WEEK 2 Flashcards

(75 cards)

1
Q

Non-blanching petechial rash

A

N. Meningitidis

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2
Q

APAP antidote

A

N. Acetylcysteine

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3
Q

Anticholinergic antidote

A

Physostigmine

Except TCA’s

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4
Q

Benzo antidote

A

Flumazenil

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5
Q

Cyanide antidote

A

Na Nitrite

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6
Q

Methanol antidote

A

Ethanol

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7
Q

Narcotic antidote

A

Naloxone

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8
Q

Garlic odor on breath

A

Acute arsenic ingestion

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9
Q

Dig toxicity causes?

A

Hyperkalemia

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10
Q

Dig reversal agent

A

Digabind

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11
Q

Pinpoint pupils and resp depression =

A

Opiate overdose

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12
Q

3 C’s of TCA tox

A

Cardiac abnormalities
Convulsions
Coma

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13
Q

EKG abnormalities in TCA tox

A

Wide QRS

Prolonged QT interval

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14
Q

Early signs of APAP tox

A

N/V

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15
Q

Rotten ages

A

NItrogen sulfide

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16
Q

ASA Tox

A

Resp alkalosis

Met acidosis

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17
Q

Normal pH

A

7.35 - 7.45

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18
Q

Normal CO2

A

35 - 45

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19
Q

Normal O2

A

83 - 102

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20
Q

Normal HCO3

A

22 - 28

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21
Q

Normal Anion Gap

A

10 - 16

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22
Q

pH: 7.48
CO2: 40
HCO3: 30

A

Metabolic Alkalosis

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23
Q

pH: 7.45
Co2: 47
HCO3: 29

A

Metabolic Alkalosis
with
Respiratory Comp

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24
Q

pH: 7.30
CO2: 40
HCO3: 18

A

Metabolic Acidosis

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25
Fruity odor to breath
DKA
26
DKA
``` *** Aggressive fluid therapy with NS *** .1 units/kg insulin per hour Continuous infusion is preferred Potassium repletion Routine bicarb not recommended ```
27
Almost all patients in DKA present with glucose above
300 mg/dL | Most will be above 500
28
HHNS occurs in
Type 2 diabetics | No ketone production because of enough insulin to use glucose in cells.
29
HHNS syndrome
Severe hyperglycemia > 600 Hyperosmolarity > 315 mOsm/kg Relative lack of ketonemia (pH >7.3)
30
HHNS presentation
Usually elderly AMS Non-ambulatory Concomitant infxn
31
Glucose less than ___ is generally a concern
About 60 | 45 is very dangerous
32
Hypoglycemia Tx
15 - 20g of glucose (nonemergent) 1 g/kg of D50 IV (emergent) Prescribe glucagon Adjust insulin therapy
33
Hypoglycemia accounts for ___% of patient presentations to the ED with AMS
7%
34
Non-diabetic causes of hypoglycemia
ETOH | Sepsis
35
Primary adrenal insufficiency
Addisons
36
Most common cause of adrenal insufficiency
Chronic exogenous steroid use
37
Darkening of skin in addisons is caused by?
Increased melanocyte stimulating hormone release
38
Hypotension in adrenal crisis is usually refractory to what tx?
Catecholamine and fluid admin. | Cortisol must be replaced
39
Where is adrenal crisis seen?
Undiagnosed addisons with serious infxn or acute stress. Adrenal infxn or hemorrhage Rarely in 2ndary insufficiency
40
Adrenal crisis presentation
Hypotension | Abd and flank pain
41
Pheo rule of 90's
90% in adrenal medulla 90% unilateral 90% of time not malignant 90% of pts are adults
42
A positive 24hr Vanillylmandelic acid secretion test =
Pheochromocytoma
43
Myxedema Coma
Uncompensated hypothyroidism in the elderly. | AMS, hypothermia, brady, hypotension
44
Myxedema coma often precipitated by ____ exposure
Cold exposure
45
Myxedema coma tx
Correct hypothermia IV levothyroxine Glucocorticoids
46
Thyroid storm
Severe life-threatening Hyperthyroidism caused by stress, trauma, sepsis S/S: Fever, arrhythmia, CHF, agitation
47
Thyroid storm tx
Stabilize, O2, fluids Beta blockers for HTN PTU (antithyroid) Iodine
48
2nd gen antipsychotics
Olanzapine: Zyprexa Risperidone (Risperidal) Ziprasidone: Geodon
49
FIrst choice for chemical restraints
Haldol and benzos
50
Lab needed in AIDS encephalopathy
CD4 count
51
Cocaine w/d tx
Supportive | no meds shown to help
52
Which paralytic in CI in meth intubation
Succs
53
What should HTN in meth OD be treated with?
Nitroprusside | Avoid beta blockers
54
NMS
Neuroleptic malignant syndrome AMS, muscular rigidity, hyperthermia Caused by compazine, neuroleptics antipsychotics
55
When do etoh w/d seizures occur?
12 - 48 hrs after last drink
56
When does w/d hallucinosis occur
12 - 24 hrs, resolve within 24 - 48 | Usually visual
57
When do DT's occur?
48 - 95 hrs | Can last 1-5 days
58
DT tx
Supportive Benzos Phenobarb if benzos not working NO antipsychotics
59
Does psychosis alone meet legal criteria for involuntary tx?
No
60
Catatonia
Inability to move normally despite physical ability to do so | Tx with lorazepam
61
Abx for meningitis
Rocephin IV
62
Paradoxical crying (cries more when being held) in an infant is indicative of?
Meningitis
63
DOC for MRSA
Bactrim | Clinda is alternate
64
Oslers nodes and janeway lesions =
Infectious endocarditis
65
Imaging for endocarditis
TEE is best
66
Toxic shock syndrome
Results from the TOXINS absorbed from a localized infxn. | NOT sepsis, but causes by bacterial infections.
67
Malaria
Caused by plasmodium falciparum Transmitted b mosquitoes Sx occur 12 - 35 days after exposure
68
Botulism
BIlateral cranial neuropathies symmetric descending weakness Absence of fever
69
Smallpox agent
Variola virus
70
Anthrax agent
Bacillus Anthracis
71
Is cutaneous anthrax painful?
No, painless
72
Anthrax tx
Ciprofloxacin or doxy for 2 months
73
Toxic dose of APAP
>140 mg/kg
74
TCA's are which class
Anticholinergic
75
Anticholinergic OD saying
Hot as a hare, red a a beet, dry as a bone, blind as a bat and mad as a hatter