IV Meds to Tx HTN Emergency (4)
- labetalol 0.2-1mg/kg
- nitroprusside gtt
- nicardipine gtt
- fenoldapam
HOCM murmur
systolic murmur that gets louder with valsalva or standing from squatting
hCG levels at which you should see a pregnancy on US (transabd vs transvag)
transabd > 6500
transvag > 1000
DDx of Late Pregnancy Bleeding? (3)
What do you do?
DDx: placenta previa, placental abruption, preterm labor
Actions: get OB STAT and don’t do a pelvic
Management Options for Laryngospasm (5)
- reposition airway
- give sustained BVM pressure/PEEP
- stimulate “laryngospasm notch” (behind the earlobe, the soft area between the skull base, mastoid bone, and mandible)
- sux 0.1-0.2mg/kg
- propofol 0.5-1mg/kg
If you see metabolic acidosis + respiratory alkalosis, you should think of this poisoning
salicylate poisoning
classic blood gas abnml with salicylate poisoning
metabolic acidosis + respiratory alkalosis
key difference in presentation between ethylene glycol and methanol poisonings
ethylene glycol: results in oxalic crystals in the urine and hurts the kidneys
methanol: results in formic acid and causes blindness
toxic alcohol resulting in blindness
methanol
toxic alcohol resulting in renal failure
ethylene glycol
J-waves/Osborn waves are seen in:
hypothermia
characteristic EKG finding of hypothermia
J-waves/Osborn waves
In treating hypothermia, at what temperature should you initiate resuscitation meds and defibrillation attempts?
T > 30C
characteristics of organic etiologies to psychosis (7)
- abrupt onset
- <12yo
- abnml VS
- abnml physical exam
- mental status changes
- abnml neuro exam findings
- visual hallucinations
treatment of adrenal crisis
1-2mg/kg of hydrocortisone
meds to acutely treat thyroid storm (4)
- propanolol
- iodide/lugols
- methimazole
- steroids
Patient comes in with occipital HA associated with ataxia/vertigo, dysarthria with short period of LOC. Symptoms resolve after emesis. What less scary dx should you think of?
basilar artery migraine
zones of the neck
- angle of mandible to base of skull
- cricoid to angle of mandible
- cricoid to clavicles/thoracic inlet
Patient with alkaline serum but aciduria - what is this???
paradoxical aciduria secondary to potassium depletion
Malaria mimic seen in New England?
Transmission?
How do you diagnose it?
Treatment?
Babesiosis
Ixodes tick
dx with thick and thin smears (like malaria); may see the Maltese cross
atovaquone + azithromycin OR clinda + quinine
Cutaneous ulcer OR purulent conjunctivitis with preauricular lymph nodes should make you think of this disease:
tularemia
radiopaque toxins (5)
COINS
1. chloral hydrate
2. opiate packets
3. iron and Hg, As, Li
4. neuroleptics
SR/enteric coated meds
poisonings that activated charcoal won’t work for (3)
ions/metals
acids/bases
alcohols
this common household object can be 17% EtOH
mouthwash
