ER Questions Flashcards by Brittany Hansel

Components of glasgow coma score

Eye opening,motor, verbalizing

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Dead patient has a GCS of

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GCS score <_ is coma

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Beck’s triad

muffles heart sounds, high neck veings, HoTN- cardiac tamponade

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Pulse felt at radial means BP of atleast

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Pulse felt at brachial means BP of atleast

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Pulse felt at femoral means SBP of atleast

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Pulse felt at carotid means SBP of atleast

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What kind of shock occurs when the heart is not pumping well enough to push adequate volume to perfuse?

cardiogenic

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what kind of shock occurs when there is not enough blood volume to perfuse?

hypovolemic

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What kind of shock occurs when cardiac output increases, but vasculature is too dilated dt inflamm rxn causing insufficient pressure to perfuse?

septic

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What kind of shock occurs when there is dilated vasculature dt spinal cord injury

neurogenic

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Potential spaces for life threatening internal hemorrhage

Chest Pelvis Abdomen Femur Scalp

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toxicology causes of HTN

CT SCAN:
cocaine
thyroid supplements
sympathomimetics
caffeine
anticholinergics, amphetamines
nicotine

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toxicology causes of HoTN

CRASH:
clonidine (CCBs)
reserpine (and other BP meds)
antidepressantes, aminophylline
sedative hypnotics
heroin and other opiates

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toxicology caues of tachycardia

FAST:
Freebase & other cocaine forms
anticholinergics, amphetamine, antihistamines
sympathomimetics, solvent abuse
theophylline

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toxicology causes of bradycardia

PACED:
propranolol & BP meds
anticholinesterases
clonidine & CCBs
ethanol & other alcohols
digoxin

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toxicology causes of tachypnea

PANT:
PCP, pneumonitis (chemical)
ASA, other salicylates
toxin induced metab acidosis

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toxicology causes of slow respirations

SLOW:
sedative hypnotics
liquor
opiates
weed

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toxicology causes of hyperthermia

NASA:
neuroleptic malig syn, nicotine
antihistamines
salicylates, sympathomimetics
anticholinergics, antidepressants

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toxicology causes of hypothermia

COOLS:
carbon monoxide
opiates
oral hypoglycemis, insulin
liquor
sedative hypnotics

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vertical or rotary nystagmus

think PCP

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toxicology causes of seizures

OTIS CAMPBELL:
organophosphates
tricyclic antidepressant
isoniazid, insulin
sympathomimetics
cocaine, camphor
amphetamines, anticholinergics
methylxanthines (theophylline, caffeiene)
PCP
benzo withdrawal
ethanol withdrawal
lithium, lidocaine
lead, lindane

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Anticholinergic toxidrome

hyperthermia, flushed skin, dry skin, dilated pupils, delirium/halluc/szs
hot as hare, red as a beat, dry as a bone, blind as a bat, mad as a hatter

tachycardia, htn, urinary retention, decreased bs

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cholinergic(organophosphates/insecticides) toxidrome

``` DUMBELS: diarrhea, diaphoresis urinar and/or fecal incontinence miosis bradycardia, bronchosecretions/spasms emesis lacrimation salvation ```

EKG showing diffuse T wave peaking

hyperkalemia

cholinergic(organophosphates/insecticides) toxidrome

contraleteral- left

tongue pointing to right/ deviating from left means stroke on which side of brain

points to contralateral- left brain

leg weakness on left means stroke on which side

contralateral- right brain

toxic dose of acetaminophen/tylenol

150 mg/kg

antidote for acetaminophen overdose

N-acetylcysteine

toxic and lethal dose of aspirin

toxic 160mg/kg lethatl 500mg/kg

treatment of aspirin OD

correct fluids and acid/base lytes- k replacement, glucose urine alkalinization via sodium bicarb if level >35mg/dL

what NSAID has 4 stages of OD

acetaminophen

"stepping out into a snowstorm" vision

methanol poisoning

Antibiotic for gonorrhea

Ceftriaxone 250mg IM

Antibiotic for chlamydia

Azithromycin 1g PO once

MC STI

chlamydia

Antibiotics for otupt PID

Ceftriaxone, Doxycycline, Flagyl

MP rash involving palms and soles with "copper penny" lesions

Syphilis

how to dx syphilis

VDRL for screening, FTA-ATBs is confirmatory

Antibiotic for syphilis | if allergy

Benzathine PCN-G (Bicillin) | Doxycycline

dx of herpes

Gold standard is tissue culture | tzank smear showing multinucleated giant cells

MC HPV types

6 & 11

MC HPV types for cervical dysplasia

16 & 18

causitive agent of chancroid

Haemophilus ducreyia

painful necrotizing genital ulcer with inguinal LAD

chancroid

antibiotcs for chancroid

azithromycin, ceftriaxone, cipro

tx for acute cystitis

Cephalexin Cipro (no prego) Nitrofuratoin (prego good) Bactrim

tx acute pyelonephritis outpt

Cipro, Bactrim DS

tx acute bacterial prostatis outpt

Cipro x 21d

acute epididymitis <40 yo

Cef + Doxy

acute epididymitis >40 yo

Cipro or Bactrim

tx for varicocele

NSAID/ Naprosyn, scrotal support

buckle fracture occurs in what part of bone

metaphysis

PEDS ortho that are MC in females

nursemaids elbow, patellar dislocation, scoliosis, systemic lupus

changes in inferior leads (II, III, aVF)

inferior MI- RCA

changes in lateral leads ( I, aVL, V5, V6)

lateral MI- left circumflex

changes in precordial leads

anterior MI- LAD

changes in anterior lead (V1)

posterior MI- RCA

changes in precordial leads and I and aVL

anterolateral MI- left main artery

hyperkalemia leads to what arrhythmia

Vfib, death

what lyte distrubance and lead to torsades

hypocalcemia, hypomagnesemia

MC cardiomyopathy

dilated- enlargement of one or all chambers or heart, systolic dysfx

intraarticular fx of thumb

Bennett's fx

comminuted thumb fx

Rolando's fx

Gamekeeper's fx involves

ulnar collateral lig of thumb (aka skier's thumb)

mallet finger is

extensor tendon injury, from hyperflexion

MC injured carpal ligament

scapholunate ligament

varus stress of knee tests

LCL

valgus stress of knee tests

MCL

distal radial fx with dorsal displacement

colles fx

distal radial fx with palmar displacement

smiths fx

comminuted distal radius fx with articular surface involvement displaced fx ulnar styloid

bartons fx

fx proximal ulna, dislocation radial head

monteggia fx dislocation

fx proximal radius, dislocation of distal radioulnar joing

galeazzi fx dislocation

proximal fibula shaft fx with distal tibia fx

maisonneurve fx

transverse fx proximal 5th metacarpal

jones fx

fx/dislocation at tarsometatarsal joint with LATERAl subluxation of metatarsal

Lis franc fx

drooling, dysphagia, distress

epiglottitis (supraglottitis) ABCs ceftriaxone IV

hard, nontender swelling on eye lid with redness

chalazion, warm compress and lid scrubs

Bells Palsy affects CN

CN7

Bells palsy is caused by? tx..

HSV1 generally, acyclovir within 72hrs