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EM > WEEK 2 > Flashcards

WEEK 2 Flashcards

1
Q

Non-blanching petechial rash

A

N. Meningitidis

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2
Q

APAP antidote

A

N. Acetylcysteine

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3
Q

Anticholinergic antidote

A

Physostigmine

Except TCA’s

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4
Q

Benzo antidote

A

Flumazenil

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5
Q

Cyanide antidote

A

Na Nitrite

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6
Q

Methanol antidote

A

Ethanol

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7
Q

Narcotic antidote

A

Naloxone

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8
Q

Garlic odor on breath

A

Acute arsenic ingestion

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9
Q

Dig toxicity causes?

A

Hyperkalemia

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10
Q

Dig reversal agent

A

Digabind

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11
Q

Pinpoint pupils and resp depression =

A

Opiate overdose

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12
Q

3 C’s of TCA tox

A

Cardiac abnormalities
Convulsions
Coma

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13
Q

EKG abnormalities in TCA tox

A

Wide QRS

Prolonged QT interval

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14
Q

Early signs of APAP tox

A

N/V

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15
Q

Rotten ages

A

NItrogen sulfide

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16
Q

ASA Tox

A

Resp alkalosis

Met acidosis

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17
Q

Normal pH

A

7.35 - 7.45

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18
Q

Normal CO2

A

35 - 45

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19
Q

Normal O2

A

83 - 102

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20
Q

Normal HCO3

A

22 - 28

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21
Q

Normal Anion Gap

A

10 - 16

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22
Q

pH: 7.48
CO2: 40
HCO3: 30

A

Metabolic Alkalosis

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23
Q

pH: 7.45
Co2: 47
HCO3: 29

A

Metabolic Alkalosis
with
Respiratory Comp

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24
Q

pH: 7.30
CO2: 40
HCO3: 18

A

Metabolic Acidosis

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25
Q

Fruity odor to breath

A

DKA

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26
Q

DKA

A 
*** Aggressive fluid therapy with NS ***
.1 units/kg insulin per hour
Continuous infusion is preferred
Potassium repletion
Routine bicarb not recommended
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27
Q

Almost all patients in DKA present with glucose above

A

300 mg/dL

Most will be above 500

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28
Q

HHNS occurs in

A

Type 2 diabetics

No ketone production because of enough insulin to use glucose in cells.

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29
Q

HHNS syndrome

A

Severe hyperglycemia > 600
Hyperosmolarity > 315 mOsm/kg
Relative lack of ketonemia (pH >7.3)

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30
Q

HHNS presentation

A

Usually elderly
AMS
Non-ambulatory
Concomitant infxn

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31
Q

Glucose less than ___ is generally a concern

A

About 60

45 is very dangerous

32
Q

Hypoglycemia Tx

A

15 - 20g of glucose (nonemergent)
1 g/kg of D50 IV (emergent)
Prescribe glucagon
Adjust insulin therapy

33
Q

Hypoglycemia accounts for ___% of patient presentations to the ED with AMS

A

7%

34
Q

Non-diabetic causes of hypoglycemia

A

ETOH

Sepsis

35
Q

Primary adrenal insufficiency

A

Addisons

36
Q

Most common cause of adrenal insufficiency

A

Chronic exogenous steroid use

37
Q

Darkening of skin in addisons is caused by?

A

Increased melanocyte stimulating hormone release

38
Q

Hypotension in adrenal crisis is usually refractory to what tx?

A

Catecholamine and fluid admin.

Cortisol must be replaced

39
Q

Where is adrenal crisis seen?

A

Undiagnosed addisons with serious infxn or acute stress.
Adrenal infxn or hemorrhage
Rarely in 2ndary insufficiency

40
Q

Adrenal crisis presentation

A

Hypotension

Abd and flank pain

41
Q

Pheo rule of 90’s

A

90% in adrenal medulla
90% unilateral
90% of time not malignant
90% of pts are adults

42
Q

A positive 24hr Vanillylmandelic acid secretion test =

A

Pheochromocytoma

43
Q

Myxedema Coma

A

Uncompensated hypothyroidism in the elderly.

AMS, hypothermia, brady, hypotension

44
Q

Myxedema coma often precipitated by ____ exposure

A

Cold exposure

45
Q

Myxedema coma tx

A

Correct hypothermia
IV levothyroxine
Glucocorticoids

46
Q

Thyroid storm

A

Severe life-threatening Hyperthyroidism caused by stress, trauma, sepsis
S/S: Fever, arrhythmia, CHF, agitation

47
Q

Thyroid storm tx

A

Stabilize, O2, fluids
Beta blockers for HTN
PTU (antithyroid)
Iodine

48
Q

2nd gen antipsychotics

A

Olanzapine: Zyprexa
Risperidone (Risperidal)
Ziprasidone: Geodon

49
Q

FIrst choice for chemical restraints

A

Haldol and benzos

50
Q

Lab needed in AIDS encephalopathy

A

CD4 count

51
Q

Cocaine w/d tx

A

Supportive

no meds shown to help

52
Q

Which paralytic in CI in meth intubation

A

Succs

53
Q

What should HTN in meth OD be treated with?

A

Nitroprusside

Avoid beta blockers

54
Q

NMS

A

Neuroleptic malignant syndrome
AMS, muscular rigidity, hyperthermia
Caused by compazine, neuroleptics antipsychotics

55
Q

When do etoh w/d seizures occur?

A

12 - 48 hrs after last drink

56
Q

When does w/d hallucinosis occur

A

12 - 24 hrs, resolve within 24 - 48

Usually visual

57
Q

When do DT’s occur?

A

48 - 95 hrs

Can last 1-5 days

58
Q

DT tx

A

Supportive
Benzos
Phenobarb if benzos not working
NO antipsychotics

59
Q

Does psychosis alone meet legal criteria for involuntary tx?

A

No

60
Q

Catatonia

A

Inability to move normally despite physical ability to do so

Tx with lorazepam

61
Q

Abx for meningitis

A

Rocephin IV

62
Q

Paradoxical crying (cries more when being held) in an infant is indicative of?

A

Meningitis

63
Q

DOC for MRSA

A

Bactrim

Clinda is alternate

64
Q

Oslers nodes and janeway lesions =

A

Infectious endocarditis

65
Q

Imaging for endocarditis

A

TEE is best

66
Q

Toxic shock syndrome

A

Results from the TOXINS absorbed from a localized infxn.

NOT sepsis, but causes by bacterial infections.

67
Q

Malaria

A

Caused by plasmodium falciparum
Transmitted b mosquitoes
Sx occur 12 - 35 days after exposure

68
Q

Botulism

A

BIlateral cranial neuropathies
symmetric descending weakness
Absence of fever

69
Q

Smallpox agent

A

Variola virus

70
Q

Anthrax agent

A

Bacillus Anthracis

71
Q

Is cutaneous anthrax painful?

A

No, painless

72
Q

Anthrax tx

A

Ciprofloxacin or doxy for 2 months

73
Q

Toxic dose of APAP

A

> 140 mg/kg

74
Q

TCA’s are which class

A

Anticholinergic

75
Q

Anticholinergic OD saying

A

Hot as a hare, red a a beet, dry as a bone, blind as a bat and mad as a hatter

EM (10 decks)

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