Emed Objectives Flashcards
(231 cards)
1
Q
Middle aged pt w uncontrolled HTN and tearing pain radiating to back
A
aortic dissection
2
Q
Aortic dissection GS test
A
CT angiography
3
Q
MC EKG finding in PE
A
tachycardia
4
Q
PERC Criteria
no to all = 1.8% chance of missing PE
A
Sa O2 <95%?
Unilateral leg swelling?
HR > 100 BPM?
Recent surgery or trauma?
History of DVT or PE?
Hemoptysis?
Age >50 years old?
Current hormone use?
5
Q
Corneal abrasion tx for contact lens wearer
A
Pseudomonas coverage (moxifloxican) + no contacts for2 wks or until optho okays
topical analgesia in ER only
6
Q
TOC for 25 yof healthy c/o lump down there, PE- fluctuant, erythematous lump 4 cm
A
I and D is TOC and definitive tx
7
Q
First tx for 14 yo type 1 diabetic high glucose Likely DKA
A
Fluids
8
Q
When evaluating the metabolic status of pt with hyperglycemia what lab value must be corrected
A
serum sodium because hyperglycemia lowers it
9
Q
Preferred O2 tx for unstable pt due to respiratory issues (such as COPD) and fatigued
A
NO intubation bc hard to wean off vent
Try Bi-pap instead
10
Q
PE diagnostic test if high risk
A
CT Pulmonary Angiography
11
Q
Vesicles on the tip of the nose
A
Herpes zoster ophthalmicus
12
Q
Tx for UTI in preg woman
A
Cephalosporins -Cephalexin 500 mg 4 times daily OR
Ampicillin 500 mg 4 times daily OR
Nitrofurantoin 100 mg twice daily OR
Aminoglycosides (Gentamycin or Tobramycin)
13
Q
Abx to avoid in pregnancy
A
Tetracyclines (adverse effects on fetal teeth and bones and congenital defects)
Bactrim - TMP/SMX in the first trimester (facial defects and cardiac abnormalities)
Chloramphenicol (gray syndrome)
Sulfonamides in the third trimester (hemolytic anemia in mothers with glucose-6-phosphate dehydrogenase [G6PD] deficiency, jaundice, and kernicterus)
14
Q
First line tx for young healthy female w/ UTI
A
Bactrim 160 mg/800 mg 1 tablet PO BID for 3d (use when bacterial resistance is < 20% and patient has no allergy) OR
Nitrofurantoin 100 mg PO BID for 5-7d or
15
Q
When should you NOT perform a speculum exam
A
Painless vag bleeding >20 wks
16
Q
Dx for abscess in neck
A
CT soft tissue w/ IV contrast to look for fluid collection
17
Q
s/r for face
A
3-5 days
18
Q
s/r for LE
A
8-12 d
19
Q
s/r for torso/UE
A
7-10 d
20
Q
s/r for scalp
A
7 d
21
Q
s/r for joints
A
10-14 d
22
Q
Hyperkalemia tx
A
Calcium gluconate if they have EKG changes*** + the following:
insulin quick (can give now)
Calcium gluconate if they have EKG changes*
Kayexalate - takes longer so not good if emergent
Bicarb
23
Q
Necrotizing otitis externa tx
A
admit bc need IV abx (mc cause is pseudomonas)
24
Q
Standing for LT, cramped, hot, a lot of people and pass out
A
vasovagal syncope
25
```
Abrupt LOC w/ facial trauma, no defensive wounds
No prodrome (or v brief)
Assoc w/ phys activity or exercise
```
cariogenic syncope
26
Postictal
5-30 min
drowsiness, confusion, nausea, hypertension, headache or migraine, and other disorienting symptoms
27
Bronchitis tx
fluids and rest ± antitussives in adults
inhaler, corticosteroid if not responsive to inhaler
28
Reversible Causes of cardiac arrest
Hypovolemia, hypoxia, H+ ion (acidosis), hypo/hyperkalemia, hypothermia
Cardiac Tamponade, toxins, thrombosis (pulm and coronary)
29
typical exam finding for Addisons
Bronzed skin mostly in palms and skin folds
30
Floaters
Vitreous detachment
31
Painless, sudden monocular vision loss, cherry-red fovea
Central retinal artery occlusion
32
Painless monocular vision loss, preceding floaters, curtain effect, usually periph 1st
Retinal Detachment
33
Most SENSITIVE way to find out if someone has SAH
LP is most sensitive
Do non-contrast CT first to r/o mass effect due to herniation risk
34
Confused, lethargic, slurred speech what should you do first
First thing you would do is check glucose (quick and can do it now for pt with AMS)
35
Coughs and common cold tx
Supportive, inhaler
36
Who should we NOT give supplemental oxygen to
Heavy smokers, COPD pts → if you put them on oxygen they stop breathing on their own and can't get them off → oxygen-induced hypercapnia
Balance the need for inc Pa02 against the possibility of producing hypercapnia
Pts w/ chronic respiratory acidosis rely on hypoxia for respiratory drive
37
Acute CP lat to affected side, unilat ↓ or absent breath sounds, hypotension, hyper-resonance
pneumothorax
38
CXR→ focal consolidation, effusions (mc bacterial)
pneumonia
39
Cough, dyspnea, CP, ↓ breath sounds, LE edema, orthopnea, night sweats, unintentional weight loss, fever, pleuritic chest pain, dullness to percussion, egophony, pleural friction rub and effusion on CXR
pleural effusion
40
Q waves/ST elevation V1-V4
Anteriorseptal
LAD
41
Q waves/ST elevation V1 and V2
Septal
Proximal LAD
42
Q waves/ST elevation I, avL, V5, V6
lateral
CFX
43
Q waves/ST elevation I, aVL, V4 + V5 + V6
anterolateral
Mid LAD or CFX
44
Q waves/ST elevation II, III, avF
inferiot
RCA
45
ST depression in V1-V2
posterior
RCA, CFX
46
Contralateral leg weakness > arm weakness
Anterior Cerebral Artery (ACA)
47
Deficits may be hidden until formally tested
Light-touch and pinprick sensation may be markedly ↓
May have visual cortex defects
Posterior Cerebral Artery (PCA)
48
If in dominant hemisphere (left for most ppl) → aphasia
Homonymous hemianopia→visual field loss on the same side of both eyes
Middle Cerebral Artery (MCA)
49
Tx for OM
1st line: Amoxicillin 500 mg po tid x 7-10d
2nd line: Augmentin 875 mg po bid x 7-10 d
If PCN all → azithromycin, clarithromycin, clindamycin
50
Tx for OE
Acetic acid soln, Neomycin, polymycin B, ofloxacin, clotrimazole
51
Tx for TM perd
Keep dry, refer to ENT, cortisporin otic suspension 1 drop qid or cipro ophthalmic 1 drop qid (abx controversial and only necessary if inf sus)
52
Otorrhea, hearing changes, tinnitus, pain
TM perf
Weber lateralizes to side of perf
53
Tx for cerumen impactation
Curette, warm water irrigation (unless TM perf), wax softeners (Debrox)
54
Vertigo tx
IV hydration
1st line: Meclizine 25-50 mg po q8-12 h or diazepam 5-10 mg IV 2-4 mg Ima, diphenhydramine 50 mg IM or po q6-8h
55
Unilateral hearing loss, tinnitus, vertigo w/ sudden onset and short duration (intense, N/V, distress)
Meniere’s disease
56
Meniere’s disease tx
low salt diet, meds for vertigo, some need surg
57
Mastoiditis tx
ENT, admit, IV abx (cefotaxime 1 g IV q 24 h or ceftriaxone 1-2 g IV q24h)
58
Barotrauma tx
Open eustachian tube → gum, Valsalva, yawn
Antihistamines, decongestants, abx to prevent inf
59
Foreign body tx
Irrigation (safest), suction, alligator forceps, acetone (Styrofoam or glue)
Antibiotic drops if trauma (dexamethasone)
60
Allergic rhinitis tx
Nasal steroids, oral antihistamines
61
mc location of epistaxis bleeding
MC in anterior septum/Kiessellbach’s Plexus
62
MC arterial source of posterior bleed
sphenopalatine artery
63
Anterior epistaxis tx
direct pressure 20 min, oxymetazoline pretreat
Topical anesthesia, vasoconstrict, cauterize → bacitracin x 1 wk
Pack for 24-48 h
64
Posterior epistaxis tx
packing 72-96 h, taper deflate balloon
Complications: necrosis of nasal ala → protect w/ gauze
65
Bacterial sinusitis tx
cephalosporins, macrolides
66
Viral sinusitis tx
sx treatment, intra-nasal corticosteroids
67
Foreign body tx
Topical vasoconstrictors, suction, balloon cath, alligators, + pressure
68
Tooth fx tx
irrigate, dry and cover w/ ca hydroxide paste + dental referral
69
Tooth avulsion tx
milk, replant immediately, splint tooth, 5 d abx pphx
70
Dental abscess tc
I& D, abx, pain control
71
Acute tonsillitis tx
IV fluid, pain control, steroids and abx
72
grey exudate, cranial and periph neuritis
Diphtheria
73
Lateral, worsening sore throat, erythema, drooling, unilat uvular deviation
peritonsillar abscess
74
gold standard for peritonsillar abscess diagnosis
collection of pus from abscess through needle aspiration
75
Tx for peritonsillar abscess
I&D or needle asp, abx, fluids, steroids
76
Enlarged, painful salivary gland, purulent drainage, fever, ↓ saliva
Sialadenitis
77
Sialadenitis tx
heat/cold compress, aggressive hydration, lemon drops
Pen VK 250-500 mg qid, erythromycin 250 mg qid, Augmentin
78
Formation of hardened deposits in ductal salivary gland system due to stagnation
Colicky postprandial pain and swelling
Sialolithiasis
79
Sialolithiasis tx
lemon drops, citrus juice, Abx for S. aureus, Nsaids, warm compress
80
most sensitive diagnostic test for organic foreign matter
US
81
wound is closed by us at or near the time of injury
Primary Intention
82
How long do you have to close face wound
must close w/in 24 hr
83
Time limit for primary intention closure
8 h
84
wound closes by natural process
Secondary Intention
85
wound prepped in ER → repaired later by us
Tertiary Intention (delayed primary)-
86
What wounds should you allow to heal by tertiary intention
Good for high bacteria load or delayed access to definitive care
Clean→ 72-96 h re-irrigate → close
87
Healing Continuum
Initial epithelization within 24-48 h
Peak collagen btwn 5-7 d
Continue to heal over next 12 mo
88
CI to anesthetic agent for wounds
Epi in fingers, toes, nose, genitalia, ↓ blood flow, blanching affects align
Cardiac or vascular dz pts, pts on propranolol
Bupivacaine in preg
89
What sutures should you avoid in contaminated wounds?
gut and silk
90
Sutures for fact
6- or 7-0
91
Suture for low tension
5-0
92
High tension suture (scalp)
3-0 or 4-0
93
Alt method to wound mgmt for linear low ten facial wound
glue
94
When should tetanus be given for wounds
>7 yr since last
Tdap preferred
95
Animal bites mgmt
Loosely close (if <8 hr) or delay primary closure
Amoxicillin-clavulanate or fluoroquinolone + clinda (if PCN all) x 3-5 d
96
Monkey bite tx
Valtrex/acyclovir x 14 d
97
ST depression (horizontal, down/upslope) and T wave inversion
Positive cardiac enzyme
Non-STEMI
98
NSTEMI mgmt
PCI w/in 72 h
Antithrombotic therapy→ Aspirin, clopidogren, UFH, enoxaparin
Adjunctive therapy→ Beta blockers (metoprolol), Nitrates, morphine, CCB
99
UA and NSTEMI mgm
Antithrombotic therapy→ Aspirin, clopidogren, UFH, enoxaparin
Adjunctive therapy→ Beta blockers (metoprolol), Nitrates, morphine, CCB
100
STEMI mgmt
Reperfusion therapy w/in 12 hrs onset
PCI w/in 3 h or thrombolytic (rTPA) w/in 12h
Antithrombotic → aspirin (chewed) or heparin
Adjunctive → beta blocker, ACEI*
If cocaine induced avoid beta blockers → vasospasm risk
101
MONA LISA
morphine, O2, nitrates, anti-platelet/coag, L v R, intervene, statin, activate PCI
102
Nitrates action
↓pre/afterload do not give if SBP <90, inf infarct or ED drugs)
103
Morphine
↓HRandSBP
104
Why should you avoid NSAIDs w/ STEMI?
block PG→ ↑ platelet aggregation (bad)
105
GS for DVT
Venography
106
DVT 1st line diagnostic test
venous duplex US
107
DVT tx
Anticoag w/ heparin or warfarin
108
Superficial thrombophlebitis tx
Supportive mgmt. (warm compress, elevation, NSAIDs, comp stock)
109
Leg pain, brown hyperpigmented, worse w/ standing
Chronic Venous Insufficiency
110
Chronic Venous Insufficiency tx
compression
111
GS diagnostic test for aortic aneurysm
Angiography
112
Thoracic Aortic aneurysm TOC
CT scan
113
TOC for aortic dissection
GS test for aortic dissection
TOC = CT w/ contrast
GS= CT angiography
114
Harsh/rumble
Stenosis
115
Blowing
Regurgitation
116
what murmur radiates to carotids
AS
117
what murmur radiates to L upper sternal border
AR
118
What murmur radiates to axilla
MR
119
Systolic ej crescendo-decrescendo @ RUSB radiates to carotid (high pitch)
↑ murmur w/ ↑ venous return → squat and lean forward
↓ murmur w/ ↓ venous return→ Valsalva
Aortic Stenosis
120
AS TOC
Surg mgmt aortic valve replacement
AVOID phys activity/vasodilators (nitrates), diuretics, beta block, CCB
121
Diastolic, decrescendo, blowing murmur max @ LUSB (high pitch)
Aortic Regurgitation
122
Aortic Regurgitation mgmt
definitive tx
afterload reduction w/ vasodilators (ACEI, ARB, Nifedipine)
No b blockers
Definitive tx is surgery
123
MC cause of Mitral stenosis
Rheumatic heart dz
124
Early-mid diastolic rumble @ apex (low pitch) *esp in LLD
MS
125
MS tx
Percutaneous balloon valvuloplasty/valvotomy or MV repair
b blockers/CCB, manage A fib and anticoagulate
126
mc valvular dz in western world
Mitral Regurgitation
127
Blowing, holosystolic murmur @ apex w/ radiation to axilla (high pitch)
Mitral Regurgitation
128
Mitral Regurgitation tx
Surgical repair preferred over replacement
Vasodilators to ↓ afterload (ACEI, nitrates, b block)
129
ECG→ diffuse ST elevations in V1-V6
Pericarditis
130
Pericarditis tx
Nsaids, or aspirin x7-14d (Colchine 2nd line)
± Corticosteroids if sx >48 hr and refractory
131
ECG → low voltage QRS
Distant muffled heart soudnds
Pericardial effusion
132
Pericardial effusion tx
± pericardiocentesis
133
distant muddled heart sounds, ↑JVP, hypotension
Pericardial tamponade
134
Pericardial tamponade tx
Immediate pericardiocentesis*, aggressive fluids
135
Unstable radycardia mgmt.
atropine
transvenous pacing (TVP), LT mgmt. = pacemaker
136
Unstable tachy arrhythmia tx
cardioversion (need to anticoag)
137
stable tachy arrhythmia tx
rate control (CCB vs b blocker) + anticoag
138
V tach tx
immediate cardioversion + rhythm control w/ amiodarone
139
V fib tx
shock + amiodarone
140
HTN Emergency
Labetalol, nitro + metoprolol or loop diuretic
141
Esophageal foreign body tx
Tx: glucagon 1 mg IV → relax esophagus, endoscope to gently push
Disc batteries out ASAP, sharp or long (>5cm) may need removal
142
Viral Gastroenteritis tx
Rehydrate (po or IV), anti-emetics, probiotics, BRATY diet
143
Bacterial Gastroenteritis tx
Rehydration po but IV faster, abx, diaper cream, probiotics, BRATY
144
Epigastric pain boring through stomach to back, N/V, improved if supine, fever, tachy, hypotension, toxic/sig pain
Pancreatitis
145
Pancreatitis tx
Pain control, NPO, aggressive IVF, generally no abx (even if febrile)
146
Bright red blood on vomiting, coffee grounds emesis
Melena (black and tarry)
Upper GI bleed
147
Upper GI bleed tx
Two large bore IVs (18g), aggressive fluid resuscitation, IV PPI, O2, NG tube low
suction, ICU consult
Endoscopy for dx and tx
If coagulopathy→ FFP
148
Bright red blood per rectum, maroon stools, ±abd pain
Lower GI Bleed
149
Lower GI Bleed tx
Two large bore IVs (18g), aggressive fluid resuscitation, O2, early transfusion, FFP if pt has coagulopathy, ICU/GI consult, endoscopy
150
MC cause of pneumonia in alcoholics
klebsiella
151
MC cause of pneumonia in IVDu
S. aureus
152
S. pneumo tx
PCN
153
Anaerobic pneumo tx
clindamycin
154
H. flu pneumo tx
3rd gen cephalosporin
155
Legionella pneumo tx
erythromycin
156
Klebsiella pneumo tx
ceftriaxone, carbapenems, aminoglycosides, quinolines
157
S. aureus pneumo tx
oxacillin
158
atypical pneumo tx
macrolides
159
PJP tx
Steroids if PAO2 <70 mmHg + Bactrim po or IV
160
MC lobe for aspiration pneumo
RLL
161
Virchows triad for PE
endothelial damage, venous stasis and hypercoagulability→ clot formation
162
PE tx
airway mgmt., anticoag, IV fluids for shock, dopamine for pressor, tPA
Anticoag stable→ Lovenox 1 mg/kg SQ, unstable → heparin
163
Acute CP lat to affected side, unilat ↓ or absent breath sounds, hypotension, hyperresonance
pneumothorax
164
Tension pneumo tx
immediate decompression
165
Central retinal artery occlusion tx
Emergency referral for ocular massage, intra-arterial fibrinolytic therapy
166
Acute angle-closure glaucoma
Emergent referral for iridotomy
Acetazolamide 1st line to ↓ IOP, topical Timolol, cholinergic
AVOID anti-cholinergic
167
Pupil mid-dilated, sluggish light reflex, photophobia, HA, nausea, steamy cornea
Acute angle-closure glaucoma
168
Unilateral, painless, visual blurring or vision loss or diplopia
Acute temporal arteritis AKA giant cell arteritis
169
Acute temporal arteritis AKA giant cell arteritis tx
high dose corticosteroids 40-60 mg x 4 wks then taper
Pphx w/ low dose aspirin, PPI, bisphosphonate, Ca and Vit D
170
Conjunctivitis tx
Atopy → topical antihistamines + vasoconstrictors
Bacterial → fluoroquinolone
Gonococcal → systemic late gen cephalosporin
Refer if CL or gonococcal for IV ceftriaxone
171
Pooled blood w/in aqueous humor of anterior chamber
Traumatic Hyphemia
172
Keratitis tx
topical NSAIDs, pphx topical abx- erythromycin ( viral), acyclovir po (HSV, VZV), topical fluoroquinolone (bacterial), irrigation
173
DKA tx
Stabilize w/ A,B, C
FLUIDS FIRST (slow unless in shock → several liters fast)
K+ Replacement
Insulin
Bicarbonate if arterial pH<6.9
174
Hyperglycemic Hyperosmolar Non-Ketotic Syndrome
Fluids, potassium, insulin (Goal is to ↓ by 50-70 mg/dL/hr bc risk cerebral edema*)
175
Hyperthyroidism tx
Beta blockers (atenolol 25-50 mg)
LT antithyroid drugs, radioiodine or surgery (methimazole or PTU)
176
Thyroid storm tx
FLUIDS→ 1L NS/hr
Vasopressor if hypotensive after fluid resuscitation o Phenobarbital for sedation
Fever → cool IV fluids, cool mist, antipyretics
Beta blockers
PTU 600-1000 mg 1st dose → 200-250 mg q4h
Lugol’s iodine 8 drops q6h after PTU
Corticosteroids→ hydrocortisone 100 mg IV q8h
Cholestyramine 4g.q6h
177
What should you AVOID in thyroid storm?
iodine contrast, amiodarone, NSAIDS, ASA and ketamine
178
Hypothyroidism tx
L-thyroxine or levothyroxine
179
Myxedema coma tx
supportive→ airway, fluid, glucose, Na replacement, warming
Rapid thyroid replacement (→ MI or arrhythmia risk)
IV T4 200-500 mcg over 1 hr then 50-100 mcg/d elderly
OR
T3 5-20 mcg/8 h for young or healthy
Broad spectrum abx→ vanc and Zosyn
Hydrocortisone 100 mcg/8hr
180
Shock refractory to fluids and vasopressors
Addisonian Crisis
181
dx TOC for Addisonian Crisis
ACTH Stim Test
182
Addisonian Crisis tx
Hydrocortisone 100 mg IV q8h
If previous dx → dexamethasone 0.1 mg/kg q8h
IV hydration→ 1-3 L NS
183
Pheochromocytoma mgmt
Supportive → IV fluid, O2 correct electrolytes
IV phentolamine 1 mg q5min→ ↑ to 5 mg q5min if no improv
CCB → IV nicardipine or IV Fenoldopam
Benzodiazepines →Lorazepam 1-2 mg IV or diazepam 5-10 mg IV)
Refer for tumor resection
184
Mc cause of mortality in first 12 wks of preg
ectopic preg
185
mc pelvic tumor
fibroids
186
MC GYN ca
uterine
187
Painful vag bleed >20wk
Abrupto placentae
188
Painless vag bleeding >20wk
Placenta previa
189
Abrupto txplacentae
Send to L/D→ emergent C-section
190
Placenta previa tx
Wkly U/S ,bedrest, c-section delivery
NO PELVIC EXAM
Corticosteroids btwn 23-34wk, rho-gam
191
GS for ovarian cyst dx
transvag US
192
PID tx
Ceftriaxone 250 mg IM x 1, doxy 100 mg po BID x 14 d
± metronidazole 500 mg po BID x 14 d
Treat partnets
No sex
193
Gray/white malodorous d/c, clue cells, whiff test
BV
194
BV tx
Metronidazole 500 mg po bid x 7days
195
Candida Vaginitis tx
Non-pregnant: fluconazole 150 mg po once or azole vag cream
Pregnant: vag azole cream (miconazole, fluconazole)
196
Profuse, pruritic, white/yellow/green, frothy, malodorous d/c, strawberry cervix,
motile/flagella
Trichomonas Vaginitis
197
Trichomonas Vaginitis tx
Metronidazole 2 g po x 1 *NO ETOH for 24 h
Treat partners
198
Chlamydia tx
Azithromycin 1 g po x 1 or doxy 100 mg po bid x 7days
199
Gonorrhea tx
Ceftriaxone 250 mg IM x 1 plus azithromycin 1 g PO x 1
200
Progestin only
w/in 72 h
201
Copper IUD
w/in 120 h
202
SE tx
Secure airway → give high flow O2
If blood sugar low → give glucose
If known alcoholic → consider thiamine
Lorazepam 2 mg IV q minute up to 0.2 mg/kg
If lorazepam doesn’t work → phenytoin 20 mg/kg IV at 50 mg/min
If neither work → phenobarbital/general anesthesia
203
Features required for diagnosis: of GB
Progressive weakness in arms and legs
Areflexia
204
GB tx
Admission to hospital (preferable w/ neuro critical care)
IV immunoglobulin or plasmapheresis (cheaper)
Watch close for intubation
Cardiac monitoring
Pain control → gabapentin, opiates
205
Abrupt onset, worst HA of my life or AMS, N/V, nuchal rigidity, photophobia
Subarachnoid Hemorrhage
206
Most impt initial test in dx of stroke
non-contrast CT scan
207
CT w/ ischemic stroke
hypodense area (dark)
208
Ischemic Stroke Algorithm
10 min→ immediate gen assessment and order CT
25 min →neuro assessment and perform CT
45 min→ interpret CT
1 hr→ initiate fibrinolytic therapy if
appropriate (aspirin if not candidate)
209
CT w/ hemorrhagic stroke
hyperintense/bright white (fresh blood) in known vascular distribution
210
SAH tx
Call neuro surg
Large bleed→surg decompression
Avoid ↑ ICP, manage HTN to avoid re-bleed
Nimodipine 60 mg po q6h to ↓ vasospasm
211
Crescent-shaped fluid over surface of brain
Sudden acceleration-deceleration of brain parenchyma w/ subsequent tearing of bridging veins
Subdural hematoma
212
Subdural hematoma tx
Neuro eval→poss blood evacuation
If low GCS → intubate
213
CSF otorrhea or rhinorrhea
Balloon shaped mass over surface of brain
Rupture of middle meningeal artery
Epidural hematoma
214
Sudden onset, severe unilat pain, swelling, N/V, high riding, absent cremasteric
Testicular torsion
215
Priapism tx
Ischemic *mc → intracavernosal sympathomimetic drug (phenylephrine) ± aspiration
Non-ischemic→ usually resolves spontaneously
216
Inability to retract foreskin
Phimosis
217
Phimosis tx
steroid cream or circumcision
218
Entrapment of foreskin behind glans
Paraphimosis
219
Paraphimosis tx
Manual reduction→ consider circumcision
220
Heaviness, unilat dull aching discomfort in scrotum, fevers, chills, ± radiation to ipsilateral flank, enlarged epididymitis
Epididymitis
221
Epididymitis tx
>35 yo→ ciprofloxacin 500 mg bid x10-14 d
<35 yo → ceftriaxone 250 mg IM x 1 then doxy 100 mg bid x 10 d
222
Soft NT, fullness of hemi-scrotum, trans-illuminates
Hydrocele
223
Hydrocele tx
elective surg
224
NT mass, does NOT illuminate, bag of worms
Varicocele
225
TOC for kidney stones
NON-contrast CT
226
kidney stone tx
Hydration (po or IV), analgesics (Toradol IV/IM)
227
Painless hematuria
Bladder ca
228
Flank pain, abd mass, wt loss, hematuria
RCC
229
Dysuria, pruritic, burning, discharge
Urethritis
230
Urethritis Tx
Signs of gonococcal→ Ceftriaxone 250 mg IM + azithromycin 1 g po x 1
W/o signs of gonococcal → Azithromycin 1 g po x 1 then doxy 100 mg BID x 7d
231
Prostatitis tx
Fluoroquinolone or Bactrim x 6 wks + NSAIDs for pain
