Top Tweets for #DailyPearl
#DailyPearl! 💡 Loop diuretic equivalents are a daily pearl on the floor. Don’t forget the low bioavailability difference for Furosemide when switching to PO—you typically need to double the dose! #MedEd
Superficial thrombophlebitis 🩸
Start anticoagulation if:
- clot is >5cm in length
- clot is located within 5cm of deep vein
#EMboards #DailyPearl 🦪
Epididymitis
<35 years old: 🦠 gonorrhea or chlamydia💊 treat with ceftriaxone and doxycycline
>35 years old: 🦠 E. Coli 💊 levofloxacin
#EMboards #DailyPearl 🦪
SALTEr Harris classification of ped fx 🦴
Slipped (I) - growth plate seperated
Above (II) - fx extends into metaphysis
Lower (III) - fx extends into epiphysis
Through (IV) - fx extends into metaphysis & epiphysis
Erased (V) - growth plate crushed
#EMboards #DailyPearl 🦪
Digoxin toxicity buzz words
👁 visual changes (yellow halos)
🫀bidirectional ventricular tachycardia
🍌 hyperkalemia = worse prognosis
💊 antidote = digoxin specific antibody (DigiFab, Digibind)
#EMboards #DailyPearl 🦪
Lyme Disease 🦠
- prophylaxis: 200mg doxycycline PO x1 dose, give if tick attached >36h and within 72h of tick removal
- treatment: 100mg doxycycline PO, BID x14-21 days, give if early symptoms present
#EMboards #DailyPearl 🦪
Symptomatic Bradycardia 🫀
If unstable -> transcutaneous pace
If stable -> atropine*
*atropine won't work for high grade (2nd degree, type II or 3rd degree) AV blocks or ventricular escape rhythms
#EMboards #DailyPearl 🦪
Pelvic fractures 🦴
- High risk of hemorrhage given nearby vasculature
- FAST exam will be negative because bleeding is retroperitoneal
- Requires IR angiography and embolization for definitive treatment
#EMboards #DailyPearl 🦪
Triggers for DKA - 5 Is 👀
Infection
Infarction (MI, Stroke)
Insulin (lack of)
Infant (pregnancy)
Initial presentation of DM
If you suspect your patient has DKA, look for the trigger!
#EMboards #DailyPearl 🦪
Penetrating neck injury 🔪
HARD indications to go to the OR
- Hypotension
- Arterial Bleed
- Rapidly expanding hematoma
- Disability (neuro deficit)
Don't forget bruit, bubbling from wound, and airway compromise!
Physical exam > neck zones
#EMboards #DailyPearl 🦪
Febrile seizures 🥵 occur in patients 6-60 months with temp >38C
Criteria for simple febrile seizure:
- single seizure within 24 hour period
- generalized seizure
- lasts <15 minutes
#EMboards #DailyPearl 🦪
vitamin C deficiency
- irritability, poor appetite, low-grade fever, tenderness, muscle weakness, blue/purple gingival swelling, hair follicle hyperkeratosis
- pseudoparalysis
- "ground glass" bones on XR w/ thin cortex & sharply outlined epiphyseal ends
#pedsboards #dailypearl
Esophageal foreign body🔋
Indications for emergent removal:
- button battery
- sharp, elongated object
- objects >6 cm
- object present for >24 hrs
- complete obstruction of the esophagus
#EMboards #DailyPearl 🦪
missed posting a #pedsboards #dailypearl yesterday because sometimes adulting is hard and you need to take a break from your study schedule
polymorphous light eruption
- most common idiopathic photosensitivity disorder
- occurs 1-2 days after intense UV light exposure
- papulovesicular/urticarial/eczematous/plaque-like lesions
- symptom control with topical steroids and oral antihistamines
#pedsboards #dailypearl
Crouzon syndrome
- most common of the syndromes involving craniosynostosis
- bilateral premature closure of the coronal sutures (brachycephaly)
- midface hypoplasia, proptosis
- normal intelligence, normal hands and feet
- 1/3 with associated hydrocephalus
#pedsboards #dailypearl
urticaria pigmentosa
- reddish-brown hyperpigmented lesions typically on trunk but may spread to extremities and neck
- Darier sign: localized erythema and urticarial wheals after stroking or rubbing the lesions (d/t release of histamine from mast cells)
#pedsboards #dailypearl
Becker nevus - typically on trunk, +hypertrichosis, more common in males
Becker nevus syndrome - spina bifida occulta; scoliosis; pectus; limb shortening; ipsilateral hypoplasia of chest, breast, & areola; no malignant changes
#pedsboards #dailypearl
congenital hypoplastic anemia/Diamond-Blackfan anemia:
- severe macrocytic anemia, reticulocytopenia, absent RBC precursors in otherwise normal bone marrow, normal WBC count
- structurally abnormal thumbs, short webbed neck, weak/absent radial pulses
#pedsboards #dailypearl
Management of nephrolithiasis 🪨
- Address pain
- Assess renal function
- Evaluate for UTI
- Determine liklihood of spontaneous passage (more likely if stone is <5mm)
#EMboards #DailyPearl 🦪
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