ED/Critical Care Flashcards
(48 cards)
1
Q
- bradycardia
- HTN
- Irregular respirations
A
Cushing Triad
2
Q
- tachycardia, muscle rigidity, increased CO2, acidosis, and fever following administration of general anesthesia
- Tx: hyperventilation, oxygen, and dantrolene
A
Malignant Hyperthermia
3
Q
- heart rate that increases with crying
- soft vibratory ejection murmur
- intermittent brisk jugular venous pulse wave of the neck
A
Complete Heart Block
4
Q
- fatigue, vomiting, HA, muscle weakness, wt loss, and salt wasting
- hypoglycemia, hyperkalemia, hyponatremia, elevated ADH
A
Adrenal Insufficiency
5
Q
- afebrile pt presenting with seizure, no trauma, previous seizure history, and developmentally normal
- may have spent a lot of time swimming
- hyponatremia
A
Water Intoxication
6
Q
When can a near drowning patient be discharged home?
A
- submerged for less than 1 minute
- no LOC
- no resuscitation required
7
Q
What are the risks for future deterioration in a near drowning patient?
A
- history of apnea or CPR in the field
- seizure or disorientation or respiratory failure
- arterial desaturation and/or tachypnea
8
Q
- pulmonary edema
- increased permeability of the alveolar capillary membranes
- Xray: fine reticular infiltrate
- worse after 8 hrs
- MOSF
A
Acute Respiratory Distress Syndrome
9
Q
-next step in a pt with flail chest or hemothorax
A
Chest tube
10
Q
-most helpful vent setting in a pt with ARDS
A
PEEP
11
Q
- infant with poor wt gain, tachycardia, and tachypnea
- CXR: cardiomegaly
- EF < 25%
- tricuspid or mitral valve regurg
- Tx: Lasix for acute failure
A
Acute Heart Failure
12
Q
- FTT and poor feeding
- Tx: ACE inhibitor
A
Chronic Heart Failure
13
Q
- gray color, poor cap refill, thready pulses
- develop gallop, HSM, and JVD after fluid resuscitation
A
Cardiogenic Shock
14
Q
- presents with muffled heart sounds and pulsus paradoxus
- decreased blood pressure during inspiration
A
Cardiac Tamponade
15
Q
- irreversible absence of cardiorespiratory function
- absence of carotid artery blood flow
- Dx: radionucleotide scan or angiography
A
Brain Death
16
Q
- -elevated serum ammonia
- change in mental status
- chronic tremor and anxiety (Wilson’s)
A
Liver Failure
17
Q
- Lidocaine
- Atropine
- Narcan
- Epinephrine
A
Meds that can be given by ETT
18
Q
- hypocalcemia
- Hyperkalemia
- CCB ingestion
- hypermagnesemia
A
Indications for Calcium administration
19
Q
-morning stiffness, evanescent rash, and fever for over a week
A
JRA
20
Q
-patient most in need of antipyretics
A
pt with CHF (reduces cardiac output demand)
21
Q
-what bugs to cover for in cat bites
A
anaerobes, S. aureus, and pasturella
22
Q
-most important first step in management of bite wounds
A
high pressure irrigation
23
Q
When are Abx indicated for lacerations?
A
Dirty cuts Crush injuries Cat bites Bites that penetrate cartilage Cuticles (feet and extremities) Immunocompromised
24
Q
- self limited local painful lesion caused by spider bite
- target lesion with a red circle surrounding a white ring that appears within hours
- Tx: supportive
A
Brown Recluse Spider Bite
25
- spider bite that appears as a puncture wound
- symptoms within 8 hours inclde muscle aches and HTN
- Tx: narcotics and anti-hypertensives
Black widow
26
-best initial treatment for hypothermia
Internal rewarming
27
- Risks: bites closer to the brain, unprovoked, unvaccinated animal
- uncommon in small rodents
- MC in carnivores (esp bat), also the woodchuck
- Tx: wash and debride, HRIG, vaccine
- observe if animal is domestic
Rabies
28
What happens when phenytoin is given too rapidly?
Bradycardia
29
-bloody discharge from the ear or hemotympanum
Temporal Bone Fracture
30
-atraumatic tap with lots of RBCs
Epidural hematoma
31
-poor prognosis for coma
Cerebral Bleeding
Brain Edema
Coma lasting longer than 6 hrs
32
- clear rhinorrhea
| - bruising over the mastoid bone or black and blue eyes, abducens CN palsy
Basilar Skull fracture
33
-treatment of nasal septal hematoma or cauliflower ear
ENT C/S for drainage
34
- within 3 months of life
- fever, swelling of the tissues of the face, jaws, and cortical thickening of the long and facial bones
- mimics NAT
Infantile cortical hyperostosis (Caffrey Disease)
35
-what disease could periorbital ecchymoses indicate?
Neuroblastoma
36
- bucket handle fractures
- corner fractures (due to pulling an extremity)
- spiral fractures in infants
- rib fractures
- multiple skull fractures
- spinous process fractures
- scapula fractures
- sternum fractures
Fractures due to abuse
37
- fracture caused by falling on an outstretched arm that is hyperextended at the elbow
- at risk for neurovascular compromise
- pallor, cyanosis of the distal extremity, pain on passive extension of the fingers
- Dx: posterior fat pad on Xray
Supracondylar fx
38
- fall on outstretched arm or directly on the shoulder
- holding arm with opposite hand
- most heal without intervention
- medial fracture with ant or post displacement at risk for possible displacement of the trachea or mediastinal structures
- Tx: shoulder immobilization
Clavicle fracture
39
- palpable step off of the right shoulder joint in the absence of creptius
- older skeletally mature teens
- pain over the distal clavicle with point tenderness over the superior aspect
- cannot raise arm above head
AC separation
40
- fall on an outstretched hand
- cortex and periosteum remain intact
- one side is broken, the other is bent
Greenstick fx
41
-a head CT is indicated for what symptoms following head trauma
```
prolonged LOC
protracted vomiting
progressing HA
retrograde amnesia
lethargy
```
42
-first step in a pt with suspected skull fracture or head bleed
ABCs
43
- full thickness burns
- distinct margins
- varying depth
- sparing of the interdigital areas*
- stocking glove distriibution
Non-Accidental Burns
44
-first step in the treatment of burns
debridement and irrigation (Abx are not indicated)
45
-what is the rule of 9s?
```
Child older than 9
arms=9% each (9x1)
legs= 18% each (9x2)
trunk= 36% (9x3)
head and neck= 10% (9x1)
perineum- 1%
```
46
-the only positive culture the is definitive conformation of sexual abuse
Gonorrhea (chlamydia can be vertically transmitted and persists for up to 3 years)
47
- vaginal bleeding in an AA girl 3-8 years
- hyperemic donut shaped mass
- Tx: warm sitz baths and /u with urology
urethral prolapse
48
- HA, vomiting, high fever, delirium
- papules->vesicles->pustules->scabs
- lesions in the same stage of evolution
- Dx: pharyngeal swab, or culture the lesions
- spread by direct contact or airborne exposure
- AKA variola
- Tx: cidofovir (experimental)
Smallpox
