Term
What is the most important test for...
- Acute chest pain?
- Abdominal pain
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Definition
- H&P
- Type and Screen/Cross
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Term
| What is an essential XR for abdominal pain? |
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Definition
| Upright CXR (pneumonitis around diaphragm) |
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Term
| What is the formula for A-a gradient? |
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Definition
Gradient = (150-1.2*PaCO2) - PaO2
>20 indicates either
- V/Q Mismatch (ex: PNA, CHF, ARDS, atelectasis, etc)
- Shunt (ex: PFO, ASD, PE, pulmonary AVMs)
- Alveolar Hypoventilation (ex: interstitial lung dz, environmental lung dz, PCP PNA)
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Term
| What are the treatments of hyperkalemia? |
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Definition
- Ca gluconate (to prevent arrhythmia)
- Insulin +D5W, ß2 agonist (to drive K+ into cell)
- Kayexalate (to promote K+ excretion)
- Hemodialysis
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Term
| What does the primary survey in trauma consist of? |
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Definition
- Airway & C-spine – jaw thrust/chin lift, clear foreign bodies, intubate obtunded/unconscious, cricothyroidectomy
- Breathing & ventilation – inspect, auscultate, palpate; treat tension pneumo, flail chest/pulmonary contusion, hemothorax, open pneumo
- Circulation – 2 14/16-gauge IVs, assess circulatory status (cap refill, pulse, skin color), direct pressure (not clamps)
- Disability – rapid neuro exam, pupil size & reactivity, level of consciousness (AVPU [alert/verbal/pain/unresponsive], GCS)
- Exposure, environment control – completely undress, hookup monitors (cardiac, pulse ox, BP, etc)
- Foley – 0.5cc/kg/hr (adult), 1cc/kg/hr (child >1), 2cc/kg/hr (child <1); retrograde urethrogram for urethral transection (blood at meatus, “hi riding” prostate, perineal/scrotal hematoma)
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Term
| What is the acute treatment of shock? |
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Definition
- Resuscitation (isotonic crystalloid = NS, LR)
- Bolus
- Adults: 1-2L/30-120min
- Peds: 10 (mild), 20 (mod), 30-50 (severe) cc/kg/hr
- Maintenance
- 4 cc/kg/hr (for first 10kg), 2cc/kg/hr (for 10-20kg), 1cc/kg (for every kg >20)
- Simple rule for adults = 40 + kg / hr
- 3 to 1 = 1/3 isotonic crystalloid remains in intravascular space
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Term
| What is the cardinal feature of hypovolemic/hemorrhagic shock? What are the different classes? |
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Definition
Low PCWP
- <15% volume depletion, <750cc lost
- 15-30%, 750-1500cc
- 30-40%, 1500-2000cc
- >40%, >2000cc
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Term
| What are the stages of hypovolemic/hemorrhagic shock? |
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Definition
- Preshock (compensated up to 10%)
- Shock (cool skin, tachy, hypotension, oliguria, AMS)
- End organ dysfunction (anuria, coma)
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Term
| What is the cardinal feature of cardiogenic shock (CHF) |
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Definition
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Term
| What is the cardinal feature of distributive shock (neurogenic, septic, anaphylactic) |
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Definition
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Term
| What is the eye component for the Glasgow Coma Scale? |
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Definition
- No response
- Open eyes in response to pain
- Open eyes in response to verbal stimuli
- Open eyes spontaneously
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Term
| What is the motor component of the Glasgow Coma Scale? |
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Definition
- No response
- Decerebrate rigidity
- Decorticate rigidity
- Flexion withdrawl to painful stimulus
- Responds to painful stimulus
- Responds to verbal command
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Term
| What is the verbal component of the Glasgow Come Scale? |
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Definition
- No response
- Incomprehensible sounds
- Inappropriate words
- Disoriented & conversant
- Oriented & conversant
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Term
| What are the types of burns? |
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Definition
- First degree - epidermis (sun)
- Second degree - dermis (hot liquids)
- Third degree - subcutaneous / fat (hot liquids, steam, hot oil, flame)
- Fourth degree - bone
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Term
| What is the order of importance for the trauma series? |
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Definition
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Term
| A burn patient comes in with a PCO2 of 25, hyperventilating. What is the first course of action? |
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Definition
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Term
| Patient comes in with gun shot wound and abdominal pain. What is high on your differential? |
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Definition
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Term
| Male with alcohol in breath s/p motor vehicle accident presents with alcohol in breath, C-collar, no pain, no focal deficits on neuro exam. Next course of action? |
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Definition
| Do not remove collar until C-spine X-ray |
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Term
| What are the major symptoms of basilar fracture? |
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Definition
- Raccoon eyes (periorbital bruise)
- Battle sign (retroauricular bruise)
- CSF otorrhea
- CSF rhinorrhea
- Hemotympanum
- CN palsies
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