Emergency Flashcards Preview

STEP 2 > Emergency > Flashcards

Flashcards in Emergency Deck (58)
Loading flashcards...
1
Q

Patient w/ hyponatremia and extremely high glucose

A

Represents DKA

-Do not treat hyponatremia; it is dilutional

2
Q

40 year old man has syncope during jog; what is diagnosis

A

Aortic stenosis

3
Q

Expressive aphasia caused by what?

A

Stroke of Left MCA

4
Q

Stroke keys:

A
  1. Do no harm
  2. Do not lower BP acutely
  3. Do not let pt drink
  4. Steroids dont help
  5. Do not start heparin
  6. Use pulse ox
5
Q

Can you prevent a patient from faking?

A

No

6
Q

Pt w/ stroke s/s; first thing to do?

A

Order non contrast CT

7
Q

Most important first step w/ meningitis

A

Start abx

8
Q

Should you give telephone advice?

A

No; will be held liable in court

9
Q

Tx for acute glaucoma

A

Acetazolamide

10
Q

Foreign pt w/ meningitis

A

Think TB meningitis or other exotic cause

11
Q

Pt on coumadin presenting after fall with initially clear head CT

A

Will see subdural hematoma hours later

12
Q

Sudden bursting headache

A

Subarachnoid hemorrhage; even if CT is negative still need to do lumbar puncture to completely r/o

13
Q

If CT shows a stroke, is a pt a candidate for tPA

A

No; but always give aspirin

14
Q

Child w/ febrile seizure and otitis media

A

Treat antibiotics and antipyretics

15
Q

Elderly lady w/ AMS and foul-smelling urine

A

Delirium 2/2 to UTI

16
Q

Young women w/ no known medical history collapses; what can you safely administer?

A

Glucose

17
Q

Pt w/ spell where they talk in gibberish and stare w/ blank look, are unresponsive, and have facial twitching w/ post-ictal symptoms; what type of seizure?

A

Complex partial seizure

18
Q

Football player w/ concussion that now has severe back pain and weakness in their arm; what is management?

A

Cervical spine stabilization and radiology

19
Q

Pt w/ 12 week uterus and vaginal bleeding; management?

A

US and Rh type

-Do not get hCG quant

20
Q

Woman w/ pelvic pain, vaginal bleeding, and left adnexal mass

A

Consider pregnancy (ectopic?)

21
Q

Cocaine induced vasospasm tx

A

Aspirin + Benzos + nitrates

22
Q

Pt w. red hot swollen foot and neuropathy but resolves w/ elevation

A

Charcot foot

23
Q

Pt. w/ history of heart murmur that now presents w/ SOB; management?

A

TTE

24
Q

First test for CP

A

EKG

25
Q

V-fib managemnt?

A

Defibrillation

26
Q

Pt w/ CP and ST segment depression and are on BBs and aspirin; what do they need prior to going to cath lab?

A

Heparin

27
Q

Pt who is vomiting blood and is hypotensive; what fluid do you start?

A

NS

28
Q

Pt w weakness in arms and legs that is on statin; management?

A

Check CPK

29
Q

Pt. w/ inferior wall MI management

A

Do EKG w/ right sided leads

30
Q

Abnormally large increase in pulse pressure (fall during inspiration >10)

A

Cardiac tamponade; you must have pulsus paradoxus to have cardiac tamponade

31
Q

Pt. w/pleuritic CP after hip replacement; diagnosis?

A

PE

32
Q

Sudden onset of ankle pain that awakens a woman from sleep; she has a temperature w/ a warm, swollen ankle that she cant bear weight on

A

Gout flare

get joint fluid

33
Q

Pt. w/ PCP pneumonia and O2 of 65; tx?

A

Bactrim + Prednisone

34
Q

Pt. w/ aortic dissection; tx?

A

Labetalol

35
Q

Pt. w/ C. diff; tx?

A

Metronidazole

36
Q

Pt. presents w/ supraventricular tachycardia; first thing to do and second thing to do

A
  1. Carotid massage

2. Give adenosine

37
Q

Pt. w/ hypoglycemia who is a nurse

A

Self-injecting

38
Q

Diagnosing Clostridium botulinum requires… and if they have SOB…

A

Serum toxin levels

Admit to ICU and monitor

39
Q

Pt. w/ breast cancer who is hypotensive w/ pulsus parodoxus; management

A

Echocardiogram needed to help w/ fluid removal

40
Q

Pt. on chronic benzos who has overdosed; what should you do?

A

Conservative management

Flumazenil only needed for acute cases

41
Q

Elderly man w/ flank pain, fever, and chills w/ normal CXR; dx and managment?

A

Pyelonephritis; need admission and IV abx

42
Q

Management for PCP

A

Sedation and low level stimulation

43
Q

Pt. w/ DKA and pneumonia tx

A

IV abx + Hydration + insulin + ICU admission

44
Q

Pt. w/ COPD who can communicate their wishes

A

Just fuckin talk to them

45
Q

Alcoholic w/ several week history of fever, night sweats, cough, and pneumonia

A

Need isolation for TB

46
Q

How else can you check for aortic dissection w/o CT?

A

Echo

47
Q

Pt. who goes to part and has great time w/ later abdominal pain

A

Pancreatitis

48
Q

Pt w/ known gallstones and elevated amylase/lipase; important drug to give

A

Pain relief

49
Q

Pt. w/ thyroidectomy and involuntary contractions; what should you do?

A

Check calcium and other electrolytes as parathyroids probably removed

50
Q

30 year old w/ sore throat, muffled voice, and difficulty swallowing; what should you think of?

A

Woodlut Titus

DO NOT MANIPULATE THROAT and call ENT

51
Q

Pt. w/ hyperkalemia and EKG changes; what should you first give?

A

Calcium gluconate

52
Q

Pt. w/ epigastric pain radiating to back w/ vomiting and elevated amylase/lipase/LFTs; first test to do?

A

US

53
Q

Pt. w/ 2nd degree heart block type II; what will they need?

A

Permanent pacemaker

54
Q

Pt. w/ plt count <20,000 and bleeding; what should you do?

A

Transfuse!

55
Q

Fastest way to reverse Coumadin

A

FFP

56
Q

Pt. w/ chemical in their eyes; what should you do?

A

Irrigate w/ water

57
Q

Elderly man w/ hot, swollen knee and fever and effusion; what should you do?

A

Tap it

58
Q

PT. w/ exercise induced astma has wheezing after playing bbal; what do they need?

A

Albuterol