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1
Q

What is hepatitis?

A

Inflammation of the liver, caused by drugs, infection, alcohol. Most common Hep A,B,C.

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2
Q

How is hepatitis A transferred? Cure?

A

Fecal-oral, close contact, hand to mouth contact with feces.
Two doses of vaccine older than 1 year old people

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3
Q

How is hepatitis B spread? Cure?

A

Contact with infected blood, seminal fluid, vaginal secretions, mother to newborn, human bite, sex.

Three doses of vaccine any age

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4
Q

How is hepatitis C spread? Cure?

A

COntact with infected blood, mother to newborn, not easily spread through sex.

No cure or vaccine

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5
Q

What is HIV? Where is it found?

A

Human immunodeficiency virus. Blood and sexual fluids, like semen, pre-seminal fluid, breast milk, vaginal secretions, rectal fluid. Part virus, part cell mutated cells. Host cell eventually ruptures, destroys the cell, finds new cells. Opportunistic infections take advantage of disabled immune system.

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6
Q

Chlaymida is what?

A

Most common STD

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7
Q

Ductus arteriosus
What is it and what does it turn into what post birth?

A

Connects pulmonary artery to aorta to bypass lungs. Become ligamentum arteriosum and it holds/connects the aorta and pulmonary artery.

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8
Q

Ductus venosus
What is it and what does it become post birth?

A

Connects umbilical vein to inferior vena cava to bypass liver.
Becomes ligamentum venosum and holds portal vein, vena cava, and liver.

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9
Q

Foramen Ovale
What is it and what does it become post birth?

A

Allows fetal blood flow from the right atrium to the left atrium to bypass lungs. closes after birth to become fossa ovale.

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10
Q

D10 drug card:

A
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11
Q

Glucagon drug card

A
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12
Q

Diabetic home medication categories (4)

A
  • Antihyperglycemics
    • Biguanides - Decrease glucose production in liver, increase insulin sensativity
      • Glucaphage (metformin)
    • Alpha glucosidase inhibitors - slow digestion of sugar, block breakdown of starches
      • Precose
      • Glyset
    • TZD’s
      • Improve insulin sensitivity to cells, allowing additional uptake of sugar.
      • Avandia
      • Actose (pioglitazone)
    • Sulfonyureas
      • Increase insulin release from the beta cells in the pancreas
      • Amaryl (Flimepiride tablets)
      • Diabeta (Glyburide)
      • Diabinese (Chlopropamide)
      • Glucotrol (Glipizide)
      • Glynase (Micronized glyburide tablets)
      • Micronase (glyburide)
      • Glyburide (Micronase)
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13
Q

What is seroconversion?

A

Development of antibodies as a result of exposure to an antigen

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14
Q

Myexedema

A

Advanced Hypothyroidism, causes bradycardia

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15
Q

What is a thyroid storm? s/s?

A

When the pituitary gland malfunctions (tumor) creates a massive release of T3 and T4.

Hypertensive = hypoglycemic,

A-flutter if you’re hypotensive.

Treatment - beta blockers if hypertensive, cardiovert if hypotensive

High heart rate, high BP, high temp, syncopal, palpations, chest pain, shortness of breath

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16
Q

Best treatment for a thyroid storm and why?

A

Atenolol (BB)

Usually hypertensive and tachycardic

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17
Q

In pregnancy, what can a cluster headache indicate? Where is the pain?

A

Around/ behind the eyes, can indicate preeclampsia

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18
Q

Umbilical cord - arteries and veins?

A

1 vein, 2 arteries

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19
Q

During delivery if umbilical cord is visible, what should you check first?

A

If it is pulsating.

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20
Q

What happens/ will you see during placental delivery?

A

Rising and hardening of the fundus

Small vaginal bleeding present

Lengthening of the umbilical cord

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21
Q

What is zollinger ellisons disease?

A

Increased circulatory gastrin from gastrin secreting in the duodenum or pancrease, causing chronic peptic ulcers.

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22
Q

What are mallory weiss tears?

A
  • Tears in the esophagus

Longitudinal tears, bleeding from a laceration in the mucosa at the junction of the stomach and esophagus. This is usually caused by severe vomiting because of alcoholism or bulimia

Upper GI bleeding

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23
Q

Lower GI versus upper GI bleeding

What structure separates the two?

A

Lower GI

Usually painless, hematochezia (red blood in the stool)

Upper GI

Dark tarry stool (melena), coffee ground emesis

Ligament of Treitz at duodenum (first part of small intestine) seperates them

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24
Q

What do pineal glands excrete?

A

Melatonin

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25
What joins the two hemispheres of the brain?
Corpus callosum
26
Where do involuntary actions in the brain take place? Like temperature regulation, sleep, water balance, stress response, emotions
Diencephalon (Hypothalamus is here)
27
What are symptoms of depression?
Sadness, dispair, discouragment IN SAD CAGES INterest loss Sleep disturbances Appetite change Depressed mood Concentration difficulty Activity level change Excessive guilt Loss of energy SI
28
Bipolar types (3)
Bipolar 1 = manic episodes lasting 7+days or severe manic requiring hospital Bipolar 2 = Patern of depressive and hypomanic episodes. Lacks full blown manic of 1 Cyclothymic disorder = 2 years or more periods of depressive symptoms. Not severe enough symptoms to meet hypomanic or depressive episodes.
29
What are hallucinations?
Senses that are not reality. Voices most common.
30
What are delusions?
Are described as false beliefs that are inconsistent with ones knowledge/experience
31
What is the proper procedure for delivering twins?
Cut cord of first baby first
32
What is angioedema?
Swelling of the vocal cords usually, also tongue and upper airways
33
1 in 7 people are diagnosed with what?
Depression
34
Stung by a scorpion, you'd expect what symptoms?
Muscle twitching, sweating, drowling, slurred speech, restlessness, abdominal pain
35
Where is an ectopic pregnancy usually found
Fallopian tubes
36
Symptoms of a snake bite, red on yellow
Convulsions, drooping eyelids, stomach pain, Slurred speech, dilated pupils, dysphagia. Later signs are flaccid paralysis/death.
37
22 year old female unresponsive at 22 weeks pregnant. what to check?
BGL
38
What does flumazenil do?
Its a GABA receptor antaganist, thus it reverses effects of benzodiazepines
39
What is the microscopic structure in the kidney that produces urine?
Nephrons
40
25 year old male has difficulty urinating - (dysuria) and maintaining erection. What could be the problem?
Enlarged prostate
41
Patent foramen ovales can cause strokes - why?
Clots can bypass the lungs (where they would cause a PE) and cause a stroke
42
* **During contraction you see amniotic sac over babies head - what next?**
Tear the sac open
43
What is erythropoetin is responsible for what?
Production of RBC's
44
Patient SOB, SPO2 is 88 and Et CO2 is 42. What is likely the problem?
Asthma or something obstructive
45
Adult patient is having a new onset seizure. What is likely the problem?
Stroke/CVA
46
Which clotting factor should be replaced when treating hemophilia type A
VIII (8)
47
What do anticoagulants do?
Take out the clotting factors in the blood, like thrombin, fibrin, vitamin K.
48
Fibrinolysis
Breakdown of clots
49
Patient has a vitamin K deficiency - what would you expect to see?
Reduced clotting, so bleeding
50
Peripheral pitting edema is most commonly seen with what?
Cor pulmonale, aka R Ventricular Failure. Seen in Emphysema
51
What does the pancreas secrete?
Glucagon and Insulin
52
On the pancreas is the islets of Langerhans, the endocrine portion. What does it secrete?
Alpha = glucagon 25% Beta = insulin 60% Delta = Somatostatin 10% F = pancreatic polypeptide 5%
53
Each hemoglobin can carry how many oxygen molecules
4
54
* **Pregnant patient gives birth and question makes it seem like baby, umbilical and placenta has been delivered - however there is a twist in question that does not clarify everything has been delivered**
Give dopamine
55
Blood type that is universal donor
O-
56
Sickle cell crisis - what is it?
Sickle shaped cells are fragile, distorted from low oxygen states. Crystallized. Become clogged in tiny blood vessels. Tissues and joints become oxygen starved, causing excruciating pain everywhere. Basically it's long term hypoxia
57
Average hematocrit level?
47% adult male
58
What is hematocrit?
Percent of blood that is RBC's
59
Most appropriate way to restrain a patient
Commercially manufactured padded ones. If not, roller bandage, blanket roll, small towels, etc.
60
How long must a TIA be cleared before it can be ruled a TIA?
24 hours
61
What kind of patient would be prescribed lithium?
Bipolar. Last ditch effort psych medication.
62
What medications can cause an anticholinergic reaction?
Phenergan and Benadryl
63
What regulates temperature, sleep, emotion?
Hypothalamus
64
What is effacement?
Thinning of the cervix
65
What is gylcosuria?
Excretion of sugar through urine, NOT NORMAL
66
Stages of addiction
Habitual Physiological dependence - physiological need for it Psychological dependence - the belief that you need it Tolerance - need more to get what you want.
67
What is withdrawal?
Components of a toxidrome
68
Drug overdose
When you take more of a substance than a body can handle
69
Abuse
Using any substance for anything other than its intended purporse
70
Cholinergic toxidrome - what gives you it, what are the signs and symptoms
Nerve agents and organophosphates SLUDGEM * Salivation * Lacrimation * Urinary * Diaphoresis * Gastro * Emesis * Myosis/spasms Bradycardia, bronchoconstriction, CNS depressent, confusion, convulsion, seizures, coma, wet skin, pinpoint pupils
71
Anticholinergic toxidrome, what gives it to you, s/s
Antihistamines, atropine, atrovent, tricyclic, antipsychotics Red, hot, dry, blind, mad
72
Sympathimometic Toxidrome, what causes it and s/s
Cocaine, meth Paranoia, diaphoresis, delusions, HTN, CNS excitability, tachy, dysrhythmias, seizures
73
Opiate Toxidrome
Fentanyl, Cocaine, Opium Resp distress, pinpoint pupils, CNS depression, seizures, coma
74
Hallucinogen sympathomimetic
LSD, marijuana, PCP Visual illusions, strange behavior, delusions, resp depressant, CNS depressant
75
Hematopoiesis
Creation of new blood cells and platelets
76
Oliguria
Low urine output, less than 400mL daily
77
Exotoxin
Toxin released by a living bacterial cell into its surroundings
78
Sensitization
Making an organism abnrmally sensitive to a foreign substance
79
What is the name for hypothyroidism, how does it lead to pituitary enlargement? S/s?
Myxedema, an autoimmune thyroid deficiency. Is a condition resulting from thyroid gland inflammation. High TSH to compensate for low T3 and T4. Iodine deficiency can cause it, along with removal, damage, cancer/radiation. #1 CAUSE IS HASHIMOTOS S/s hypoglycemia, weight gain, weakness, bradycardia, depression, hypothermia, slowness Treatment is levothyroxine, supportive.
80
If you have a thyroid storm causing hypotension, what is the reason for this?
Hypertension, leads to A-fib/A Flutter, reducing cardiac output, leading to hypotension.
81
What is graves disease?
Hyperthyroidism Autoimmune, “thyroid storm” Overproduction of T3/T4 Neoplasm on pituitary gland that causes decrease in TSH S/S Weight loss, tachcardia, hypertension, A FIB or A FLUTTER, sweating, tremors, hyperthermic, protruding eyes, difficulty sleeping, diarrhea TX = BETA BLOCKERS
82
What is hashimotos thyroiditis?
Thyroid gland is attacked by a variety of cell and antibody mediated immune processes. Causes hypothyroidism
83
What is an acute hypothyroidism event? S/s?
Myxedema crisis Pituitary glands stop releasing TSH, or trauma to the thyroid directly. S/s - hypotension, bradycardia, skin swelling, hypoglycemia, shallow respirations, coma.
84
Chronic complications of diabetes
Blindness Kidney disease Peripheral neuropathy Autonomic neuropathy Heart disease and stroke Vascular disease
85
DKA pathophysiology
* Associated with type 1 diabetes * Profound low levels of insulin prevents glucose from entering cell. * Cells are starved, use fat for energy. * Generates acid and glycerol * Acid generations ketoacids, thus ACIDOSIS * Potassium leaves blood to enter vascular space, going to urine * causes low levels of potassium but body is still HYPERKALEMIC * Sodium level extracellular decreases, replaced by hydrogen ions, furthering ACIDOSIS * Osmotic diuresis, plus vomiting and dehydration, cause SHOCK * Can cause seizures and AMS.
86
Treatment for DKA
10 mL/kg (1-2L) of saline, 12 lead. Too much fluid can cause cerebral edema, a reverse fluid shift into brain QRS widens? CRITICAL Consider bicarb, albuterol, calcium (arrests)
87
Causes and S/s of DKA
Forgot insulin, new type 1, Stress, infection, MI, progression of type 2 to type 1 Warm, dry skin Diuresis Tachy, thready pulse 3 P's Polyuria, dypsia, phagia ABD pain Acidosis N/v KUSSMAUL respirations to attempt to reduce CO2 level
88
HHNS pathophysiology
Acute diabetic decompensation IN TYPE 2, but develops over time from sustained hyperglycemia BGL rises 600+ Still have some insulin so NO KETONES (like DKA) Less acidity, but still present. Osmotic diuresis that results in dehydration and electrolyte loss. Commonly caused by infection or illness Relative insulin deficiency Hyperosmalarity of the blood due to high BGL Early S/S are polyuria and polydipsia
89
HHNS S/S
Extreme volume depletion, causes orthostatic syncope Polyuria Tachycardia Warm, dry skin Fever Confusion Convulsions NEED FLUID AND INSULIN
90
Why do DKA patients lose consciousness?
Hyperosmalarity of the cells cause fluid to escape, crenate. Sodium and potassium shifts into vasculature, causing hyperkalemia.
91
Addisons Disease pathophysiology, causes, s/s, treatment
Adrenal deficiency Adrenal glands fail to produce enough aldosterone and/or cortisol, as well as epi and norepi. Hypotension, hypoglycemic, (increased sensitivity to insulin so BGL drops) Weakness, lethargy, abd pain, N/V, hyperpigmentation. Causes - trauma, tumors, autoimmune diseases, chronic steroid use. Tx: D10, which usually wont respond, then SOLUMEDROL.
92
Emphysema pathophysiology
Pink puffers, COPD, caused by chronic lung irritants Elastin broken down by elastase increase in lungs. Alveoli damaged, decrease in recoil, loss of structures, narrowing results. Increased residual volume to compensate and due to damage of walls. Hence long torso Chronic hypoxia causes polysythemia to compensate, spO2 now abnormally low. Respiratory acidosis due to air trapping with compensated metabolic alkalosis, now depend on oxygen to breathe instead of CO2. Pulmonary hyperinflation strains the heart, causes cor pulmonale. CPAP, 12 lead, IV Albuterol, atrovent, fluid.
93
Generalized seizures vs partial seizures
Partial = localized part of brain. * Simple = no LOC. Numbness, tingling, abnormal movements, blank stare * Complex = LOC in some degree. Blank stare, unable to talk lip smacking Generalized = all of brain * Absent aka PETIT MAL * Vacant and unresponsive for 30 seconds ish. Slight twitching. Daydreaming. Common in kids. * Tonic clonic GRAND MAL * Muscle contraction, shaking, incontinent, absent breathing sometimes. * Postictal after.
94
Reversible causes of apgar 3
Bradycardia, hypoxia, hypotension
95
Irreversible causes of apgar 3
Lack of surfactant Tetrology of fallot Transposition of great arteries
96
Hep A, B, C differentials and infection
* **Hep A** - Symptoms may be **flu like**, acquired via infected persons **stool.** May have jaundice; typically _clears on its own_ in a few weeks, **Vaccine!** * **Hep B** - Symptoms may be **flu like**, acute or chronic, acquired via infected persons bodily fluid like **semen or blood**; May have _jaundice_; typically _clears on its own_ in a few weeks, **Vaccine!** **Hep C** – May have no symptoms. Symptoms may be **flu like**, chronic illness, acquired only via infected persons **blood**; It can be acute or chronic; May have jaundice, cirrhosis, if untreated can _lead to liver and kidney failure_; **NO vaccine!**
97
phenergan drug card
98
Thiamine drug card
99
Valium drug card
100
Benadryl drug card

233 Medical Emergencies (4 decks)

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