Emergency Medicine3 Flashcards
(104 cards)
1
Q
Q400. treatment of temporal arteritis?
A
A400. prednisone 60mg po, arrange a biopsy to confirm diagnosis
2
Q
Q401. Often compression of ______________ can improve the pain of migraine?
A
A401. the ipsilateral superficial temporal or carotid artery
3
Q
Q402. ergotamine is contraindicated in… ? Should be used w/ caution in ….?
A
A402. Pregnancy; Caution in HTN or CAD
4
Q
Q403. Patients should avoid _____ while in the midst of cluster headaches?
A
A403. Alcohol
5
Q
Q404. This causes headaches often in overweight women in their 30s…
A
A404. Pseudotumor Cerebri (benign intracranial HTN)
6
Q
Q405. 90% of patients with Pseudotumor Cerebri have ….?
A
A405. papilledema
7
Q
Q406. in Pseudotumor Cerebri, head CT will show…? LP will show…?
A
A406. CT - slit-like ventricles; LP - increased opening pressure
8
Q
Q407. treatment of Pseudotumor Cerebri..?
A
A407. Acetazolamide 250 mg pid
9
Q
Q408. treatment of post LP HA?
A
A408. caffeine sodium benzoate
10
Q
Q409. cherry-red coloration of skin/mucous membranes, retinal hemorrhages, AMS?
A
A409. CO poisoning
11
Q
Q410. sudden onset of head/eye pain, decreased visual acuity?
A
A410. Acute angle closure glaucoma
12
Q
Q411. treatment of acute uncomplicated UTI?
A
A411. Bactrim for 3 days
13
Q
Q412. Pyelonephritis w/ systemic sx tx?
A
A412. admit for IV antibiotics
14
Q
Q413. pregnant women with UTI tx?
A
A413. macrobid for 7 days
15
Q
Q414. What % of pts presenting with classic UTI sx show minimal to no bacteria on UA?
A
A414. 30-40%
16
Q
Q415. Sudden onset of testicular pain in children and young men?
A
A415. Testicular torsion
17
Q
Q416. most common cause of urinary retention?
A
A416. BPH
18
Q
Q417. >100 ml postvoid residual urine volume is diagnostic of…?
A
A417. urinary retention
19
Q
Q418. what is fournier’s gangrene?
A
A418. aggressive fasciitis of the perineum in a toxic appearing pt likely with history of DM, urethral trauma, surgery, or obstruction
20
Q
Q419. treatment of fournier’s gangrene??
A
A419. immediate surgery - complete debridement of necrotic tissue
21
Q
Q420. tender, swollen, painful epididymis and testis usually accompanied by fever?
A
A420. Epididymitis
22
Q
Q421. testicular US can distinguish…?
A
A421. torsion from epididymitis
23
Q
Q422. the cremasteric reflex is present in _____ but not in ___________?
A
A422. epididymitis; torsion
24
Q
Q423. nonspecific infection of the glans penis is called…?
A
A423. balanitis
25
Q424. abnormally small opening in the foreskin?
A424. phimosis
26
Q425. abnormal painful swelling of the glans penis occurring after aggressive retraction of a phimotic foreskin?
A425. paraphimosis
27
Q426. flank/abdominal pain, does not change with position or remaining still, radiation to groin...
A426. stones
28
Q427. work up of stones?
A427. IVF; IV narcotics; UA - will generally show hematuria; BMP
29
Q428. test of choice for kidney stones?
A428. noncontrast CT
30
Q429. stone <3mm probability of passing spontaneously?
A429. 0.8
31
Q430. Indications for urology consults or admission in kidney stones...?
A430. Associated UTI; uncontrolled pain/emesis; extravasation of contrast; renal failure; single kidney; hydronephrosis + hydroureter; stone > 6mm
32
Q431. in a patient >60, first time renal colic is _________ until proven otherwise...
A431. AAA
33
Q432. of those women who experience bleeding in the first trimester, ______________ will undergo spontaneous abortion
A432. 40180
34
Q433. threatened abortion...?
A433. vaginal bleeding with a pre-viable fetus and closed cervix
35
Q434. inevitable abortion?
A434. vaginal bleeding with cervical dilatation
36
Q435. incomplete abortion
A435. vaginal bleeding with partial passage of products of conception and dilated cervix
37
Q436. complete abortion
A436. passage of all products of conception and closed cervix
38
Q437. missed abortion
A437. fetal demise and retention of products of conception, cervix closed
39
Q438. 6-8 weeks gestation with amenorrhea, spotting, and cramping lower abdominal pain....concerning for...?
A438. ectopic
40
Q439. gold standard in diagnosing an ectopic?
A439. US
41
Q440. any patient who presents with vaginal bleeding and is _____ should be given RhoGAM?
A440. Rh -
42
Q441. 2 most common pregnancy related causes of vaginal bleeding in the second trimester?
A441. miscarriage; hydatidiform mole
43
Q442. pre-eclampsia that occurs prior to 20 weeks gestation is pathognomonic for...?
A442. trophoblastic disease
44
Q443. most common presentation of placenta previa?
A443. late 2nd to early 3rd trimester painless bleeding
45
Q444. ____________- may occur in up to 1/3 of placental abruptions?
A444. DIC
46
Q445. pre-eclampsia?
A445. triad of HTN, edema, and proteinuria of >100 mg/dl
47
Q446. HELLP syndrome?
A446. subset of pre-eclamptic pts:; Hemolysis, Elevated Liver enzymes, and Low Platelets
48
Q447. In preeclampsia and eclampsia, the most important part of the CBC is...?
A447. the platelet count
49
Q448. seizure prophylaxis in pre, eclampsia?
A448. MgSO4
50
Q449. preterm labor is defined as occurring...?
A449. before 37 weeks gestation
51
Q450. Strawberry cervix?
A450. trichomonas
52
Q451. average blood loss in normal menses/
A451. 30-60cc
53
Q452. benign leiomyomas that develop in the uterus and often result in menometrorraghia?
A452. fibroids
54
Q453. dysfunctional uterine bleeding tx..?
A453. NSAIDs, and OCPs; rule out endometrial carcinoma
55
Q454. Chlamydia can cause....?
A454. Asymptomatic infection; Urethritis; Cervicitis; PID
56
Q455. PID?
A455. Lower abdomen. tenderness, cervical motion tenderness, and adnexal tenderness; + fever or increased WBC or ESR etc..
57
Q456. most common cause of infectious arthritis in young sexually active adults?
A456. Gonorrhea
58
Q457. green-gray discharge?
A457. trichomonas
59
Q458. thin-gray malodorous discharge, non sexually transmitted
A458. bacterial vaginosis
60
Q459. most common cause of pelvic pain in women not associated with infection is...?
A459. Rupture of an ovarian cyst
61
Q460. 50% of cases of ovarian torsion are caused by..?
A460. Benign dermoids that cause the ovary to twist
62
Q461. A major cause of pelvic pain, dyspareunia, and dysmenorrhea
A461. Endometriosis
63
Q462. postcoital contraception?
A462. norgestrel
64
Q463. first, second, etc degree frostbite?
A463. 1st - warm, hyperemic, sensate; 2nd - clear vesicles; 3rd - purple bullae; 4th - mummification
65
Q464. ED management of frostbite?
A464. treatment hypothermia; IVF; remove nonadherent wet apparel; rapid thawing thawing in 42C water bath; unroofing clear blisters; aloe vera; tetanus prophy; ibuprofen, ascorbic acid, nifedipine
66
Q465. How to estimate total body surface area for burns..?
A465. 9's; LUE - 9%,; LLE - 18%,; posterior torso - 18%,; head - 9%
67
Q466. burn degrees?
A466. 1st - superficial epidermis (no blisters, heals w/out scar); 2nd - superficial dermis (blisters, scarring in 3 wks...); 3rd - all of dermis (charred, painless, scars with contractures)
68
Q467. How do you determine IVF needs in a burn victim?
A467. If TBSA >15%.... 4ml x kg weight x tbsa% = total volume of replacement needed in first 24 hrs
69
Q468. don't forget _________ in frostbite, burns, and a variety of other injuries....?
A468. tetanus prophylaxis
70
Q469. hypothermia defined?
A469. core temp < 35 C
71
Q470. presentation of mild hypothermia?
A470. confusion, lethargy, fatigue, shivering, tachycardia, respiratory alkalosis
72
Q471. resuscitation in severe hypothermia should include _________ in order to treat cardiac dysrhythmias...?
A471. Warming until core temp > 32 C
73
Q472. severe dehydration, thermoregulaory failure, temp >40C, tachycardia, hypotension, confusion, rhabdo...?
A472. Heat stroke
74
Q473. treatment of heat stroke..?
A473. rapid cooling, monitoring, seizure prophylaxis
75
Q474. voltage > _____________ is considered high tension..?
A474. 1000 V
76
Q475. the _________ the resistance, the more the current and damage
A475. less
77
Q476. AC current is ___________ dangerous than DC, because?
A476. more; increased duration of exposure; increased likelihood of Vfib
78
Q477. barotrauma of ascent?
A477. when a diver fails to exhale when ascending, exacerbating the overexpansion of the airspaces
79
Q478. type 1 decompression sickness? type 2?; treatment if severe?
A478. 1 - joint, skin, bone problems; 2 - neuro, lung, CV problems; Hyperbaric oxygen chamber
80
Q479. what agent can mimic acclimatized state in the treatment of altitude sickness?
A479. Acetazolamide - causes a compensatory respiratory alkalosis
81
Q480. most infection prone bite injury?
A480. human bite to the hand
82
Q481. ___________ is implicated in 50% of infected cat bites and 30% of infected dog bites?
A481. Pasteurella
83
Q482. complications of this infection include encephalitis, Painaud's, osteolytic bone lesions, purpura, and erythema nodosum
A482. Bartonella
84
Q483. describe phases of rabies briefly?
A483. Incubation period - couple months; Prodrome - 1 week of localized pain, malaise, N/V; Acute neuro phase - 1 week; Coma - up to 2 weeks
85
Q484. Loxosceles spider bite tx?
A484. wound care; antibiotics if superinfected; antihistamines and analgesics; dapsone to prevent ulceration; IV steroids in viscerocutaneous loxoscelism to prevent hemolysis
86
Q485. sudden onset fever, centripetal rash spread, severe HA, myalgia, N/V, and abdominal pain
A485. Rocky mountain spotted fever
87
Q486. treatment of rocky mountain?
A486. teracycline or chloramphenicol; supportive care for shock, DIC, ARDS, CHF
88
Q487. complications of auricular hematoma?
A487. cauliflower ear, cartilage necrosis
89
Q488. pathogens of otitis externa?
A488. pseudomonas and staph
90
Q489. treatment of anterior bleeding epistaxis?
A489. pinching pressure, decongestion, silver nitrate, packing, abx to prevent sinusitis
91
Q490. problem with posterior bleeding epistaxis?
A490. pharyngeally stimulated hypoxia and stopped breathing
92
Q491. ____________ cures >95% of peritonsillar abscesses?
A491. I and D
93
Q492. Ludwig's angina? big concern?
A492. Trench mouth - dental origin infection of submandibular space due to horrible hygiene; Concern - airway compromise
94
Q493. duck quack cry is characteristic of...?
A493. Retropharyngeal deep space infection
95
Q494. swallowed coins appear ____________ in trachea, _____________ in esophagus?
A494. side on; face on
96
Q495. diagnosis and treatment of esophageal foreign body?
A495. EGD for visualization; glucagon for esophageal relaxation
97
Q496. epiglotitis has traditionally been associated with which infection?
A496. Hemophillus B
98
Q497. diagnosis of epiglotitis?
A497. loss of V-shaped dip in neck plain film (valecula sign)
99
Q498. if suspecting epiglotitis in kids....what next?
A498. call ENT or anesthesia - no IV's, oral exam, nothing that stimulates/agitates the child
100
Q499. croup? what type of cough?
A499. laryngotracheobronchitis - viral infection; seal-like barking cough
101
Q500. difference in presentation in kids with croup vs. epiglotitis?
A500. in croup, kids generally appear well
102
Q501. treatment of croup?
A501. racemic epinephrine,; humidified air,; steroids
103
Q502. angioedema? tx
A502. inflammatory autoimmune reaction, increased capillary permeability; treatment - H1 blocker, steroids, H2 blocker, epinephrine for severe cases
104
Q503. causes of pharyngitis?
A503. group A strep; Mono with lymphadenopathy, splenomegaly; adenovirus
