Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Board Reivew > URGE > Flashcards

URGE Flashcards

1
Q

Fluid resuscitation in for hypotensive shock in a child.

A

Bolus of 20 cc/kg

3:1 rule: give the above bolus x 3, if bp still not responding, give prbc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Head trauma in a patient between the age of 2-20 that seems fine. No PE findings. What’s the recommendation.

A

Observation by reliable family member at home for 24 hours.

If LOC < 1 minute, head CT vs observation (if no LOC, chance of head pathology is 1/5000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the rules to clear a patient from a c-collar?

A

NEXUS (C-Spine) Guidelines

No posterior midline cervical tenderness

No focal neurologic deficits

Normal level of alertness / **No EtOH intoxication / **No distracting injuries

100% sensitive!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Soft neck collar needed for whiplash?

A

No. It actually worsens neck pain and reduces mobility.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Objective dx of compartment syndrome?

A

Tissue pressure > 30mmHg (tissue pressure exceeds perfusion pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Radial nerve injury. What is the motor deficit in the hand?

A

Can’t extend wrist and fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Median nerve injury. What is the motor deficit?

A

Can’t flex wrist and fingers. Can’t make the “OK” sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ulner nerve injury. What is the motor deficit?

A

Can’t abduct the fingers. (Can’t make the live long and prosper sign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Spiral fracture of the tibia vs radius. Which is NOT concerning for child abuse?

A

Spiral fx of tibia is a “toddler’s fracture”.

The kids “spin out” and fx the leg. It’s the most common fx of toddler’s presenting with a limp. –> Below the knee walking cast.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which bite is the most likely to cause infection?

Cat to hand, Human to face, Dog to thigh, Spider to leg

A

Cat to hand

Cat bite is deeper. Hand is less vascular than face.

–> Augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment for cat scratch disease?

A

Que no.

Self-limiting (…in 1-2 months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment for brown recluse spiider bite?

A

None that really work.

Venom causes skin necrosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment for black widow spider bite?

A

Supportive for pain, anxiety

Resolves in 72 hours

No local inflammation

Venom is neuro toxin (muscle cramps/pain, N/V)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Snake bite to arm while camping remotely. What do you do?

A

Elevate arm to reduce edema, drive to hospital.

Antivenom (CroFab) is given to those with severe edema or signs of DIC.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pt just ate peanuts, now with uticaria, low bp, tachycardia, oral and facial swelling.

Tx?

A

Epinephrine 1:1000 IM or SQ (1:10000 IV is for life-threatening reaction)

+

Benadryl (H1 blocker)

+

Solumedrol

+

ranitadine (H2 blocker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is scomboid poisoning? Tx?

A

A pseudo fish allergy that occurs after eating spoiled fish.

Tx with H1, H2 blockers

Histadine in the fish muscle breaks down into histamine –> pt eats a bunch of histamine –> experiences facial flushing, diaphoresis, hives, diarrhea, peppery taste. Usually seen in tuna or mackerel (scombridae family)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Difference between heat exhaustion and heat stroke?

A

Heat stroke has abnormal neuro exam.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acetaminophen overdose. Tx

A

N-acetylcysteine (Mucomyst)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Meds that cause serotonin syndrome.

Tx?

A

SSRIs, MAOI

Cocaine, Amphetamine, Dextromethorphan, Venlafaxine, Meperidine

Cyproheptadine (NOT dantrolene)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Toxic patient with breath smell of bitter almond. Dx?

A

Cyanide poisoning.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Toxic patient with breath smell of violets. Dx?

A

Turpentine poisoning.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Toxic patient with breath smell of mothballs almond. Dx?

A

Camphor (cough suppressant in Vicks) poisoning, naphthalene (the ingredient in mothballs)

23
Q

Toxic patient with breath smell of garlic. Dx?

A

Arsenic poisoning

24
Q

Toxic patient with breath smell of pear. Dx?

A

Chloral hydrate (used in a “Micky”)

25
Q

Tox substances/meds that may cause hyperthermia?

A

Anticholinergics, SSRIs, Neuroleptics

Amphetamines, PCP, cocaine

Thyroid meds

Nicotine

Aspirin

26
Q

Tox substances/meds that may cause hypothermia?

A

CO2

EtOH

sedative-hypnotics, barbituates

27
Q

Patient being treated for frostbite is found to have black eschar, no pulses on affected fingers and toes. Next step?

A

Observe. Don’t debride yet. It takes weeks for demarcation line to become apparent.

28
Q

Asymptomatic patient with household bleach ingestion. Next step?

A

Observe (only if household bleech and asymptomatic)

If industrial bleach or drain cleaner –> to GI for possible endoscopy

29
Q

Patient with heat stroke. Ice pack are contraindicated. Why?

A

Ice packs supposedly cause cutaneous vasoconstriction which slow cooling. Better to use fans and cool wet cloths for evaporative cooling.

30
Q

Lab test to confirm heat stroke?

A

LFTs are almost uniformly elevated in heat stroke

(normal LFTs should make you question your diagnosis)

31
Q

What is the significance of a normal ABG in a tachypneic patient in asthma exacerbation?

A

Danger

The patient should have a low CO2 from the tachypneia. Normal = retaining in this situation.

32
Q

Asthma exacerbation stepwise treatment.

A

1. Oxygen (for O2 > 90%), peak flow, SABA nebs (or MDI) +/- ipratroprium bromide…. then

2. Prednisone…. then

3. Better when FEV1 or PEF > 70%

4. home vs admit

33
Q

What peak flow is considered “good” for discharge to home from the ED.

A

FEV1 or PEF > 70%

34
Q

How many albuterol MDI treatments = a nebulizer treatment?

A

8-10

May give albuterol nebs continuously if needed (tachycardia usually improves as does the oxygenation)

35
Q

Tx for status asthmaticus?

A

Magnesium sulfate IV

36
Q

Kid is wheezing after eating peanuts. Looks good otherwise. Stepwise tx?

A

1. Benadryl (H1 blocker) + cimetidine (H2 blocker)

2. Solumedrol

3. Epinephrine 1:1000 IM or SQ (1:10000 IV is for life-threatening reaction)

37
Q

Patient just successfully treated for bee sting (or peanut) allergic reaction. Discharge meds?

A

Benadryl q6h x 48 hours

+

Cimetidine q12h x 48 hours

+

Anaphylaxsis kit

38
Q

Young man with sudden testicular pain. Dx? Tx?

A

Diagnose testicular torsion with surgical exploration.

Treatment is surgery –orchiopexy within 6 hours!

39
Q

What is the most common cause of epididymitis in a 21 year-old male?

A

Chlamydia trachomatis (second most common is Neisseria gonorrhoeae)

40
Q

What is the most common cause of epididymitis in a 55 year-old male?

A

E.Coli (then Klebsiella, Pseudomonas)

41
Q

Do pregnant patients need to be admitted for pyleonephritis?

A

Not if they are < 24 weeks with VSS

42
Q

Patient with ab pain in the ED, HCG = 440 IU/L. US is negative for ectopic pregnacy. What’s the deal with beta HCG and US in ectopic pregnancy dx?

A

Beta HCG doubles ~ q72h in normal pregnancies, in etops it does not. –> check a HCG again in 48 hours.

US is not sensitive until ~ HCG=2000 IU/L so you can’t count on it with a level of 440

43
Q

Unresponsive patient is brought in. No info available. Exam is not helpful. Where do you start immediately?

A

DONT

Dextrose (finger stick)

Oxygen

Naloxone

Thiamine

44
Q

What are contraindications to placing a foley catheter in the trauma setting?

A

Blood at the urethral meatus

Perineal hematoma

High-riding soft boggy prostate (means urethra has been disrupted and the prostate has shifted).

45
Q

You identify a patient with HTN and an aortic dissection. Next step?

A

Start labetalol and nitroglycerin/nitroprusside drip to control the bp (to minimize stress on aortic wall)

46
Q

3 year-old male with belly pain, hematemesis, pill ingestion. What is the presentation of iron toxicity? Tx?

A

Phase 1: Abdominal pain, N/V/D,** +/- **Hematemesis, Hematochezia (gastric irritation)

Phase 2: relatively Asymptomatic,

Phase 3: Hypotension, Acidosis, Multisystem organ failure, Coma

Phase 4: sometimes Hepatic necrosis

Phase 5: Bowel obstruction 2-4 weeks later

47
Q

For what substances does activated charcol not work?

A

Iron

Lithium

Lead

These substance do not absorb to activated charcol.

48
Q

Patient reportedly ingested iron, but is asymptomatic. When is he “out of the woods”?

A

6 hours + normal KUB

If no symptoms (abdominal pain, NV/D are the first sx) by then AND no ab xray evidence of iron in the GI tract, pt may be discharged with close follow-up.

***chewable multivitamins will not show up on xray!!!

49
Q

Newborn that has not been eating well, T=38.2 Exam is normal. Normal urine/stool output far. Next step?

A

You don’t have a source in this < 28 day-old baby, so be concerned for:

Neisseria meningitides, Listeria monocytogenes, GBS (peak incidence is day 7, but may occur up to 30 days old), HSV (cold sores)

Do it all: CBC, BCx, catherterized UA/Cx, lumbar puncture

50
Q

Treatment for newborn with suspected meningitis?

A

Ampicillin and gentamycin

51
Q

Febrile child that is < 28 days old. Next step?

A

Assume its bacteremia seeding to the CSF.

–> CBC, CRP, BCx, UA/UCx, lumbar puncture, (stool if diarrhea), CXR (if respiratory sx)

Admit for IV abx (amp/gent empirically)

Age 1-3 months, if WBC < 15000 with band < 1500, CTX IM in office and again the next day with observationl otherwise admit for IV abx and BCx.

52
Q

Febrile child that is 6 weeks old. Next step?

A

Age 1-3 months, if WBC < 15000 with band < 1500, CTX IM in office and again the next day with observationl otherwise admit for IV abx and BCx.

In neonates (< 28 days old), full workup and possible admission.

53
Q

6 month-old with difficulty breathing, some runny nose, wheezing, brassy sounding cough. Positive steeple sign on xray (not needed). Dx? Tx?

A

Croup (=laryngotracheobronchitis)… swelling of epiglottis

cased by parainfluenza, influenza, and RSV, etc

**Dexamethasone 0.6mg/kg IM/PO/IV x 1 **

+

racemic epinephrine nebulizer

54
Q
A

Board Reivew (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions