Deck 1 Flashcards
(25 cards)
Asthma ventilation settings
Low RR
High inspiration flow rate
Maintain plateau pressure below 30
Permissive hypercapnia
aerospace manufacturing pneumoconiosis
Berylliosis
Pneumoconiosis types
Asbestosis: shipping, roofing, plumbing
• Berylliosis: aerospace, fluorescent bulbs
• Byssinosis: cotton
• Silicosis: foundries, sandblasting, mines
• Coal worker’s lung: coal
• Siderosis: iron
• Stannosis: tin
• SOB + nonproductive cough + chronic hypoxia
• PFTs: reduced lung volumes
• CXR: interstitial fibrosis
• Asbestos: from the roof, but affects the base (lower lobes)
• Silica, coal: from the base(earth), butaffect the roof (upper lobes)
• Corpulmonale
Apnea in neonate from opioid dependent mother
Treat only with respiratory support and ventilation. Naloxone not recommended can lead to seizures and withdrawal
Pregnant. Elevated blood pressure. Maybe right upper quadrant pain
HELLP Syndrome (Hemolysis, Elevated Liver function tests, and Low Platelets) • Patient will be a pregnant • Labs will show microangiopathic hemolytic anemia (low hemoglobin and schistocytes on blood smear), thrombocytopenia, and elevated liver function tests • Management is blood pressure management, magnesium sulfate for prevention of eclamptic seizures and delivery of the fetus
How to prevent boutonnière deformity
Put PIP in extension. Leave DIP and MCP normal range of motion
Scleroderma renal crisis treatment
Treat renal failure lyre abnormalities.
Once hyperK corrected can start captopril
efavirenze side effects
vivid dreams, headache, severe rash, dizziness and lightheadedness
indinavir side effects
kidney stones, hyperbili, hepatitis
normal adult spinal cord ends as conus medullaris at what level
L1-L2
Indications for emergent hemodialysis in acute salicylate toxicity
serum salicylate level >100 (acute) (40 chronic) rapid rising level AMS Kidney or liver failure pulmonary edema severe acid/base disturbance worsening clinical status
Type I hypersensitivity
Type I reactions are immediate hypersensitivity where binding of antigens to IgE on mast cells and basophils leads to deranulation of mediators
Type II hypersensitivity
involve cell lysis resulting from antibody binding to membrane-bound antigens (auto immune hemolytic anemia)
Type III hypersensitivity
immune complex-mediated reactions. Antibodies bind to antigens to form immune complexes. These are deposited on vessel walls leading to local inflammation and eventually tissue injury. Type III reactions are seen in systemic lupus erythematosus and serum sickness. Serum sickness presents with rash, fever, polyarthralgias and polyarthritisusually begins 1-2 weeks after exposure to a causative agent.
Type 4 hypersensitivity
cell-mediated delayed hypersensitivity requires sensitized lymphocytes to start the inflammatory reactions. Type IV reactions are seen in contact dermatitis, Stevens-Johnsonsyndrome and toxic epidermal necrolysis.
Interpretation of medical literature: which is strength of recommendation and which is quality of the evidence
Classes are strengths of recommendation Class I to III (I is highest, IIa moderate strength, IIb weak recommendation, III benefit equals risk or risk is greater)
Levels are levels of evidence (A to C. C is expect opinion)
Behcet syndrome
recurring genital, oral ulcerations. relapsing uveitis.
estimate weight peds
(2 x age) + 8
pediatric dextrose administration in hypogylcemia
<1 year: D10 2-5 mL/kg
1-8 years: D25 2mL/kg
>8 years: D50 1 mL/kg
keraunoparalysis
transient extremity paralysis from vasospasm after lightning injury
malrotation with midgut volvulus
80% cases present in first month of life. infant with bilious vomiting.
upper GI study gold standard showing corkscrew appearance of jejunum. tx with fluids, NG tube, abxs, surgery.
thrombotic thrombocytopenic purpura
autoantibody mediated inhibition of enzyme ADAMTS13. results in microangiopathic hemolytic anemia and thrombocytopenia. classic pentad: fever, microangiopathic hemolytic anemia, thrombocytopenia, renal dysfunction, and neurologic changes. plasma exchange tx, also IV corticosteroids.
labs: elevated LDH, elevated indirect bilirubin, normal coags, microangiopathic hemolytic anemia, thrombocytopenia
post-partum endometritis
risk factors: C section, PROM > 24 hours, stage 2 labor >12 hours, high number of pelvic exams
tx: clinda plus gent, unasyn
hyperosmolar hyperglycemic state
profound dehydration, hyperosmolarity and decreased mental status
