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Step2CK > EM Surg Uworld > Flashcards

EM Surg Uworld Flashcards

1
Q

eschar causes compartment syndrome

A

do escharotomy

if Sx don’t improve then fasciotomy

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2
Q

lithium in pregnancy

A

ebstein anomaly
malformed inferiorly attached tricuspid valve
causes right ventrilce to become part of right atrium

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3
Q

lithium in second or third trimester

A

goiter

transient neonatal Neuromuscular dysfunction

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4
Q

Tx tourette

A

risperidone

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5
Q

Sx iron poisoning

A

abdominal pain, comiting, diarrhea, hypotensive shock with reflex tachycardia
metabolic acidosis

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6
Q

Dx findings for iron poisoning

A

anion gap metabolic acidosis and radiopaque pills

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7
Q

Tx iron poisoning

A

whole bowel irrigaiton
deferoxamine
supportive ABC

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8
Q

aspiritn OD

A

tinnitus, fever, hyperapnea (respiratory alkalosis) and metabolic acidosis

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9
Q

acute OD of vitamin A

A

nausea vomiting and blurry vision

can lead to pseudotumor cerebri (ICP)

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10
Q

vit D toxicity

A

hypercalcemia: n/v confusion, polyuria and polydipsia

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11
Q

vit K toxicity

A

hemolytic anemia and hyperbilirubinemia in infants

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12
Q

when to kids have imaginary friends

A

2-6 years old

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13
Q

how does NaHCO3 help with TCA OD

A

sodium alleviated depressant action on myocardial Na channels

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14
Q

signs of TCA OD

A

mental status changes
seizures and resp depression
sinus tachy, hypotension
prolonged PR QRS QT
arrhythmias
dry mouth, blurred vision, dilated pupils
urinary retention, flushing, hyperthermia

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15
Q

Tx TCA OD

A

O2
IV
activated charcoal if within 2 hours
IV NaHCO3 for QRS widening or arrhythmia

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16
Q

methanol toxicity

A

nausea, HA vomiting, epigastric pain

can cause vision loss and coma

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17
Q

what ingestion causes extremely low bicarb and metabolic acidosis

A

methanol ingestion and ethylene glycol ingestion

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18
Q

hyperemic optic disc

A

methanol ingestion

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19
Q

what causes heat stroke

A

inadequate/failure of thermoregulation

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20
Q

screening serum lead is elevated in child, next step

A

measure venous lead

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21
Q

when is chelation Tx given for lead poisoning

A

> 45 ug/dL

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22
Q

Tx trichotillomania

A

CBT

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23
Q

target rate for rewarming patient with hypothermia

A

1-2 C/hr

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24
Q

benzo OD signs

A

slurred speech
ataxia
drowsiness

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25
Q

what to use of neuroleptic malignant syndrome

A

dantrolene

then bromocriptine and amantadine

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26
Q

what drugs cause neuroleptic malignant syndrome

A

haloperidol

and aytpicals like risperidone

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27
Q

PCP intoxication

A

hallucinations, dissociative feelings, agitaiton, confusion, pupillary dilation tachy and nystagmus

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28
Q

patient beginint to have alcohol withdrawl

A

give chlordiazepoxide (librium) its a benzo and used for this

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29
Q

next step after caustic ingestion

A

upper GI endoscopy within first 12-24 hours in hemodynamically stable patients

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30
Q

if suspect perforation after ingestion caustic material

A

abcominal XR with water soluble contrast

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31
Q

smoke inhalation at risk for

A

cyanide poisoning and carbon monoxide poisoning

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32
Q

Tx cyanide poisoning from inhalation

A

hydroxocobalamin

Na thiosulfate

33
Q

what induce methemoglobinemia

A

nitrites

34
Q

acute toxicity cyanide

A

HA, vertigo, dizziness, hyperventilation,t achy nausea and vomiting
Cv and resp depression
coma, seizures, brady, hypotension and cardioresp arrest

35
Q

how do nitrites induce methemoglobinemia

A

increase ferric iron Fe3+ in circulating Hb and cyanide binds this

36
Q

how does cyanide cause lactic acidosis

A

inhibit ETC in mitochondria blocking production ATP from ox phos
forces anaerobic metabolism
causes tachypnea and fall in arterial PaCO2

37
Q

effects of heroin and methadone on fetus

A

IUGR, macrocephaly, SIDS, neonatal abstinence syndrome

38
Q

neonatal abstinence syndrome

A

first few days of life with irritability, high pitch cry, poor sleeping, tremors, seizures, sweating, sneezing, tachypnea, poor feeding, vomiting and diarrhea

39
Q

signs of ethylene glycol ingestion

A

flank pain, hematuria, oliguria cranial nerve palsies and tetany

40
Q

lab results in ethylene glycol ingestion

A

high osmolar ga
high anion gap metabolic acidosis
Ca oxalate crystals in urine

41
Q

Tx for ethylene glycol ingestion

A

fomepizole which competetively binds alcohol dehydrogenase
NaHCO3 for acidosis
hemodialysis may be required

42
Q

signs opioid withdrawl

A

n/v/d cramps dysphoria restlessness rhinorrhea, lacrimation, myalgias and arthralgias
mydriasis, goose bumps, hyperactive bowel sounds

43
Q

Tx withdrawl opioid

A

methadone

44
Q

bath salt intoxication

A

severe agitation, combativeness, psychosis, delirium, myoclonus and rarely seizures

45
Q

signs of CO poisoning

A

HA, n/v abdominal pain, confusion, coma

pink hue to skin color

46
Q

Tx CO poisoning

A

hyperbaric O2

47
Q

which antipsychotic can contribute to hypothermia

A

fluphenazine because it inhibits the body’s shivering mechanism and autonomic thermoregulation

48
Q

Patient with tourrettes is most likely to develop what at later age

A

ADHD and OCD

49
Q

patient with normal labs but claims to have taken lots of acetominophen 2 hours ago

A

give activated charcoad if within 4 hours of ingestion

50
Q

how long can acetominophen intoxication be asymptomatic

A

24 hours

51
Q

signs of benadryl toxicity

anticholinergic

A 
dry mouth
blurry vision
hyperthermia
urinary retention
decreased bowel sounds
52
Q

serotonin syndrome

A

tachy hyperthermia, inc bowel sounds, HTN, metnal statu changes, dilated pupils and clonus or hyperreflexia

53
Q

what do people die from in TCA Od

A

TCA induced hypotension

54
Q

what is buspirone

A

anti anxiety drug

55
Q

Cyanide poisoning

A

HA vomiting, abdominal pain and flushed skin

inhalational can cause bitter almond odor

56
Q

thoracic GSW and FAST exam was limited due to body habitus

next step

A

ex lap

57
Q

US shows blood in peritoneal cavity in hemodynamically unstable patient

A

urgent laparotomy

58
Q

CT shows ruptured aorta with blood collection in adventitial layer
next step

A

exploratory abdominal surgery

59
Q

hemodynamically stable patient with US showing blood in spleno renal angle after MVA
next step

A

CT scan

60
Q

chronic growth on hard palate of mouth

A

torus palatinus

61
Q

patient had last tetanus shot 12 years ago and has deep laceration from rusty barbed wire fence
next step

A

administer tetanus diptheria toxoid vaccine only

62
Q

when do you give tetanus Ig

A

if dirty or severe wound in unimmunizaed, or less than 3 tetanus toxoid doses

63
Q

preferred airway in someone with facial lacerations or temporal skull fracture but no significant facial trauma

A

orotracheal

64
Q

what intubation is contraindicated with basilar skull fractures

A

nasotracheal

65
Q

MVA accident and BP not responding to IV fluids

abdominal distention and absent bowel sounds

A

go to surgery ex lap

66
Q

post MVA
persistent pneumothorax despite chest tube placement
subcutaneous emphysema

A

tracheobronchial performation

67
Q

components of glascow coma scale

A

eye opening, verbal response

motor response

68
Q

management penile fracture

A

retrograde urethrogram followed by surgical exploration of penis

69
Q

next step after seeing pneumoperitoneum (air under diaphragm) on CXR

A

abdominal CT

70
Q

complicaiton of rhinoplasty that results in whistling noise during rsepiration

A

septal perforation from a hematoma

71
Q

penetrating injury to abdomen

A

ex lap

72
Q

how to identify splenic injury

A

abdominal CT with contrast if patient is stable

73
Q

blunt abdominal trauma, FAST is negative
8 hours later has LUQ pain with left shoulder pain and mild nausea, low BP and tachycardia
fluids help a little

A

splenic injury

74
Q

what is msot sensitive vital sign for blood loss

A

heart rate

75
Q

abdominal pain that refers to the shoulder

A

peritonitis and irritation of diaphramg. kehr sign

‘

76
Q

which part of bladder is convered by peritoneum

A

the dome is the only park

77
Q

bladder area most susceptible to rupture from blunt trauma if bladder is distended

A

dome

78
Q

nasopharyngeal carcinoma is associated with what

A

EBV
mediterranean or far eastern descent
smoking
nitrosamine consumption (salted fish)

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