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MTBs Step 2CK > EM/Toxicology > Flashcards

EM/Toxicology Flashcards

1
Q

Treatment of subdural and epidural hematoma

A 
subdural = crescent
epidural = lens
both:
1. intubation + HYPERVENTILATION
2. Mannitol
3. Mannitol
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2
Q

When can you do a percordial thump?

A
  1. <10 min aka you saw them drop
  2. no pulse
  3. no AED around
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3
Q

what is the CHADS2 score?

A

criteria to give anticoags for A-fib

CHF, HTN, Age>75, DM, Stroke/TIA , 2+ gets anticoag w/goal INR 2-3

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4
Q

In the case of toxicology when do you do “gastric emptying/gastric lavage”?

A

only if within 1hr after overdose & OD was not with acids or bases

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5
Q

In the case of toxicology when do you do “whole bowel irrigation”?

A

iron ingestion, lithium, drug filled packets(butt cocaine)

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6
Q

In the case of toxicology when do you do give “naloxone, thiamine & dextrose”?

A

anytime there is acute mental status changes of unclear etiology = naloxone wont hurt anyone so give this first

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7
Q

In the case of toxicology when do you do give “charcoal”?

A

most cases. this wont hurt anyone

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8
Q

1 cause of OD in the USA? whats #2?

A

Acetaminophen, #2 is ASA

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9
Q

SX of Acetaminophen tox?

A

first 24hrs = nausea and vomiting

>24 hrs(48-72) = hepatic failure

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10
Q

Antidote for Acetaminophen

when do you give this?

A

N-Acetylcysteine = give to ANY patient with acetaminophen OD before you check levels; only give if within 24 h

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11
Q

Toxic acetaminophhen levels? deadly?

A

10g = toxic; 15g = deadly

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12
Q

Antidote for ASA

A

Bicarbonate to alkalinize the urine

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13
Q

Antidote for Benzodiazepines

when do you give this?

A

Flumazenil = only give if you know for sure the person isnt a chronic user. if you give to a chornic user can get a seizure = better to just let them ride it out. benzos wont kill you

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14
Q

Antidote for Carbon monoxide poisoning

A

100% O2, Hyperbaric o2 if severe

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15
Q

Antidote for digoxin

A

digoxin-binding antibodies

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16
Q

Antidote for Ethylene glycol

A

fomepizole or ethanol; same as methanol

17
Q

Antidote for methanol

A

fomepizole or ethanol; same as ethylene glycol

18
Q

Antidote for Methemoglobinemia

A

methylene blue

19
Q

Antidote for Neuroleptic Malignant Syndrome

A

bromocriptine, dantrolene

20
Q

Antidote for Opiates

21
Q

SX of ASA poisoning? what labs would you see?

A
  • this is a brain stimulant and a toxin to the lungs =
  • metabolic acidosis = lactic acidosis from hypoxic metabolism
  • respiratory alkalosis = hyperventilation
  • renal insufficiency = anion gap
  • elevated prothombin time
  • CNS: confusion
  • Fever
  • Tinnitus***

normal pH, low PCO2(rep. alk), low HCO3(met acid)

22
Q

can you overdose on benzos and dies? why is this important when considering antidote?

A

nope! not fatal by itself so dnt give flumazenil for OD unless you kn`ow the person isnt a chronic user. if they are a chronic user it can precipitate seizures

23
Q

MCC of death in fires?

A

CO poisoning

24
Q

sx of CO poisoning?

A

**looks like anemia w/cherry red blood = blood unable to release O2 into tissue

  • SOB, lightheadedness, HA, disorientation, metabolic acidosis(tissue hypoxia), fatigue
    tx: 100% O2
25
Q

Digoxin Tox sx? tx?

A

yellow “halos” around objects, arrhythmia w/downsloping of ST segments, Encephalopathy, Hyperkalemia

tx: dig. antibodies

26
Q

Whats up with potassium and digoxin

A

K & Dig compete for the same spot on NaK. so Hypokalemia can trigger dig toxicity(recent use of lasix) but dig tox causes hyperkalemia

27
Q

Sx of Ethylene Glycol/Antifreeze poisoning

A

renal insufficiency = envelope shaped oxalate crystals, hypocalcemia, kidney stones, hypocalcemia, kidney stones

28
Q

sx of Methanol poisoning

A
  • wood alcohol, cleaning solutions, pain thinner

sx: visual disturbances(ocular toxic = retinal inflammation), retinal hyperemia

29
Q

sx of Methemoglobinemia

A
  • Hg locked into the oxidized state = cant pick up oxygen
  • like anemia but w/o oxygen
  • cyanosis, SOB, Dizziness, Confusion, HA, Seizures
30
Q

What should you look for in the history for methemoglobinemia?

A

hx of nitrate use, anethetics, dapson, or other oxidants or drugs that end with -caine

31
Q

tx of methemoglobinemia

A

100% O2 & Methylene blue

32
Q

Sx of Organophosphate/Nerve Gas

A
  • blocks AChE so will have sx of increased ACh

- salivation, lacrimation, urination, diarrhea, wheezing from bronchospasm, constricted pupils

33
Q

tx of organophosphate/nerve gas

A
  1. atropine
  2. pralidoxime
  3. remove clothes & wash the rest of hte patient
34
Q

sx of TCA overdose

A

Coma, Cardiac(arrhythmias = wide QRS), Convulsions(seizures)

+ anticholinergic sx = dilated pupils, dry mouth, constipation, urinary retention

35
Q

tx of TCA overdose

A

NaHCO3 to protect the heart & give IVF to flush out

36
Q

Hypothermia sx? tx?

A

cardiac shit = this is what kills!

EKG = J-waves of Osborn

MTBs Step 2CK (20 decks)

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