What is acute chest syndrome?
Acute chest syndrome is characterized by fever, chest pain, wheezing, cough, hypoxia, and a new lung infiltrate in at least one whole lung segment in patients with a history of sickle cell disease.
Which of the following medications improves mortality in patients with spontaneous subarachnoid hemorrhage (thought to possibly prevent cerebral vasospasm)
Nimodipine
a calcium-channel blocker, has been shown to reduce the occurrence of secondary ischemia with a favorable trend toward reducing case fatality. The mechanism of this improvement is unclear, and this benefit has not been demonstrated in other calcium-channel blockers. It is appropriate to administer nimodipine 60 mg PO every 4 hours. If the patient cannot swallow, the nimodipine should be crushed and given via nasogastric tube, as there is no evidence of the efficacy of intravenous nimodipine.
What BBs are indicated in heart failure management?
Bisoprolol, carvedilol, and metoprolol
_______ is the treatment of choice in hemodynamically stable wide complex tachydysrhythmias in WPW syndrome
Procainamide
Electrical cardioversion can be used if procainamide fails or in patients with hemodynamic instability.
What is the Cushing triad of ICP?
bradycardia, hypertension and diminished irregular breathing (irregular breathing)
What is the tx for ASA toxicity? What acid base disorder is it associated with?
sodium bicarb
metabolic acidosis and respiratory alkalosis
What is the MOA for the botulism toxin?
blocks the release of acetylcholine from the nerve terminal
What is the tx for cocaine induced MI? What drug class should be avoided?
CCB
BB
What is the pathophysh behind an herniated disc?
the nucleus pulposus protrudes posterolaterally through the annulus fibrosus
Describe a junctional rhythm
QRS complex is narrow (unless there is baseline QRS conduction aberrancy), and the rate is typically between 40 and 60 bpm. P waves may be negative or hidden within the QRS complex
What effect will the administration of atropine have on third-degree heart block?
It alters conduction ratios without changing the appearance of the ventricular escape rhythm.
Describe a first degree heart block
defined by normal AV conduction with a prolonged PR interval (> 200 msec). There is a 1:1 relationship between P waves and QRS complexes
head trauma (usually from a fall from significant height or MVA), MC in young adults, LOC followed by a period of lucid interval. Then HA and vomiting. What am I?
epidural hematoma
Epidural hematoma is a tearing of what artery?
middle meningeal artery
What are the symptoms of a lidocaine overdose?
dizziness, headache, tingling, tinnitus, sedation, tremors, and seizures. Cardiovascular effects include bradycardia, heart block, and arrhythmia.
What is the max dose of lidocaine without epi?
lidocaine is 3-5 mg/kg without epinephrine
What is the max dose of lidocaine WITH epi?
lidocaine 5-7 mg/kg WITH epinephrine
What are the Salter-Harris fx classifications?
What type of Salter-Harris fx is commonly missed on xrays?
type I
What is the definitive way to dx and clear a cervical spine injury?
cervical spine MRI
What information does a flexion-extension cervical spine X-ray provide?
joint instability
What is a common cause of subdural hematomas?
tearing of bridging dural VEINS due to sudden acceleration-deceleration. WILL cross cranial suture lines
This results in accumulation of blood in the space between the dura mater and arachnoid mater
What are the 2 major risk factors for subdural hematoma?
extensive atrophy of the brain (older pts)
alcohol use disorder
What are 4 minor risk factors for subdural hematoma?
include age < 2 years
low cerebrospinal fluid volume
prior head trauma
anticoagulation