Spring 2006 St Francis PA prog prof Bunn
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| Laryngoscopic Views Grade I | can see the epiglottis, vocal cords, posterior structures of the larynx
🗑
|
||||
| Laryngoscopic Views Grade II | can see the epiglottis, but only posterior elements of larynx
🗑
|
||||
| Grade III Laryngoscopic Views | can only see the epiglottis
🗑
|
||||
| Laryngoscopic Views Grade IV | none of the above are seen
🗑
|
||||
| Mallampati Classes of Laryngoscopic Views | Grade I – (best view possible) can see the epiglottis, vocal cords, posterior structures of the larynx
🗑
|
||||
| Why doEnd-tidal carbon dioxide detection? | Confirmation of Endotracheal Tube Placement
🗑
|
||||
| Confirmation of Endotracheal Tube Placement name 4 ways | Clinical assessment 2)End-tidal carbon dioxide detection 3)Aspiration techniques 4)Chest radiograph
🗑
|
||||
| Clinical Assessment of Confirmation of Endotracheal Tube Placement name 6 | 1) Visualize ET tube passing through 2)Chest auscultation 3)Gastric auscultation 4)Bag resistance 5)Condensation within ET tube 6)Pulse oximeter reading
🗑
|
||||
| best way : Confirmation of Endotracheal Tube Placement | End-tidal carbon dioxide detection
🗑
|
||||
| what drug:Reduces the :intracranial response to laryngoscopy ? | Lidocaine (used during intubation)
🗑
|
||||
| What drug:Reduces the bronchospastic response to laryngoscopy and intubaton | Lidocaine (used during intubation)
🗑
|
||||
| Do not forget to__?____ to patients after they are placed on the ventilator! | sedate patients after they are placed on the ventilator!
🗑
|
||||
| Plastic double-lumen tube with one lumen functioning as an esophageal airway and the other lumen functioning as a tracheal airway. whats it called? | Combitube (Esophagotracheal)
🗑
|
||||
| DOC for SVT ? | Adenosine
🗑
|
||||
| Drug forsymptomatic sinus bradycardia ? | Atropine... dopamine is second line
🗑
|
||||
| Vasopression.. What is it? | naturally occurring antidiuretic hormone; potent vasoconstrictor
🗑
|
||||
| What drug? use for known or suspected hyperkalemia? | Calcium chloride
🗑
|
||||
| Adenosine DOC for what? | SVT DOC
🗑
|
||||
| Shock name 6 types | 1) hemorrhagic 2)septic 3)cardiogenic 4) Anaphylatice shock 5) Anaphylactoid 6) spinal shock
🗑
|
||||
| Give crystalloids in what 3 types of shock ?: | hemorrhagic, septic, and anaphylactic shock
🗑
|
||||
| Pt presents with = bradycardia + peripheral vasodilatation after an MI. Whats this reflex called? | Bezold-Jarish reflex
🗑
|
||||
| hemorrhagic shock is what?... By how much? | decrease intravascular volume by 20%
🗑
|
||||
| pts. with adequate oxygenation but impaired ventilation whats good to give'em? | Heliox
🗑
|
||||
| rapid sequence intubation ..what do you want to give them? (hint :K____) | Ketamine – sedation
🗑
|
||||
| RV enlargement secondary to malfunction of the lungs causing pulmonary artery HTN | Cor Pulmonale
🗑
|
||||
| ST-T changes most common but non-specific of what? | PE
🗑
|
||||
| PE EKG b. Most common rhythm? | tachycardia
🗑
|
||||
| Whats the name of the condition: pulmonary edema in the absence of volume overload or depressed left ventricular dysfunction | ARDS
🗑
|
||||
| b. PE – GOLD standard imaging ? | Angiogram
🗑
|
||||
| a. 3rd trimester normal BP ? | 125/75 mm Hg
🗑
|
||||
| What you give'em??? for HTN Emergency.... quick think fast! | nitroprusside
🗑
|
||||
| what is a HTN emergency in a pregnate patient? | BP > 140/90 w/ signs and symptoms
🗑
|
||||
| How fast do you reduce BP in a Patient with diastolic over 115 but NO endorgan damage? | reduce BP over 24 – 48 hours
🗑
|
||||
| mild HTN how is it defined? | less than 115 diastolic w/ no organ damage
🗑
|
||||
| HTN Urgency how defined ? | diastolic over 115 with no end organ damage
🗑
|
||||
| How fast do you reduce BP in an HTN urgency? | a. reduce BP over 24 – 48 hours
🗑
|
||||
| kids who present with bradycardia .. what endocrine problem do you suspect? | hypoglycemia do an Accucheck
🗑
|
||||
| adults have focal neurologic deficit what endocrine problem do you keep in you dif dx | 1. Suspect hypoglycemia
🗑
|
||||
| combo of lack of insulin & excess stress hormones what endocirne emergency? | DKA .
🗑
|
||||
| IV TX for Hypoglycemia | – D50
🗑
|
||||
| In DKA acidosis masks what ? | low potassium
🗑
|
||||
| DKA TX | 1 L of NS in the first hour
🗑
|
||||
| 5. HH Nonketotic Coma – underlying illness such ... | Infection
🗑
|
||||
| 5. HH Nonketotic Coma –slow increase in ___? How high?? | sugar; usually gets at least 800 -1000
🗑
|
||||
| 5. HH Nonketotic Coma –underlying illness such? | infection
🗑
|
||||
| 6. Alcoholic ketoacidosis what do you give them? | b. Give D5NS, thiamine prior to glucose;
🗑
|
||||
| 6. Alcoholic ketoacidosis : Dont give them what? | Do NOT give insulin!!!!!!
🗑
|
||||
| myxedema coma: the pt HYPO or HYPER thermic? | 7. Hypothermia is a very common symptom of myxedema coma
🗑
|
||||
| goiter, exophthalmous, pretibial edema what disease? | Graves Disease
🗑
|
||||
| in hyperthyroidism .. do you give ASA? | NO! Donot give ASA to hyperthyroid Pt.
🗑
|
||||
| I am having a thyroid storm what can you give me? help I may die! | Beta blockers
🗑
|
||||
| 12. insufficient glucocorticoid & mineralcorticoid is | primary adrenal insufficiency
🗑
|
||||
| Coma cocktail whats in it? | Glucose, Oxygen Narcan
🗑
|
||||
| Toxicology: Pinpoint pupils .. what? | narcotics
🗑
|
||||
| dilated pupils .. what? | sympathomimetics & withdrawal
🗑
|
||||
| Cholinergics what sx/signs? (hint there is a 6 letter word that helps remembering) | SLUDGE – Salivation, lacrimation, urination, defecation,gastric cramping, emesis
🗑
|
||||
| Cholinergic poisening ...Most common is..what ?and who? | organic phosphate poisoning seen in farmers
🗑
|
||||
| Tocicology :sedative-hypnotics what skin sign? | Bullae
🗑
|
||||
| 8. Goosebumps (piloerection) are characteristic of ? | withdrawal
🗑
|
||||
| The best airway | endotracheal tube
🗑
|
||||
| Tox.: High BP & tachycardia | amphetamines, cocaine
🗑
|
||||
| Tox: BP & bradycardia | opiates, barbiturates, beta blockers
🗑
|
||||
| Tox: Tachycardia & low BP | Tricyclics
🗑
|
||||
| Tox: Rapid respirations | Acidosis, sepsis
🗑
|
||||
| Tox: Hypothermia | narcotics
🗑
|
||||
| Tox: vii. Diaphoresis & salivation | cholinergics
🗑
|
||||
| Tox:dry skin & dry mouth | Anticholinergics
🗑
|
||||
| Tox: Rotational nystagmus | PCP
🗑
|
||||
| Tox: Horizontal nystagmus | ETOH
🗑
|
||||
| 11. Arterial Blood gases detectwhat 3 things: | PH (acidosis); CO2 (ventilation); O2 = hypoxemia
🗑
|
||||
| what is Na – (HCO3 + Cl) calculating? | Anion gap
🗑
|
||||
| Anion gap how do you calculate? | Na – (HCO3 + Cl)
🗑
|
||||
| iii. Accumulation of inorganic acids (hint : At Mud Piles) cause what? | High anion gap: ( think of a High mud pile)
🗑
|
||||
| ii. Loss of bicarb via diarrhea what does that do to Anion gap? | Nothing ,its a Normal Anion gap
🗑
|
||||
| AT MUD PILES what is it a reminder of:? | Alcohol, Toluene, Methanol, Uremia, DKA, Paraldehyde, Iron, Isoniazid, Lactic acidosis, Ethylene glycol, Salicylates, Strychnine
🗑
|
||||
| i. Osmolar gap = calculated osmoles – serum osmoles; Whats the most common cause? | ethanol - most common cause of osmolar gap
🗑
|
||||
| (ME DIE) or 1. Methanol, Ethanol, Diuretics, Isopropanol, Ethylene glycol do what to the 13. Osmolar gap? | i. > 10 is abnormal: caused by ME DIE
🗑
|
||||
| CHIPES stands for what? | i. Chloral hydrate, heavy metals, iron, phenothiazines, enteric coated tabs, solvents
🗑
|
||||
| CHIPES effect what ? How? | Radioopaque ( or white on Xray) :Chloral hydrate, heavy metals, iron, phenothiazines, enteric coated tabs, solvents
🗑
|
||||
| I am having a seizer and injested a caustic subtance what poisen TX do you AVOID giving me? | Syrup of ipecac
🗑
|
||||
| I have a nonobstruvtive nonsharp FB in my Bowl what can you givw me? | GoLYTELY or whole bowel irrigation
🗑
|
||||
| liquification necrosis of an eye is caused by | Alkaline material
🗑
|
||||
| definitive therapy for ASA overdose is? | ???? Im confused
🗑
|
||||
| with your wood’s lamp you see a Pts urine fluoresces what did they drink? | Antifreeze ingestion
🗑
|
||||
| Antifreeze ingestion : what do you look for in the urine | Oxalate crystals seen in urine ( and wood’s lamp to see if urine fluoresces)
🗑
|
||||
| POSTERIOR CIRCULATION includes what vessel and what 7 areas? | Vertebral artery : brain stem, cerebellum, thalamus, auditory and vestibular centers, medial temporal lobe and the visual cortex
🗑
|
||||
| ANTERIOR CIRCULATION what vessel and what areas? | optic nerve, retina,and frontal, parietal, and anterior-temporal lobes
🗑
|
||||
| What vessel perfuses the largest portion of the brain? | Carotid circulation & perfuses 4/5 of brain
🗑
|
||||
| area of the brain in which small amounts of flow are preserved by collateral circulation what is it called? | Ischemic Penumbra
🗑
|
||||
| ischemic penumbra is it electricaslly active? | Electrically silent
🗑
|
||||
| What overdose will cause pulmonary edema? | Narcotic overdose
🗑
|
||||
| What is drug of choice for cocaine O.D.?? | Diazepam
🗑
|
||||
| TX for OD of Sulfonylurea? | hypertonic dextrose
🗑
|
||||
| Antizol what does it do? | prevents the formation of oxalate crystals
🗑
|
||||
| CCB overdose: what can your give? | 20. Calcium, glucagons, & phosphodiesterase inhibitors
🗑
|
||||
| TX for Cyanide ? | w/ oxygen, bicarb, nitrates, thiosulfates (cyanide kit)
🗑
|
||||
| Tylenol overdose < 8 hrs | i. don’t initiate NAC therapy
🗑
|
||||
| Tylenol overdose > 8 hrs | NAC (N-acetylcysteine) or Mucomyst
🗑
|
||||
| Methanol injestion TX for ? | ethanol, formepizole, or hemodialysis
🗑
|
||||
| slow onset disturbance of cognitive functioning, NO clouding of consciousness what is it called? | Dementia
🗑
|
||||
| acute onset impairment of cognitive functioning with rapid deterioration what is it called? | Delirium
🗑
|
||||
| Delirium name 3 things it can be caused by? | overdose, intercerebral hemorrhages, and electrolyte imbalances
🗑
|
||||
| same symptoms as schizophrenia but they are present less than 6 months.. whatit called | 3. Schizophreniform disorder
🗑
|
||||
| 5. Most common types of delusional disorders ? | – persecutory
🗑
|
||||
| c/o of symptoms but no medical disorder can be identified what is it called? | Somatoform disorder
🗑
|
||||
| social and occupational functioning impairment.. what is it called? | Personality disorder
🗑
|
||||
| Psych patients: first thing you asess? | ABC’s !
🗑
|
||||
| continuous and chronic (at least 6 months) than panic disorder | Generalized Anxiety Disorder GAD
🗑
|
||||
| Ovral | pregnancy prophylaxis given within 72 hours
🗑
|
||||
| pregnancy prophylaxis given within 72 hours.. what substance? | Glycoprotein p30
🗑
|
||||
| what substance?: high levels found in semen; use when no sperm is found | Acid phosphatase
🗑
|
||||
| pessimistic outlook w/o psychotic features | Dysthymic disorder
🗑
|
||||
| trauma is “converted” into physical signs and symptoms | Conversion disorder
🗑
|
||||
| g. Genetic typing uses what 4 markers ?: | i. ABO blood group antigens, peptidase A, phospoglucomutase, DNA
🗑
|
||||
| dissociative agent – produces “trancelike state” | Ketamine
🗑
|
||||
| How to sedate kids? | , initial IM dose of Ketamine
🗑
|
||||
| for sedation: opioid of choice? | Fentanyl
🗑
|
||||
| for sedation: Benzo drug of choice? | Midazolam (Versed)
🗑
|
||||
| Barbiturate drug of choice? | Methohexital (Brevital)
🗑
|
||||
| benzo antagonist; IV what? | 12. Flumazenil (Romazicon)
🗑
|
||||
| Ticlopidine (Ticlid) - PO is what class? | GP IIb/IIIa Inhibitors
🗑
|
||||
| Abciximab (ReoPro) - IV is what class? | GP IIb/IIIa Inhibitors
🗑
|
||||
| Lamifiban / Tirofiban (Aggrastat) is what class? | GP IIb/IIIa Inhibitors
🗑
|
||||
| Clopidogrel (Plavix) - PO is what class? | GP IIb/IIIa Inhibitors
🗑
|
||||
| Reduces preload and O2 requirements but SE include hypotension, histamine response...what drug? | Morphine
🗑
|
||||
| Smooth muscle relaxant that Should NOT be used in right ventricular infarction | Nitroglycerin
🗑
|
||||
| Why becarful with using Nitroglycerin during a inferior wall MI ? | It is the Rt side of the heart .. BP may tank
🗑
|
||||
| Other then ischemic-type pain name 3 other conditions nitromay help | HTN, CHF, large anterior wall MI
🗑
|
||||
| what drug good for all 3: Non-ST segment elevation MI, PTCA and PTCA? | plavix, Glycoprotein IIb/IIIa Inhibitors
🗑
|
||||
| Convert PSVT, A-fib, A-flutter to NSR Can Beta Blockers do that? | YES Beta Blockers CAN Convert PSVT, A-fib, A-flutter to NSR
🗑
|
||||
| Heparin Therapy optimal PTT ? | 50 to 70 seconds is optimal
🗑
|
||||
| aPTT of >70 seconds increases risk of ??? | ICH
🗑
|
||||
| Rate control for rapid atrial arrhythmias in patients with impaired LV function . What Drug? | Amiodarone
🗑
|
||||
| Termination of ectopic or multifocal AT with preserved LV function what drug? | Amiodarone
🗑
|
||||
| Polymorphic VT, wide-complex tachycardias of uncertain origin | Amiodarone
🗑
|
||||
| Control of hemodynamically stable VT when cardioversion is unsuccessful, especially in patients with LV dysfunction | Amiodarone
🗑
|
||||
| Dalteparin (Fragmin) and Nadroparin (Fraxiparin) are examples of what drug? | LMWH
🗑
|
||||
| Rate control for AF/Afib when other therapies are ineffective | Amiodarone
🗑
|
||||
| Amiodarone Precautions : others then CVS | renal failure use with caution and extremely long half life ( 40 days)
🗑
|
||||
| Wide-complex tachycardias uncertain type? | Lidocaine , Amiodarone
🗑
|
||||
| Wide-complex PSVT ? what drug | Lidocaine
🗑
|
||||
| what is replacing Lidocaine in many cases? | Amiodarone
🗑
|
||||
| Refractory VF after lidocaine | Magnesium Sulfate
🗑
|
||||
| digitalis toxicity causing Life-threatening ventricular arrhythmias Drug TX? | Magnesium Sulfate
🗑
|
||||
| Wide variety of arrhythmias: Proarrrythmic, especially in the setting of AMI, hypokalemia, hypomagnesemia | Procainamide
🗑
|
||||
| Stable wide-complex tachycardia of unknown origin, Wide-complex tachycardias uncertain type | Procainamide, Lidocaine, Amiodarone, Procainamide.. looks like all 3 emailed J Bunn
🗑
|
||||
| Diltiazem big percaution: | Do not use in wide-complex tachycardias or for poison/drug-induced tachycardia, WPW, SSS, or patients with AV block without a pacemaker
🗑
|
||||
| Diltiazem is used to control : what? | ventricular rate in AF
🗑
|
||||
| Alternative drug (after adenosine) to terminate PSVT with narrow QRS complex and adequate BP and preserved LV function | Verapamil, Diltiazem
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
pnelson
Popular Medical sets