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Flashcards in PREP:EM Questions Deck (45):
1

mild vs moderate vs severe hypothermia
(definitions and treatment)

mild 32-35: active external warming
moderate 28-32: +active core (bladder, gastric lavage)
severe < 28: ECMO, pleural lavage

2

treatment of shivering

BDZs

3

atropine dose

0.02mg/kg (minimum dose of 0.1mg)

4

What's a normal ankle-brachial index?

>0.9

5

disorder with mousy/musty odor

PKU

6

fishy odor

trimethylaminuria

7

sweaty feet smell

isovaleric acidemia

8

SIRS criteria

Core temp < 36 or >38.5
tachycardia or bradycardia
tachypnea
leukocytosis, lymphopenia, or 10%+ bandemia

9

Septic shock definition

sepsis + SIRS + continued cardiovascular dysfxn after 40ml/kg fluids

10

refractory septic shock definitions

fluid refractory: after 60ml/kg fluids
catecholamine refractory: after 10 mcg/kg/min of dopa, epi, or norepi

11

severe sepsis definition

when associated with:
ARDS
cardiovascular dysfxn
dysfxn of 2 or more organ systems

12

what is hydrogen sulfide

mustard gas
causes superficial skin burns, eye irritation, and resp tract irritation

13

What are the classifications of neutropenia

severe < 500
moderate 500-1000
mild 1000-1500

14

What is the discriminatory zone with HCG?

transvaginal US- 1,500 mIU/mL
transabdominal US- 6,000 mIU/mL

15

symptoms of carbemazepine toxicity

can cause resp compromise, altered mental status, vomiting, drowsiness, slurred speech, nystagmus, hallucinations, hypotension, coma, dystonic reactions, seizures
has some anticholinergic properties
false positive for TCAs on UDS

16

expected compensation for acute resp acidosis

increase in serum bicarb 0.1 meq for each 1 mmHg PCO2

17

expected compensation for acute metabolic acidosis

decrease in PCO2 1.2 mmHgfor each 1 meq of bicarb

18

expected compensation for acute resp alkalosis

decrease in serum bicarb 0.2 meq for each 1mmHg PCO2

19

expected compensation for acute metabolic alkalosis

increase in PCO2 0.6 mmHg for each 1meq of bicarb

20

how frequently can you repeat epi in anaphylaxis?

3-4 times every 5-15 minutes

21

what is the pathophys of staph scalded skin syndrome?

hematogenous spread of epidermolytic or exfoliative toxin; children are more affected that adults due to inefficient renal clearance

22

most common nerve injury in supracondylar fracture

median nerve

23

most common artery injury in supracondylar fracture

brachial artery

24

treatment of DUB

combo pills or progestin only pill taper

25

risk factors for patellar dislocation

patella alta
genu valgum
increased femoral anteversion
ligamentous laxity

26

sites for IO access

proximal tibia
distal tibia
distal femur
proximal humerus
sternum in adults

27

MUDPILES

methanol/metabolic defects
uremia
DKA, alcoholic ketoacidosis, starvation
paraldehyde
iron and INH
lactic acidosis
ethylene glycol
salicylates
* also CO, cyanid, hydrogen sulfide, metformin, phenformin, sulfur, theophyllin, and toulene!

28

normal CSF opening pressure

< 20 cm H2O

29

LR +

= (positive test/presence of disease) / (positive test/absence of disease)
= sensitivity / (1 - specificity)

30

LR -

= (negative test/presence of disease) / (negative test/absence of disease)
= (1 - sensitivity) / specificity

31

How do you use LRs?

You have to convert the pretest probability to odds
This is pretest probability / (1 - pretest probability)
Then you multiply by the LR
Finally, you convert the odds BACK to the probability!

32

What are clinically significant LRs?

LR + > 10
LR - < 0.1

33

Amanita phalloides ingestion

white mushroom that can kill. classically:
stage I: 6-24hrs of no sxs
II: V/D 12-24hrs
III: seeming recovery
IV: 2-4d later with liver and renal failure

34

typical murmur for HOCM

midsystolic harsh ejection murmur

35

Brown Sequard syndrome

hemisection of the spinal cord
loss of contralateral pain and temperature
loss of ipsilateral motor

36

loss of contralateral pain and temperature
loss of ipsilateral motor

Brown Sequard syndrome
hemisection of the spinal cord

37

Anterior cord syndrome

disruption of the anterior spinal artery
loss of motor and pain sensation
preserved temp and proprioception

38

loss of motor and pain sensation
preserved temp and proprioception

Anterior cord syndrome
disruption of the anterior spinal artery

39

Central cord syndrome

upper extremities affected more than lower extremities

40

upper extremities affected more than lower extremities

central cord syndrome

41

Posterior cord syndrome

loss of proprioception and pain sensation

42

loss of proprioception and pain sensation

posterior cord syndrome

43

ectasy/MDMA intoxication

hyponatremia, concentrated urine, altered mental status
may see serotonin syndrome

44

formula for odds ratio?

(AxD)/(BxC) in standard 2x2 table

45

what's the difference between odds ratio and relative risk?

relative risk is used when patients are followed over time.
odds ratio is used when patients already have the outcome and you look back retrospectively at an exposure of interest