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PEDS 7500 > CLIPP 24 > Flashcards

CLIPP 24 Flashcards

1
Q

uremia can cause

A

AMS

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2
Q

type of AMS seen in seizures

A

alternating agitation and unresponsivness

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3
Q

AMS in metabolic disorders

A

in a 2yo, would likely have shown some sx previously, or would have hx of recent illness that triggered it

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4
Q

AMS in intracranial mass

A

gradual not abrupt onset

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5
Q

organophosphates / Insecticides

A 
cholinergic
Miosis and blurred vision
Increased gastric motility (nausea, vomiting, diarrhea)
Excessive tearing, salivation, sweating and urination
Bronchorrhea and bronchospasm
Muscle twitching and weakness
Bradycardia
Seizures and coma

Mnemonic: “SLUDGE” (salivation, lacrimation, urination, defecation, GI motility, emesis)

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6
Q

diphenhydramine, TCAs

A 
anti cholinergic
Mydriasis (dilated pupils) "blind as a bat"
Dry skin "dry as a bone"
Red skin (flushed) "red as a beet"
Fever "hot as Hades"
Delirium and seizures "mad as a hatter"
Tachycardia
Urinary retention
Ileus
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7
Q

benzos, barbs

A 
sedative hyponotics
Blurred vision (miosis or mydriasis)
Hypotension
Apnea and bradycardia
Hypothermia
Sedation, confusion, delirium, coma
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8
Q

opioids

A 
codinee, morphine heroin
Miosis (constricted pupils)
Respiratory depression
Bradycardia and hypotension
Hypothermia
Depressed mental status (sedation, confusion, coma)
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9
Q

sympathommimetics

A 
cocaine, pseudoephedrine, amphetamiens
Mydriasis
Fever and diaphoresis
Tachycardia
Agitation and seizures
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10
Q

Mydriasis
Fever and diaphoresis
Tachycardia
Agitation and seizures

A

sympathomimetics

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11
Q 
Miosis (constricted pupils)
Respiratory depression
Bradycardia and hypotension
Hypothermia
Depressed mental status (sedation, confusion, coma)
A

opiods

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12
Q 
Blurred vision (miosis or mydriasis)
Hypotension
Apnea and bradycardia
Hypothermia
Sedation, confusion, delirium, coma
A

benzos,barsbs

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13
Q

Miosis and blurred vision
Increased gastric motility (nausea, vomiting, diarrhea)
Excessive tearing, salivation, sweating and urination
Bronchorrhea and bronchospasm
Muscle twitching and weakness
Bradycardia
Seizures and coma

A

chlinergic

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14
Q 
Mydriasis (dilated pupils) "blind as a bat"
Dry skin "dry as a bone"
Red skin (flushed) "red as a beet"
Fever "hot as Hades"
Delirium and seizures "mad as a hatter"
Tachycardia
Urinary retention
Ileus
A

anti chol

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15
Q

miosis vs mydriaiss

A

mydraiais = dilated pupils

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16
Q

pupillary changes of benzos

A

nystagmus

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17
Q

pupillary changes of acetaminophen and aspirin

A

none

18
Q

effect of cholinergics on VS, skin, neuro, abd

A

lower HR, sweaty skin, constrict pupils, hyperactive BS

19
Q

effect of ANTIcholinergics on VS, skin, neuro, abd

A

incr HR/hyperthermia i.e. fever?, dry skin, dilate pupils, hypoactive BS

20
Q

effect of sedatives/hyponotic on VS, skin, neuro, abd

A

HR, BP, RR depressed, altereted sensory exam, hypoactive BS

21
Q

effect of opiods on VS, skin, neuro, abd

A

HR, BP, RR depressed / hypothermia, constricted, hypoactievs BS

22
Q

effect of sympathomimetics on VS, skin, neuro, abd

A

HR, BP, RR eelvated, hyperthermia, diaphoretic, dilated and hyperreflexia , hyperactiv BS

23
Q

key cardio finding in TCA ingestion

A

hypotension

24
Q

SSRI ingesiton

A

serotinin syndrome like - diarrhea, myoclonus, hyperfelxia, shivering, ataxia **not carcinoid!?

25
Q

presentation of anti histamine OD

A

anti cholinergic similar to TCA but TCA has more cardiac issue

26
Q

decongestant OD

A

sympathomimmetic picture

27
Q

agitation and tachycardia but there is no mydriasis. what is the OD of?

A

aspirin

28
Q

TCA pathophys and most common cause of deaht with this OD

A

blocks mAch R and periephal alpha receptors(?). refractory hypotension. is antichol.

29
Q

octreotide use with respect to insulin

A

blocks insulin release thus can e used in sulfonylurea OD refractory to dextrose

30
Q

AG metabolic acidosis suggests what OD

A

salicylate (nsaid, aspirin) toxicity

31
Q

most common accidental ingestion

A

tylenol

32
Q

methods to enhance toxin elimination

A 
Syrup of ipecac
Activated charcoal
Gastric lavage
Cathartics
Hemodialysis
Hemoperfusion.

-could also do things like urinary alkalization for things like salicylate intox

33
Q

what antidote for ingestions NOT due to small molecules or heavy metals and what contraindications

A

activated charcoal , stops absorption o fpoison by pooping out- contraindicated if loss of protected airway reflexes due to aspiration risk thus consider selective intubation
-if antichol used, additional doses of charcoal needed due to further decr GI motility as a result of anti chol activity

34
Q

cathartic agent use

A

in OD, increases bulk of feces/laxativey

35
Q

NG lavage

A

has not demo’d a good consistent effect

36
Q

syrup of ipecac

A

not first line due to side effects - can aspirate the vomit if AMS like pt does in this case. also has potential for cardiac and seizures.

37
Q

EKG findings in TCA OD

A

The EKG shows an irregularly irregular rhythm.
P waves are not distinctly seen.
There is a wide QRS.
The QT interval is prolonged.

38
Q

life threatening dysrhythmia seen in severe TCA toxicity is? what is the wide complex tachycardia seen in general TCA fox?

A

A wide-complex tachycardia is the characteristic life-threatening dysrhythmia seen with severe TCA toxicity. The wide-complex tachycardia seen with TCA toxicity, however, is often not ventricular tachycardia, but sinus tachycardia with a wide QRS / aberrant conduction

39
Q

tx appraoch to TCA toxicity

A

cardiac monitoring, alkalinaation w Nabicarb of serum, antiarrhthmics (not 1a like quinidine, dispyramide, procainamide or 3), tx hypotension, tx seizures

40
Q

peak time effects of TCA and glipizde

A

7-8h for tca, 2-3h for glipize after ingestion

41
Q

tca vs decongestant overdose differnces in terms of BP, pupils and presence or absence of fever and sweating

A

unlike TCA overdose, decongestant overdose will cause hypertension, constricted pupils, fever/sweating

PEDS 7500 (32 decks)

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