ED/Trauma Flashcards

Question

Abdominal and Pelvic injuries are more likely associated with...

Answer 1

side-on collisions

Answer 2

``` Rule of nines arms-9% each Legs-18% for whole leg each Trunk- 18% on each side Perineum, hand-1% ```

Answer 3

4 cc/kg x % BSA that was burned over 24 hours | 1/2 in the first 8 hours

Answer 4

Inhalation Thermal Electrical Chemical

Answer 5

Edema, Obstruction, Hypoxia

Answer 6

Entrance and Exit wound Do not look bad but do have a lot of nerve, vessel and muscle damage Unable to calculate surface area burned

Answer 7

Length of contact and concentration is needs to be taken into account

Answer 8

hypovolemic shock

Answer 9

Hypernatremia | Hypokalemia

Answer 10

Superficial partial thickness Redness, no blisters Blanches/tender

Answer 11

Deep partial thickness Appears moist, may blister Painful-nerve endings exposed

Answer 12

Full thickness burns Pale yellow to brown Dry leathery No pain-superficial nerve endings destroyed Somatic pain from inflammation and ischemia

Answer 13

``` Airway- TOP PRIORITY Remove clothing Cool, moist NS compresses 2 large bore IVs IVF replacement- LR fluid of choice ```

Answer 14

``` Monitor for dysrhythmias- hypokalemia Monitor NGT output- can get ileus Monitor UO- can go into rhabdo Prepare for escharotomies Topical antimicrobial agents ```

Answer 15

Copious amounts of purulent discharge | Mild discomfort

Answer 16

gram stain, Giemsa stain and culture Tetracycline erythromycin single dose azithromycin

Answer 17

Bilateral tearing and stringy discharge

Answer 18

Topical antihistamines and/or steroids Naphazoline H1 receptor antagonist (Ketotifen (gtts), loratadine (PO), fexofenadine (PO), cetirizine (PO) NSAIDS (Ketorolac)

Answer 19

Purulent discharge | Mild discomfort

Answer 20

``` Usually self-limiting Topical antibiotic solutions and ointments Gentamicin Neomycin Polymyxin Sulfacetamide Ofloxacin ```

Answer 21

Redness Discharge Irritation Possible photophobia

Answer 22

Most are benign, with a self-limited process

Answer 23

Tetanus prophylaxis- indicated for foreign objects with dirt Eye patch- no longer indicated Antimicrobial therapy

Answer 24

suspected retained foreign body | suspected corneal ulcerations

Answer 25

``` Eye pain (occasionally described as severe) Tearing Sensation that a foreign body is present Inability to open effected eye Photophobia Pain with movement Blurred vision ```

Answer 26

``` At least two of these: Unilateral Ocular pain Nausea and Vomiting History of intermittent blurring or vision with halos At least three of these: IOP > 21 mmHG Conjunctival injection (bloodshot eye) Corneal epithelial edema mid-dilated nonreactive pupil shallower chamber in the presence of occlusion ```

Answer 27

Acetazolamide (Diamox)- Diuretic- reduce the amount of aqueous fluid (can use mannitol or glycerol as well) Topical beta blocker Topical alpha blocker Topical steroid Emergent opthamologic consultation (once pressure is down, laser peripheral iridectomy is the permanent cure)

Answer 28

Topical antibiotics- fluoroquinolones | Topical steroid- once you have confirmed its bacterial

Answer 29

Staphylococcal abscess on the upper and lower eyelid

Answer 30

localized edema acutely tender pain is proportional to the amount of edema

Answer 31

based on physical findings alone, no tests need to be run

Answer 32

Warm compress Bacitracin or erythromycin I/D

Answer 33

A granulomatous inflammation of a meibomian gland | May follow a hordeolum

Answer 34

``` May not be any Visual distortion if large enough Itching Hard, non-tender cyst red conjunctiva ```

Answer 35

Incision and curettage

Answer 36

A chronic, bilateral inflammation of the lid margins

Answer 37

Staphylococcus, Seborrhea, Meibomian gland dysfunction

Answer 38

``` Irritation Burning Itching Erythema Crusting of lid margins Red rimmed eyes ```

Answer 39

``` Clean scalp and eyebrows removal of scales antibiotic ointment expression of meibomian gland systemic antibiotics topical steroids ```

Answer 40

inflammation over the posterior surface of the lids and up over the sclera to the cornea

Answer 41

Watery discharge

Answer 42

Symptomatic treatment only

Answer 43

an abnormal progressive opacity of the eye causing visual blurring and decrease in acuity (occurs in 46% of people age 75-85)

Answer 44

``` Age Congenital Systemic disease (diabetes) Systemic corticosteroid use Substance abuse (tobacco, alcohol) ```

Answer 45

``` Enhanced glare decrease in vision painless Loss of red reflex Opacity ```

Answer 46

Lens replacement- only definitive treatment (Contact lenses magnifying glasses- in interim while waiting for surgery)

Answer 47

``` Bacterial infection (gram negative bacteria) Recent water exposure (swimmers ear) Mechanical trauma (Qtip use) Fungal infection (will look like tiny poppy seeds in the external canal ```

Answer 48

Otalgia Pruritis Purulent discharge

Answer 49

Remove exudate (warm water lavage) Topical otic drops Protect from moisture

Answer 50

Cortisporin Aminoglycoside and anti-inflammatory Cipro

Answer 51

``` Decreased hearing Otalgia Fever Pressure Vertigo Nausea/vomiting ```

Answer 52

A bacterial infection of the mucosally lined air contained spaces of the temporal bone

Answer 53

Streptococcus H. Flu M. Catarrhalis Often follows a viral Upper respiratory infection

Answer 54

Erythematous tympanic membrane (TM) Bulging or retration Occasional bull Decreased TM movement

Answer 55

``` Amoxicillin Cephalexin Septra (for beta lactase producing bug) Ceclor Cipro Nasal decongestant ```

Answer 56

a blocked eustachian tube and an inability to equalize the pressure. May be precipitated by allergy, barotrauma, neoplasm or subacute infection

Answer 57

``` Hearing loss Ear fullness Popping sounds with pressure changes Air bubble posterior to the TM Decreased membrane mobility Changes in Rinne, Weber (conductive hearing loss) ```

Answer 58

Oral decongestants

Answer 59

chronic otitis media from prolonged auditory tube dysfunction, chronic middle ear pressure which creates a a sec which causes chronic infection and can eventually erode into the bone.

Answer 60

Hearing loss Dependent on the degree of bone erosion Tympanic membrane retraction or perforation

Answer 61

Surgical- removal of the sec

Answer 62

Medication Middle ear infection CNS disorder Labyrinthitis

Answer 63

``` Room spinning Sensation of falling Nausea/vomiting Tinnitus Hearing loss ```

Answer 64

Serum B12 Medication levels to check for toxicity (digoxin) CT/MRI of the head Syphillis testing

Answer 65

Diazepam- for acute symptom management Antihistamines Anticholinergics Antiemetics

Answer 66

``` Due to something blocking the conduction of sound Cerumen impaction Foreign body Otitis media Otosclerosis Cholesteatoma ```

Answer 67

Correct the source of blockage

Answer 68

Neuro problem, can get overlap with vertigo ``` Acoustic neuroma Meniere's disease (if hearing loss and vertigo think) Presbycusis Syphilis CNS disease Medication toxicity ```

Answer 69

Refer to ENT

Answer 70

"Viral Rhinitis" | Caused by Rhinovirus and adenovirus

Answer 71

``` sore throat fever malaise anorexia myalgia ```

Answer 72

Epstein-barr virus

Answer 73

Posterior cervical chain lymphadenopathy Exudative tonsillitis Splenomegaly Rash

Answer 74

Supportive care | Corticosteroids

Answer 75

Monospot will be positive Lymphocytic leukocytosis Early rise in IgM Permanent rise in IgG

Answer 76

``` Pain and pressure over the maxillary sinuses, worse with dependent head positions Headache Toothache Discolored nasal discharge Postnasal drip and cough ```

Answer 77

X-ray may show thickening of the sinus mucosa with or without air/fluid levels Head CT is more sensitive but more expensive You can culture the nasal discharge

Answer 78

``` Amoxicillin Bactrim DS Ceclor Afrin nasal spray Guaifenesin Sudafed ```

Answer 79

10-21 mmHG

Answer 80

``` Initially asymptomatic Cupping of the disc Constriction of visual fields Central vision is good until late IOP > 21 (30-50) ```

Answer 81

``` Beta blockers Carbonic anhydrase inhibitors (Trust, adopt) Prostaglandin analogs (Xalatin) Adrenergic agonists (Alphagan, iodine, propine) Cholinergic agonists (Pilocar, isopto carbachol) ```

Answer 82

Respiratory support Gastric lavage Nalaxone 5 ug/kg IV then 2-20 mg if unresponsive

Answer 83

Nausea/vomiting RUQ pain at 24-48 hr Hepatotoxicity- jaundice prolonged bleeding time, hepatic encephalopathy

Answer 84

``` Blood levels 4 hours after ingestion Induce emesis/gastric lavage Activated charcoal N-acetylcysteine Blood levels every 4 hours ```

Answer 85

``` Drowsiness Ataxia Confusion Slurred speech Unsteady gait Respiratory depression Hypoactive reflexes ```

Answer 86

Monitor BP and support respirations Gastric lavage Flumazenil

Answer 87

``` Insomnia Irritability Dry mouth Anorexia Arrhythmias Chest pain heart block HTN Seizures ```

Answer 88

``` Induce emesis (Ipecac) NS lavage Activated charcoal Reduce stimuli Administer Chlorpormazine or diazepam Beta blockers ```

Answer 89

``` Respiratory depression Nystagmus Mydriasis Diplopia Coma Seizure Tachycardia Hypotension Hypoglycemia ```

Answer 90

ABCs HD for severe toxicity IV glucose Thiamine, multivitamin, folic acid

Answer 91

``` Nausea Vomiting Diarrhea Dizziness Blurred Vision Bradycardia Hypotension Cardiovascular collapse Tinnitus Hearing loss Confusion Delirium Psychosis Seizures ```

Answer 92

12 lead and tele Charcoal Atropine, overdrive pacing, Isuprel

Answer 93

``` CNS depression Drowsiness Confusion Coma Hypothermia Respiratory depression Respiratory acidosis Absent DTR, gag, corneal Miosis ```

Answer 94

Maintain airway charcoal within 1 hour of OD Insert NGT hemodynamic support

Answer 95

``` Bradycardia Hypotension CNS depression Coma Bronchospasm Myocardial depression Cardiogenic shock Heart failure ```

Answer 96

``` ABCs Glucagon Charcoal or whole bowel irrigation Calcium IV Monitor K and glucose Treat hypotension Temporary pacing ```

Answer 97

``` Bradycardia Conduction disturbances hypotension cyanosis seizure coma death ```

Answer 98

``` IV calcium Glucagon Atropine, Isuprel Aggressive GI decontamination Activated charcoal Insulin with glucose Tele monitoring ```

Answer 99

``` Dysrhythmias Cardiac arrest Heart failure Respiratory depression hypoxia ```

Answer 100

100% oxygen | Hyperbaric oxygen for carboxyhemoglobin level greater than 25%

Answer 101

``` N/V/D Blurred vision Green halos Anorexia Abdominal pain Fatigue Dizzy Hallucinations ```

Answer 102

Maintain high normal K levels Lidocaine for dysrhythmias Activated charcoal Digibind

Answer 103

``` N/V/D Muscle weakness tremor rigidity ataxia dementia delirium ```

Answer 104

``` Saline bolus No charcoal Gastric lavage Supportive care Diuretics for levels > 2-3 HD for levels > 4 Benzos for seizures ```

Answer 105

``` Tachypnea cyanosis metabolic acidosis respiratory alkalosis dehydration hyperthermia ```

Answer 106

``` Monitor serum concentrations and electrolytes volume replacement activated charcoal Sodium bicarb HD ```

Answer 107

Shallow respirations Respiratory depression Pinpoint pupils Coma

Answer 108

``` Miosis Seizures paralysis coma bradycardia conduction defect respiratory depression/paralysis ```

Answer 109

Maintain airway Wash skin thoroughly Activated charcoal if ingested Atropine 2 mg IV every 15 min (up to 40 mg/day not uncommon) until atropinization (flushing, dry mouth, dilated pupils, tachycardia) Pralidoxime (reverse nicotinic signs such as muscle weakness and respiratory depression- not for asymptomatic patients) Urinary catheter

Answer 110

``` Dystonia Extrapyramidal symptoms (rigidity, stiff neck, hyperreflexia) Deep sleep Neuroleptic malignant syndrome urinary retention Hypotension AV block widened QRS prolonged QT ```

Answer 111

Activated charcoal Benzotriptine mesylate (cogent)- for EP signs Dantrolene for Neurleptic malignant syndrome Supportive care Vasopressors

Answer 112

``` Hallucination Confusion Blurred vision AMS Urinary retention tachycardia hypotension seizures arrhythmias ```

Answer 113

``` activated charcoal sodium bicarb to target pH 7.5-7.55 Benzos for seizures Ativan for rigors Cyproheptadine for delirium, skeletal muscle tone Montior for hypotension ```

Answer 114

``` Vomiting Hematemesis Restlessness Agitation Irritability Tachycardia PVCs Atrial arrhythmias Seizures ```

Answer 115

``` Airway Treat arrhythmias Activated charcoal until level less than 20 Consider whole bowel irrigation Ativan for seizures ```

Answer 116

severe hemorrhage

Answer 117

For heparin- given protamine For coumadin- give Vitamin K for FFP No antidote for other anticoagulants

Answer 118

``` drowsiness Ataxia metabolic acidosis pupillary dilation hypotension rapid pulse ```

Answer 119

Correct acidosis Administer folic acid HD for severe cases

Answer 120

``` Euphoria Nausea Seizures CNS depression Progressive metabolic acidosis Flank pain Tubular necrosis Renal failure ```

Answer 121

Maintain ABCs Fomepizole every 12 hours until methanol levels below 20 Bicarb infusion To facilitate metabolism (Pyridoxine, thiamine, magnesium) In severe cases- HD

Answer 122

Painless visual changes Floaters Light flashes Blurred vision

Answer 123

Immediate Ophthalmologist referral

Answer 124

Gram stain Giemsa stain Culture Single dose ceftriaxone

Answer 125

Gentamicin | Sulfacetamide

ED/Trauma Flashcards

(153 cards)