2023 Family_Med_EOR_study_guide Summary with well Explained Topics

In urgent care, respiratory failure or arrest due to acute hypoxemic respiratory failure (ARDS) is a life-threatening condition characterized by severe hypoxemia without signs of heart failure. It is commonly seen in critically ill patients, typically developing hours to days after an inciting event such as sepsis. The condition is caused by pro-inflammatory cytokines leading to inflammatory lung injury, diffuse alveolar damage, and impaired oxygenation. Symptoms include rapid onset of dyspnea and hypoxemia, while physical examination reveals tachypnea, frothy sputum, and diffuse crackles. Diagnosis is based on severe refractory hypoxemia, bilateral pulmonary infiltrates on chest X-ray, and the absence of cardiogenic pulmonary edema or congestive heart failure. Treatment involves tracheal intubation with the lowest level of positive end-expiratory pressure (PEEP). Other urgent care scenarios include deteriorating mental status or unconsciousness, which can have various causes including structural or metabolic issues, gas exchange problems, or traumatic injuries. Allergic reactions or anaphylaxis can occur due to triggers such as drugs, insect stings, venom, foods, or latex, and require immediate management with airway support, administration of epinephrine, antihistamines, and corticosteroids. Acute abdomen conditions, such as abdominal aortic aneurysm or mesenteric ischemia, necessitate prompt evaluation and appropriate interventions. In the case of burns, the severity is categorized based on the depth and extent of the injury, and the treatment includes monitoring the airway, providing fluid replacement, and applying topical agents. Third-trimester bleeding scenarios involve placenta previa, abruptio placentae, and vasa previa, each requiring specific management approaches. Bites and stings from various sources, such as brown recluse spiders, black widows, and animals, have distinct clinical presentations and treatment strategies. Finally, fractures and dislocations, including clavicular fractures and shoulder dislocations, should be assessed and managed accordingly, with conservative measures or surgical interventions when necessary.