ADRENAL / ENDOCRINE EMERGENCIES Addisonian Crisis Addisonian crisis is acute adrenal insufficiency and can lead to severe hypotension and shock. Common signs and symptoms include: - Severe hypotension - Weakness and fatigue - Abdominal pain - Hyponatremia - Hyperkalemia - Dehydration Treatment: - IV fluids - Hydrocortisone Key concept: Without cortisol, the body cannot maintain blood pressure during stress. Myxedema Coma Myxedema coma is a severe complication of hypothyroidism. Common signs and symptoms include: - Hypothermia - Altered mental status - Bradycardia - Hypotension - Cold intolerance - Dry skin Exam clue: A patient with known hypothyroidism who is extremely cold and has altered mental status. RESPIRATORY Bronchodilator Contraindications Bronchodilators such as albuterol stimulate beta receptors to relax airway smooth muscle. Relative contraindication: Beta blockers Reason: Beta blockers block beta receptors and can reduce the effectiveness of bronchodilators. COMMUNICATION / ETHICS Pediatric Cardiac Arrest – Communicating with Parents When informing parents about the death of a child: Important principles: - Be honest - Speak clearly - Avoid medical jargon - Show empathy - Allow time for questions Example statement: “We did everything we could to save your son, but unfortunately he died.” DIABETIC EMERGENCIES DKA vs HHS (HHNS) DKA (Diabetic Ketoacidosis): - Rapid onset - Blood glucose typically above 250 - Ketones present - Fruity breath odor - Kussmaul respirations (deep rapid breathing) - More common in younger patients HHS / HHNS (Hyperosmolar Hyperglycemic State): - Gradual onset - Blood glucose often above 600 - Little or no ketones - No fruity breath - Respirations usually normal - More common in elderly patients GERIATRIC PATIENT MOVEMENT Lifting a Patient from the Floor Best device: Scoop stretcher Reasons: - Minimizes spinal movement - Can be separated and slid under the patient - Ideal for elderly fall patients

Here's a video on today's prep. Hope it helps! Good topics to review before sitting for your exam.

You have just delivered a baby. According to current AHA guidelines, what should the newborn's target oxygen saturation (SpO2) be at 2 minutes after birth?

Which of the following conditions is most likely to present with pelvic pain, fever, and chills in a female patient?

Cranial Nerve for Tongue/Speech CN XII (Hypoglossal Nerve) = motor control of the tongueAlso know: - CN X (Vagus): speech/swallowing - CN IX (Glossopharyngeal): gag reflex, taste Patient Already Triaged “Red” Becomes Unresponsive Answer: Immediate BLS or ALS resuscitation→ Priority transport 🧠 Triage is dynamic. You always reassess. Don’t leave a red patient dying just because triage is "complete." 💔 Aortic Dissection Clue: Unequal BP in arms + tearing chest/back pain Other signs: - Pulse deficits - New murmur - Neurologic symptoms Transport to surgical center. Avoid excessive fluid bolus if hypertensive. 💢 Epidural vs Subdural Hematoma Epidural: - Arterial bleed - Lucid interval - Rapid decline - Temporal fracture → middle meningeal artery Subdural: - Venous bleed - Gradual onset - Elderly, alcoholics, falls 🧠 Lucid interval = Epidural 📈 Inferior Wall of LV – Which Lead? Correct: Lead II, III, and aVF 🧠 You chose aVF — that is correct. All three monitor inferior wall supplied by RCA. 🦠 What Kills C. difficile? Correct: Chlorine-based disinfectantsAlcohol-based sanitizers do not kill spores. Use: - Bleach - EPA-registered sporicidal agents ☠️ Cushing Reflex Classic triad (↑ ICP): 1. Hypertension 2. Bradycardia 3. Irregular respirations 🧠 This = brainstem herniation risk. Needs rapid airway, ventilation, and hospital intervention. Left-Sided vs Right-Sided Heart Failure Left-Sided Heart Failure Failure of the left ventricle → blood backs up into lungs. Signs/Symptoms - Dyspnea - Orthopnea - Crackles - Pulmonary edema - Pink frothy sputum Key Mechanism↓ Cardiac output → ↑ pulmonary pressure Right-Sided Heart Failure Failure of right ventricle → blood backs up into systemic circulation. Signs/Symptoms - JVD - Peripheral edema - Hepatomegaly - Ascites Often caused by: - Left-sided failure - Pulmonary hypertension - COPD (cor pulmonale) Pulse Pressure Pulse pressure = Systolic − Diastolic