QUESTIONS SOLUTIONS GRADED A+
◉ Respiratory failure/arrest. Answer:
◉ Deteriorating mental status/unconscious patient. Answer:
◉ Allergic reaction/anaphylaxis. Answer:
◉ Acute abdomen. Answer: peptic ulcer disease
◉ Burns (degrees). Answer: 1st -- minor damage/epidermis --
ERYTHEMA
2nd- Partial-thickness- painful
superficial/Papillary dermis-- BLISTERS
deep/reticular dermis -- RUPTURED blisters
3rd -Full/destroy-dermal appendages - no* sensation
white, leathery, charred
,4th -- muscle, bone
5th -- loss of a body part
◉ What is the most common type of burn?. Answer: Scald**
◉ Rule of 9:. Answer:
◉ Treatment for chemical burns:. Answer: white phosphorus -- 1%
copper sulfate/calcium gluconate
acid burns -- lavage x30min
◉ Manage burn shock by aggressive fluid* resuscitation -- Parkland
formula:. Answer: % burn area x body wight (kg) x4ml/hr= total
amount of fluid needed x24hrs
half -first 8 hrs/ Ringer's lactate** solution /measure UO
◉ Additional tx for burn pts:. Answer: NG tube -- for gastric
distention
Foley catheter -- UO at least 0.5 ml/kg/hr -- adult
escharotomy -- compartment syndrome/ventilation diff
Sulfadiazine -- topical burn ointment
,deep burns/full-thickness -- autography
◉ Complications of burns:. Answer: gastric/duodenal ulcers --
"Curling ulcers"
*** injection
chronic healing -- malignant -- SCC -- "Marjolin ulcer"
◉ What is the most common cause of third (3rd) trimester
bleeding?. Answer: Abruptio placentae ***
-- premature separation of placenta AFTER 20 weeks // PAINFUL
◉ Risk factors are known for the development of Abruptio placentae
(9):. Answer: Trauma, smoking, HTN, decrease folic acid, cocaine**,
alcohol (>14 drinks/week), uterine anomalies, high parity, previous
abruption (re-occur 10-17%), advance age
◉ What is the most common type of abruption/less severe?.
Answer: EXTERNAL abruption -- bleeding occurs
◉ Management of Abruptio placentae:. Answer: Delivery - C-sec* --
definitive tx
Blood type, cross match, and coagulation studies
, ◉ ? Placenta previa:. Answer: No digital exam *** -- covers the
cervical os
Painless bleeding -- before 20 weeks
dx: US tx: watchful wait/c-sec
◉ Bites/stings: human. Answer: Eikenella corrodens -- tx:
Augmentin
◉ Bites/stings: spider (2). Answer: brown recluse - Loxosceles
reclusa -- infarct of skin/rapid blood coag./sinking macule/pale
gray/ halo LARGE -- tx: would cleansing & analgesia
black widows -- neurological -- tx: Diazepam & calcium gluconate
◉ Foreign body aspiration s&s:. Answer: * choking, coughing,
unexplained wheezing/hemoptysis
asphyxia - obstructing, PNA - toxic, ARDS - gastric asp.
◉ Diagnostic studies for FBA:. Answer: Expiratory X-ray -- regional
hyperinflation -- check valve effect
◉ Tx for FBA:. Answer: Tx: Heimlich maneuver -- lifesaving