Term
| Drugs that cause Bradycardia: |
|
Definition
PACED
- Propanolol
- Poppies
- Anticholinesterases
- Ethanol
- Digoxin |
|
|
Term
| Drugs that may cause Tachycardia: |
|
Definition
FAST:
- Freebase
- Anticholinergics
- Sympathomimetics
- Solvents
- Theophylline |
|
|
Term
| Drugs that may cause hypothermia: |
|
Definition
COOLS:
- Carbon monoxide
- Oral hypoglycemics
- Opiates
- Liqour
- Sedatives/Hypnotics |
|
|
Term
| Drugs that may cause hyperthermia: |
|
Definition
NASSA:
- N.M.S., Nicotine
- Antihistamines
- Sympathomimetics
- Salicylates
- Anticholinergics |
|
|
Term
| Drugs that cause Hypotension: |
|
Definition
CRAAASH:
- Clonidine, CCBs
- Resperine
- Anti-HTN
- Aminophylline
- Antidepressants
- Sedatives
- Hypnotics/Heroine (opiates) |
|
|
Term
| Drugs that cause hypertension: |
|
Definition
CTSCAN:
- Cocaine
- Thyroid supplements
- Sympathomimetics
- Caffeine
- Anticholinergics
- Amphetamines
- Nicotine |
|
|
Term
| Drugs that cause hypoventilation: |
|
Definition
SLOW:
- Sedatives/hypnotics
- Liqour
- Opiates
- Weed (marijuana) |
|
|
Term
|
Definition
COPS
- Clonidine
- Cholinergics
- Organophosphates
- Opiates
- Pontine bleed
- Phenothiazines
- Sedatives/Hypnotics |
|
|
Term
|
Definition
AAAS
- Antihistamines
- Antidepressants
- Anticholinergics (Atropine)
- Symathomimetics (Cocaine) |
|
|
Term
| Anticholinergics like atropine will cause the pupils to ___. |
|
Definition
dilate
(PNS constricts pupils, so blocking this will cause them to dilate) |
|
|
Term
|
Definition
APSTBV:
- Anthrax
- Plague
- Smallpox
- Tularemia
- Botulinum toxin
- Viral hemorrhagic fevers (ebola, marburg) |
|
|
Term
| Anthrax prophylaxis after exposure: |
|
Definition
| 60 days of Doxy, Cipro, or Amoxicillin |
|
|
Term
|
Definition
| - Cipro, Doxy, or PCN for 60 days |
|
|
Term
|
Definition
CRC:
- Cipro, Rifamin, and Clindamycin x 60 days |
|
|
Term
|
Definition
| - Cipro + Vancomyin x 60 days |
|
|
Term
| High fevers, chills, headaches, coughing up blood, SOB, toxic appearing: |
|
Definition
|
|
Term
| Pneumonic plague management: |
|
Definition
- Droplet isolation for 72 hours
- Ciprofloxacin + Doxycycline + Gentamycin
- Post-exposure prophylasis abx for 7 days |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| - Febrile prodome + One of major (backache, headache, chllls, vomiting, abdominal pain, prostration) + classic pox lesions + lesions all in same stage |
|
|
Term
| Moderate risk for small pox: |
|
Definition
- Febrile prodrome + 1 major risk factor OR
- Febrile prodrome + 4-5 minor criteria (centrifugal distribution, firs lesion on oral mucosa/palate, face, or forearms, pts appear toxic, slow evolution of lesions, lesions on palms and soles) |
|
|
Term
|
Definition
- No viral prodrome OR
- Febrile prodrome + less than 4 minor criteria |
|
|
Term
|
Definition
- Supportive
- Cidofovir?
- Vaccination
(isolation and expectant care) |
|
|
Term
|
Definition
| - live virus vaccination within 3 days |
|
|
Term
|
Definition
| airborne and contact precautions for 17 days after exposure |
|
|
Term
|
Definition
- Rabbit Fever
- Francisella tularensis |
|
|
Term
|
Definition
|
|
Term
|
Definition
- culture of blood and sputum (isolation and identification may take several weeks)
LAB MUST BE NOTIFIED IF TULAREMIA IS SUSPECTED AS IT POSES A CONTAGIOUS RISK TO THE LAB PERSONEL |
|
|
Term
|
Definition
- Gentamycin OR Streptomycin
TularEMIA is Meana so treat with aminoglycosides. |
|
|
Term
|
Definition
| Doxycycline or Ciprofloxacin for 14 days |
|
|
Term
| Botulinum toxin presentatin: |
|
Definition
- 24-36 hours after inhalation
- weakness
- dizziness
- dry mouth
- blurred vision
- double vision
- slurred speech
- difficulty swallowing
- descending paralysis
- paralysis of facial musles and then respiratory muscles |
|
|
Term
|
Definition
- supportive care
- ventilator
- anti-toxin- prevents further damage, but does not alter current damage, available through state health department |
|
|
Term
|
Definition
1. Food saftey threats
2. Water safety threats
3. RICIN
4. Staphylococcal enterotoxin B
5. Viral encephalitis |
|
|
Term
|
Definition
NHS
- Nipah virus
- Hantavirus
- SARS |
|
|
Term
|
Definition
| 2-7 days (but may be up to 10 days) |
|
|
Term
|
Definition
1. Standard precautions (hand hygiene)
2. Contact precautions (gowns, gloves)
3. Airborne precautions (negative pressure room and N-95 or better mask)
4. Eye protection |
|
|
Term
| 4 broad categories of chemicals: |
|
Definition
1. Choking
2. Blister
3. Blood
4. Nerve |
|
|
Term
|
Definition
|
|
Term
|
Definition
1. Mustard
2. Lewisite
3. Phosgene oxime |
|
|
Term
|
Definition
|
|
Term
|
Definition
- Tabun
- Sarin
- Suman
- VX |
|
|
Term
|
Definition
| - Atropine + 2-PAM (pralidoxime) |
|
|
Term
|
Definition
| soap and water for exposed persons |
|
|
Term
| Vapor or gas chemical decontamination: |
|
Definition
|
|
Term
|
Definition
- area immediately adjacent to location of incident
- minimal traige and limited medical care activities occur herre
- all staff here are in protective gear |
|
|
Term
|
Definition
| - distance of at least 300 feet uphill and upwind from the outer perimeter of the hot zone |
|
|
Term
| common causes of Pharyngitis/Tonsilitis: |
|
Definition
- H. flu
- S. pneumo
- M. cat |
|
|
Term
| Tmt of Pharyngitis/Tonsilitis: |
|
Definition
- Penicillin po x 10 days OR Single IM injection of PCN G
- Eryhtromycin for PCN allergic pts
- Second line abx: Amoxicillin, Clindamycin, and oral Cephalosporins |
|
|
Term
| Tmt of Peritonsilar abscess: |
|
Definition
- I&D
- Amoxicillin/Augmentin
- Biaxin/Bactrim
- Cefuroxime (Ceftin)/Cefprozil (Cefzil) |
|
|
Term
| Pts with mono almost always get a rash if placed on ___, this can be dx. |
|
Definition
|
|
Term
|
Definition
- Diptheria antitoxin
- Airway support
- PCN or Erythromycin |
|
|
Term
| Diptheria antibiotic tmt: |
|
Definition
- Erythromycin (po or IM) for 14 days (40 mg/kg per day with mag of 2 g/day) OR
- Procaine Penicillin G IM for 14 days
Patients with allergies to PCN or Erythromycin can use RIFAMPIN OR CLINDAMYCIN |
|
|
Term
| Etiology of ludwig's angina: |
|
Definition
- Strep
- Staph
- Mixed: B. fragilis
about 40% are resistant to beta lacatamases |
|
|
Term
|
Definition
- Extended spectrum PCN (Amoxicillin/Sulbactam, Ticarcilli/Vlavulate, Piperacillin/Tazobactam)
- PCN allergy> Cipro + Clindamycin
- B. fragilis> Metronidazole
- Plus steroids (dexamethasone 10-20 mg IV then 4-6 mg every 6 hours for 8 doses) |
|
|
Term
|
Definition
- Urine output > 0.5 ml/kg/hr
- Central Venous Pressure (CVP) 8-12 mmHg
- Mean Arterial Pressure (MAP) 65-90mmHg
- Central Venous Oxygen Saturation (ScvO2): >70%
- Potassium 3.5-5.0 |
|
|
Term
| Formula for bicarb deficit: |
|
Definition
- bicarb deficit = (normal bicarb-pts bicarb) x 0.5 x weight(kg)
- give first half over 10-20 minutes and second half over next 6-8 hours
- stop when arterial pH is greater than or equal to 7.25 |
|
|
Term
|
Definition
- nasogastric tube
- PPI
- H2 blockade (for gastric bleeding)
- Octreotide (for variceal bleeding)
endoscopy for upper GI bleed |
|
|
Term
| Tmt of shock from fluid loss (V/D): |
|
Definition
|
|
Term
| cardiogenic shock from tachydysrhytmias tmt: |
|
Definition
|
|
Term
| Tmt for cardiogenic shock from bradydysrhythmias: |
|
Definition
- immediate Transcutaneous pacing
- but Atropine may be tried first for sinus bradycardia or second degree type I Wencebach block |
|
|
Term
| general tmt of cardiogenic shock: |
|
Definition
- oxygen
- aspirin
- heparin
- gentle fluid challenge (250 cc) if there is no overt pulmonary edema
- echo search for fixable cause
(but first cardioversion if tachy, or pacing if brady)
pulmonary artery cath for fluid and pressor therapy |
|
|
Term
| drugs to be avoided in cardiogenic shock: |
|
Definition
- Nitro
- Beta blockers
- CCBs |
|
|
Term
|
Definition
- beta agonist aerosol
- epinephrine
- crystalloids fluid
- H1 and H2 histamine receptor blockade (Diphenhydramine, Ranintidine, Famotidine)
- steroids |
|
|
Term
| Hallmark of septic shock: |
|
Definition
SIRS (systemic inflammatory response syndrome) characterized by at least 2 of the following:
1. Temp > 38C or < 36C
2. HR> 90 bpm
3. RR > 20 bpm
4. PaCO2< 32
5. WBC > 12000, < 4000, or >10% bands |
|
|
Term
| early evidence of hypoprofusion: |
|
Definition
|
|
Term
| SIRS is associate with __ SVR. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
- SIRS
- hypotension
- erythematous rash |
|
|
Term
| frequent sites of occult infection leading to sepsis: |
|
Definition
- biliary tree
- urinary tract
- retoperitoneum
- perirectal areas |
|
|
Term
| drugs that can be used for induction with septic shock: |
|
Definition
- Etomidate- neutral hemodynamic effect and can be used once
- Ketamine- sedative agent during inductinon, favorable hemodynamic effect in critically ill |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| optimize venous oxygen content: |
|
Definition
- vasopressors or transufion of hematocrit > 30
goal venous oxygen saturation > 70% |
|
|
Term
| good abx for immunocompetent septic shock: |
|
Definition
| - 3rd or 4th Cephalosporin + Vancomycin |
|
|
Term
| drugs to avoid in septic shock: |
|
Definition
steroids
glucose control with insulin
antiendotoxin antibodies
nitric oxide synthase inhibitors |
|
|
Term
| Drug to give in septic shock: |
|
Definition
- Recombinant human activated Protein C (drotrecogin alfa or RHAPC)
- CI in pts with increased risk of bleeding, those with history recent surgery or intracranial hemorrhage |
|
|
Term
| hallmark of drug-induced vasodilation shock: |
|
Definition
- hypotension
- warm skin
- NO compensatory tachycardia |
|
|
Term
| tmt of drug induced vasodilation shock: |
|
Definition
- Glucagon 5-10 mg will imporove beta blocker and CCB toxicity
- Calcium gluconate good for CCB toxicity
- Atropine or pacing
- Decontamination with charcoal
- Fluid resuscitation |
|
|
Term
| causes of obstructive shock: |
|
Definition
- tension pneumothorax
- pericardial tamponade
- massive PE
all 3 impair ventricular filling and CO |
|
|
Term
| Pericardial tamponade signs: |
|
Definition
- Hypotension
- Elevated JVD
- Pulsus paradoxus (fall in systolic bp with inspiration)
- Kussmaul's sign (increased jugular venous pressure on inspiration) |
|
|
Term
| good test to look for pericardial effusion: |
|
Definition
|
|
Term
| Shock complicating PE is an indication for: |
|
Definition
|
|
