A continuation of the massive hemoptysis case from last week. The patient was intubated and ROSC was obtained. Chest X-Ray showed a large cavitary lesion on the left side. On mechanical ventilation, lung protective strategy was used and despite increasing PEEP the patient's SaO2 ranged from 60-79%.
John Cafaro MD
48M arrives in the passenger seat of wifes car coughing up a large amount of blood. He is very pale appearing, his pulse becomes thready and the patient starts to become unresponsive. Wife tells you he has a history of AML and is being treated with Amphotericin B for an Aspergilloma. The patient arrives to the resuscitation room in cardiac arrest.
Which anti-epileptic is most likely to cause hyponatremia?
C. Valproic Acid
Answer is A - Carbamazepine or Tegretol
Bonus Question: What is the first line management in Trigeminal Neuralgia?
Answer: Carbamazepine or Tegretol
A 40 year old man presents via ambulance after he was found stumbling around a park on a hot summer day. He is mumbling, not responding to questions appropriately, and very disoriented. His skin is dry and hot to touch. Rectal temperature is 106.1 F. IV access has been obtained and normal saline has been started. What is next most effective immediate treatment for cooling?
A. Rectal Acetaminophen
B. Cooling with fans and skin wetting from a spray bottle.
C. Bladder lavage.
D. Ice packs placed on axillae and groin.
E. Cardiopulmonary bypass/ ECMO.