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Oral Boards EM
Emergency Medicine Oral Boards
| Question | Answer |
|---|---|
| Crotalid Envenomation (pit vipers) | CroFab 4-6 vials till initial control envenomation syndrome - Given in 250ml NS over 60 min |
| Glaucoma Meds | 1) Acetazolamide 500mg IV 2) Timolol 0.5% 1-2 drops q10 min (x 3 doses) until IOP <20 3) Mannitol 20%, 1g/kg over 30 min 4) Pilocarpine 2% 1 drop q30min till pupil constricted HOURLY IOP checks |
| Toxic ASA level | 30 mg/dL - Dialysis for acute ingestion level > 100 mg/dL chronic ingestion level > 60 mg/dL |
| ASA overdose Mngmnt | 1) Multi dose charcoal 1mg/kg if w/in 2 hours 2) Sodium Bicarb 1mgEq/kg IV bolus 3) Sodium Bicarb drip 2 ml/kg/h + 40 mEq KCl 4) Consider Hemodialysis 5) Check q2 hours: - urine/serum pH (keep ~ 7.5) - K levels - ASA levels (want < 20) |
| Lithium Overdose Mngmnt | 1) WBI 250 ml/hr polyethylene glycol (Peds) or 2 L/hr (adult) 2) Hemodialisis - AMS/seizures/coma/renal impairment/CV toxicity - Acute level > 4 mEq/L - Chronic level > 2.5 mEq/L 3) Measure Levels q2 hr |
| Iron Overdose Mngmnt | 1) WBI 250 ml/hr polyethylene glycol (Peds) or 2 L/hr (adult) 2) Deferoxamine 5-15 mg/kg/h (shock, acidosis, serum iron> 350 mg/dL) 3) Rpt Iron levels q4h until peak and start decreasing |
| Anion Gap | Na - (Cl + HCO3) Normal - 8-12 mEq/L |
| Causes high anion gap acidosis | ACAT MUDPILE Alcoholic ketoacidosis Cyanide, CO Aspirin Toluene Methanol, Metformin Uremia Dka Paraldehyde Iron, Isoniazid Lactic acidosis Ethylene Glycol |
| Serum Osmolarity | 2 (Na) + BUN + Glu + EtOH 2.8 18 4.6 Normal < 10 |
| Sodium Bicarb Drip | 3 amps of 50 mEq NaHCO3 into 1 L D5W, run at 2 ml/kg/h + 40 mEq KCl rider |
| Methanol Antidote | Fomepizole |
| Ethylene Glycol Antidote | Fomepizole |
| Organophosphate Antidote | 1) Atropine - 0.5mg up to 100mg - repeat freq titrate to secretions/bronchospasm/bronchorrhea) 2) Pralidoxime - 2g bolus followed by 250 mg/hr infusion |
| Anticholinergics Antidote | Physostigmine |
| Carbon Monoxide Antidote | Oxygen / HBO |
| Cyanide Antidote | 1) Sodium Nitrite 2) Sodium Thiosulfate 3) Vitamin B12 |
| Methemoglobinemia Antidote | Methylene Blue 1mg/kg IV Symptoms with level >15% |
| Arsenic / Lead Antidote | Peds level > 70 ug/dL 1) BAL 300 IM divid q4h 2) CaNaEDTA 1000 IV (start 4 hours after BAL) Adult level > 100 1) BAL 450 IM divid q4h 2) CaNaEDTA 1000 IV (start 4 hours after BAL) |
| Acetaminophen Tox Mngmt | Toxic dose 140 mg/kg Toxic level @ 4 hr 150 mg/mL N-acetylcysteine (NAC) 1) 140 mg/kg PO first dose 2) 70 mg/kg PO q4h x 17 doses |
| Digoxin Tox Mngmt | Dig level >10 ng/mL at 6 hours (or ingestion of 10 mg in adult or 4 in child Digoxin-specific antibodies - Empiric dose 10 - 20 vials |
| Ped tube size | [16 + age] / 4 |
| Intubation Premedication meds | Increased ICP 1) Lidocaine 1.5 mg/kg bolus 2) Fentanyl 0.3ug/kg over 30s Peds < 10yo 1) Atropine 0.02 mg/kg (min dose 0.1mg, max 0.5mg) |
| Peds Sedation meds | 1) Etomidate 0.3 mg/kg 2) Ketamine 1mg/kg 3) Midazolam 0.2 mg/kg |
| Peds Paralytic | 1) Succinylcholine 2 mg/kg 2) Rocuronium 1 mg/kg |
| Peds Septic Arthritis Abx | 0-2 months 1. Nafcillin and 2. Gentamicin > 2 months 1. Nafcillin 2. Ceftriaxone 3. +/- Vancomycin |
Created by:
blondeurope
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