Seizure features

The following features can be used to distinguish a seizure from a faint:

CATCH A seizure:

• Confusion (post-ictal)
• Amnesia (post-ictal)
• Tongue-biting
• Cyanosis
• Headache (post-ictal)

• Aura (e.g. olfactory)

Eye changes (Grave’s Disease)

NO SPECS
0 = No signs or symptoms 
1 = Only signs (lid retraction or lag), no symptoms 
2 = Soft tissue involvement (periorbital edema)
3 = Proptosis (>22 mm)
4 = Extraocular muscle involvement (diplopia)
5 = Corneal involvement
6 = Sight loss

Non GIT causes of Vomiting :

ABCDEFGHI:
Acute renal failure
Brain [increased ICP]
Cardiac [inferior MI]
DKA
Ears [labyrinthitis]
Foreign substances [Tylenol, theo, etc.]
Glaucoma
Hyperemesis gravidarum
Infection [pyelonephritis, meningitis]

Xylocaine: Where not to use with Adrenaline?

"Digital PEN"

Digits (Fingers and toes)
Penis
Ear
Nose tip

Adrenaline causes vasoconstriction which helps to trap Xylocaine (anaesthetic) locally prolonging its duration of action. The two are not used together at sites supplied by end arteries as the vasoconstriction produced by adrenaline can cause ischemic necrosis of the tissues.
Adrenaline is also referred to as Epinephrine.

Absolute Indications for Dialysis

Remeber the vowels: A, E, I, O, U

Acidosis : intractable metabolic acidosis
Electrolytes : severe persistent hyperkalemia
Intoxications : menthol, ethylene, glycol, lithium, aspirin
Overload : hypervolemia (not managed by other means)
Uremia : based on clinical presentation (like uremic pericarditis)

Nephrotic syndrome: causes for secondary nephrotic syndrome

DAVID: Diabetes mellitus Amyloidosis Vasculitis Infections Drugs

Subarachnoid hemorrhage (SAH) causes

BATS:

Berry aneurysm
Arteriovenous malformation/ Adult polycystic kidney disease
Trauma (eg being struck with baseball bat)
Stroke

Syncope causes, by system

HEAD HEART VESSELS:

CNS causes include HEAD:
Hypoxia/ Hypoglycemia
Epilepsy
Anxiety
Dysfunctional brain stem (basivertebral TIA)

Cardiac causes are HEART:
Heart attack
Embolism (PE)
Aortic obstruction (IHSS, AS or myxoma)
Rhythm disturbance, ventricular
Tachycardia

Vascular causes are VESSELS:
Vasovagal
Ectopic (reminds one of hypovolemia)
Situational
Subclavian steal
ENT (glossopharyngeal neuralgia)
Low systemic vascular resistance (Addison's, diabetic vascular neuropathy)
Sensitive carotid sinus

Coma causes checklist

AEIOU TIPS:

Acidosis/ Alcohol
Epilepsy
Infection
Overdosed
Uremia
Trauma to head
Insulin: too little or or too much
Pyschosis episode
Stroke occurred

Coma: differential

UNCONSCIOUS:

Units of insulin
Narcotics
Convulsions
Oxygen
Nonorganic
Stroke
Cocktail
ICP
Organism
Urea
Shock

ICU confusion causes

ICU CONFUSION:


ICU psychosis
Cardiac output low [hypotension, post cardiac arrest]
Uncontrolled temperature [hypo/hyperthermia]
Convulsion [post ictal]
Oxygen [hypoxia, hypercarbia]
Nociception [pain]
Full bladder
Uremia Sugar [hypo/hyperglycemia]
Infection
Opiates
Natremia [hypo/hyper]

Meningicoccal meningitis: complications

SAD REP:

Sepsis/ Shock/ Subdural effusion
Ataxia/ Abscess (brain)
DIC/ Deafness
Retardation
Epilepsy
Paralysis

Miosis: causes of pin-point pupils

CPR ON SLIME:


Clonidine
Phenothiazines
Resting (deep sleep)
Opiates
Narcotics
Stroke (pontine hemorrhage)
Lomotil (diphenoxylate)
Insecticides
Mushrooms/ Muscarinic (inocybe, clitocybe)
Eye drops

Ipecac: contraindications

4 C's:

Comatose
Convulsing
Corrosive
hydroCarbon

Acute LVF management

LMNOP:

Lasex (frusemide)
Morphine (diamorphine)
Nitrates
Oxygen (sit patient up)
Pulmonary ventilation (if doing badly)

Asystole: treatment

"TEA":

Transcutaneous pacing
Epi
Atropine

Atrial fibrillation: causes of new onset

THE ATRIAL FIBS:

Thyroid Hypothermia
Embolism (P.E.)
Alcohol
Trauma (cardiac contusion)
Recent surgery (post CABG)
Ischemia
Atrial enlargement
Lone or idiopathic
Fever, anemia, high-output states
Infarct
Bad valves (mitral stenosis)
Stimulants (cocaine, theo, amphet, caffeine

Endotrachial tube deliverable drugs

O NAVEL:


Oxygen
Naloxone
Atropine
Ventolin (albuterol)
Epinephrine
Lidocaine
If you can't get IV access established, and have necessity to administer resuscitative meds, remember you have the airway and can give the above drugs.
Drug delivery is enhanced if diluted with 10cc NS and rapid introduced for aeresolization.

JVP: raised JVP differential

PQRST (EKG waves):

Pericardial effusion
Quantity of fluid raised (fluid over load)
Right heart failure
Superior vena caval obstruction
Tricuspid stenosis/ Tricuspid regurgitation/ Tamponade (cardiac)

JVP: raised JVP: extra-cardiac causes

FAT PEA:

Fever
Anaemia
Thyrotoxicosis
Pregnancy
Exercise
A-V fistula
These are in addition to all the cardiac ones (pericardial effusion, RHF, tricuspid stenosis, SVC obstruction, etc).