Neurological Emergencies
A patient states feeling numbness and tingling starting in his toes and working towards his waist. What condition could you assume he has?
(Ch 19: Neurological Emergencies Slides, Slide 24)
Guillain-Barre Syndrome
(Ch: 19 Neurological Emergencies Slides, Slide 24)
What is the compensatory mechanism for metabolic acidosis?
(Ch 23:
Toxicology
Slides, Slide 25)
The natural compensatory mechanism for metabolic acidosis is respiratory alkalosis. The body is holding too much acid and signals the brain to start breathing faster in order to offload CO2.
(Ch 23:
Toxicology
Slides, Slide 25)
What is the difference between hematochezia and melena?
(Ch 20&32: Abdominal and GI Emergencies, Slide 18)
Hematochezia is bright red blood during defecation that is not digested. Melena is dark, tarry stool that is digested before passing through the colon and exiting the body during defecation.
(Ch 20&32: Abdominal and GI Emergencies, Slide 18)
What disease does a patient have when their RBCs are deformed and oblong shaped, which can lead to thrombosis due to deformed RBCs lodging in small blood vessels?
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 11)
Sickle Cell Disease creates crescent shaped RBCs, which can hook onto each other and restrict blood flow in joints and smaller blood vessels, leading to chronic pain.
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 11)
What is wheezing a sign of?
(Ch 17: Respiratory Emergencies #1 Slides, Slide 30)
Wheezing is a sign of bronchoconstriction/bronchospasm. Bronchospasms are caused by asthma or asthma secondary to an allergy.
(Ch 17: Respiratory Emergencies #1 Slides, Slide 30)
What does AEIOU-TIPS stand for and assess?
(Ch 19: Neurological Emergencies Slides, Slide 27)
It stands for Alcohol, Endocrine, Infection, Oxygen, Uremia, Trauma, Insulin, Psychosis, Shock/Seizure/Stroke. This mnemonic is used in assessing patients with an altered mental status.
(Ch 19: Neurological Emergencies Slides, Slide 27)
What is a toxidrome?
(Ch 23:
Toxicology
Slides, Slide 9)
A toxidrome is a constellation of symptoms, vital signs, or findings that are typically associated with a specific toxin. (the toxidrome of an opioid overdose is respiratory depression, pinpoint pupils, hypothermia, and bradycardia)
(Ch 23:
Toxicology
Slides, Slide 9)
When assessing an infant, you notice their diaper is dry and ask the mother when the last time she changed the infant's diaper. She stated that she only changed diapers once in the last 12 hours. What is this a sign of?
(Ch 20&32: Abdominal and GI Emergencies, Slide 28)
Lack of urine and diaper changes can be a sign of dehydration, which is a common cause for childhood deaths (1 in 9 child deaths are caused by dehydration).
(Ch 20&32: Abdominal and GI Emergencies, Slide 28)
What are some major risk factors for clotting disorders?
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 19)
Major risk factors include recent surgery, prolonged immobility, birth control, pregnancy, smoking, infections, and atrial fibrillation.
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 19)
What are the treatments for stridor?
(Ch 17: Respiratory Emergencies #1 Slides, Slide 15)
In order of priority:
1. Remove the FBO
2. If no FBO, IM Epi
3. O2
4. Vitamin G
(Ch 17: Respiratory Emergencies #1 Slides, Slide 15)
You are dispatched to a call for a 76 year old patient at a nursing home who has hit her head after falling out of bed. The nurse stated the patient did not experience a lucid interval after the fall. Which type of hematoma could you suspect the patient has?
(Ch 19: Neurological Emergencies Slides, Slide 48)
The patient can be experiencing a subdural hematoma. A lucid interval is indicative of an epidural hematoma, which the patient did not experience. Moreover, the patient is elderly, and subdural hematomas are more common in elderly patients and alcoholics.
(Ch 19: Neurological Emergencies Slides, Slide 48)
You notice your patient is covered with an unknown powder. How would you remove the substance?
(Ch 23: Toxicology Slides, Slide 16)
You would first need to gently cut off the clothing. Once the clothes are off, brush off any remaining powder with a gloved hand. DO NOT use liquid to remove powder.
(Ch 23: Toxicology Slides, Slide 16)
Your patient presents with black and purple bruises along their back and sides after a car accident. What sign is this? What is this indicative of?
(Ch 20&32: Abdominal and GI Emergencies, Slide 42)
The bruises along the sides and back are part of Grey Turner's Sign which indicates retroperitoneal bleeding. The organs that fall under this type of internal bleeding include the kidneys and pancreas.
(Ch 20&32: Abdominal and GI Emergencies, Slide 42)
What are the two main functions of the urinary system?
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 31)
The two main functions are to regulate electrolyte levels, water content, and acids in the blood and remove metabolic waste, drugs, and excess fluids in the blood.
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 31)
Your patient has had a productive cough for 5 months and reports "looking blue" for weeks before calling. What respiratory condition might the patient have?
(Ch 17: Respiratory Emergencies #2 Slides, Slide 17)
The patient could be experiencing chronic bronchitis, which is one of the two diseases under COPD. Patients with chronic bronchitis are chronically cyanotic and overweight secondary to fatigue.
(Ch 17: Respiratory Emergencies #2 Slides, Slide 17)
What is the difference between a syncopal episode and a seizure?
(Textbook: Ch 19: Neurological Emergencies, Page 1031)
(Notes: Ch 19: Neurological Lecture, Simmons)
Syncope is the medical definition for passing out and lacks the postictal phase of a seizure episode. Individuals who go through a syncopal episode mya still lose postural tone that can look lie the tonic stage of a seizure. The postictal state is the determining factor you should look for.
(Textbook: Ch 19: Neurological Emergencies, Page 1031)
(Notes: Ch 19: Neurological Lecture, Simmons)
You are dispatched to a park for a patient unconscious on a bench. You notice his breathing is fast and his pupils are dilated. You feel for a pulse and note he is hyperthermic, tachycardic, and diaphoretic. After assessing the patient you notice white powder around his nose. What do you suspect happened to the patient?
(CH 23: Toxicology Slides, Slide 34)
The patient is showing signs and symptoms of a sympathomimetic overdose. Cocaine is a common stimulant that can be snorted, and the white substance can be a form of stimulant. To treat the patient, you should provide supportive care, supplemental O2, and cool the patient.
(Ch 23: Toxicology Slides, Slide 34)
Why might esophageal varices be caused by hepatitis?
(Ch 20&32: Abdominal and GI Emergencies, Slide 47)
The esophagus gets blood directly from the liver via the portal vein. If the liver is functioning properly due to cirrhosis secondary to hepatitis, then the blood can start to back up into the portal vein. This can then cause ruptures in the esophageal wall, which causes the varices.
(Ch 20&32: Abdominal and GI Emergencies, Slide 47)
Your patient is complaining of upper right abdominal pain and right shoulder pain after having fried pork for dinner. What do you suspect?
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 40)
You should suspect gallstones because symptoms appear at night or 30 minutes after a fatty meal.
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 40)
What are the signs for right-sided CHF? What about left-sided?
(Ch 17: Respiratory Emergencies #2 Slides, Slide 22)
A patient with Right-sided CHF presents with JVD, ascites, and pitting edema. With left-sided CHF a patient will experience orthopnea, pink frothy sputum, and PND.
(Ch 17: Respiratory Emergencies #2 Slides, Slide 22)
You are dispatched to a call for a 86 year-old female who has fallen off a ladder while decorating her Christmas tree. You notice her blood pressure is widening after every BP check and her respirations have periods of apnea. What should you suspect? How do you know?
(Ch 19: Neurological Emergencies Slides, Slide 50)
You should suspect an increased ICP in the patient. Cushing's Triad is a telltale sign of increased ICP. Lowered HR, irregular respirations, and a widening pulse pressure are all indicative of increased ICP. If you have found two signs, you are missing the third.
(Ch 19: Neurological Emergencies Slides, Slide 50)
You are dispatched to an overdose on a farm. According to witnesses, the patient is a farmhand who was fertilizing crops when he suddenly collapsed. You notice the patient has pinpoint pupils and is pale, cool, and clammy. His vitals are 90/56 BP, 8 RR, 50HR, and a BGL of 79. What do you suspect he overdosed on?
(Ch 23: Toxicology Slides, Slide 40)
The patient likely overdosed on an opioid. Although the patient was around organophosphates like fertilizers, the patient was experiencing bradycardia and respiratory depression. These findings are not indicative of a cholinergic overdose because cholinergics do not affect respiratory or cardiac drive.
(Ch 23: Toxicology Slides, Slide 40)
You pull up to a patient with abdominal pain in their RLQ. You checked McBurney's Point and note no rebound tenderness or pain where the appendix lies. What else could be causing the patient's pain?
(Ch 20&32: Abdominal and GI Emergencies, Slide 20)
Crohn's disease can also cause pain in the RLQ. This disease causes inflammation of the intestines and can happen anywhere in the small and large intestines.
(Ch 20&32: Abdominal and GI Emergencies, Slide 20)
You notice your patient with pulmonary edema has a fistula on their right arm a few inches below their palm. What is a pertinent question to ask?
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 48)
"When was your last dialysis treatment?"
"Did you skip your last dialysis treatment?"
(Ch20&21: Hematologic/Urinary Emergencies Slides, Slide 48)
What may a patient present as when in respiratory distress?
(Ch 17: Respiratory Emergencies #2 Slides, Slide 45)
A patient in respiratory distress may have pale skin, may be using accessory muscles to breathe, and may be increasing respiratory effort. The patient may also have increased respirations, blood pressure, and heart rate. They may be altered due to lack of oxygen. If O2 and medications like epi and albuterol/Atrovent do not help the patient improve, CPAP may be indicated.
(Ch 17: Respiratory Emergencies #2 Slides, Slide 45)