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Step 2 CK > Preventative and EM MTB Chapters > Flashcards

Preventative and EM MTB Chapters Flashcards

1
Q

Ingestions of unknown substance– time window for lavage + when to avoid

A

first two hours

not for caustic ingestion or with altered mental status

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2
Q

Treatments that are almost always bad options for ingestion

A
  • diuretics
  • cathartics
  • whole bowel irrigation
  • ipecac (this is pre hospital)
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3
Q

Treatment that is is almost always a decent option in ingestion

A

charcoal

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4
Q

Most common causes of death by overdose nationwide

A

aspirin and acetaminophen LOL

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5
Q

Person with AMS of unclear etiology– first two steps

A

naloxone and dextrose (these do no harm)

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6
Q

Amount of acetaminophen that is dangerous? lethal?

A 
8-10 = danger 
12-15 = fatal
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7
Q

When is NAC safe for acetaminophen

A

first 24 hours

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8
Q

Metabolic disturbance in acetaminophen tox?

A

respiratory alkalosis and metabolic acidosis

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9
Q

Benefit of OD with BDZ + TCA

A

BDZ prevents seizing from TCA but if you give flumazenil all bets are off.

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10
Q

TCA EKG change

A

wide QT –> Torsades

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11
Q

TCA OD signs & tx

A

dry everything; sodium bicarb

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12
Q

Treatment caustic ingestion

A

endoscopy, flush with water

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13
Q

COD in CO poisoning

A

MI

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14
Q

Metabolic disturbance in CO poisoning

A

lactic acidosis

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15
Q

Lab to check first for CO poisoning

A

ABG (check for low pH 2/2 lactic acidosis…. low bicarb)

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16
Q

Two common drugs causing methemoglobinemia

A

anesthetics

nitrites

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17
Q

Treatment for methemoglobinemia

A

100% O2 and Methemoglobinemia

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18
Q

Color of blood in CO poisoning vs methemoglobinemia

A

CO- red

Met- brown

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19
Q

Nerve gas pathophys

A

blocks acetylcholinesterase …. ^ Ach ….^ secretions

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20
Q

COD in nerve gas + first step in treatment

A

bronchorhea –> bronchospasm –> respiratory arrest

*first give atropine

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21
Q

What predisposes to dig tox?

What lab is seen in dig tox

A 
hypokalemia = risk factor 
HYPER= lab finding (blocks Na/K ATPase and Dig competes with K+)
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22
Q

Dig tox symptom + tx

A

visual disturbance

Can give dig specific antibodies if CNS/ Cards Involvement

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23
Q

Specific signs of lead tox

A

ATN

wrist drop

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24
Q

Treatment lead tox

A

chelating agents (ie succimer, EDTA, dimercaprol)

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25
Treatment of mercury tox
chelating agents (same as lead)
26
Methanol/ ethylene glycol tox treatment
fomepizole, dialysis
27
Tox metabolite in methanol/ethylene glycol tox?
methanol - formic acid | ethylene glycol- oxalate
28
Methanol/ethylene glycol organs effects
methanol -eyeballs | ethylene- kidneys
29
Osmolality equation
sosm= (2Na) + (BUN/2.8) + (Glu/18) | actual should = calculated else you have extra osmoles.
30
How do snake bites kill?
hemolysis/ DIC and respiratory paralysis
31
Treatment of snake bites
pressure, immobilization, antivenin PRN
32
Lab finding in black widow bite?
hypocalcemia... can cause muscle/ abdominal pain
33
Treatment black widow bite?
antivenin, calcium PRN
34
Treatment brown recluse bite?
Dapsone, steroids, debride
35
Abx for dog, cat, human bites?
augmentin for all.
36
Concussion vs contusion management
observe contusion inpatient
37
Indications for GI px
intubation head trauma, burns coagulopathy with respiratory failure
38
Burns first two steps
assess airway --> give fluids
39
Equation for fluid replacement in burns
4x % BSA X kg
40
Rate and type of fluids for burns
normal saline 1/2 first 8 hours, 1/4 next 8, 1/4 next 8
41
Equations for BSA burnt
arm and head are 9 leg chest and back are 18 each *Hand width = 1%
42
Common px abx in burns
topical (ie silver sulfadiazine)
43
Difference between NMS and Malignant hyperthermia
both have high CPK/ Temp and can get dantrolene. But NMS is by antipsychotics and could also get a dopamine agonist. MHTN is from anesthetics
44
Hypothermia cause of death
arrhythmia
45
Cause of death in salt water vs fresh water drowning
salt- CHF | fresh- hemolysis (hypotonic fluid in vasculature, cells burst)
46
Management of drowning
positive pressure ventilation
47
What is basically never the right answer in cardiac arrest
precordial thump
48
Which two rhythms can get unsynchronized cardioversion?
vfib, pulseless vtach
49
Besides CPR, whats treatment of asystole?
epi
50
Drugs for unstable vtach and vfib
epi/amio alternations
51
Some common causes of pulseless electrical activity x4
TPTX PE tamponade K+ disorder
52
Unstable afib treatment | chronic stable afib treatment
unstable- Synch cardioversion | stable/chronic- rate control and either anticoagulate or asa if low risk
53
Whats the CHADS score for afib anticoagulation?
``` C-CHF/cardiomyopathy H- HTN A-Age above 75 D- DM S- Stroke/ TIA = 2 ```
54
SVT treatment
vagal maneuvers --> adenosine --> BBer/CCB/Dig
55
Least safe for anticoagulating in afib?
least safe is warfarin... can do dabigatran/rivaroxaban/apixaban
56
Two drugs to avoid in WPW
dig and CCB
57
Two antiarrythmics to use in WPW
procainamide or amio
58
Cure for WPW
ablation
59
EKG findings in WPW
short PR | Delta wave
60
Vtach soon after MI... what do you need?
remove the clot
61
how to assess risk for repeat ventricular arrhythmia?
echo
62
Before you can implant defibrillator..... what type of ventricular arrhythmia must be present?
sustained.. can do EP studies to try and provoke sustained v tach.
63
Cancer screen with largest mortality decrease-
mammo after 50
64
How to benefit asx pt with many first degree relatives that have breast cx
SERMs- tamoxifen/raloxifene
65
Age group for paps
21-65 every 3 years or q5 with cotest after 30
66
Age group for chlamydia screening
15-25
67
When is PSA the right answer?
patient asks for it
68
Age for lipids in males vs females
males 35; females 45... or with CAD/equivalent... or DM, HTN etc.
69
When to screen for DM
people with HTN, HLP
70
Caveat to flu over age 50
has to be inactivated at 50 or with chronic disease
71
Order of the two PNA vaccines
13 --> 23
72
Who gets PNA vaccines before 65
chronic disease, CSF leak, cochlear implant, alcohol/tobacco, etc.
73
When does someone get the PNA vaccines twive?
If their first dose was before 65... or if theyre immunocompromised. Wait at least 5 years before dosing again
74
Who gets Hep A and B as adults
chronic liver disease; household contact; MSM; IVDU.... A: travelers B: Health Care, DM, ESRD
75
Age for DEXA/AAA screen
65

Step 2 CK (8 decks)

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