Brainscape's Knowledge GenomeTM

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


See full index

Quarter 4 > E med > Flashcards

E med Flashcards

1
Q

low flow system

A

2-8 L

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

low flow system examples

A

nasal cannula, simple/partial rebreathing, non re breathing, trach collar

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

high slow system

A

up to 40L

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

high flow system examples

A

aerosol, T piece, venture

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

which can deliver the most % of oxygen?

A

Manual rescue (AMBU) > mask w reservoir > simple face > oxygen cannula (the least)

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

Anaphylaxis

A

IgE, mast cells, vasodilation, bronchoconstriction

tx: Epi (IM pref)

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

Hymenopytera

A

bee sting

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

Persistent cough

Unilateral wheezing

A

Foreign body

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

with Foreign Body in toddler, what are we worried about?

A

post obstructive Atelectasis or PNA

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

Type II and III Le Forte fracture

A

NO NASAL AIRWAY. there is a big risk of cribiform plate fracture

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

Battle sign and Raccoon eyes are signs of what

A

Basilar skull fracture

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

Angioedema

A

Larger swollen area involving DERMIS and SUBCUTANEOUS

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

Angioedema

A

usually involving head and neck

onset: min to hours

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

What causes angioedema (head and neck, subQ and dermis)

A

C1 esterase inhibitor deficiency (hereditary) OR

taking ACE-I (acquired)

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

How long does it take for Angioedema to resolve?

A

Hours to days

tx: C1 est inh, Epi, Antihist, steroid, danazol, ecalantide, icatibant

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

Ludwig’s Angina

A

Bilateral, rapidly spreading, submandibular CELLULITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q 
Suffocating sensation
Tongue elevated
Hard, firm induration on floor of mouth
Trismus
Mediastinitis

signs of what?

A

Ludwig’s angina

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

2nd and 3rd molars

A

Ludwig’s angina

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

Tx for Ludwig’s angina

A

Surgery
Intubation (fiber-optic)
Tracheostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q 
Pain swallowing
Fever
Drooling
Torticollis
Airway obstruction

signs of what?

A

Retropharyngeal abscess

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

Compare Ludwig’s vs Retropharyngeal abscess

A

Ludwigs: bilateral, suffocating sensation, trismus

Retro: stridor, airway obstuction, drooling, torticollis

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

Mixed gram (-), tonsillitis, otitis media, pharyngeal trauma can lead to:

A

RARE condition which is Retropharyngeal abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Dx of Retroph abscess

A

Clinical dx, or
X Ray or CT

soft tissue lateral neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Epiglottitis

A 
Age 2-7 
ABRUBT onset
Toxic appearing!
Altered LOC
Cyanotic
Airway obstruction
FEVER
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Epiglottitties

A

Thumbs up sign

DONT USE TONGUE BLADE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Epiglottities

A

Ceftriaxone (Rocephin)

Surgery/abx once airway is secured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Croup

A

Barking seal cough

Para-influenza

“steeple sign”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Usually self limiting and benign, “steeple sign”, barking seal cough

There is a seal in the chicken coop with the steeple

A

CROUP

If needed, supportive tx: cool mist, O2, Epi, steriods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pertussis

A

Paroxyms of cough

Post tussive emesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Pertussis dx

A

Nasopharyngeal swab Culture (gold stand)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Tx for Pertusssis

A

Erythromycin/Azithro

Treat contacts also

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Bronchiolitis

A

RSV!!

Tachypnea, retractions, wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Sx of Bronchiolitis are d/t

A

Submucosal edema and mucous plugging

Clinical dx unless bad sx, then order CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

For severely ill pts with Bronchiolitis, what do we give?

A

Ribavirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Tx for acute Asthma exacerbation

A

Stacked SVN w/SABA

3 tx every 30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Status asthmaticus!

A

if FEV1 does not increase >40% with treatment

complication: PNA

Tx: B agonist, HIGH DOSE steroid, O2, and ADMIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Tracheal deviation to opposite side

Marked resp distress

Dec breath sounds, tachypnea, tachycardia

A

Tension PNX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Tx for PNX

A

<20% involved: observe

> 20%: Intervene: needle decomp, simple aspiration, thoracostomy (chest tube)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Most common cause of preventable mortality

A

Hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Early death after trauma is 1-4 hrs after, d/t

A

Pulm or CV collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Late death after trauma is

A

days to weeks after injury

Sepsis or multiple organ failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Interventions to try, SALT Mass casualty protocol

A

Control hemorrhage
Open airway
Chest decomp
Inject antidotes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

ABCDEF

A 
Airway
Breathing
Circulation
Disability (neuro)
Exposure (check body)
FAST (focued assess w sonography)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the definitive airway that protects the airway from collapsing?

A

Endotracheal intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Order of trach and crico

A

Do endotracheal intubation first,
THEN
if no success: Cricothyroidotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Tension PNX
Massive hemothorax
Cardiac tamponade

are

A

immediate threats to life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Where to do Needle Decompression to tx PNX?

A

4th or 5th ICS, mid axillary line

tube thorac immediately following

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Lethal triad of trauma/shock

A

Hypothermia
Coagulopathy
Acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How to treat lethal triad?

hypothermia
coag
acid

A

1L NS
1-2 units O(-) blood

Start MTP (Massive transfusion protocol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

MTP includes

A

1:1:1 ratio of
PRBC: FFP: Platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

<35C is considered

A

Hypothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

AMPLLE stands for

A 
Allergies
Medicine
PMHx
Last meal
Last menses
Event leading to this
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

NEXUS criteria

If pt meets all of these, does NOT need X Ray

A 
No midline spinal tend
No focal neuro def
Normal alert
No intox
No painful distracting injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

PECARN criteria for YOUNG pts <2YO

A

YES get a CT if:
AMS
GCS <15
Can feel a skull fracture

MAYBE get a CT if:
LOC >5 sec
Non frontal hematoma
Not acting normal
Severe mechanism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

PECARN for OLDER than 2YO

A

YES get a CT if:
AMS
GCS <15
Signs of Basilar fx

MAYBE get a CT if:
LOC
Vomiting
Severe HA
Severe mechanism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Most freq injured organ in PENETRATING Trauma

A

Liver (RUQ)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Most comm injured organ in BLUNT Trauma in adults

A

Spleen (LUQ)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What to do if you have soft signs of penetrating trauma and ABI is <0.9:

A

CT angiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Hard sings of vascular injury with penetrating trauma

A 
Active/pulse bleeding
Expanding hematoma
Pulseless limb
Shock
Compartment synd
Bruit thrills
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Soft signs of penetrating trauma

A

Non expanding hematoma
Venous oozing
Hx of pulsatile bleeding
Unexp neuro def

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Normal ABI

A

> 0.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Order of how to handle big fracture

A

1: assess neurovascular
2: pressure
3: immobilize
4: Tetanus/abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

6 Ps of compartment synd

A 
Pain
Paresthesia
Pallor
Poikilo
Paralysis
pulseless
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Trauma PAN SCAN

A

all are NON CONTRAST, except

trunk (chest, abd, pelvis): use contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Ringer’s Lactate for burn

A

2-4 mL x %body surface area burned x weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Ringer’s lactate administration

A

first 8 hrs: give 1/2

next 16 hrs: give rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

BURN:

Red, cap refill is fast, sensation/pain (+), heals 1-2 wks

A

Superficial

1st degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q 
BURN:
wet, PINK, blisters
cap refill fast
sensation/pain (++)
heals 2-4 wks
A

Partial superficial

2nd degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

BURN:
more red, less wet
cap refill slow or absent
may or may not have sensation

heals in 3-8 wks w SEVERE scarring
Needs graft

A

Partial deep

2nd degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q 
BURN:
dry, WHITE
No cap refill
No sensation
Needs grafting
A

Full thickness

3rd degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

HSV1 Keratitis

A

ACUTE onset

Ciliary flush & Dendritic lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

HSV1 Keratitis

A

URGENT ophtho referral

Topical/oral antivirals

Acyclovir, Gangyclovir, or Corneal transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What do we not want to use with HSV1 Keratitis?

A

do NOT use topical glucocorticoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

UV Keratitis/Photokeratitis

A

Intensely painful

Usually self-limited though

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

UV Keratiits/Photokeratitis

A

Pt is acting cray cray bc it hurts so badly

Photophobia/ FB sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

UV Keratitis/photokeratiits

SO PAINFUL

A

Tearing, injection, chemosis of bulbar conjunctiva

Cornea hazy

Superfifcial punctate staining of cornea

pupils are miotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What causes Photokeratitis?

A

UV exposure
usually self limited, better in 24-72 hrs

Pain med, abx
F/u in 1-2d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Tx for UV Keratitis/photokeratisis

A

Just pain med, usually better in 1-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Preseptal cellulitis

A

Unilateral eye edema w red, warm, tender

tissue anterior to orbital septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Orbital cellulitis

A

TRUE EMERGENCY

structures deep to orbital septum

Vision loss, impaired EOM, diplopia, proptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Other signs of orbital cellulitis (more serious)

A 
Deep eye pain
Pain w eye mov
Proptosis
Vision impairment
Chemosis
Fever
Leukocytosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What causes preseptal and orbital cellulitis?

A

Complication of other infection: sinusitis, strep PNA, strep pyogenes, staph, H inf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Dx of preseptal/orbital cellulitis

A

CT WITH contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Tx of preseptal cellulitis

A

Oral abx

F/u in 1-2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Tx of Orbital cellulitis

A

Admit
IV abx
Consult ophtho and ENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Corneal ulcer

A

break in epithelium exposing the underlying corneal stroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Corneal abrasion

A

defect in corneal surface (not a complete break)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Sx of corneal abrasion/ ulcer

A

Severe eye pain
FB sensation

can impair vision leading to –> scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

PE of corneal ulcer/abrasion

A

Mild conjunctival injection or

Ciliary flush

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Tx of corneal abrasion

A

Topical lubricant and ABX

Erythromycin
Sulfa
Polymyxin
Cipro
Oflaxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What to NOT do with corneal abrasion/ulcer?

A

NO steroid

NO patching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Tx for Abrasion AND Ulcer

A

URGENT ophtho if

  • blunt trauma
  • impaired vision
  • ulcer
  • wears contacts
93
Q

Uncomplicated lid laceration

A

Superficial lac, horizontal, follows skin lines

If <25% (clean and surgical tape)

If >25% (suture)

94
Q

Complicated lid laceration

A

REFER

95
Q

Dx of Orbital floor fracture

A

Thin cut coronal CT

96
Q

Tx of orbital fracture

A 
Proph abx
Cold pack (first 48 hr)
Raise head of bed
Avoid sniffling/blowing nose
Surgery
97
Q

Open globe rupture

A

following blunt eye injury

AVOID pressure to eyeball (eyelid retraction, IOP)

Dx: Axial and coronal CT of eye WITHOUT contrast

98
Q

Optic neuritis

A

Inflammatory, demyelinating condition

Acute, monocular vision loss

High associated with MUSCULAR SCLEROSIS

99
Q

Optic neuritis sx

A

Vision loss (hours to days), peak at 1-2 weeks

Eye pain, worse w mov

Afferent pup defect

Loss/reduced color vision

100
Q

Tx of Optic neuritis

assoc w/ Multiple sclerosis

A

Steroids (IV)

do NOT recommmend Oral prednisone

101
Q

Normal Intra Ocular Pressure

A

8-21

102
Q

Closed angle glaucoma pressure

A

> 30

103
Q

Gold standard dx of Close angle Glaucoma

A

Gonioscopy

104
Q

Tx of Acute angle glaucoma

A

Emergent ophto eval

if >1 hr, empirically tx with pressure lowering eyedrops: Timolol, apraclonidine, Pilocarine

105
Q

3 meds for glaucoma

A

Timolol
Apraclonidine
Pilocarpine

106
Q

What to give IV for Glaucoma?

A

Acetazolamide

check pressure 30-60 min after tx

107
Q

Sudden onset floaters- cobweb

Vision loss

A

Retinal detachment

108
Q

Tx of Retinal detachment

A

emergent eval ophtho

109
Q

FB in ear

A

Neutralize bugs w mineral oil

Do not irrigate organic material- may cause infection

110
Q

Acute Otitis Externa

A

Pseudomonas aeruginosa

Ear fullness, drainage, pain-tragal motion tenderness

111
Q

Acute Otitis Externa tx

A

Debridement
Abx drops-Ciprodex or Cipro HC

caution Malignant otitis

112
Q

Viral Acute Otitis Externa

A

Ramsey-Hunt (herpes zoster)

Vesicles in ear canal
Facial PARALYSIS whaat
Hearing loss
Vertigo

113
Q

Viral Acute Otitis Externa tx

A

Antivirals
Steroids
MRI brain to r/o skull base tumor

114
Q

Facial paralysis
Vesicles in ear canal
Haring loss

A

Ramsey Hunt- Herpes zoster virus

Viral AOE

115
Q

Malignant Otitis externa

A

Pseudomonas aeruginosa

HIGH RISK: Old, DM, immunocomp

116
Q

Sx like Acute Otitis Externa but pt appears acutely ill

A

Consider Malignant Otitis Externa

117
Q

Dx of Malignant AOE

A

CBC- leukocytosis
Culture
Head CT- osteomyelitis skull base

118
Q

Tx of Malignant Otitis Externa

A

Admit
Debridement
Parenteral abx
(Cipro)

119
Q

Abx to use with Malignant OE

A

Cipro

120
Q

Tx for TM perforation

A

Most resolve on own! (95%)

If needed,
Abx- ofloxacin drops
Tympanoplasty in refractory cases

121
Q

Auricular hematoma

A

Cauliflower ear

Tx: drain/aspirate, f/u in 24 hours for 3-5 days

Refrain from sports for 7 days!!

F/u right away if worse

122
Q

Perichondritis

A

inflammation and infection of cartilage

red, pain, abscess, systemic sx

123
Q

Dx and Tx of Perichondritis

A

C&S

I&D if indicated
Empiric abd
CIPRO

124
Q

Imaging usually not needed for FB in nose UNLESS

A

suspect Button battery or magnet

125
Q

If more than 2 unsuccessful attempts at removing nose FB,

A

refer to ENT

126
Q

Which type of nosebleed are far more common?

A

Anterior nosebleed

127
Q

Tx of nosebleed

A

Step wise fashion
Conservative:
-Oxyemtazoline (Afrin) 2 sprays
-Direct pressure against septum 10 min

If no further, nasal hydration

128
Q

If source of nosebleed is easily identified,

A

Cauterize

avoid large areas
remove excess silver nitrate with cotton tip applicator

129
Q

When to remove nasal packing

A

3 days normal pt

5 days for pt on anticoags

130
Q

Abx with nasal packing

A

Keflex, Augmentin

131
Q

Nasal trauma imaging

A

CT WITHOUT contrast

132
Q

Nasal trauma

A

If really swollen, wait 4-6 wks before surgery BUT

attempt closed reduction right away (maximize airway)

133
Q

Nasal obstruction and pain are signs of

A

Septal hematoma

PE: Soft, tender swelling of septum

134
Q

Tx of septal hematoma

A

Iand D

if untreated, can –> septal perforation or “saddle nose” deformity

pack nose (remove in 24 hrs)
Recheck
re-pack

135
Q

Mastoiditis

A

suppurative infection of mastoid air cells

Acute if sx < 1month

136
Q

Mastoiditis

A

no sx OR

ear pain, drainage, tenderness, erythema over mastoid process

137
Q

what do we want a CT WITH contrast for?

A

Mastoiditis

best to see temporal bone changes

Culture if infection

138
Q

Tx of Mastoiditis

A

If good immune system: Oral abx

If recurrent dz or compromised: Mastoidectomy and IV abx

139
Q

Abx to use for Peridontal Abscess

A

Augmentin or Clinda 7-14 d

f/u with dentist

140
Q

If unable to re-implant tooth immediately after avulsion

A

Store in:

balanced saline
cold milk
pt’s saliva

141
Q

Success of re-implant tooth

A

85-97% at 5 min

nearly 100% at 1 hour

142
Q

Tx for tooth losss

A

Tetanus proph

Abx

143
Q

When to repair tongue lac

A 
Large >1cm
Deep on lateral border
Large flap or gap
Significant hemorrhage
May have improper healing
144
Q

Tongue lacs that don’t need repair

A

<1 cm

non gaping

145
Q

First degree frostbite

A

Numbness, central paleness with surrounding redness

NO blisters

146
Q

Second degree frostbite

A

blisters of skin w surrounding red/edema

147
Q

Third degree frostbite

A

Entire thickness tissue loss, hemorrhagic blisters

148
Q

Fourth degree frostbite

A

Entire thickness tissue loss involving deep structures, resulting in LOSS OF LIMB

149
Q

Frostbite tx, immerse in water what temperature

A

101.5-102.2
until red and pliable
20-30 min

consider pain med

150
Q

When to do CT angiography in frostbite?

A

if cyanosis PROXIMAL to ITP joints

151
Q

Hypothermia

A

<95 F

152
Q

4 clinical stages of hypothermia

A

Mild- confused, increased shivering
Moderate- lethargy, bradycardia, decreased shivering
Severe- unconscious
Level 4- no vitals, cardiac arrest

153
Q

Heat stress (exhaustion)

A

Heat cramps PLUS systemic sx (n/v, dizzy, ortho hypo)

154
Q

Heat stress (exhaustion) PE

A

temp <104

No signs of CNS impairment

155
Q

Heat stroke

A

Temp >104

PLUS Altered Mental Status

156
Q

Goal temperature in treating Heat Stroke

A

102.2

157
Q

Alternating current

A

cyclical
standard in homes
most power lines

pt can’t let go

158
Q

Direct current

A

lightning
batteries
long distance power lines

pt jolted away

159
Q

Augmentin or Clinda

A

Peridontal abscess

160
Q

Cipro

A

Malignant AOE

Perichondritis (oozing ear)

161
Q

Ceftriaxone (rocephin)

A

Epiglotittis

162
Q

Ribavirin

A

Severe bronchiolitis

163
Q

Erythro/Azithro

A

Pertussis
WHOOPING cough
paroxysms
post tussive emesis

164
Q

Steroids

A 
Optic neuritis (MS)
Viral Ramsey Hunt (AOE)
165
Q

numbness, central pale w surrounding red/swelling. NO blisters

A

1st degree frostbite

166
Q

blisters w surrounding red/swelling

A

2nd degree frostbite

167
Q

tissue loss entire thickness, hemorrhagic blsisters

A

3rd degree frostbite

168
Q

tissue loss entire thickness, deep structures –> loss of ENTIRE part

A

4th degree frostbite

169
Q

CT angiography when

A

cyanosis proximal to ITP joint

170
Q

Consider tPA and Lovenox in frostbite patients if:

A

within 24 hrs of injury, high risk of amputation and there are no CONTRA

171
Q

primary hypothermia

<95F

A

d/t exposure to weather (wind, rain, water, snow)

172
Q

secondary hypothermia

A

d/t lack of thermoregulation

173
Q

secondary causes of hypothermia

A 
alcohol
sepsis, shock, hypothyroid, burn
meds
newborns
malnutrition
blood transfusion
other cold infusion
174
Q

89-95 F

A

mild hypothermia

stage 1

175
Q

82-89 F

A

moderate hypothermia

stage 2

176
Q

below 82 F

A

severe hypothermia

stage 3

177
Q

consicous but confused, increased shivering

A

stage 1 hypothermia

178
Q

lethargy, bradycardia, decreased shivering

A

stage 2 hypothermia

179
Q

vitals present but UNCONSCIOUS, hypotension, pulm edema, rigid

A

stage 3 hypothermia

180
Q

NO VITALS, cardiac arrest

temp 82-89

A

stage 4 hypothermia

181
Q

Can use rectal and bladder temps in pts:

A

who are conscious and have not have lavage

182
Q

In severe hypothermia, how can you take temp?

A

Esophageal temp with ET intubation

183
Q

How does insulin react with hypothermia?

A

Can have initial HYPERglycemia then low levels after rewarming

insulin doesnt work below 86F

184
Q

Cold blood is prone to

A

hemolysis (rupture/destruction of RBC)

185
Q

Tx for mild hypothermia

stage 1

A

passive external

encourage movement

186
Q

tx for moderate hypothermia

stage 2

A

ABC
intubate prn
AVOID ROUGH MOV
active external AND internal

beware paroxysmal temp drop

187
Q

tx for severe hypothermia

stage 3

A

ABC
intubate prn
AVOID ROUGH MOV
active external AND internal PLUS

Irrigation w warm saline (104-107)

188
Q

tx for hypothermia stage 4

A

High quality CPR
Prevent further heat loss (wet clothes)
Thorac lavage
ACLS protocol

189
Q

How mnay cycles of ACLS to do with hypothermia stage 4?

A

up to 3 then defer until core temp increases or pt improves

190
Q

Complications of re-warming

A 
Hypotension
Electrolyte abn
Rhabdo
Multi syst organ failure 
Late Lung, Kidney, Neuro failure
191
Q

Tx for Heat exhaustion (cramps PLUS systemic sx, n/v/dizzy)

A

Bolus infusion of IVF

if not responding after 30 min, may need external cooling

goal core temp:102.2

192
Q

Heat STROKE tx

A 
Fluids
Evap cooling
Ice packs
Immersion
Invasive

many options

193
Q

Direct current has how many wounds?

A

2

Entrance AND exit

194
Q

Classic electrical injury

A

wounds can be underestimated
body IS part of circuit

entry AND exit wounds

195
Q

Flash (arc) electrical injury

A

strikes skin but does NOT enter body

196
Q

Lightening electrical injury

A

Direct current
shock wave transmitted THROUGH body

Mechanical trauma
“lichtenberg figures” (flowers)

197
Q

Burns with lightning shock?

A

rare, superficial

blast effect

198
Q

Burns with high voltage?

A

common, deep

199
Q

Type of current associated with low voltage

A

usually ALTERNATING

200
Q

Type of current associated with high voltage

A

BOTH

Direct or Alternating

201
Q

What type of injury is common of High voltage?

A

Neuro
Vascular
Muscle

*risk of compartment syndrome

202
Q

Tx for High voltage

A

Same as trauma
FAST
CT head and spine
X ray spine and extremitis

203
Q

Tx for High voltage

A

FAST (ultrasound)
CT
X Rays

204
Q

Tx for Low voltage injury

A

EKG

thorough exam

205
Q

black widow

A

southwest

OUTSIDE in AZ

206
Q

brown recluse

A

inside houses in the midwest bc it’s cold

207
Q

black widow

A

sx onset sooner, within 3 hours
systemic effects in 4-6

spasm and muscle pain back, chest, abdomen

sweating

Severe: n/v, HA, tachy, HTN

208
Q

brown recluse sx

A

pain and itching
ulcer and necrosis

pale, gray, eroded center w halo of swelling/hemorrhage

RARELY: rhabdo, DIC, acute hemolytic anemia

209
Q

which type of spider bite can RARELY result in Rhabdo, DIC, acute hemolytic anemia?

A

Brown recluse

210
Q

Which spider bite has Antivenom?

A

Black widow

211
Q

How long does it take for BROWN recluse bite to heal?

A

5-10 days

212
Q

Sx of Tachy, HTN, tachypnea, muscle spasm

A

Bark scorpion

213
Q

How long to monitor pt after Bark scorpion sting?

A

8-12 hrs

214
Q

Is there an antivenom for Bark scorpion?

A

YES

give to all pts w severe sx who are not responding to supportive care

215
Q

Fibrinolysis
Thrombocytopenia
Unstable vitals, AMS

A

Rattlesnake bite

216
Q

Serum sickness is assoc w what type of antivenom

A

Rattlesnake

Give oral prednisone to treat serum sickness for 1-2 wks

217
Q

Neurotoxic venom
no local injury
can take hours for effects to onset

A

Coral snake

218
Q

Closely monitor respiratory fx bc once these sx onset they are irreversible

A

Coral snake

219
Q

During DESCENT
unable to eq pressure b/w TM and external canal

pain, fullness, conductive hearing loss, hemotympanum

A

Barotitis (ear squeeze)

220
Q

Descent

A

Barotitis

221
Q

Sinus barotrauma

A

Sinus ostia occluded
DURING DESCENT as well
Bleeding into mask

pain over affected sinus
epistaxis

222
Q

Inner ear barotrauma

A

pt attempts Vasalva
Ruptures OVAL/ROUND window, tearing vestibular membrane

inner ear

223
Q

Sensineural hearing loss

A

INNER ear barotrauma

224
Q

Stat ENT consult, head of bed up, no nose blowing, Antivertigo meds

A

INNER ear barotrauma

225
Q

Ascent injuries

A

Pulm barotrauma

Arterial gas embolism

226
Q

Pulmonary barotrauma

A

overinflation “burst lung”

227
Q

SOB, CP, subQ air, PNX

A

Pulm barotrauma

Tx: If only pneumomediastinum: symptomatic

PNX: intervene

228
Q

Arterial gas embolism

A

ANY neuro sx in the setting of pulmonary barotrauma

229
Q

Tx for Arterial gas embolism

NEURO sx

A 
ABC
High flow O2
IV hydrate
Immediate recompression (HYPERBARIC O2)
Stat Neuro consult

Quarter 4 (10 decks)

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