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EM Exam

Terms

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The most common organ damaged by penetrating trauma
Liver
CASE STUDY: Pt has massive hemothorax. Chest releases 1600mm of blood in initial chest output. What is the treatment?
Transport immediately to surgery.
Meniscal tears are seen best on which form of imaging?
MRI
What is the best pre-hospital care for MI patients?
MONA (Morphine, Oxygen, Nitrogen, ASA)
What percentage of heart attacks are silent?
30%
If the pt's ECG presents with a long PR interval, what should you avoid giving the pt?
Avoid giving Morphine
What deficiency leads to presentation of Wernicke-Korsakoff Syndrome?
Thiamine (Vitamin B1)
What do you give a pt with altered mental status?
Thiamine, Dextrose, Naloxlone
You give Naloxlone to avoid intoxication of what?
Opioids
One ounce of whiskey, one beer, one glass of wine raises blood-alcohol level to what?
25mg/d
Calcium anion gap:
Na - (Cl + HCO3)
Answer: 20
History most likely to cause hip dislocation
MVA with hit to knees
Which LeFort fracture involves maxilla, nasal bones, and medial aspects of orbits?
LeFort II
Orbital blow out fracture
Ophthalmus, Diplopia, Infraorbital Hypesthesia, Inability of ocular movement
N-AC (N-acetylcysteine) is given to a pt for intoxication of what?
Acetaminophen
Most snake bites occur where?
In or near the home
Most common ocean bite is what?
Sting ray
CASE STUDY: An older man is hospitalized for CHF and develops upper abdominal pain. His most likely dx is what?
MI
CASE STUDY: 24yo girl with LLQ pain.
Ectopic Pregnancy
CASE STUDY: Soapy-burn on arm
Corrosive Alkaline
Most common cause of facial trauma
MVA
Pt has a tearing pain in chest/abdomen and his BP is different in each arm. What is the likely dx?
Dissection of aorta (AAA)
When do most trauma deaths occur?
Immediately
Raccoon eyes is a sign of which fracture?
Basilar fracture
Colic flank pain that migrates to inguinal area is indicative of which condition?
Passage of renal stone
You happen upon a victim of a gunshot wound. Besides asking someone to call 911 for help, what is the top priority in management of this patient?
Management of airway and breathing
CASE STUDY: A pt presents post-MI with multiple PVCs. What must you monitor in this pt?
Potassium/Magnesium
CASE STUDY: A 20yo male presents with scrotal edema & tenderness. His cremasteric reflex is intact. WBCs are 4-6. Pt has A Fib. Your dx is?
Epididymitis
Pt presents with a tension pneumothorax. How should you treat the patient?
Needle thoracotomy
An MVA pt with minor head injury is awake and disoriented then goes unconscious. She awakens in the ambulance, and opens her eyes on command. She is oriented and converses with you. However, she is only able to localize to painful stimuli. What is her Gl
14
What is a common sign found in Korsakoff Psychosis that is indicative of this disease?
Confabulation
Patient has a Glasgow Coma Scale of 14. Which of the following is indicative of this score?
a) Massive head trauma
b) Minor head injury
c) Comatose
d) Stroke
b) Minor head injury
Pt presents with motor weakness in arms greater than in legs. Which spinal cord injury may this patient have?
Central cord syndrome
Ipsilateral loss of motor function, proprioception, and vibratory sensation with contralateral loss of pain and temperature distal to level of injury.
Brown-Sequard
Dilated loops of bowel, air fluid levels, distended stomach
Small Bowel Obstruction
Involuntary guarding, board-like abdomen
Peritonitis
Which drug causes urinary retention?
Amitriptyline (tricyclic antidepressant)
Which is NOT indicator of pulmonary embolism?
D-dimer
Which is NOT a risk factor for Pulmonary Embolism?
Diabetis Mellitus
CASE STUDY: A lady lost lots of blood. You don't know her blood-type, but she needs an emergency blood transfusion. What blood type do you give her?
O-negative blood
Blood loss, initial fluid replacement
Lactated ringers (the one without %)
You should give all multi-system trauma patients what?
100% oxygen
What do you give to MI patient?
IV beta-blockers
When would you NOT give prophylactic anti-convulsant meds?
a) Previous seizures
b) Depressed skull fracture
c) Penetrating GSW (brain injury)
d) Sub-dural hemorrhage
e) Sub-arachnoid hemorrhage
e) Sub-arachnoid hemorrhage
CASE STUDY: Pt with may have gallstones. Which imaging procedure do you initiate to confirm this?
Ultrasound

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