High Yield Emergency Medicine

Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms
antipsychotics (NMS)

side effects of corticosteroids
acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies

treatment for DTs
benzodiazepines

treatment for acetaminophen overdose
N-acetylcysteine

treatment of opioid overdose
naloxone

treatment for benzodiazepine overdose
flumazenil

treatment for NMS and malignant hyperthermia
Dantrolene

treatment for malignant hypertension
nitroprusside

treatment of a-fib
rate control, rhythm conversion, and anti-coagulation

treatment of SVT
if stable, rate control with carotid massage or other vagal stimulation. If unsuccessful, consider adenosine

causes of drug-induced SLE
INH, penicillamine, hydralazine, procainamide, chlorpromazine, methyldopa, quinidine. (look for anti-histone ab)

Macrocytic, megaloblastic anemia with neurologic symptoms
B12 deficiency

macrocytic, megaloblastic anemia without neurologic symptoms
folate deficiency

A burn patient presents with cherry-red flushed skin and a coma. What are the labs and treatment
SaO2 is normal, Carboxyhgb is elevated = CO poisoning. Treat with 100% O2 or with hyperbaric O2 if the poisoning is severe or patient is pregnant

blood in the urethral meatus or high-riding prostate
bladder rupture or urethral injury

test to rule out urethral injury
retrograde cystourethrogram

radiographic evidence of aortic disruption or dissection
widened mediastinum (>8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of the left main stem bronchus

radiographic indications for surgery in patients with acute abdomen
free air under the diaphragm, extravasation of contrast, sever bowel distention, space-occupying lesion (CT), mesenteric occlusion (angiography)

most common organism in burn-related infections
pseudomonas

method of calculating fluid repletion in burn patients
Parkland formula: 24h fluids = 4 x kg x %BSA

acceptable urine output in a trauma patient
50cc/h

acceptable urine output in a stable patient
30 cc/h

signs of neurogenic shock
hypotension and bradycardia

signs of increased intracranial pressure
Cushing’s triad: HTN, bradycardia, and abnormal respirations

Values in hypovolemic shock
decreased CO and PCWP, increased PVR

values in cardiogenic shock
decreased CO, increased PCWP and PVR

values in septic or anaphylactic shock
decreased PVR and PCWP, increased CO

treatment of septic shock
fluids and antibiotics

treatment of cardiogenic shock
identify cause, pressors (eg dopamine)

treatment of hypovolemic shock
identify cause, IVF and blood repletion

treatment of anaphylactic shock
diphenhydramine or epinephrine 1:1000

supportive treatment for ARDS
continuous positive airway pressure

signs of air embolism
a patient with chest trauma who was previously stable and suddenly dies

signs of cardiac tamponade
pulsus paradoxus (decreased SBP >10mmHg with inspiration) + becks triad: distended neck veins, hypotension, diminished heart sounds

absent breath sounds, dullness to percussion, shock, flat neck veins
massive hemothorax

absent breath sounds, tracheal deviation, shock, distended neck veins
tension pneumothorax

treatment for blunt or penetrating abdominal trauma in hemodynamically unstable patients
immediate exploratory laparotomy

increased ICP in alcoholics or the elderly following head trauma (recent or distant). Crescent shape on CT
subdural hematoma

head trauma with immediate loss of consciousness followed by a lucid interval and then rapid deterioration. Head CT shows a convex shape
Epidural hematoma

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absolute contraindications to surgery DKA and diabetic coma nutritional depletion indicators that are contraindications to surgery albumin

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