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Final Exam Prep > Common Problems In Acute Care > Flashcards

Common Problems In Acute Care Flashcards

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1
Q

Differentiate between 1st, 2nd, and 3rd degree burns

A

1st: Dry, Red, NO BLISTERS, epidermis only
2nd: (Partial thickness), Moist, Blisters, extends beyond the dermis
3rd: (Full thickness), Dry, leathery, waxy, extend from epidermis to dermis, underlying fat/muscle/bone

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2
Q

Rule of nines for burns

A

Each arm= 9%
Each Leg= 18%
Thorax: 18% front, 18% back
Head= 9%
Genitals= 1%

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3
Q

Fluid resuscitation in Burns; include Parklands Formula

A

PF: 4mls/kg x TBSA% burned during the first 24 hours
1/2 needs to be administered in the first 8 hours and the remaining is given over the next 16 hours

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4
Q

Metabolic complications of burns

A

Metabolic acidosis
Hyperkalemia during the first 24 -48 hours then hypokalemia 3 days post

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5
Q

Indications for prophylactic intubation in burns

A

Burn to the face
Singed eyebrows
Dark soot from nares or mouth

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6
Q

What is the immediate post burn regimen

A

Submerse the area in clean water
Wrap in clean dry towels and go to hospital
Sterile saline to area
Maintain temp 37-37.5 C
Fentanyl or morphine for pain

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7
Q

What is used to remove tar from a tar burn

A

Petroleum based products

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8
Q

What constitutes a burn center referral

A

-Partial thickness >10% TBSA
-Burns to face, hands, feet, genitalia, or joints
-3rd degree
-Electrical/chemical/inhalation
-Trauma
-Children

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9
Q

Differentiate between a fracture and dislocation

A

F: Broken or crushed bone
D: disruption between relationship of normal joint surfaces

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10
Q

Subluxation

A

Incomplete dislocation

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11
Q

Differentiate between a closed, open, and avulsion fracture

A

C: skin is not broken
O: Skin is broken
A: Bone fragments are pulled off by attached ligaments and tendons

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12
Q

What is Giant Cell Arteritis, S/S, Labs, and Management

A

Inflammatory condition that can lead to blindness
S/s: headache, scalp tenderness, jaw claudication, temporal artery is nodular/enlarged/tender, fever (104), chills/rigors
Labs: high ESR, normal WBC, and temporal artery biopsy
TX: prednisone and a referral

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13
Q

Describe Diabetic Retinopathy on exam and what is the earliest sign

A

Earliest sign is micro aneurysms, flame shaped hemorrhages, cotton wool spots

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14
Q

What is AV nicking a sign of

A

Chronic hypertension

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15
Q

What is arcus Aenilis

A

A cloudy appearance of the cornea with a gray/white arc due to the deposition of lipids, has no effect on vision

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16
Q

Treatment for chemical conjunctivitis

A

Flush with NSS

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17
Q

Bacterial conjunctivitis discharge and tx

A

Purulent
Flouroquiniolone drops or tobramycin, gentamycin drops

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18
Q

Gonococcal conjunctivitis discharge and treatment

A

Copious purulent
Ceftriaxone 250mg IM + azithromycin

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19
Q

Chlamydia conjunctivitis treatment

A

Ceftriaxone 250mg IM + azithromycin

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20
Q

Allergic conjunctivitis discharge and treatment

A

Stringy, tearing
Oral antihistamines, referral to allergist and ophthalmologist

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21
Q

Viral conjunctivitis discharge and treatment for mild and moderate

A

Watery
Mild: saline drops and artificial tears
Moderate: antihistamines, NSAIDs, ABX drops

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22
Q

Herpetic conjunctivitis discharge and treatment

A

Bright red and irritated
Refer to an ophthalmologist

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23
Q

Corneal abrasion tx

A

Anesthetize eye for exam
Topical ABX especially for those with contacts
NO steroid drops

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24
Q

S/S of open vs closed Glaucoma

Study These Flashcards
A

Increased intraoccqular pressure
Open (Chronic): asymptomatic, elevated IOP, cupping of disc, constriction of visual fields
Closed (Acute): Extreme pain, blurred vision, halos around lights, pupils fixed or dilated

25
Labs/ Diagnostics and treatment of Glaucoma
Labs: Tonometry Tx: -Open: Prostaglandin analogs (Prost drops), Alpha 2 adrenergic agonists (Brimonidine), Beta adrenergic blockers (Timolol), Mitotic agents (pilocarpine) -Closed: Carbonic anhydrase inhibitors (Acetazolamide/ Diamox), Osmotic diuretics (mannitol), Surgery
26
What is the highest treatable cause of blindness
Cataracts
27
causes of cataracts
Aging, heredity, trauma, toxins, congenital, diabetes, UV sun exposure
28
S/s of cataracts
Painless, clouded vision, difficulty seeing at night, diplopia, no red reflex, opacity of lens
29
Cataract management
Refer to surgery
30
S/s of HIV
Flu like symptoms Fever, night sweats, and weight loss
31
when does HIV become AIDS
CD4 count <200 And/or an opportunistic infection is present in an HIV patient
32
Labs and diagnostics of HIV/AIDS
HIV 1/2 antigen/antibody conversion, if positive then test HIV1/HIV2 antibody differentiation immunoassay CD4 count PCR for viral load
33
Normal CD4 Count
500-1200
34
What is given to HIV patients to prevent PJP and Mycobacterium Adium
PJP: Bactrim MA: Azithromycin
35
Indications for HIV pre exposure prophylaxis
Anal/vaginal sex in the past 6 months and have: -HIV + partner, not consistently used a condom, been diagnosed with an STD in the past 6 months For People who inject drugs: -HIV + partner -Share needles
36
Which PrEP agent is recommended for patients who have high risk sex AND drug use
Truvada
37
What PrEP agent is recommended for patients with high risk sex EXCLUDING vaginal sex
Descovy
38
Differentiate the patho behind OA and RA
OA: denegerative joint disease RA: autoimmune inflammation of connective tissue
39
Differentiate the inflammation of OA vs RA
OA: Asymmetrical RA: Symmetrical
40
Herberden’ s vs Bouchard’s nodes
H: DIPs B: PIPs
41
Stiffness and pain in OA vs RA
OA: better in morning worse as day goes on RA: worse in morning, better as day goes on
42
Synovial aspirate in OA vs RA
OA: normal RA: WBCs
43
Management of OA
ASA, Acetaminophen, NSAIDS, COX2 inhibitors (Celebrex)
44
RA management
High dose salicylates, NSAIDS, DMARDS, corticosteroids
45
S/s of Lupus
Fever, anorexia, malaise, weight loss, butterfly rash, alopecia, raynauds, joint symptoms (early manifestation) SPLINTER HEMORRHAGES
46
Labs and diagnostics in SLE
ANA positive Antiphospholipid antibodies Anemia, leukopenia, and thrombocytopenia
47
Management of SLE
Bed rest, naps, sun protection, topical glucocorticoids for skin lesions, NSAIDS, hydroxychloroquine, glucocorticoids
48
Which joints are mainly effected in OA and RA
PIPs
49
What are 2 herbals that women take for cramps?
Primrose and black kohosh
50
What medication can mimic lupus symptoms
Procanimide
51
Who is the worst off in ALL
>60 yrs old, difficult to get into remission
52
What xray results indicate RA
Osteopenia
53
What effect does hodgkins lympphoma have on RBCs, EBCs, and plasma cells
Increases them
54
What is Thromboangitis obliterans and how do you treat it?
Small blood clots that get stuck in small vessels Pentoxifylline
55
What is sodium polystyrene sulfonate
Kayexalate used to treat hyperkalemia
56
Typical antiregection meds
Corticosteroid plus antimetabolites (Imuran or cellcept) plus CAlcineurin inhibitor (prograf)
57
What are two normal artery to vein ratio in the retina
4:5 and 2:3
58
What drugs are contraindicated with ST. Johns wort
SSRIs, Oral contraceptives, digoxin, alprazolam, amitryptilyine, narcotics, antiretrovirals
59
What is given to patients with corneal abrasions to decrease itching
Levocalbastine

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