CLIPP 24 Flashcards by Sanyu Janardan

uremia can cause

AMS

How well did you know this?

Not at all

Perfectly

type of AMS seen in seizures

alternating agitation and unresponsivness

How well did you know this?

Not at all

Perfectly

AMS in metabolic disorders

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

How well did you know this?

Not at all

Perfectly

AMS in intracranial mass

gradual not abrupt onset

How well did you know this?

Not at all

Perfectly

organophosphates / Insecticides

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)

How well did you know this?

Not at all

Perfectly

diphenhydramine, TCAs

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

How well did you know this?

Not at all

Perfectly

benzos, barbs

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

How well did you know this?

Not at all

Perfectly

opioids

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

How well did you know this?

Not at all

Perfectly

sympathommimetics

cocaine, pseudoephedrine, amphetamiens
Mydriasis
Fever and diaphoresis
Tachycardia
Agitation and seizures

How well did you know this?

Not at all

Perfectly

Mydriasis
Fever and diaphoresis
Tachycardia
Agitation and seizures

sympathomimetics

How well did you know this?

Not at all

Perfectly

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

opiods

How well did you know this?

Not at all

Perfectly

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

benzos,barsbs

How well did you know this?

Not at all

Perfectly

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

chlinergic

How well did you know this?

Not at all

Perfectly

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

anti chol

How well did you know this?

Not at all

Perfectly

miosis vs mydriaiss

mydraiais = dilated pupils

How well did you know this?

Not at all

Perfectly

pupillary changes of benzos

nystagmus

How well did you know this?

Not at all

Perfectly

pupillary changes of acetaminophen and aspirin

none

effect of cholinergics on VS, skin, neuro, abd

lower HR, sweaty skin, constrict pupils, hyperactive BS

effect of ANTIcholinergics on VS, skin, neuro, abd

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

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

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

effect of opiods on VS, skin, neuro, abd

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

effect of sympathomimetics on VS, skin, neuro, abd

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

key cardio finding in TCA ingestion

hypotension

SSRI ingesiton

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

presentation of anti histamine OD

anti cholinergic similar to TCA but TCA has more cardiac issue

decongestant OD

sympathomimmetic picture

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

aspirin

TCA pathophys and most common cause of deaht with this OD

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

octreotide use with respect to insulin

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

AG metabolic acidosis suggests what OD

salicylate (nsaid, aspirin) toxicity

most common accidental ingestion

tylenol

methods to enhance toxin elimination

``` Syrup of ipecac Activated charcoal Gastric lavage Cathartics Hemodialysis Hemoperfusion. ``` -could also do things like urinary alkalization for things like salicylate intox

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

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

cathartic agent use

in OD, increases bulk of feces/laxativey

NG lavage

has not demo'd a good consistent effect

syrup of ipecac

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.

EKG findings in TCA OD

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

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

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

tx appraoch to TCA toxicity

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

peak time effects of TCA and glipizde

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

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

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