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Oral Baord Review > Oral Board Review > Flashcards

Oral Board Review Flashcards

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1
Q

Intentional Iron Overdose (5)

A
  1. Large bore IV access& fluid bolus
  2. EKG
  3. Whole bowel irrigation
  4. Deferoxamine
  5. Aspirin & Acetaminophen levels
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2
Q

What is whole bowel irrigation?

A

250-500 mL/hr polyethylene glycol in children and 2L/hr in adults

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3
Q

Pyloric Stenosis (4)

A
  1. IV access and adequate rehydration
  2. Abdominal examination
  3. NG tube, NPO
  4. Abdominal US
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4
Q

Nontraumatic Intracranial Hemorrhage (7)

A
  1. Manage airway upon arrival
  2. Large bore IV access and fluids
  3. Bedside serum glucose level
  4. Laboratory evaluation (coags)
  5. Head CT for new onset coma
  6. Reversal of anticoagulation (FFP, Vitamin K, PCC)
  7. Neurosurgical and ICU consults
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5
Q

Tension PTX (6)

A
  1. Needle thoracostomy
  2. Tube thoracostomy
  3. Upright CXR
  4. Pain management
  5. Diligent search for other traumatic injuries
  6. Surgical consult
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6
Q

Cholecystitis (5)

A
  1. Large bore iV access
  2. RUQ US
  3. Pain management
  4. Surgery consultation
  5. IV abs
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7
Q

Neonatal Septic Shock from Bacteremia (4)

A
  1. IV/IO access
  2. Fluid boluses
  3. Abx early
  4. ICU consult
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8
Q

Boorhave’s Syndrome (5)

A
  1. Note crepitus on exam
  2. Consider esophageal tear in differential
  3. CXR to eval lungs, mediastinum
  4. CT surgery consult
  5. Resus w fluids and bs abx
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9
Q

Epidural Abscess (5)

A
  1. Consider this dx in an individual w back pain
  2. Obtain a rectal temperature
  3. Obtain stat imaging
  4. NS consult
  5. Determine cause - UTI in given case
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10
Q

Necrotizing Fasciitis (5)

A
  1. Early recognition based on appearance, rapidity of symptom development, art of pain, and possible development of sepsis
  2. Aggressive IVF resus
  3. BS abx IV
  4. Immediate surgical consultation
  5. Do not delay operative treatment
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11
Q

Hyperkalemia (5)

A
  1. Obtain EKG
  2. Note HyperK on EKG or labs
  3. Immediate stabilization of cardiac membrane with calcium
  4. Administration of medications to shift potassium into cells and also decrease total body potassium
  5. Admission
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12
Q

Acute Angle Closure Glaucoma (4)

A
  1. Thorough eye exam, including visual acuity, intraocular pressure and slip lamp
  2. Early administration of glaucoma medications (acetazolamide, timolol, apraclonidine, pilocarpine)
  3. Frequent administration until IOP normalizes
  4. Emergenct ophthalmology consult
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13
Q

Incarcerated Hernia with SBO (6)

A
  1. Recognition of hernia
  2. Large bore IV access and fluid bolus
  3. Upright CXR w obstructive series
  4. NGT
  5. Pain management
  6. GS consult
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14
Q

Salicylate Toxicity (6)

A
  1. Large bore IV access
  2. Pregnancy test
  3. Obtain history of salicylate use
  4. Alkalinization of urine w sodium bicarb
  5. Close monitoring of pt and salicylate levels
  6. ICU admission
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15
Q

Henoch-Schonlein Purpura (5)

A
  1. Fluid resuscitation
  2. Abdominal XR
  3. Pain mgmt
  4. Lab evaluation of liver and renal injury
  5. Surgery consult (r/o intussusception)
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16
Q

Pit viper bite without envenomation (7)

A
  1. Assess ABC
  2. Examine wound
  3. Identify snake and risk for venom exposure
  4. Evaluate for laboratory signs of envenomation
  5. Observe for physical signs of envenomation
  6. Contact poison control
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17
Q

Central retinal vascular occlusion (2)

A
  1. Ocular examination

2. Ophthalmology consult

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18
Q

Prolonged QT / Torsades (4)

A
  1. EKG
  2. Recognition of tornadoes after decompensation
  3. Resusciation per PALS guidelines
  4. Cardiology consultation
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19
Q

Retropharyngeal abscess (pediatric) (5)

A
  1. Prepare for intubation
  2. Antibiotics
  3. Soft tissue neck XR
  4. ENT consult
  5. ICU admission
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20
Q

Slipped Capital Femoral Epiphysis (4)

A
  1. Physical exam of hips bilaterally
  2. Bilateral hip XR with lateral views
  3. Ortho consult for SCFE
  4. Pain mgmt
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21
Q

Testicular Torsion Pediatric (7)

A
  1. Testicular examination
  2. Immediate emergency Urology/Peds sx consult
  3. Testicular color flow doppler US
  4. Pain mgmt
  5. Manual detorsion if prompt surgical consult not avail
  6. OR for surgical exploration and detorsion
  7. NPO
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22
Q

Gastric Perforation (4)

A
  1. Large bore IV access and fluid bolus
  2. Upright CXR
  3. Pain mgmt
  4. GS consult
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23
Q

Pertussis Infant (5)

A
  1. Oxygen
  2. Recognize tachycardia and give saline
  3. CXR
  4. Abx for pt and close contacts
  5. Admission to respiratory isolation
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24
Q

Leaking AAA (4)

A
  1. Large bore IV access and fluid bolus
  2. Bedside US
  3. Surgery consult
  4. Blood transfusion
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25
Carbon monoxide poisoning (5)
1. 100% NRB 2. Obtain FSBG 3. Obtain history with CO poisoning 4. Obtain COHb level 5. Transfer to hyperbaric facility
26
Awake Intubation: describe procedure
1. Glycopyrrolate 2. Local anesthetic 3. Sedation 4. Preoxygenate 5. Position 6. DL/VL/fiberoptic
27
Assault to face (4)
1. Early airway control using advanced airway techniques, * with cric setup spontaneously 2. Hemorrhage control 3. C-spine immobilization 4. CT head, c-spine, max face
28
Facial burns/Burns to neck (6)
1. Large bore IV access and fluid resuscitation (following Parkland formula) 2. Analgesia 3. Intubation 4. Escharotomy for circumferential third degree burn to extremity 5. Tetanus admin 6. Transfer to burn unit
29
Variceal Bleeding (6)
1. Large bore IV access 2. Hemodynamic monitoring 3. Blood transfusion 4. Plt/FFP 5. GI consultation for emergent EGD 6. ICU admission
30
Symptomatic Bradycardia (6)
1. EKG 2. Obtain O2 sat 3. Atropine 0.5mg IV (may repeat until total 3mg) or glucagon 5-10mg IV 4. Pacing (transcutaneous or transvenous) 5. Cardiology consultation 6. Admission to ICU
31
Status Asthmaticus (7)
1. Pulse ox 2. Cardiac monitoring 3. Supplemental O2 4. Admin of albuterol, ipratroprium and steroids 5. Frequent reassessment 6. Adjunctive therapies ie mag, terbutaline, epi, bipap 7. ICU admission
32
Stevens Johnson Syndrome (6)
1. Obtain hx of recent antibiotic use 2. Skin exam 3. Establish dx of SJS 4. Stop offending agent 5. Dermatology and Ophthalmology consult 6. ICU admission
33
SBO (5)
1. IV access and fluid bolus 2. Obstructive series with upright chest xr 3. Pain mgmt 4. GS consult 5. NG tube
34
Cocaine-induced CP (7)
1. EKG and VS monitor 2. O2 admin 3. Benzo 4. Nitrates 5. Troponin 6. CXR 7. Observational admission
35
Simple febrile seizure (3)
1. Detailed H&P to assess for meningitis, other red flags 2. Acetaminophen q4h or ibuprofen q6h 3. Counsel parents about simple febrile seizure and f/u
36
Pulmonary Embolism (5)
1. EKG 2. CXR 3. VQ or CTA 4. Heparin tx or NOAC 5. Admit for anticoagulation
37
Anaphylaxis (7)
1. Airway assessment 2. Oxygen 3. Epinephrime IM 4. NS IV bolus 5. Benadryl or hydroxyzine w albuterol, steroid 6. Observe at least 6h 7. If dc, must get script for episode pen and antihistamine
38
Acute appendicitis (8)
1. Urine hcg 2. UA 3. Pelvic exam in woman of child bearing age 4. Pain mgmt 5. Antibiotics pre-op 6. Serial abdominal exam 7. CT abdomen pelvis w contrast (enteric) 8. GS consult
39
Subdural hematoma w midline shift (7)
1. Early FS BG 2. Obtain hx recent fall 3. Noncon head CT 4. Lab eval 5. Pain mgmt 6. NS consultation 7. Admission to ICU
40
Uncomplicated perianal abscess (5)
1. Pain medications 2. Thorough exam to r/o signs of fistula formation and systemic involvement 3. I&D 4. Discuss post-incision drainage mgmt - sit baths, stool softeners, frequent dressing changes 5. Arrange follow up
41
Ectopic Pregnancy (8)
1. large bore IV access and fluid bolus 2. Blood type and cross 3. Rhogam 4. Hcg quant 5. Pelvic exam 6. Pelvic US 7. Pain mgmt 8. Emergent OBGYN consult
42
Alcohol intoxication (4)
1. FS BG 2. Non con Head CT 3. Chem 7 and osm gap 4. Lac repair
43
DKA with UTI (7)
1. Early BG assessment 2. Fluid replacement (NS during first hour, followed by 1/2 NS) 3. Insulin drip 4. Replete potassium 5. EKG 6. ICU admission 7. Abx for UTI
44
Inferior wall MI with RV involvement (7)
1. EKG 2. Right sided EKG 3. IV access and fluid bolus 4. Asa admin 5. AVOID nitro admin 6. Cardiology consultation 7. Cath lab activation
45
Ovarian torsion (5)
1. Pregnancy test 2. Pelvic exam 3. OBGYN consult for laparoscopy for detorsion 4. Analgesia and re-assessment
46
Opioid OD (5)
1. FS BG 2. Narcan admin 3. EKG 4. CXR 5. Frequent re-assessment after interventions
47
Traveler's Diarrhea (5)
1. Elicit social history, travel, RF for immune compromise, antibiotic us 2. Send stool sample w ova, parasites, Giardia antigen, C diff toxin, fecal leukocytes 3. Rehydrate and electrolyte repletion 4. Prescribe abs 5. Arrange f/u
48
Thrombotic Thrombocytic Purpura (6)
1. Note petechiae on physical exam 2. Obtain cbc 3. Steroids 4. Plasmapheresis 5. Hematology consultation 6. Admission
49
Ludwig's Angina (4)
1. Airway mgmt - assessment for difficult airway characteristics and anticipate advanced airway mgmt techniques 2. Antibiotics 3. ENT consult - consult should not be delayed for diagnostic imaging 4. Admission
50
Cat bite (3)
1. Appropriate abx 2. Tetanus immunization 3. Follow up for wound check
51
Tubo-ovarian abscess (6)
1. Urine pregnancy test 2. Pelvis US 3. Antibiotics 4. Gyn consult 5. Pain meds 6. Urogenital exam 7. Admission for pain meds and iv abx
52
Cavernous sinus thrombosis (4)
1. Early abx and steroids 2. LP 3. MRI for dx 4. ICU
53
Kawasaki Disease (3)
1. Treatment of Kawasacki disease: asa and IVIC 2. Discussion w family regarding diagnosis and mgmt 3. Consultation with rheum or ID
54
Cauda Equina Syndrome (5)
1. Pain control 2. Complete neurological exam 3. MRI 4. NS consultation 5. Consider dexamethasone w NS consult
55
PALS epi dose
0.01 mg/kg of 1:10,000 epi q 3m
56
SIDS (4)
1. Initiate PALS 2. Assess for signs of abuse 3. Resuscitation to ensure temp is within normal limits before pronouncement of death 4. Provide psychosocial support to family
57
Septic arthritis (4)
1. Pain mgmt 2. Joint aspiration for gram stain, culture, crystals, abc 3. Antibiotics after gram stain, fluid results 4. XR for osteomyelitis
58
Rocky Mountain Spotted Fever (5)
1. Obtain travel hx ie camping 2. Examination of rash 3. CBC, BMP, LFT 4. Complete physical exam including chest, lungs, abdomen, neurological exam 5. Antibiotics
59
Acute Chest Syndrome (7)
1. Oxygen 2. IVF 3. Pain control with IV opiates 4. CXR and identification of pulmonary infiltrate 5. Antibiotics 6. Exchange transfusion or hematology consult 7. Admission to ICU
60
Bacterial Meningitis (4)
1. Appropriate antibiotic therapy before imaging or LP 2. LP 3. Admission to isolation bed ICU 4. Assessment of public health concerns
61
Pericarditis (5)
1. EKG 2. Cardiac examination 3. Echocardiogram 4. NSAID 5. Admission
62
Hypoglycemia secondary to sulfonurea (5)
1. IV access 2. FS BG 3. IV dextrose 4. Further anti hypoglycemia intervention ie octreotide 5. Admission
63
High Altitude Cerebral Edema (3)
1. Treatment with dexamethasone 2. Rapid descent 3. Oxygen
64
Digoxin toxicity (6)
1. EKG 1a. Dig level 2. Atropine or pacer pads requested +/- pacing 3. Digibind 4. Treatment for hyperkalemia 5. CCU admission
65
CHF Exacerbation (5)
1. Oxygen 2. High dose nitro drip / sequential SL nitro 3. Furosemide 4. Asa 5. CCU consult (bipap??)
66
Critical Aortic Coarctation, 10 day old M (7)
1. Recognition of respiratory distress 2. Oxygen administration & intubation 3. IV access 4. EKG, CXR 5. Recognition of cardiomegaly and cardiac cause of respiratory distress 6. Cardiology consult 7. PGE1 admin
67
Renal Colic (5)
1. Large bore IV access and hydration with greater than 1L NS 2. Early pain control 3. Confirmation of renal colic w CT w/o contrast 4. UA 5. Temperature
68
Status Epilepticus (7)
1. FS BG 2. IV access 3. IV benzo 4. Head CT 5. Labs to eval metabolic 6. Serum tox 7. Neurology consult (for new onset seizure)
69
Fournier's Gangrene (4)
1. Full physical exam looking for fever source 2. Adequate fluid resuscitation 3. Emergency surgical consult 4. BS Abx
70
Intussusception (4)
1. NS bolus 2. Complete physical exam 3. Barium enema 4. Pediatric surgical consult
71
HIV PNA, likely PCP (6)
1. Oxygen supplementation 2. IVF 3. CXR 4. UA 5. Abx 6. Respiratory isolation
72
SVT (5)
1. Large bore IV access 2. EKG 3. Discussion w patient re side effects of adenosine 4. Adenosine w rhythm strip, rapid push 5. Repeat EKG after resolution
73
Community Acquired Pneumonia (5)
1. IV access 2. NS fluid bolus 3. CXR 4. Abx 5. Admission
74
C-spine fracture, SCI, Neurogenic Shock (6)
1. Large bore IV access 2. C-Spine precautions 3. CT c-spine 4. Neurosurgery consult 5. Intubation 6. Pressors for neurogenic shock
75
Pancreatitis (4)
1. 2L NS IV 2. Type and hold 3. Pain meds and opiates 4. Discussion re alcohol cessation
76
Ischemic bowel secondary to mesenteries artery occlusion (5)
1. NS 2L 2. CT abdomen pelvis w contrast 3. Abx 4. Sx or IR consult 5. Pain meds
77
COPD Exacerbation (5)
1. O2 supplementation 2. Duoneb 3. Steroids 4. CXR 5. CPAP or BIPAP
78
Stroke - Left MCA (5)
1. FS BG 2. Head CT 3. Neurology/Stroke team notification 4. BP control w IV agents
79
Pelvic fracture w hemorrhage & | Open R ankle fx (7)
1. IV access with at least 2 large bore catheters 2. Blood transfusion 3. Immediate activation of surgery/trauma service 4. FAST exam 5. CXR and Pelvis XR 6. Reduction and fixation of pelvis 7. IR consultation for angiographic intervention
80
Pyelonephritis (5)
1. Pain control 2. Urine preg 3. IVF 4. Abx 5. Ensure proper outpatient tx, instructions, f/u
81
Thyrotoxicosis & PNA (8)
1. NS fluid bolus 2. FS BG 3. CXR 4. Abx 5. CT and LP to r/o CNS pathology 6. Serum tox 7. Propranolol, PTU, iodine 8. ICU consult
82
NAAT & Splenic Lac (5)
1. Recognition of potentially life threatening serious abdominal injury 2. CT abdomen 3. Recognition of inconsistent story/abuse 4. GS consult 5. SW/CPS consult
83
Methemoglobinemia (4)
``` 1. Poison control 2 High flow O2 3. ABG 4. Methylene blue (consider hyperbaric or exchange transfusion) ```
84
Hemolytic Uremic Syndrome (4)
1. Large bore IV access 2. Discussion with family 3. Admission 4. Pediatric hematology consult
85
Foreign body aspiration in toddler (4)
1. Airway management preparation 2. Oxygen supplementation 3. CXR 4. ENT consult
86
Acetaminophen OD (5)
1. Determine timing of ingestion 2. Check acetaminophen level and potentially co-ingested substance levels 3. Start NAC immediately based on calculated level >140 mg/kg 4. Check EKG 5. Place pt on suicide watch
87
Anterolateral STEMI (5)
1. Cardiac Monitor 2. EKG within 10 min 3. Cardiology consultation (cath lab) 4. Asa 5. Pain control with morphine or nitro
88
SIRS (Sepsis) d/t PNA in elderly (7)
1. Large bore IV access and fluid bolus 2. Lactate 3. CBC 4. Blood and urine culture 5. CXR 6. Eval for sources of fever including cellulitis, decub ulcer, UA 7. Early abx
89
Heatstroke (7)
1. Check BG 2. Large bore IV access and fluid bolus 3. Immediate cooling 4. Core temp monitor 5. CT head 6. ICU admission
90
Pericardial tamponade (5)
1. Large bore IV access and fluid bolus 2. CXR 3. EKG 4. Bedside cardiac echo 5. CT surgery consult to emergent pericardial window
91
Tension PTX s/p stab wound (5)
1. Emergent decompression 2. FAST 3. Pain mgmt 4. CXR to confirm chest tube placement
92
Diverticulitis w fever (6)
1. Pelvic exam 2. Urine hcg 3. Pain mgmt 4. CT abdomen pelvis w contrast (IV and PO) 5. Early surgery consult 6. Abx
93
Eclampsia (5)
1. Large bore IV access 2. Mag IV 3. CT head 4. Emergency obstetrics consult 5. UA
94
Ventricular Tachycardia w pulse (4)
1. EKG 2. Amiodarone boluses followed by drip while stable 3. Syncronized cardioversion for instability, including hypotension, CP, AMS 4. Cardiology consult
95
TCA Toxicity (6)
1. Large bore peripheral IV access 2. Fluid bolus 3. EKG 4. Repeat EKG after treatment 5. Sodium bicarbonate 6. MICU Admission
96
Post liver transplant fever (6)
1. IV access and fluid bolus 2. Cultures before antibiotics 3. Pracentesis w peritoneal fluid analysis/cultures 4. BS abx 5. Pain meds 6. Contact appropriate consultant
97
Blunt Abdominal trauma / splenic rupture (7)
1. Large bore IV access and fluid bolus 2. Blood type and cross 3. Pain control 4. Trauma surgery or general surgery consult 5. FAST exam 6. Early prbc infusion 7. Advocate for laparotomy
98
Necrotizing Enterocolitis (4)
1. IV access and fluid bolus 2. Abdominal XR +/- US 3. Cultures and abx 4. Pediatric surgery consult
99
Spontaneous bacterial peritonitis (4)
1. IV access and fluid bolus 2. Early paracentesis 3. Early abx 4. Pain mgmt
100
Pulmonary inhalation anthrax (7)
1. Intubation 2. CXR 3. Early antibiotics 4. MICU admission 5. Isolation 6. Contact CDC 7. Prophylaxis for HCW and family
101
Hypertensive Emergency (5)
1. IV antihypertensive medication 2. Pain control 3. CT brain 4. LP 5. Admission w tele
102
Hypothermia secondary to cold water immersion (6)
1. Airway mgmt 2. Undressing patient and assessing for any signs of trauma 3. Temperature monitoring via internal probe 4. poc glucose 5. Aggressive rewarming 6. PIC admission (CT head and c-spine)
103
Enterinvasive diarrhea (3)
1. Rehydration 2. Repletion of electrolytes 3. Abx
104
INH Tox (5)
1. Airway mgmt 2. POC BG 3. Pyridoxine admin 4. Serum tox 5. Serum tox 6. Non con CT brain
105
Elder Abuse & Dehydration (6)
1. Reporting of case as mandated for elder abuse 2. SW involvement 3. IV hydration 4. Check CK 5. EKG 6. Workup for infectious source
106
Acute gout (3)
1. Aspiration of joint to r/o septic arthritis 2. Pain mgmt 3. Counseling on alcohol reduction
107
Carotid Artery dissection (5)
1. Pain control 2. CT w/o 3. CTA 4. Neurology consult 5. Heparin
108
Sigmoid Volvulus in Elderly (5)
1. Pain control 2. IV line 3. Obstructive series 4. NG tube 5. Consult GI and GS
109
LVAD Failure d/y pump thrombosis (4)
1. EKG 2. Bedside echo 3. Heparin drip 4. VAD coordinator of CT surgery/Cards consult
110
Nursemaid's Elbow (2)
1. Attempt manual reduction | 2. Reassess ROM, vascular integrity & tenderness post reduction
111
Sepsis w DIC (5)
1. Fluid resuscitation 2. Find source of sepsis 3. Abx 4. Recheck lactate 5. Recognize DIC
112
DIC Treatment
FFP and Plt
113
Pulseless v-tach Cardiac arrest w ROSC (6)
1. Confirm airway placed in field 2. Cardiac monitor 3. Recognize VT w rose 4. Neuro exam 5. Therapeutic hypothermia 6. Appropriate sedation
114
DVT after Surgery (3)
1. US 2. Anticoagulation 3. Pain mgmt
115
SVC Syndrome (4)
1. Clinical idenfication of the dx 2. Elevate head of bead and give diuretics 3. Start supplemental O2 and monitor closely 4. Consult Heme/Onc and IR
116
Hydrofluoric Acid Exposure (7)
1. Diagnose HF burn 2. Check EKG for dysrhythmia 3. Attempt Calcium therapy 4. Admin analgesics 5. Consult toxicologist or burn specialist 6. Admit patient 7. Labs (check other electrolytes)

Oral Baord Review (1 decks)

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