp-NS

Natriuretic peptide- inhibit RAS/sympathetic NS
A: atrial B: ventricle C: endothelium

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EF normally is ?

? dysfunction is seen early on in ischemic induced HF cascade

What Sxs have the highest sens/spec for HF

60%; Systolic failure <50%

Diastolic dysfunction leading to CADz

Sensitivity: dyspnea w/ exertion
Specificity: PNDyspnea, Orthopnea, Edema

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What PE finding has the highest positive likelihood for acute HF

What CXR findings are the most specific for Dx of Acut HF

? E-FAST finding suggests elevated central venous pressure

S3 sound

Pulm congestion, Megaly, Interstitial edema

IVC >2cm, Collapse <50%

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Acute HF Pts need to keep O2 levels above ?

? intervention can help avoid intubation for these Pts

What is the next step for persistent HOTN after Nitro use

95%

Dec after load w/ vasodilators- Nitro then Nitroprusside

Dec volume or RV infarct- give NS bolus

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? is the best predictor for recurrence of syncope

Prolonged QTc is defined as ?

Myocarditis can lead to ? and is definitively Dx by ?

Syncope w/in preceding year

> 470msec

Dilated myopathy, Biopsy

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? is the MC Sx of Pericarditis

? is a distinguishing feature

? is the MC and most important PE finding

Chest pain worse w/ supine, relieved w/ sitting

Pain referred to L trap

Friction rub w/ diaphragm at LLSB

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What rare CXR finding may aid w/ Dx pericarditis

? is the image modality of choice for detection and confirmation

How do Pts die from PE

Epicardial fat pad sign

Echo

PEA/Asystole or RV failure and circulatory shock

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? joint are most and least likely to be the origin of PEs

? combo causes the greatest risk for VTEs

? surgical procedures have the highest rates of VTE formation

Least: Elbow Shoulder Ankle Knee Hip- most

Same sided hip-knee immobile w/ non-weight bearing

Abdominal to remove cancer
Joint replacement
Brain/spine w/ neuro deficits

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When are cancer Pts at highest risk for developing VTEs

? are the two MC Sxs of PE

What are the two rare CXR findings of PE

During chemo Tx

Dyspnea, Chest pain

Westermark- lobar artery obstruction
Hampton- pulmonary infarction

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Leg size difference of ? suggests PE

Where are these measurements taken

PE R/o Criteria

≥2cm

10cm below tibial tubercle

HAD CLOTS:
Hormones Age >50 +DVT/PE Hx
Coughing blood Leg swollen O2 <95 Tachy >100 Surgery/Trauma <4wks

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Well’s Score for DVT

EAT CHIPS:
Edema/Pain/DVT Sx- 3
Alternative Dx unlikely- 3
Tachy- 1.5
Ca- 1
Hemoptysis- 1
Immobile >3 days: 1.5
Previous DVT/PE: 1.5
Surgery <1mon: 1.5

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MC imaging modality for PE

Criteria for Pre-E

What are the 4 etiologies of catecholamine induced HTN emergencies

CT angiography w/ contrast

≥140/≥90 after 20wks

Clonidine d/c or withdrawl
Autonomic dysfunction
Pheo
Sympathetic drug use- cocaine, meth, PCP

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How quickly is BP lowered during HTN Emergency

What is the therapeutic goal for aortic dissections

? is the mainstay of Tx

Dec SBP x 25% in first hour
<160/100 over 2-6hrs
To normal <48hrs

SBP 100-20 w/ HR ≤60bpm w/in first hour

Nitrates

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How are HTN Emergencies induced by cocaine/meth Tx

What is used if Pts don’t respond to this Tx

What is used as 3rd line agents

IV Benzos, avoid BBs (except labetalol- +A-blocker effect)

Nitro or Phentolamine

CCBs

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First line Tx for Pheo induced HTN Emergency

? medication is used pre-op

Aortic dissections occur d/t damage to ?

Phentolamine

Phenoxybenzamine

Intima- blood enters between intima and adventitia

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How are aortic dissections Dx

If properly trained, ? is equally sensitive and specific

Criteria for P-HTN

CT w/ and w/out contrast

TEE

Aterial pressure >25mm at rest, >30 w/ exertion

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Definitive method to Dx P-HTN

Why does P-THN lead to RV failure

? is the MC EKG finding

R-sided catheter

RCA perfusion depends on diastolic, RA pressure during systole and diastole. Dz dec systolic perfusion, CO

RAD

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? is the best initial test to assess P-HTN What Tx step is avoided if possible in this population Size criteria for AAA and repair is needed ?

TTE RV failure exacerbated w/ intubation (pos-press ventilation) ≥3cm w/ repair indicated at ≥5cm

? part of the GI tract is involved in aortoenteric fistula development ? images are used to Dx AAA Define Trepopnea

Duodenum Unstable: bedside US Stable: CT w/ contrast Dyspnea when laying on side w/ more diseased lung

What does negative inspiratory force assess What is this used to Dx Define Hypoxia and Hypoxemia

Diaphragm/Inspiration muscle strength Neuromuscular dz Insufficient O2 content/delivery to tissues Low arterial oxygen tension

Only medication FDA approved to Tx hiccups Define Pneumonia Organisms can distribute through the lungs by spreading through the pores called ?

Chlorpromazine Infection of alveolar portion of lungs Pores of Kohn

MC microbe identified in CAP What are the two MCC of infections of nursing homes How is Aspiration pneumonia Tx How is CAP Tx

Pseudomonas UTIs > Aspiration pneumonia Clinda, Amp-Sulbactam, Moxifloxacin Clinda, Azith, Doxy

MC PE finding during pneumothorax ? is the initial image ordered What are two normal findings on US

Tachypnea Standing PA CXR Comet tail, Sliding sign

When can pneumothorax be observed for Tx These Pts are observed for a minimum of ? long When are f/u exams needed after d/c

First time and stable w/ <20% of lung volume affected 4hrs 1-2wks

Needle decompressing pneumothorax need ? size What are the two locations decompression is performed What size chest tube are used

14g, 2"/5cm long 2nd ICS above rib at mid-clavicular line 4th ICS above rib at anterior axillary line Non-traumatic: 10-14F 14-22F: larger w/ need for mechanical vent

? is the MC chronic dz of childhood w/ ? MC acute stimulus of attacks What are three PE findings suggesting a severe case is present

Asthma; Viral respiratory infections Accessory muscle use Inability to speak in full sentence Pulsus paraduoxus

? is the preferred initial therapy for asthma bronchospasms ? maintenance therapy meds are used What is given to Pts upon d/c after attack/exacerbation

Albuterol (B2-agonist): promote broncho/vaso-dilation LABAs: Salmeterol, Formoterol 5-10 day non-tapered course of Pred or, 2 day course of Dexamethasone or, Non-compliant Pt: Methylprednisolone x 1 dose

? medication can be added to Albuterol in the ED during asthma exacerbations to reduce severity and admission Pts are safe to d/c home w/ ? FEVR measurement Criteria for COPD O2 therapy

Ipratropium bromide FEVR >70% PaO2 ≥55, SaO2 ≤88%

# Define Visceral pain Define Parietal pain Define Referred pain

Crampy/dull pain d/t unmyelinated fiber stretching/inflammation Irritated mylinated fibers covering anterior peritoneum causing tender/guard/rebound= immobile Pt Ipsilateral pain d/t embryological development

Why does appendicitis pain begin in umbilical region How much blood loss is needed for systolic changes to be seen PE sine a quon for peritonitis

Bilateral, T-10 innervation causing sensation at midline 30-40% Rebound tenderness

? type of image to Dx appendicitis, kidney/ureter stones ? type of image to Dx aortic aneurysms and mesenteric ischemia ? is the MCC of N/V in USA

Non-contrast CT IV contrast CT VGE

Where is the vomit center in the brain ? type of image used for suspected intestinal obstruction ? medication can help w/ frequency of BMs in adults w/ chronic constipation

4th ventricle- chemo receptors outside of BBB CT w/ IV/PO contrast Psyllium (bulking agent)

# Define Ogilvie Syndrome What causes this syndrome to develop MCC of upper GI bleeds

Colonic pseudo-obstruction w/ S/Sxs and image findings of large bowel obstruction but no evidence of distal obstruction Dysregulated autonomic control of colonic motor activity PUDz

BUN elevation above ? suggests bleeding source from upper GI ? study is c/i in these Pts ? is the most reliable method to Dx this issue in ED

≥30 Barium contrast studies Visual inspection of aspirate for blood/maroon/coffee ground appearance (endoscopy- study of choice)

When Tx upper GI bleeds in Pts taking anti-coagulant therapy, ? are the indications to reverse their therapy Why are PPIs used during Tx ? other medication can be used to help reduce bleeding

INR ≥1.5= predictor; Reverse elevated INR or platelets <50K Platelet aggregation needs pH >6.o for clot formation Octreotide

What Pts w/ upper GI bleeds need ABX What ABX are used for Tx What two meds are promotility agents used to enhave endoscopic visualization in these Pts

Cirrhosis- impaired immune system Cipro, Ceftriaxone Erythromycin, Metoclopramide

What two meds are used for scoping upper GI bleeds in the ED MCC of lower GI bleeds MCC of intestinal ischemia

Etomidate/Ketamine- cardiovascular stable meds ``` Upper GI bleeds are the MC source but, Diverticular dz (MC on L-side, but R-sided bleed more) ``` Ischemic colitis Dx w/ angiography

? is the Dx test of choice for Ischemic Colitis/Mesenteric Ischemia ? is the MC source of anorectal bleeds Define Vascular Ectasia

CT Angiography or Scintigraphy Hemorrhoids Causes lower GI bleeds d/t AV malformations and dysplasia of colon

Meckels Diverticulum are MC found in ? area What are the 3 locations the esophagus constricts in adults Define Barretts Esophagus

Embryonic tissue in terminal ileum C6- cricopharyngeal T4- aortic arch T10-11- GE junction Gastric epithelium extends into distal esophagus w/ risk for dysplasia

MCC of esophageal perforations MC site of Boerhaave Syndrome What image is used for Dx

Iatrogenic Full thickness perf on L-side of distal esophagus CT w/ IV contrast

Ingested foreign bodies can be Dx w/ ? images ? can be administered to help relax LES and pass objects in distal esophagus ? is the MC food impaction and ? is c/i for Tx

CXR then CT Glucagon Meats, Proteolytic enzymes d/t risk for mucosal damage and perf

How are battery ingestions Tx What are the lab results Dx for pancreatitis ? enzyme becomes activated and causes the pain of pancreatitis

Lithium- bad prognosis Through esophagus- 24 f/u scans/ensure passage Amylase x 3, Lipase x 2 Trypsinogen into Trypsin

? lab result indicates pancreatitis d/t gallstone etiology ? is the image modality to Dx pancreatitis When are Pts w/ pancreatitis admitted

Alanine aminotransferase >150 CT w/ IV contrast First time Dx, Biliary etiology, IV pain med/NPO

Chronic pancreatitis is MC d/t ? What stimulates gallbladder to contract ? types of stones are radiolucent vs paque

Alcoholism Cholecystokinin Black/Brown pigmented: -paque

Jaundice from compression of CBD from regional inflammation is called ? syndrome ? is the MC non-OB emergency in pregnancy Appendicitis w/ nausea will present ?

Mirizzi's Syndrome Appendicitis- RUQ tenderness but RLQ still MC location for tenderness Nausea after pain onset

Scoring System for Appendicitis ? is the next step in Tx for straightforward cases of suspected appendicitis in adults What US finding aids w/ Dx

Alvarado: MANTRELS Migration Anorexia Nausea Tenderness Rebound Eleveted temp Leukocytosis Shift, WBC (T, L- 2pts; Toal- 10) Early surgical consult Appendix >6mm in diameter

Where do diverticula form in the intestines What are the MC microbes isolated from diverticulitis What are the RFs for perforations

Vasa recta- site of vasculature penetration of circular muscle layer Bacteroides fragilis, E Coli Steroid Opioid NSAID

What UA result may be seen during diverticulitis flares What imaging modality is used for Dx Define Un/Complicated cases

Sterile pyuria d/t bladder inflammation CT w/ IV contrast Un: inflammation isolated to bowel wall Comp: Fistula Obstruction Perf Abscess Stricture

How are cases of uncomplicated diverticulitis Tx Complicated diverticulitis is classified per ? MCC of acute mesenteric ischemia

1st: Metro + TMP/Levo/Cipro/Cefuroxime Alt: Augmentin or Moxifloxacin Hinchey: 1: small 2: large abscess 3: perf 4: perf w/ fecal contamination Arterial embolism

What 3 structures supply blood to the mesentery

Celiac: liver, spleen, prox duodenum SMA: pancreatic head, distal duodenum, small bowel (MC, usually d/t Afib) IMA: transverse colon through rectum

Image modality of choice to Dx mesenteric ischemia 2 MCC of Small Bowel Obstructions ? type of bowel obstruction has dec/absent bowel sounds

CT w/ IV contrast 1st: adhesion 2nd: incarcerated hernia Adynamic ileus

What is the image of choice for suspected bowel obstructions What is the image appearance of sigmoid volvulus Name of anal mucosal columns

CT w/ IV contrast Coffee bean shaped large bowel dilation Morgagni

Parasympathetic control of rectal wall comes from ? Sympathetic control of rectal wall comes from ? ? is the MC and LC location of rectal abscesses

S2-4 L1-3 MC: perianal LC: Supralevator/pelvirectal

? is the only type of rectal abscess that can be Tx in the ED MCC of intrinsic AKIs AKIs usually remain ASx until ? develops

Simple/Isolated and fluctuant perianal ischemic tubular necrosis Severe uremia: N/V/AMS, Coma

What are 3 common Sxs seen w/ AIN MOA of ACEI Normal GFR is ?

Fever Arthralgia Rash Efferent dilation >90 mL/min

Rhabdomyolysis muscle damage is d/t increased amounts of ? What causes mental status changes to occur ? is the most reliable Dx method

Disrupted NaKATP pump and Ca transport- inc intracellular Ca and necrosis Urea induced encephalopathy Inc serum CrK levels 5x above normal

Only two time ASx bacteriuria is Tx Define Uncomplicated UTI Catheter induced UTI is Dx w/in ? hrs

Pregnancy, Prior to invasive urinary procedures Normal anatomy/function No comorbidities No GU instrumentation <48hrs from cath

What are 3 etiologies of UTIs that don't react on nitrite dipstick How are UTIs Tx First line choice for Tx of uncomplicated UTIs

Pseudomonas Enterococcus Acinetobacter Fosfomycin TMP-SMX, Nitro Fosfomycin 3g x 1 dose

First line Tx for ASx Bacteriuria and Simple Cystitis during pregnancy is ? What is the MCC of hematuria Pt w/ recent Urologic Surgery and now has urinary retention, ? is the next step

Amoxicillin or Cephalexin UTIs Uro consult prior to cath placement

? two elements aid w/ prevention of urologic stone formation What types of stones are commonly seen in females w/ recurrent UTI infections These stone are the MCC of ?

Mg, Citrate Struvite- Mg Ammonium Phosphate Staghorn calculi- forming casts in renal pelvis

What causes the pain associated w/ urologic stones Nephrolithiasis is the MC mis-dx given to ? Dx ? is the Dx imaging of choice

Pressure against Gerota's fascia= flank pain AAA rupture/expansion Non-contrast CT

? is the MC used drug for urological stone expulsion Stones larger than ? size need Uro consult Testicular torsions occur d/t abnormal fixation within ? structure

Tamsulosin >5mm Tunica vaginalis- bell clapper deformity

Most sensitive finding to r/o suspected testicular torsions What direction are detorsion maneuvers performed ? etiology of epididymal infection is considered in men who practice insertive anal intercourse

Present cremaster reflex Medial to lateral x 1.5 rotations Coliform

? is the leading cause of maternal death in the first trimester MC location of ectopic implantation Abdominal ectopic pregnancies MC occur d/t ?

Ruptured ectopic pregnancy d/t exsanguination after rupture Ampulla Early rupture/abortion of tubal pregnancy

Only MedHx that totally excludes ectopic pregnancy How are ectopic pregnancies monitored in stable Pts MC medical Tx for ectopic pregnancy

Hysterectomy w/ oophrectomy b-HCG trends q2 days Methotrexate- folic acid antagonist= dec D/RNA synthesis

Stable Pts w/ b-HCG levels above discriminatory zone and empty uterus on US are given ? Dx and ? next step MCC of death d/t PIDz What can cause chronic PID infections

Ectopic pregnancy- OB consult in ED Tubo-Ovarian abscess M tuberculosis

? microbe causes PID in Pts w/ IUDs in place Untreated chlamydia can lead to the development of ? Gold standard for Dx of PIDz

Actinomyces Perihepatitis: Fitz Hugh Curtis syndrome w/ peritonitis Laparoscopy

How is PIDz Tx OutPt How is PID Tx if IUD is in place How are tubo-ovarian abscesses Tx

Ceftriax 1g IM w/ Doxy and Metronidazole x 14d Placement <21d- OB consult >9cm- surgical consult Doxy w/ Clinda or Metronidazole x 14d but f/u in 72hrs to ensure response to Tx

? is the MCC of soft tissue infections MC valves affected by endocarditis in order MC microbe to cause endocarditis

Community acquired MRSA Mitral Aortic Tricuspid Pulmonic Staph > Strep

? is the MC neuro complication to arise from endocarditis Coronary artery emboli during endocarditis MC arise from ? location How is this condition Dx

Embolic stroke in middle cerebral artery Aortic valve TTE then TEE

How is bacterial endocarditis Tx What Pts need prophylaxis What meds are used for prophylaxis

Ceftriax or Naf/Oxa-cillin or Cefepine + Vanc Prosthetic material/valve Cyanotic lesion Previous Dx MRSA: Vanc and Clinda Amox/Amp-cillin, Cefazolin/Ceftriaxone PCN Allergy: Cephalexin Clinda Az/Clar-ithromycin

What are the two MC Sxs of bacterial meningitis What are two lab results that indicate LP c/I Once bacterial meningitis is considered, what s the next step

HA > Fever Platelets <20K, INR >1.5 Empiric ABX- Cefotax/Ceftriax + Vanc w/ Dexamethasone to reduce CSF inflammation

When are CTs not needed prior to LP Bacterial meningitis will have ? predominance in CSF results What results are seen w/ viral meningitis

Healthy MedHx, Normal neuro exam 1-2K w/ neutrophilic predominance Normal opening pressure, Neg Gram stain, normal glucose

What is the risk of HSV-2 induce viral meningitis How are PTs Tx TIAs are viewed and Tx similar to ? CV Dx

Necrotizing encephalitis Admit w/ IV Acyclovir Unstable Angina

What is done for medical Tx of TIAs Carotid revascularization via endarterectomy is best done in ? time frame ? is the standard assessment for delirium

Dipyridamole w/ ASA- prevents future events <2wks from TIA MMSE

? is the MCC of vertigo This form of vertigo tends to last ? long ? is the 2nd MCC of vertigo

BPPV <2min Vestibular neuritis- viral infection of vestibular nerve w/ vertigo x days but no pain, HL, or tinnitus

Labyrinthitis is a complication from ? What do Pts present w/ How are these peripheral vertigos Tx

AOM Pain HL Tinnitus Vertigo Mainstay: antiemetic, vestibular suppression- Scopolamine then CCB (Cin/Flu-narizine Nimodipine) Promethazine/Metoclopramide- Tx N/V Odansetron- anti-nausea Betahistine- inc cochlear blood flow, dec peripheral vestibular input

How is vertigo d/t MS Tx Define Ataxia and Gait D/o Define Apraxic Gait

Gabapentin Ataxia: uncoordinated movement Gait d/o: abnormal pattern/style of walking Pt has lost ability to initiate walking process

# Define Status Epilepticus Define Refractory Status Epilepticus What meds are approved for monotherapy in adults after their first seizure

Seizure activity >5min or two seizures w/out return to baseline Persistent seizure activity despite two antiepileptics Valproate Topiramate Oxcarbazepine Lamotrigine Levetiracetam

? is the MCC of provoked seizures in the developing world How are seizures during pregnancy Tx Why does status epilepticus become an emergency after 5min

Taenia solium induced neurocysticercosis IV Mg sulfate BBB compromised and invaded by K, Albumin. Diminished seizure threshold

What is the initial medical Tx of choice for status epilepticus What medication can be used for Trench Foot Tx What medication can be used for Chilblain/Pernio Tx

IV Lorazepam Limaprost Nifedipine, Pentoxyfilline, Triamcinolone cream

? medication may be started for Tx of Cold Induced Urticaria What are the 3 zones of injury during frost bite Frostbite is Tx by submerging in warm water at ? temp and blisters are managed by ?

Loratadine Coagulation: most severe, usually distal Hyperemia: most superficial, usually proximal, least damage Stasis: middle ground 98-102*F, Aloe cream q6hrs

How is vasculature assessed in Pts w/ frostbite Heat stress Tx What are the two cardinal features of heat stroke, and how is this heat injury Tx

Doppler US then Tech-99 scintigraphy Fluid/E+ replacement and rest Temp >104 and AMS; Cool until temp of 102.2 w/ cooling method to tolerance; Most rapid: CardioPulm bypass

Shivering during the Tx of Heat Stroke are managed by ? What is the sequence of Tx for DKA What are the goals of Tx

Benzos, Phenothiazines Fluid, K, Insulin Glucose <200, BiCarb ≥18, pH >7.3

How quickly are fluids given during Tx of DKA When is the fluid use changed per glucose levels How does pH correlate to HypoK levels

First 2L: 0-2hrs Next 2L: 2-6hrs Additional 2L over 6-12hrs Glucose <250- change to 5% dextrose in 1/2NS 0.1 dec in pH= K rises 0.5mEq

Do not give insulin for DKA Tx until K is over ? ? type of insulin is used Only give BiCarb during Tx if below ?

≥3.5 Regular ≤6.8

DKA is more likely to occur in ? while HHS is more common in ? Glucose criteria to Dx HHS Define Endophthalmitis

DKA: Type 1, HHS: Type 2 Glucose >600 Infection of eye globe

How is Pre-Septal cellulitis Dx and Tx Post-Septal cellulitis is MC d/t ? Stye is infection d/t ? located ?

CT w/ contrast; Augmentin Ethmoid sinusitis Staph infected follicle/Zeis or Moll gland

# Define Chalazion Blepharitis is d/t over growth of ? microbe Define Keratoconjunctivitis

Inflammation d/t blocked meibomian gland Strep epidermis Corneal involvement of conjunctivitis w/ corneal involvement of punctate ulcerations Epidemic= viral

How is Bacterial Conjunctivitis Tx Contact wearers need coverage for Pseudomonas which is done w/ ? ? is avoided when Tx Herpes Simplex Keratoconjunctivitis and ? can be used to prevent secondary infection

TMP-Polymyxin B, Neomycin -floxacin, -mycin Steroids, Erythromycin

Herpes Zosther Opthalmicus involves ? nerve and indicates ? emergency How are corneal ulcers Tx ? is used if fungal etiology is suspected

Huthcingson Sign: V1 of Trigeminal, ocular involvement Cipro/Oflox-acin Natamycin, Amphotericin, Fluconazole

? test is performed for eye trauma to exclude globe perforations How are conjunctival abrasions Tx ? PE finding makes a ruptured globe Dx certain

Seidel test- will be pos w/ corneal lacerations Erythromycin 0.5% Flat anterior chamber

If a flat anterior chamber is observed on PE, ? are the next steps Hyphemas develop from bleeding from ? structure Spontaneous hyphemas are associated w/ ? MedHx

Stop exam, place metal shield on injured eye, consult Ophtho Iris root vessel Sickle Cell

Blow out Fxs frequently occur at ? two locations Suspected Fxs need to avoid ? maneuver Because of the location of sinus wall Fx, ? ABX is used

Inferior wall (maxillary sinus) and medial wall (ethmoid sinus) Sneezing/Blowing nose- subcutaneous emphysema Cephalexin

Suspect globe ruptures w/ ? PE findings What are the next steps once suspicion is present What ABX are used

Eyelid puncture/laceration injuries Cover eye w/ metal shield, Consult immediatley Vanc + Cefriax

If able, avoid ? RSI medication in Pts w/ suspected globe ruptures

Rocuronium