Emergency objectives

Question 1

Components of glasgow coma score

Answer 1

Eye opening 1-4
Verbal response 1-5
Motor response 1-6

Severe: 3-8
Moderate: 9-13
Mild: 14-15

Question 2

Types of shock

Answer 2

Hypovolemic: blood loss, fluids, third spacing
Cardiogenic: dysrrhythmias, MI
Obstructive: tension pneumo, pericardial disease, pulmonary blockages
Distributive: Septic shock, anaphylactic shock, neurogenic shock, vasodilatory drugs

Question 3

Hypocalcemia

Eti, S/s, workup, manage

Answer 3

Eti: Renal, vit D, increase Phos, low mag, hypoPara, sequestration by pancrease, alkalosis, malabsorb
S/s: tetany, cramps, arrhythmias (long QT), hyperreflexia
Test: Chvostek and Trousseau’s
Workup: Mg, PTH, Vit D, phos, albumin, ionized Ca
Tx: Give Ca and Vit D

Question 4

Hypercalcemia

Eti, S/s, workup, manage

Answer 4

Eti: HyperPTH, malignancy, thyrotoxicosis, Inc Vit D, bone destruction…
S/s: Renal stones, bone pain (moans), abdominal (groans), MS changes (psychiatric overtones).
Dx: PTH, phos, vit d, albumin, Ionized Ca, CXR, TSH
Tx: Urine excretion
Comp: cardiac arrhythmias

Question 5

Hypokalemia

Eti, S/s, workup, manage

Answer 5

Eti: Diuretics, vomiting, diarrhea, CKD, primary aldosteronism
S/s: paresthesias, muscle cramps, tetany
EKG: flat T waves, ST depression, U wave, atrial arrhythmias
Dx: Chemistries, urine, 24-hour urine
Tx: increase K+, check Ca, Mg

Question 6

Hyperkalemia

Eti, S/s, workup, manage

Answer 6

Eti: Acute kidney failure, CKD, addison’s disease, EToH, Ace inhibitors, RBC destruction
S/s: paresthesias, muscle weakness, confusion, hyperactive DTRs, decreased strength
ECG: Peaked t-waves, PR prolongation, QRS widening, ventricular arrhythmias
Dx: Chem, urine, EKG, urinary output
Tx: Calcium gluconate/chloride for cardiac stability
possibly dialysis

Question 7

Types of hyponatremia

Answer 7

Hypotonic: Low mOsm
Isotonic: Normal mOsm: pseudohyponatremia
Hypertonic: assess for hyperglycemia

Question 8

Types of hypotonic hyponatremia

Answer 8

Hypovolemic: decreased water and sodium
Euvolemic: increased water, normal sodium
Hypervolemic: increased total body water

Question 9

Causes of respiratory acidosis
S/s:
Dx:
Tx:

Answer 9

Abnormal hypoventilation:
- COPD
- Drugs
- Pneumonia
- Neuro disorders (guillain barre)
- Respiratory disfunction
S/s: somnolence, confusion, asterixis, myoclonus
Dx: up pCO2, down pH, up HCO3
Tx: mechanical ventilation

Question 10

Causes of respiratory alkalosis
S/s:
Dx:
Tx:

Answer 10

Hyperventilation: CO2 is blown of faster
Eti: PE, prego, sepsis, hypoxemia, mechanical vent, anxiety, stimulation of respiratory center
S/s:may have symptoms of low Ca (perioral numbness, tetany, paresthesias)
Dx: low pCO2, high pH, low HCO3
Tx: Treat disorder, mechanical vent

Question 11

Causes of metabolic acidosis
S/s:
Dx:
Tx:

Answer 11

Body producing too much acid or not enough bicarb, increase lactic acid, ketoacids, or kidney failure.
S/s: Comp hyperventilation, kussmaul breathing
Dx: Low bicarb, low ph, low pCO2 (comp)
Tx: treat cause, buffer, hemodialysis

Question 12

Mnemonic for metabolic acidosis

Answer 12

M: methanol
U: Uremia (CKD)
D: Diabetic ketoacidosis
P: Propylene glycol
I: infection, iron, isoniazid, inborn errors of metabolism
L: Lactic acidosis
E: Ethylene glycol
S: salicylates

Question 13

Causes of metabolic alkalosis
S/s:
Dx:
Tx:

Answer 13

Eti: requires both loss of H+ and maintance (impairment of renal HCO3 excretion, decreased GFR)
Vomiting: loss of acid, K+, Na+
S/s: no specific symptoms

Question 14

Abdominal pain associated symptoms questions

Answer 14

N?V?D?C?CP?SOB?back pain?Urinary sx?

females: missed periods, vaginal bleeding or discharge

Question 15

Abdominal pain questions

Answer 15

Po intake, anorexia, symptoms change with eating, is the pain constant or intermittent, what was the ride to ER like?
Medical history: GERD, history of ulcers
Surgical history: endoscopy, colonoscopy…

Question 16

Abdominal pain physical exam

Answer 16

PE: mucous membranes, heart and lungs, CVA tenderness,
Lay down: Point where it hurts, check BS, rebound, guarding and peritoneal signs,
Check for testicular torsion

Question 17

Abdominal pain ddx

Answer 17

appendicitis
cholecystitis
pancreatitis 
diverticulitis
bowel obstruction
mesenteric ischemia
bowel perforation
kidney stone
gastritis
gastroenteritis
AAA

Question 18

abdominal pain work up labs?

Answer 18

Abdominal lab set: pregnancy
UA: kidney
CBC: anemia, wbc for surgery prep
chem 10: hypokalemia = ileus, creatinine for CT prep
coags: pre-op lab, early sign of liver disease
lfts: cholecystitis workup
lipase: pancreatitis
vbg with lactate for older patients: screen for mesenteric ischemia

Question 19

Pain control for abdominal pain

Answer 19

Morphine: frequent titrated doses
0.1mg/kg, 70kg male = 7-8mg
safer more conservative dose: 4mg IV, may repeat Q15minutes for 3 total doses PRN for pain
Hold for somnolence, hypoxia, or systolic blood pressure under 100
Zofran: 8mg IV with narcotics
Benedryl: for histamine response: 12.5-25mg IV for rash if needed

Question 20

Abdominal pain imaging when required by quadrant?

Answer 20

LUQ: rigid abdomen or suspected obstruction
EpiG: rarely needs imagine: US RUQ to look for stones
RUQ: cholecystitis: US for stones or sludge
RLQ: appendicitis: usually iv contrast CT of abdomen and pelvis
suprapubic: UTI
LLQ: diverticulitis: CT with IV contrast
Flank pain: colic pain: kidney stones: CT abdomen/pelvis w/o contrast

Question 21

If you have an elderly patient with HTN or afib that complains of intense abdominal pain but not a lot of tenderness, that get worse every time they eat: check?

Answer 21

VBG with lactate to screen for mesenteric ischemia

and get surgeons involved early

Question 22

If the person has had multiple abdominal surgeries and vomiting with diffuse tenderness think?

Answer 22

Bowel obstruction: and CT with PO contrast if they can tolerate their kidneys can tolerate the contrast.

Question 23

Elderly patient with HTN that present with back pain, abdominal pain, syncope or hematuria think what?

Answer 23

AAA
Have a low threshold to ultrasound patients
Aorta >2cm and symptomatic for AAA = OR immediately
Between 2-5cm and asymptomatic = need follow up
>5cm = surgical consult

Question 24

OPQRST

Answer 24

Onset
Provocation
Quality
Radiation
Severity
Time

Question 25

Female specific qualities of abdominal pain | Additional questions to ask

Answer 25

``` Vaginal bleeding, or discharge Missed periods Urinary symptoms Fevers, chills Nausea, vomiting, diarrhea, back pain Pregnancy history Sexual history ```

Question 26

Sexual history

Answer 26

Ever had sex Last time How many partners Get parents out of room

Question 27

DDx female specific abdominal pain

Answer 27

``` Ectopic pregnancy Threatened abortion Normal pregnancy STDs: gonorrhea, chlamydia, trichomoniasis PID Tubo-ovarian abscess Ovarian torsion Ovarian cyst Bacterial vaginosis, candidiasis ```

Question 28

Female patient with: - Sudden onset of lower abdominal or pelvic pain with nausea or vomiting What should be suspected

Answer 28

Ovarian torsion There is such a thing as intermittent torsion - Negative US does not rule out ovarian or testicular torsion. - Torsion is a clinical diagnosis, US can be helpful

Question 29

What is the treatment for gonorrhea and chlamydia?

Answer 29

Standard for of care is to treat for both even if only treat positive for one. Cervicitis: - Ceftriaxone 125mg IM, 1g Azithromycin PO 1 dose - Zofran can be given with for nausea PID: (cervical motion tenderness) - Ceftriaxone 250mg IM, Doxycyclin 100mg BID 14days Shouldn't have sex for 7 days, and partners should be tested and treated.

Question 30

Tubo-ovarian abscess | S/s

Answer 30

Eti: usually a severe PID that has gone untreated and formed an abscess S/s: low abd pain, vag discharge In cases where suspicious of ovarian torsion, should be suspicious of tubo-ovarian abscess as well. Tx: usually admitted and given IV abx, obgyn consult

Question 31

trichomoniasis

Answer 31

Eti: motile organism on wet prep s/s: itching, discharge, dysuria, dyspareunia, abd pain rare symptom Tx: Flagyl, 2g 1 time dose, 500mg BID x 7days - Don't drink EtoH while on Flagyl

Question 32

bacterial vaginosis

Answer 32

Overgrowth of gardnerella vaginalis, replaces normal flora of lactobacilius S/s: usually presents as malodors discharge Dx: wet prep: clue cells Tx: Flagyl, 2 g 1 time dose, 500mg BID x 7days

Question 33

candidiasis

Answer 33

yeast infection, common after abx use s/s: itching or discharge dx: KOH; fungal elements tx: 1 dose fluconizole 150mg PO, or topical treatment 7 days

Question 34

Chest pain questions

Answer 34

OPQRST, what where you doing when the pain started Associated symp: n/v/sweat/abd/back pain/syncope Have you had this pain before Past hx: htn, hyperL, MI, CHF, Recent ECG, echo, stress test, catheterization Medications:

Question 35

DDX of chest pain: 6 most deadly

Answer 35

``` Pulmonary embolism Esophageal rupture Tension pnuemo MI Aortic dissection Cardiac tamponade ```

Question 36

Physical exam for chest pain

Answer 36

``` What is there volume status: heart and lung sounds, murmurs, JVD Press on chest wall Abdominal exam (AAA) Back exam Legs: edema or swelling (pitting) Pulses: aortic dissection ```

Question 37

Work up for chest pain

Answer 37

ECG and chest x-ray (esophageal rupture, pneumo)

Question 38

Esophageal rupture (boerhaave's syndrome)

Answer 38

Xray: free air under diaphragm, peritonitis on abdominal exam, history of recent forceful vomiting, alcoholics, recent endo

Question 39

Aortic dissection Risk S/s Dx

Answer 39

Risk: HTN, pregnancy, marfans, ellohrs danlos S/s: ripping or tearing pain the radiates to the back Difference of BP between L and R arms greater than 20mmHg. Chest pain plus motor neuro deficit else wear in the body Dx: CT chest with IV contrast

Question 40

Cardiac tampanode | S/s

Answer 40

Becks triad: muffled heart sounds, jvd, hypotension (late finding) Narrow pulse pressure

Question 41

MI S/s Work up

Answer 41

Pressure, made worse by exersion, left side of body, diaphroesis, pain that radiates to the shoulder Work up: ECG, chest xray, CBC, chem 10, coags, cardiac enzymes (troponins, ckmb

Question 42

Initial treatment of suspected MI

Answer 42

325 aspirin past 24 hours Nitroglycerin 0.4mg q5mintues x 3 doses (no ED meds) morphin + zophran

Question 43

Pulmonary embolism s/s risk

Answer 43

sx: pluritic chest pain all over the chest, tachycardia, tachypnea, SOB, hypoxia risk: pregnancy, OCP's, trauma, recent surgery, malegnancy

Question 44

Pulmonary embolism | w/u

Answer 44

EKG chest xray cbc, chem 10, coags

Question 45

PE rule out criteria: PERC rule

Answer 45

``` Breaths: can be used if low risk blood in sputum room air sat less than 95% estrogen use age greater than 50yo thrombosis in the past, PE or DVT heart rate greater than 100 surgery in last 4 weeks ``` Perc pos: d-dimer

Question 46

PE treatment

Answer 46

submassive: lovonox or heparin drip, cardiac enzymes plus BNP hemodynamicly unstable and PE: thrombolytics

Question 47

GI bleed ddx: upper gi

Answer 47

Esophageal varices Mallory-weiss tear peptic ulcer diease Dieulafoy lesion

Question 48

Lower GI bleeding ddx

Answer 48

Arteriovenous malformation Diverticulosis Colon cancer Hemorrhoids

Question 49

GI bleed PE

Answer 49

``` VS: blood pressure, pulse, mental status Nose and throat Abdomen; peritoneal signs Rectal exam and FOBT Extremities: looking for signs of shock (cool clammy extremities) ```

Question 50

What should be done to a patient with suspected GIB?

Answer 50

- 2 large bore IVs to establish access - Oxygen - Labs: for baseline: crossmatch, CBC, chem, coag, - ECG: in patients with CAD for signs of ischemia in GOB

Question 51

demarkation point between Upper GIB and Lower?

Answer 51

Ligament of treitz

Question 52

Acute mesenteric ischemia | Etiology and pathogenesis

Answer 52

Eti: Blood supply to bowel is insufficient to meet the metabolic demands. MC: is embolism to the superior mesenteric artery from the intracardiac thrombus from afib. Path: necrosis of mucosa, later muscular and serosal layer, no longer effective barrier to intraluminal bacteria = generalized peritonitis.

Question 53

Acute mesenteric ischemia history and PE

Answer 53

Hist: Acute onset of vague diffuse abdominal pain in an elderly patient with a history of CAD or afib. Pain: classically described as being out of proportion to findings. PE: Virtually normal except, vague mid to lower abdominal pain without peritoneal signs.

Question 54

DDX for acute mesenteric ischemia

Answer 54

``` AMI Peptic ulcer disease pancreatitis small bowel obstruction volvulus diverticulitis cholecystitis nephrolithiasis ruptured AAA ```

Question 55

Diagnostics for AMI? Lab features.., Gold standard? Tx:

Answer 55

Labs: leukocytosis, metabolic acidosis, lactate levels up Gold standard: angiography! Tx: O2, cardiac monitor, IV access, fluids, abx's, nasogastric tube (gastric decompression) Laparotomy and surgical embolectomy followed by resection of necrotic bowel.

Question 56

Angiography

Answer 56

IV contrast plus xray or flouroscopy. | The word itself comes from the Greek words ἀνγεῖον angeion, "vessel", and γράφειν graphein, "to write" or "record"

Question 57

Epidemiology for cholecystitis

Answer 57

4 F's: fat, female, fertile, forty

Question 58

What is a life threatening complication of cholecystitis?

Answer 58

Ascending cholangitis: obstruction of the common bile duct and infection of the duct

Question 59

Back pain physical exam?

Answer 59

``` PE: HEENT, h&L Point where it hurts, middle or paraspinal muscles, CVA Abdominal exam Males: testicular exam, sensory exam of groin pubic, RE.. Motor and Sensory exam: Strength: Hip flexor, and LE strength Sensory: legs and feet Straight leg raise test ```

Question 60

DDx back pain

Answer 60

``` Start with assumption of serious cause work backward. Abdominal aortic aneurysm Aortic dissection Renal colic Cauda equina Epidural abscess Tumor or mass Fracture Pylo or UTI Abdominal Zoster Muscular skeletal ```

Question 61

Abdominal aortic aneurysm | Epi and classic symptoms

Answer 61

Epi: older adult with HTN Low threshold for US 2-5cm who are symptomatic or >5cm urgent referral

Question 62

Aortic dissection | Epi and classic symptoms

Answer 62

Usually presents with chest pain, but can present with back pain, think with both. s/s: think in patients with pulse or motor defects

Question 63

Renal colic | Epi and classic symptoms

Answer 63

Usually younger patients Usually sudden onset of back or flank pain, CVA tender Microscopic hematuria 70-80% They look like they can't get comfortable, writhing

Question 64

Cauda equina

Answer 64

Sudden onset of ripping or tearing back pain that has loss of bowel or bladder control, saddle anesthesia. Sudden loss of motor function. Real life symptoms early: urinary retention followed by overflow incontinence.

Question 65

Epidural abscess

Answer 65

Pt. Fever back pain in an IV drug user

Question 66

Tumor or mass with back pain | Epi, s/s

Answer 66

Epi; Red flags (weight loss, night sweats, back pain at night, hx cancer), current history of active cancer. S/s: motor deficits

Question 67

Back pain and fracture: who and when

Answer 67

Epi: trauma, older patient pointing to middle of back

Question 68

Pyelonephritis: basic symptoms

Answer 68

Back pain and fever, with or without urinary symptoms

Question 69

mnemonic for serious back pain etiology

Answer 69

``` CRAFTI: Cauda equina Renal Abdominal Aortic Aneurysm or Aortic dissection Fracture Tumor or mass Infection ```

Question 70

Workup for back pain

Answer 70

UA, CBC, Chem 10 (really depends on clinical picture) | Imaging: Ultrasound, CT of aorta, plain films

Question 71

Definition of dizziness

Answer 71

Patient has sensation of room is spinning around them.

Question 72

Dizziness questions

Answer 72

``` when it started how suddenly constant or comes and goes had before neuro symptoms tinnitus, loss of hearing = central vs peripheral vertigo ```

Question 73

Peripheral vertigo vs central

Answer 73

Peripheral: dysfunction in patients ear: BPPV Central: central nervous system: tumor, stroke, intracrania bleeding Peripheral (not as serious): central (more serious) Peripheral: suggested by acute onset, feeling really bad, episodic Central: continuous, gradual in onset

Question 74

Components of peripheral vertigo

Answer 74

``` Sudden Severe Seconds to minutes Horizontal nystagmus Worsened by certain head positions No neuro findings Auditory: may have tinnitus or decreased hearing ```

Question 75

Components of central vertigo

Answer 75

``` Gradual onset Mild intensity Duration weeks to months Nystagmus: horiz, vert, or rotary No relation to head position Usually neuro findings Auditory: usually none ```

Question 76

Dizziness PE

Answer 76

Don't forget the ears Neuro exam: (focus points: finger to nose, rapid alternating movements, pronator drift, walking the patient) = posterior stroke worry. Testing of EOM: look for nystagmus. BPPV = horizontal only. (Induction of dizziness with EOM and resolution with visual fixation)

Question 77

Ddx of dizziness serious central etiologies?

Answer 77

``` Central etiologies: Tumor/mass/intracranial bleeding Carotid or vertebral artery dissection Cerebellar stroke Infection ```

Question 78

DDx of dizziness peripheral etiologies

Answer 78

Benign paroxysmysal positional vertigo (BPPV) Acute otitis media (ear pain and bulging TM) Labrynithitis (usually have preceding URI sympt) dizziness with hearing loss Perilymphatic fistula (hearing loss, worse with valsalva) Meniere's: Triad: dizziness, fluctuating hearing loss, tinnitus, waxing and wanes over years. Ear canal foreign body: anything that irritates TM

Question 79

Dizziness workup

Answer 79

Labs: usually low yield Imaging: central? CT non-con head CT, MRI for cerebellar or posterior stroke.

Question 80

Treatments used to treat dizziness

Answer 80

``` Meclizine (Antivert): antihistamine with anti-emetic properties 25mg PO BID Diazepam (valium): 5mg PO TID Ondansetron (Zofran): 4 to 8mg PO Q6hr Epley maneurver: hand out ```

Question 81

Syncope definition

Answer 81

Rapid loss of consciousness followed by rapid return to baseline

Question 82

Syncope hx:

Answer 82

Differentiate between dizziness, lightheaded, or syncope Pt. describe in their own words what happened Stressors: emotion, hydration, food Associated symptoms Duration of being out, seizures? Postictal state? Syncope w/ HA or with neuro symptoms, with CP, BP complete ROS Past med hx: seizures, DM, stroke/tia, MI, known AAA, family hx of heart disease (sudden cardiac death).

Question 83

PE for patient with syncope

Answer 83

check head for trauma neuro exam heart for murmurs (and while bearing down and squatting) head to toe exam (checking for back and abd tenderness)

Question 84

Ddx syncope

Answer 84

``` Seizure SubA/intracranial hemorrhage Ruptured AAA Aortic dissection Stroke/TIA GI bleed MI Aortic stenosis Pulmonary embolism Arrhythmia Carotid sinus sensitivity Hypoglycemia Sepsis Toxicologic Orthostatic hypotension ```

Question 85

Syncope workup

Answer 85

pay special attention to cardiac etiology Every patient need at least: ECG, and bHCG(if women) Tests to add to older patients: CBG, CBC, Chem 10, UA, non-con head CT

Question 86

ECG of patient with syncope: 4 things to look for?

Answer 86

Prolonged QT: higher chance of PVC falling on T wave (Long QT: males: longer than 440ms, females: 460ms) 10-11 small squares on paper (T wave within first 1/2 between R-R interval) Look for Wolf parkinson white (delta wave before QRS) Brugada syndrome: young otherwise healthy individual without heart disease with episode of syncope EKG: (RBBB pattern and ST elev V1-V3) HCOM: Young and healthy athlete ECG: Large R waves in V4-V6 or AVL, deep q waves in lateral leads

Question 87

Disposition patients with syncope

Answer 87

Patients over 50 should probably be admitted, definitely over 65

Question 88

San Francisco Syncope Rule

Answer 88

``` CHESS CHF Hematocrit <30 EKG abnormalities SOB Systolic BP ```

Question 89

Rehydration in the ED

Answer 89

Clinical signs of dehydration: | most sensitive sign: tachycardia

Question 90

Acetaminophen overdose S/s W/u: Tx:

Answer 90

Delayed hepatic injury 24-72 hrs later S/s: may be asx, anorexia, n/v, RUQ pain, hepatic necrosis (jaundice, LFTs) W/u: LFTs (AST>ALT), serum acetaminophen level, 4 hr post ingestion level, use nomogram to predict severity Tx: if 4hr > 150, start N-acetylcysteine (12-16 hrs of ingestion)

Question 91

Aphetamines/stimulates overdose: S/s: W/u: Tx:

Answer 91

Sympathomimetic (like cocaine) s/s: psychomotor agitation, euphoria, mydriasis, diaphoresis, tachycardia, HTN, hyperthermia, possible seizures W/u: serum drug level not helpful. ECG, cardiac enzymes, check urine for myoglobin Tx: Supportive (cooling, sedation w/benzos, hydration), no specific antidote. Propranolol if v-tach.

Question 92

``` Sedative overdose (benzos) Tx: ```

Answer 92

Flumazepil

Question 93

Carbon monoxide S/s W/u Tx:

Answer 93

Hx: multiple individuals same location S/s: tachypnea, flu like sxs, CNS symp, vomiting, (cherry red oral mucosa) W/u: VBG, chem, trops, CK, ECG, ct Tx: 100% O2 by nrb, hyperbaric therapy

Question 94

Salicylates overdose S/s W/u Tx

Answer 94

ASA, oil of wintergreen, pepto Toxicity >150mg/kg S/s: n/v, tinnitus, tachyC, hyperthermia, hyperventilation, respiratory alkalosis (turning into metabolic acidosis W/u: serum salicylate Tx: ABCs, treat electrolyte inbalances, activated charcoal Severe tx: hemodialysis

Question 95

Opiates overdose s/s w/u tx

Answer 95

consider in ams patient with pinpoint pupils S/s: CNS depression, miosis, respiratory depression, hypothermia, hypoT, bradyC W/u: blood/urine levels Tx: ventilation and/or naloxone

Question 96

Tricyclic antidepressants overdose

Answer 96

3 C's: Cardiac abnormalities, convulsions, coma | Tx: supportive, cardiac monitoring, sodium bicarb if arrhythmias

Question 97

Alcohol overdose

Answer 97

CNS depressant S/s: ataxia, dysarthria... W/u: serum ethanol, osmolar/anion gap metabolic acidosis, hypoglycemia Tx: Supportive, thiamine (wernickes aphasia), IV glucose (if hypoglycemic)

Question 98

cocaine overdose

Answer 98

Sympathomimetic | Tx: cooling, sedation w/ benzos, hydration

Question 99

cyanide overdose

Answer 99

S/sx: CNS, CV, respiratory, n/v, w/u: lactate, VBG, ABG Tx: Hydroxocobalamin, sodium thiosulfate, sodium nitrate

Question 100

organophosphates

Answer 100

Tx: airway, pralidoxime, atropine

Question 101

poisonous mushrooms

Answer 101

s/s: GI, CNS, | Tx: activated charcoal, benzo, atropine

Question 102

Heavy metal overdose

Answer 102

Tx: chelation therapy w/ deferoxamine

Question 103

sympathomimetic syndrome

Answer 103

Too many adrenergic signals Adrenergic signs: mydriasis (dialation of pupil), diaphoresis, psychosis, paranoia, bruxism (grinding of teeth), CV, HA, arrhythmias

Question 104

sympatholytic syndrome

Answer 104

blocks anything to do with epi | S/s: orthostatic hypoT, fatigue, sedation, respiratory dep

Question 105

serotonin syndrome

Answer 105

increased serotonergic activity in CNS S/s: mental status changes, diaphoresis, tachyC, hyperthermia, HTN, v/d, mydriasis, dry MM, flushed skin, myoclonus, hyperreflexia

Question 106

When to use activated charcoal

Answer 106

<60 mins after ingestion | - salicylates, poisonous mushrooms...

Question 107

What does decorticate represent on GCS

Answer 107

Definition: To remove the cortex | In GCS: abnormal flexion of the arms, scoring 3 on motor response

Question 108

What does decerebrate represent on GCS

Answer 108

Definition: to remove the brain or to cut the spinal cord. | In GCS: arms extended to sides, scoring 2 on motor response