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193 Cards in this Set
- Front
- Back
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Vital components of rescusitation
|
O2
IV access Monitor |
|
Coma Cocktail
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Thiamine
D50 Narcan |
|
Kids Tylenol Dosage
|
15mg/kg
|
|
Kids Ibuprofen Dosage
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5-10mg/kg
|
|
Most commonly OD drug
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tylenol
|
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Which pain reliever is safe in pregnancy?
|
tylenol
|
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When should keterolac be avoided?
|
renal insufficiency and GI bleed
|
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What is the dose for Narcan?
|
0.1mg/kg q2-3 minutes
|
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What is the dose for Flumazenil?
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0.01-0.02 mg/kg up to 2mg
|
|
Determinants of Wound Infection
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Degree of Contamination
Mechanism of Injury Location Patient Age Comorbid Conditions |
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Lidocaine toxicity
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5mg/kg w/o Epi
7 mg/kg w/ Epi |
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scalp sutures
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3-0 or 4-0
remove in 7-10 |
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face sutures
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6-0
remove in 3-5 |
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eyelid sutures
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6-0 or 7-0
remove in 3 |
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ear sutures
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4-0 or 5-0
remove in 7-10 |
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inside mouth sutures
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4-0 or 5-0
remove in 7-10 |
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trunk sutures
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4-0 or 5-0
remove in 7-10 |
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arm sutures
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4-0 or 5-0
remove in 10-12 |
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leg sutures
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3-0 or 4-0
remove in 12-14 |
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top of the foot sutures
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4-0 or 5-0
remove in 10-12 |
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bottom of the foot sutures
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3-0 or 4-0
remove in10-12 |
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joint sutures
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4-0 or 5-0
remove in 14 |
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first line for black widow bite
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calcium gluconate-unless they have a G6PD deficiency
|
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Aspirin
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dialysis
|
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acetaminophen
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n-acetylcysteine
|
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acids/alkali
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dilute/lavage
cortisol for alkali burns calcium gluconate |
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anticholinergics
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physostigmine
|
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anticholinesterases/organophosphates
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atropine
pralidoxime |
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arsenic
mercury gold lead |
lavage
dimercaprol-BAL penicillamine |
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Benzos
Beta Blockers |
flumazenil
glucagon |
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beta blockers
|
glucagon
calcium |
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cadmium
|
edetate
|
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carbon monoxide
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oxygen
|
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copper
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penicillamine
|
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cyanide
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amylnitrate sodium
thiosulfate |
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digitalis
|
fab antibodies
|
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ethylene glycol
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ethanol
|
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fluoride
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calcium gluconate
|
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heavy metals
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BAL-dimercaprol
EDTA Penicillamine DMSA |
|
Heparin
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Protamine
|
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Iron
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deferoxamine
|
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isoniazid
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pyridoxine
|
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methanol
|
ethanol
folate pyridoxine fomepizole |
|
methemoglobinemic agents
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methylene blue
|
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mushrooms/amantia
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physostigmine
|
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opioids
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naloxone
|
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phenobarb
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sodium bicarb
|
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phenothiazine
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diphenhydramine
benztropine |
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quinidine
|
magnesium and isoproterenol
|
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TCAs
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Sodium bicarb
|
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theophylline
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beta blockers
|
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warfarin
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vitamin k
FFP |
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streptokinase/tpa
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aminocaproic acid
|
|
Who gets tetanus IG?
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high risk of infection and incomplete vx history
|
|
Beck's triad
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hypotension
jvd muffled heart sounds -cardiac tamponade |
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Subdural hematoma
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crescent on CT
|
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Epidural Hematoma
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biconvex or lenticular
|
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Subarachnoid bleed with hypertension
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nimodipine
|
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Placental abruption presents as...
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abdominal pain, vaginal bleeding, contractions, DIC
|
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Indications for emergency C section
|
fetal tachycardia
poor viability deceleration |
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Hallmark of Tension Pneumothorax
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dyspnea, hypoperfusion, JVD and decreased breath sounds
|
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incomplete fracture, seen commonly in kids
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Greenstick
|
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Malleolar Fractures-Uni, Bi and Tri
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Henderson Scheme
|
|
dinnerfork deformity
fracture of distal radius with dorsal angulation |
Colles Fracture
|
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anterior angulation
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Smith Fracture
|
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fracture of the distal radius with a radial head disloaction
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Monteggia Fracture
|
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fracture of the distal radius with an associated distal radioulnar joint dislocation
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Galeazzi Fracture
|
|
fracture along the radius
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Nightstick
|
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fracture to 5th metacarpal
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Boxer's
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Fracture to 5th metatarsal
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Ballet Dancer Fx
|
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Trochanteric Fracture
|
pain
shortening of leg external rotation |
|
Most common long bone fracture
|
tibia
|
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Most common fracture of the lower extremity
|
tibia
|
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Shortened leg, internal rotation and abduction
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hip dislocation
|
|
individual bones are broken without a break in the pelvic ring
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Type I Pelvic Fx
|
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single break in the pelvic ring, no displacement
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Type II
|
|
double break in the pelvic ring
unstable |
Type III
|
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Cause of Croup
|
parainfluenza
|
|
Cause of Bacterial Tracheitis
|
Staph
Strep H Flu |
|
Cause of Epiglottitis
|
Strep
|
|
Cause of Peritonsillar Abscess
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Strep pyogenes
Staph |
|
Cause of Retropharyngeal Abscess
|
Strep
Staph Polymicrobial |
|
Age for Croup
|
6 mo-3 years
peak 1-2 years |
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Age for bacterial tracheitis
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3mo-13 years
majority <3 years |
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Age for Epiglottitis
|
all ages
classically 1-7 |
|
age for peritonsillar abscess
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10-18 years
|
|
age for retropharyngeal abscess
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6m-4 years
|
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Onset of Croup
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1-5 days
|
|
onset of bacterial tracheitis
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2-7 day viral URI
|
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Onset for Epiglottitis
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Rapid, hours
|
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Onset for peritonsilar abscess
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antecedent pharyngitis
|
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Onset for Retropharyngeal Abscess
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insidious over 2-3 days after URI or local trauma
|
|
Postion effect of epiglottitis
|
worse supine
tripod sit |
|
position effect of peritonsilar abscess
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worse supine
|
|
position effect for retropharyngeal abscess
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may improve in sniffing position
almost opisthotonic |
|
Stridor in Croup
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inspiratory and expiratory
|
|
Stridor in Bacterial Tracheitis
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Inspiratory and expiratory
|
|
Stridor in Epiglottitis
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only inspiratory
|
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Croup Cough
|
seal like bark
|
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bacterial tracheitis cough
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usually
possible thick sputum |
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Croup Voice Change
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Hoarse, not muffled
|
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Bacterial Tracheitis Voice Change
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Usually normal
May be raspy |
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Voice Change in Epiglottitis
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Muffled, Hot potato
|
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Voice Change in Peritonsilar Abscess
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muffled hot potato
|
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Voice Change in Retropharyngeal Abscess
|
muffled hot potato
|
|
What causes drooling?
|
epiglottitis
peritonsillar abscess retropharyngeal abscess |
|
Who gets dysphagia?
|
epiglottitis
peritonsillar retopharyngeal |
|
Rads of Croup
|
subglottic narrowing
"steeple" distended hypopharynx |
|
Rads of Bacterial Tracheitis
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Subglottic Narrowing
Ragged Tracheal air shadow Tracheal foreign bodies |
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Rads of Epiglottitis
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Enlarged epiglottis
vallecular space loss supraglottic ballooning thumbprint |
|
Rads of Peritonsillar Abscess
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Enlarged tonsillar soft tissue
Uvula shifted to opposite side |
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Rads of Retropharyngeal Abscess
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thickened bulging of pretracheal soft tissue
|
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With a foreign body in the bronchi, the affected side is...
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hyper inflated...ball-valve effect
|
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Decreased Fremitus
|
COPD
Asthma Pleural Effusion Pneumothorax |
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Increased Fremitus
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suggests consolidation
Fluid in lung |
|
triad of asthma
|
ASA sensitivity
Asthma Nasal polyp |
|
watery diarrhea, winter, most common agent
|
rotavirus
|
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watery diarrhea, concurrent respiratory symptoms
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enteric adenovirus
|
|
watery diarrhea, epidemic, fever, headache, myalgias
|
norwalk
|
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fever, abdominal pain, watery or bloody diarrhea, may mimic appedicitis, animal reservoir
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camphylobacter
|
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Tx for Camphylobacter diarrhea
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EES and rehydration
|
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Fever, abdominal pain, headache, mucoid diarrhea
|
shigella
|
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Tx of Shigella Diarrhea
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Rehydration and Bactrim
|
|
Fever, bloody diarrhea, animal reservoir, antibiotics prolong the carrier state
|
Salmonella
|
|
Rice water diarrhea
|
Cholera
|
|
Treatment of Cholera
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Rehydration and bactrim
|
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fever, vomiting, diarrhea, abdominal pain, may mimic appedicitis
|
yersinia
|
|
Tx for Yersinia Diarrhea
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rehydration and ceftriaxone
|
|
Recent antibiotic use
|
C. dif
|
|
Tx for C dif
|
metronidazole
|
|
food poisoning
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staph
|
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treatment for staph diarrhea
|
rehydration
|
|
bloody, mucoid stools, hepatic abscesses
|
entamoeba histolytica
|
|
Tx for histolytica diarrhea
|
metroniadazole
|
|
diarrhea, flatulance, exposure to day care centers, mountain streams
|
giardia
|
|
tx for giardia diarrhea
|
metronidazole
|
|
What bacteria often causes Erisipelas?
|
group A beta hemolytic strep
|
|
What is the treatment for facial cellulitis?
|
cefotaxime-due to H flu
|
|
Immunocompromised with cellulitis:
|
clinda and gent and amp and vanc
|
|
Cardinal signs of Septic tenosynovitis
|
1. tenderness along the flexor tendon sheath
2. sausage digit 3. flexed posture of digit 4. marked pain with passive extension |
|
DMOC for appedicitis
|
IV contrast CT
|
|
DMOC for biliary tract disease
|
Ultrasound
|
|
RUQ pain that's intermittent
may be constant sudden onset recurrent, infrequent9pm-4am resolves within 2-6 hours |
Biliary Colic
|
|
usually secondary to obstruction
increased bili >6 hours of pain |
Cholecystitis
|
|
inflammation of bile duct
usually in the setting of CBD stone the most life threatening complication of cholelithiasis |
cholangitis
|
|
stone in CBD
|
choledocholithiasis
|
|
Charcot's triad
|
fever
jaundice biliary colic -cholangitis |
|
DMOC for SBP
|
paracentesis
|
|
1st line tx for varices
|
endoscopic sclerotherapy
|
|
Chronic pancreatitis
|
increased lipase
|
|
acute pancreatitis
|
incresed amylase
|
|
Treatment of Choice for CBD stones
|
ERCP
|
|
vaginal bleeding with a closed cervix
benign exam no tissue |
threatened abortion
|
|
vaginal bleeding with tissue present
|
inevitable/incomplete abortion
|
|
marked elevated BHCG
grape like structure |
gestational trophoblastic disease
|
|
hyperemesis gravidarum may cause:
|
hypokalemia
ketonemia low birthweight infant |
|
Normal vaginal pH
|
<4.5
|
|
Yeast vaginitis pH
|
<4.5
|
|
Trichomoniasis pH
|
>5.0
|
|
BV pH
|
>4.5
|
|
Which vaginitis has the fishy odor?
|
trich but really with BV
|
|
Which vaginitis has inflammation of vulvar or vaginal epithelium>
|
yeast and trich
|
|
What is the color of trichomonas discharge?
|
yellow green
|
|
clue cells
|
BV
|
|
Which vaginitis needs the partner treated?
|
trichomonas
|
|
Causes of normal anion gap metabolic acidosis:
|
Enteric: diarrhea, fistula
Renal tubular acidosis vigorous volume resuscitation carbonic anhydrase inhibitor adrenal insufficiency |
|
Respiratory Acidosis
|
CNS depression from toxins/drugs/CVA/head injury/infection
Airway obstruction Acute lung injury |
|
Metabolic alkalosis
|
GI loss
Primary hyperaldosteronism excess HCO3 intake cirrhosis/CHF, dehydration, blood loss |
|
Respiratory Alkalosis
|
Central hyperventilation, hypocapnia, pulmonary edema, anemia, altitude, pregnancy, mechanical ventilation
|
|
Tx for Hypercalcemia
|
admit
specialist consult calcitonin, bisphosphonates and glucocorticoids |
|
Treatment for Hypocalcemia
|
mild-oral calcium and vitamin D
Severe-calcium gluconate IV Magnesium replacement if normal renal function phosphate binders is secondary to hyperphosphatemia |
|
Treatment of Hyponatremia
|
gradually correct: free H2O restriction if <130
if euvolemia then NS with IV lasix |
|
Treatment of Hyperkalemia
|
A-albuterol
B-bicarb C-calcium-give first D-D50 +insulin E-Kayexalate |
|
Treatment of Hypokalemia
|
potassium
|
|
DMOC for renal colic
|
spiral CT
|
|
DMOC for pretty much anything in pregnancy
|
US
|
|
anterior epistaxis is secondary bleeding from:
|
Kiesselbach's plexus
|
|
what do you do for a posterior bleed?
|
admit
posterior pack with Merocel |
|
Laryngeal foreign bodies cause...
|
obstructive cough that resembles croup
|
|
Tracheal foreign bodies...
|
cause coughing and wheezing, intermittent cyanosis and a precordial thud
|
|
Brochial foreign bodies pften present with...
|
blood streaked sputum, sough and dyspnea withi or without wheezing
|
|
If an object is in the saggital plane...
|
probably in the larynx
|
|
If an object is in the coronal plane...
|
probably in the esophagus
|
|
90% of penumonia is caused by...
|
pneumococcus
|
|
abrupt onset with single shaking chill
ill appearing and febrile tachycardia and tachypnea signs of consolidation |
strep pneumoniae pneumonia
|
|
Often associated with debilitating conditions or recent hospitalization
usually sudden onset ill appearing and febrile tachycardia and tachypnea |
H flu pneumonia
|
|
Most common pattern of H flu pneumonia
|
Bronchopneumonia
|
|
presenting symptoms: pharyngitis, hoarseness, fever. Repsiratory tract symptoms may not appear for days to weeks
Mycoplasma like |
Chlamydia pneumonia
TWAR |
|
Infection follows inhalation of organism from contaminated water
Presenting symptoms: anorexia, malaise, fever, cough, metal confusion, abdominal pain, diarrhea |
Legionella pneumonia
|
|
Pneumonia in age 5-40 healthy people
|
S pneumoniae
Mycoplasma Chlamydia Flu Virus H flu |
|
Treatment for pneumonia in young "healthy" people
|
macrolides or cefpodoxime
|
|
Pneumonia in healthy >40
|
s pneumoniae
h flu M pneumoniae |
|
Pneumonia in >40 y/o group with underlying disease states
|
think of Klebsiella and legionella
|
