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boards 10 Flashcards

1
Q

immediate collapse at scene of fire

A

cyanide

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2
Q

what will pulse ox measure in CO

A

normal - need to measure carboxyhb– PA02 is normal too - oxyhb calculates dissolved o2 which is normal

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3
Q

yellow green gas, pungent odor

A

chlorine gas

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4
Q

OD with coma miosis, resp depression, bradycardia, hypotenison, AV block

A

clonidine- mimics opiate- tx fluids, atropine, pressors

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5
Q

mecehanism of cyanide

A

binds cytochoromes- causes anareobic metab and lactic acidosis - BITTER ALMOND smell

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6
Q

does cyanide get cyanotic?

A

no, normal Pao2 and O2 sat but acdosis

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7
Q

how do nitrate treat sodium vs cyanokit

A

create met Hb that binds CN- excreted renally as thiocyante and cyanokit uses hydroxcobalmin b12 precursor to make b12 cyanocobalalin

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8
Q

how does dig work

A

inhbitis na k atpase, - hyperkalemia, AV blocks, arr- DIGIBIND- binds .5mg dig - start 10 vials of digibind

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9
Q

most common dig tox dysrhythmia, what is pathognomoinc rhythm, most common EKG change

A

PVC, paroxymal Atrial tachycaric with AV block, Salvador Dali ST segment

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10
Q

tox, etching, rust remover

A

hydrogen fluoride- deep cutanoues burns, systemic hypocalcemia- skin can appear normal despite deep burn- give Ca gluconate- keep going till pain goes away - intrademal

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11
Q

INH od tox

A

dec vit b6, dec sz threshold -coma, acidosis

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12
Q

common cause of poisining death in kids

A

iron, toxic dose 30-40mgkg

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13
Q

iron progressiono f sxs

A

0-6 GE, dehydration 6-48 - qiuescenet 12-48 acidosis, coma, hepatic injury 2-6 weeks recovery, GI scarring, obstruction —- risk of people doing down DKA pathway bc hgih glucose and sugar

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14
Q

iron tox work up and tx

A

GI sxs suggest significant exposure - 4 hour Fe level, CHARCOAL Doesnt bind, labs show inc gap glucose WBC - KUB XR - Bezoar pills - TREATMENT - WHOLE BOEL IRRIGATION and deferoxiamine ( if severe)

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15
Q

tox with headache, encephalophathy, anorexia, abd pain

A

lead - CNS, GI, peripheral neuropathy - wrist drop - serum >50 severe

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16
Q

what is seen on smear with pb

A

basophilic stippling

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17
Q

are serum levels helpful in lithium OD, how to ttreat

A

no, patients have sz use benzos/phenobarb, aggressive hydration- DIALYSIS, worst risk in RF or initiation of diuretic

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18
Q

what EKG changes does Li cause

A

bradycardia, QT prolongation- T wave flatterning

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19
Q

EKG changes to know in tox

A

PAT AV block - dig, bradycardia QT prolonged, T flat - lithium, TCA - wide QRS with R wave in AVR

20
Q

hyperthermia and agitation HTN

A

MAOI- amphetaminses, cheese, wine, fava beans with tyramine

21
Q

when is methylene blue CI

A

G6pd deficiency

22
Q

neuroleptic malignant syndroe- slow onset, AMS, hyperthermia, lead pip rigidity tx?

A

dantrolene, benzos

23
Q

antich plants and dig tox plants

A

deadly nightsahde bellaodnna, henbane, jimsonweed, dig is foxglove oleander, lilly of the valley

24
Q

nms vs serotonin syndrome

A

slow onset vs fast onset, lead piipe vs myoclonus- tx cooling and dantrolene vs cooling and cyrproheptadine

25
Q

TCA OD effects

A

anticholinergic - dilated pupils, CNS seizures- acidosis- CV effects- hypotension, Wide QRS V tach , torsades -

26
Q

TCA Tx

A

charcoal, ivf, bicarb (MOST IMPR DEC CARDIAC TOX), lidocaine , benzos

27
Q

TCA EKG

A

wide QRS, R wave in AVR - monster R wave- R in R cardio tox in TCA

28
Q

tox smells - bitter almonds, mothball,s garlic, roton egs, wintergreen, fruity, fresh grass, bleach

A

cyanide, camphor, arsenic oragnophos, sulfer, ,ethy salicylate, dka isopropanol, phosgene, chlorine

29
Q

charcoal not useful drugs

A

alchol, cyanide, ion, lithium, arsenic,

30
Q

charcoal contraindicated

A

caustics

31
Q

whole boel irrigation indication

A

sustained rleased drugs, body packer, charcoal CI

32
Q

nondialyzable drugs

A

CN TCA iron benzo phenothiazindes, hallucinogens

33
Q

dialysis for these drugs

A

methanol, isopropyl alchol, ethyne glycol, lithium, salicylate, theophyline, phenobarb

34
Q

which is worse AC or DC

A

AC worse due to tetany

35
Q

most commoc cause of electrocution death? etiology

A

low voltage < 1000 household- V fib

36
Q

high volatage electrical injury

A

Asystoic, >1000v

37
Q

wat arrhythmia w lightning

A

asystole, can also have respiratory arrest from paralysis to diaphragm

38
Q

dose response radiation 1 gy 4.5 gy 8 gy

A

GI sxs, medial lethal, unsurvivable- N V D desquamation first, lymphocytes are most affected < 300 is lethal

39
Q

bug causing axialllary adenpathy of cat scratch fever- small vescile, adnoatphy - self limited

A

bartonella

40
Q

biggest chacne of rabies

A

bats, racoon, fox, - globally dogs are most common

41
Q

PEP for rabies

A

active 0 3 7 14 and 28 if IC, passive HRIG 20/kg

42
Q

coral snake bite vs rattlesnake

A

delayed sxs up to 12 horus - can cause respiraotyr failure paresthesias

43
Q

diseases transmitted by mosquitos

A

yellow fever, malaria, West ile- encephalitits - dengue- hemorrhagic- aedes- equine encephalitis

44
Q

treatment of RV infarct w JVD hyoptension

A

IVF

45
Q

whihc pneumonia has GI symptoms

A

NV hyponatremia- legionaella- atpical not on gram stain

46
Q

dose of rhogam for 15 wk spab

A

300ug

47
Q

antidote for clonidine overdose

A

naloxone

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