Emergency medicine Flashcards
(161 cards)
1
Q
deal with painOPQRST
A
OPQRST Onset Percipitating factor Quality Radiation Symptoms Temporal course/Treatment modalities
2
Q
in case of abdominal pain if the patient remebers the exact time of the pain onset what to think
A
perforation
3
Q
Management of female patient with an acute abdomen(4)
A
pelvic exam
pregnancy test
ectopic pregnancy
ovarian torsion
4
Q
localisation of Mc burney point
A
2/3 of the distance from the anterior superior illiac spine to the umbilicus
5
Q
Hamburger sign in appendicitis
A
if the patient wants to eat it’s not appendicitis
6
Q
psoas sign in appendicitis
A
passive extensionof the hip elicits RLQ pain
7
Q
obturator sign in appendicitis
A
passive rotation of the hip elicits RLQ pain
8
Q
rovsing sign
A
dep palpation of the LLQ elicits RLQ pain
9
Q
what to rule out in case of second and first rib /sternal fracture
A
aortic disruption
10
Q
rule of 9 (4)
A
head and each arm 9%
back and chest 18%
each leg 18%
perineum 1%
11
Q
Packland formula
A
4poids en Kg% BSA
12
Q
how to give fluid in burns(2)
A
50 % determine par packland formula during first 8 hours
50 % sur 16 hrs
13
Q
second leading cause of death in kids
A
burns
14
Q
Management of asystole(2)
A
epinephrine
atropine
15
Q
management of VFIB
A
desinchronised shock with 200,300 and 360 joules
16
Q
failure with external shock in VFIB(2)
A
epinephrine
or
vasopressin
17
Q
failure with epinephrine or vasopressin in VFIB(2)
A
lidocaine or
amiodarone
18
Q
failure with lidocaine or amiodarone in VFIB(2)
A
procainamide or
magnesium
19
Q
stable VTAC(2)
A
lidocaine
or
amiodarone
20
Q
unstable and pulseless VTAC
A
desynchronised shock
21
Q
rx of PEA(2)
A
epinephrine
or
atropine
22
Q
AFIB /flutter unstable
A
shock starting at 100j
23
Q
stable AFIB/flutter < 48 h(5)
A
control rate Calcium blocker digoxin b blocker plus rythm conversion
24
Q
stable afib/flutter > 48 h(5)
A
control rate Calcium blocker digoxin b blocker anticoagulateor perform TEE before rythm conversion
25
management of supraventricular tachycardia(SVT)
rate control
26
Means to control rate in SVT(3)
valsalva
carotid sinus massage
cold stimulus
27
resistant SVT to rate control next step
adenosine
28
bradycardia in mobitx 2 or 3 degree AV block
transvenous pacemaker
29
zone 1 du cou
en dessous du cartilage cricoide
30
zone 2 du cou
situe entre le cartilage cricoide et une ligne joignant les deux gognons
31
zone 3 du cou
situe au dessus de la ligne joignant les 2 gognons
32
trauma in zone 1 next step
aortography
33
trauma in zone 2 next step
surgical exploration if platysma is penetrated
34
trauma in zone 3 du cou next step
aotography and triple endoscopy
35
previuosly patient with chest trauma dies suddenly next step
air embolism
36
cuases of post op fever 5 W
```
Wind: Atelectasis,
pneumonia
Water: UTI
Walking: DVT
Wounds: Wound
infection, abscess
Wonder drugs: Drug
reaction
```
37
clue for carbon monoxyde poisonning(3)
cherry red skin
headaches
hypoxemia
38
when to suspect smoke inhalation in burns(5)
```
singed nose hairs
facial burns
hoarseness
wheezing
carbonaceous sputum
```
39
Induction of P-450 enzymes(4)
enzymes Barbiturates
phenytoin
carbamazepine
rifampin.
40
Inhibition of P-450 enzymes(3)
Cimetidine
ketoconazole
INH.
41
Metabolism by P-450 enzymes(11)
```
Benzodiazepines
amide anesthetics
metoprolol
propranolol
nifedipine
phenytoin,
quinidine
theophylline
warfarin
barbiturates.
```
42
↑ risk of digoxin toxicity(4)
Quinidine
cimetidine
amiodarone
calcium channel blockers
43
Competition for albumin-binding sites(3)
Warfarin
ASA
phenytoin
44
Blood dyscrasias (4)
Ibuprofen
quinidine
methyldopa
chemotherapeutic agents.
45
Hemolysis in G6PD-deficient patients (6)
```
Sulfonamides
INH
ASA
ibuprofen
nitrofurantoin
primaquine
```
46
Gynecomastia (3)
Cimetidine
ketoconazole
spironolactone
47
Stevens-Johnson syndrome(2)
Ethosuximide
| sulfonamides.
48
Photosensitivity(3)
Tetracycline
amiodarone
sulfonamides.
49
Drug-induced SLE(4)
Procainamide
hydralazine
INH
penicillamine.
50
antidote of Acetaminophen
N-acetylcysteine
51
management of Acid/alkali ingestion
Upper endoscopy to evaluate for stricture
52
Anticholinesterases, organophosphates antidote
Atropine
| pralidoxime.
53
Antimuscarinic/anticholinergic agents
Physostigmine.
54
Arsenic, mercury, gold antidote (2)
Succimer
| dimercaprol.
55
β-blockers antidote
β-blockers Glucagon
56
Barbiturates (phenobarbital) antidote (3)
Urine alkalinization
dialysis
activated charcoal.
57
Benzodiazepines antidote
Flumazenil
58
Black widow bite antidote
Calcium gluconate.
59
Carbon monoxide antidote(2)
100% O2
| hyperbaric O2.
60
Copper, arsenic, lead, gold antidote
Penicillamine.
61
Cyanide Nitrite
sodium thiosulfate
62
Digitalis antidote(4)
Stop digitalis
normalize K+,
lidocaine (for torsades),
anti-digitalis Fab.
63
Heparin antidote
Protamine sulfate.
64
Iron salts antidote
Deferoxamine.
65
Lead antidote(3)
Succimer
CaEDTA
dimercaprol.
66
Methanol, ethylene glycol (antifreeze) antidote (3)
EtOH
fomepizole
dialysis.
67
Methemoglobin antidote
Methylene blue.
68
Opioids antidote
Opioids Naloxone.
69
Phencyclidine hydrochloride (PCP) rx
NG suction.
70
Salicylates antidote(3)
Urine alkalinization
dialysis
activated charcoal
71
TCAs antidote(3)
Sodium bicarbonate for QRS prolongation
diazepam or lorazepam for seizures
cardiac monitor for arrhythmias.
72
Theophylline antidote
Activated charcoal.
73
tPA, streptokinase antidote
Aminocaproic acid.
74
Warfarin antidote(2)
Vitamin K
| FFP.
75
ACEIs side effect(6)
```
Cough
rash
proteinuria
angioedema
taste changes
teratogenic effects.
```
76
Amantadine side effect(2)
Ataxia
| livedo reticularis
77
Aminoglycosides side effect(2)
Ototoxicity
| nephrotoxicity (acute tubular necrosis).
78
Amiodarone side effect(4)
Pulmonary fibrosis
peripheral deposition → bluish discoloration, arrhythmias,
hypo-/hyperthyroidism
corneal deposition
79
Amphotericin side effect(4)
Fever/chills
nephrotoxicity
bone marrow suppression
anemia
80
Antipsychotics side effect(6)
```
Sedation
acute dystonic reaction
akathisia
parkinsonism
tardive dyskinesia,
neuroleptic malignant syndrome.
```
81
Azoles (e.g., fluconazole) side effect
Inhibition of P-450 enzymes.
82
AZT side effect(2)
Thrombocytopenia
| megaloblastic anemia
83
β-blockers side effect (3)
Asthma exacerbation,
masking of hypoglycemia
impotence.
84
Benzodiazepines side effect(3)
Sedation,
dependence
respiratory depression.
85
Bile acid resins side effect(2)
GI upset
| malabsorption of vitamins and medications.
86
Calcium channel blockers side effect(3)
Peripheral edema
constipation
cardiac depression.
87
Carbamazepine side effect(3)
agranulocytosis
Induction of P-450 enzymes
aplastic anemia
88
Chloramphenicol side effect(2)
Gray baby syndrome
| aplastic anemia.
89
Cisplatin side effect(2)
Nephrotoxicity
| acoustic nerve damage.
90
Clonidine side effect (3)
Dry mouth
severe rebound headache
hypertension
91
Clozapine side effect
Agranulocytosis
92
Corticosteroids side effect(7)
```
Mania (acute)
immunosuppression
bone mineral loss
thinning of skin
easy bruising,
myopathy (chronic)
cataracts.
```
93
Cyclophosphamide side effect(2)
Myelosuppression
| hemorrhagic cystitis.
94
Digoxin side effect(3)
disturbance
yellow visual changes
arrhythmias
95
arythmias in digoxin(2)
junctional tachycardia
| SVT
96
Doxorubicin side effect
Cardiotoxicity (cardiomyopathy).
97
Ethyl alcohol side effect
Renal dysfunction
98
Fluoroquinolones side effect
Cartilage damage in children
| Achilles tendon rupture in adults.
99
Furosemide side effect(3)
Ototoxicity
hypokalemia
nephritis.
100
Gemfibrozil side effect(2)
Myositis
| reversible ↑ in LFTs.
101
Halothane side effect(2)
Hepatotoxicity
| malignant hyperthermia.
102
HCTZ side effect(3)
Hypokalemia
hyperuricemia
hyperglycemia.
103
HMG-CoA reductase inhibitors side effect(2)
Myositis
| reversible ↑ in LFTs.
104
Hydralazine side effect
Drug-induced SLE.
105
Hydroxychloroquine
Retinopathy
106
INH side effect(4)
Peripheral neuropathy
hepatotoxicity
inhibition of P-450 enzyme
seizures with overdose.
107
prevention of neuropathy in INH
B6
108
MAOIs side effect(2)
```
Hypertensive tyramine reaction
serotonin syndrome (with meperidine).
```
109
Methanol side effect
Blindness.
110
Methotrexate side effect(3)
Hepatic fibrosis
pneumonitis
anemia.
111
Methyldopa side effect(2)
Coombs’ test
| drug-induced SLE.
112
Metronidazole side effect(3)
Disulfiram reaction
vestibular dysfunction
metallic taste.
113
Niacin side effect
Cutaneous flushing.
114
Nitroglycerin side effect(4)
Hypotension
tachycardia
headache
tolerance.
115
Penicillin/β-lactams side effect
Hypersensitivity reactions
116
Penicillamine side effect
Drug-induced SLE
117
Phenytoin side effect(4)
Nystagmus
diplopia
ataxia,
gingival hyperplasia, hirsutism.
118
Prazosin first dose side effect
hypotension.
119
Procainamide side effect
Drug-induced SLE.
120
Propylthiouracil effect
Agranulocytosis.
121
Quinidine effect
Cinchonism
thrombocytopenia
arrhythmias
122
arrythmia in quinidine
torsades de pointes
123
cinchonism quid(2)
headache
| tinnitus
124
Reserpine side effect
Depression.
125
Rifampin side effect(2)
Induction of P-450 enzymes
| orange-red body secretions
126
Salicylates side effect (6)
```
Fever
hyperventilation with respiratory alkalosis and metabolic acidosis
dehydration,
diaphoresis
hemorrhagic gastritis.
```
127
SSRIs side effect(2)
Anxiety
| sexual dysfunction.
128
Succinylcholine side effect
Malignant hyperthermia.
129
Tetracyclines side effect(3)
Tooth discoloration
photosensitivity
Fanconi’s syndrome
130
TCAs side effect(5)
```
Sedation
coma
anticholinergic effects
seizures
arrhythmias.
```
131
Valproic acid side effect
Teratogenicity → neural tube defects.
132
Vancomycin side effect(3)
Nephrotoxicity
ototoxicity
“red man syndrome
133
quid of redman syndrome(2)
caused by histamine release
| not allergy
134
Vinblastine side effect
Severe myelosuppression
135
Vincristine side effect
Peripheral neuropathy
136
why avoid Beta blockers in cocaine intox
unopposed @ activity causes HTA
137
quid of opiods withdrawal rx moderate symptoms(2)
clonidine
| buprenorphine
138
severe symptoms for opiods withdrawal rx
methadone
139
indication for rx opiods iitox who are drug free 7-10 days
naltrexone
140
Vitamin A(2)
Night blindness
| dry skin.
141
Vitamin B1 (thiamine)
Beriberi
142
symptom in beriberi (5)
```
polyneuritis
dilated cardiomyopathy
high-output CHF
edema
Wernicke-Korsakoff syndrom
```
143
Vitamin B2 (riboflavin)(3)
Angular stomatitis
cheilosis
corneal vascularization
144
Vitamin B3 (niacin)
Pellagra
145
Pellagra(3)
diarrhea,
dermatitis
dementia.
146
Vitamin B5 (pantothenate)(4)
Dermatitis
enteritis
alopecia
adrenal insufficiency
147
Vitamin B6 (pyridoxine)(3)
Convulsions
hyper irritability
required during administration of INH.
148
Vitamin B12 (cobalamin)(4)
Macrocytic,
megaloblastic anemia
neurologic symptom
glossitis.
149
neurologic symptom in B12(3)
optic neuropathy
subacute combined degeneration
paresthesia
150
Vitamin C deficiency
Scurvy
151
quid of scurvy(4)
swollen gums
bruising
anemia
poor wound healing
152
Vitamin D deficiency (3)
Rickets in children
(bending bones),
osteomalacia in adults (soft bones),
hypocalcemic tetany.
153
Vitamin E deficiency
Vitamin E ↑ fragility of RBCs.
154
Vitamin K
Neonatal hemorrhage
↑ PT and aPTT
normal BT.
155
Biotin deficiency(2)
Dermatitis
| enteritis
156
cause of biotin deficiency
ingestion of raw eggs
157
The most common vitamin deficiency in the United States.
Folic acid
158
disease causing folic acid deficiency
sprue
159
symptom in folic acid deficiency(3)
macrocytic
megaloblastic
anemia without neurologic symptoms
160
Magnesium deficiency(5)
```
Weakness
muscle cramps
exacerbation of hypocalcemic tetany,
CNS hyperirritability → tremors,
choreoathetoid movement,
```
161
Selenium deficiency
keshan disease (cardiomyopathy).
