Emergency Flashcards
Measured serum osmolality estimate formula
2[Na+]+[glucose]/18+[BUN]/2.8
Anticholinergic toxidrome
Mad as a hatter, dry as a bone, red as a beet, hot as a hare, blind as a bat (tachycardia, urinary retention, ileus)
Cholinergic-muscarinic toxidrome
DUMBELLS Diarrhoea, urination, miosis. Brady/bronchoconstrict Emesis Lacrimation Lethargy Salivation
Cholinergic-nicotinic toxidrome
Days of week Miosis Tachycardia Weakness Tremors Fasiculations Seizures Somulence
Anion gap
[Na+]-([Cl-]+[HCO3-])
Resist adrenaline dose
10mcg/kg
Toxins which constrict and dilate pupils
Constrict: organophosphates, cholinergics (tears everywhere - salivation, lacrimation, sweat, incontinent )
Dilated: anticholinergics including TCA(mad as a hatter, red as a beet, dry as a bone, Lind as s bat, hot as hell)
Serotonin syndrome clinically
Agitated, delirium Tachycardia Fever Sweating Dilated pupils Nausea and vomiting Increased tone and reflexes and myoclonic jerks
Pupils in ecstasy
Dilated
Cyprhepidate if antidote critical
Carbon monoxide most important toxic mechanism
Reverse binding to cytochrome A3
Iron chelation agent in overdose
Desferoxamine
Snake bite most common manifestation
Coagulopathy
Lead poisoning on X-ray
Dense white metsphysesl bands
Mnemonic for wormian bones
PORK CHOPs
Pyknodysostosis Osteogenesis imperfection Rickets Kinky hair Cleidocranial dysostosis Hypothyroid hypophosphataemia Idiopathic Progeria Syndromes
Do retinal haemorrhages occur in pertussis
No
NAI fracture types
Spiral fracture and fracture of distal metaphasis (bucket handle and corner fracture)
Myocarditis causes
Coxsackie, adeno, echo
Drugs
Immune mediated
Chest wall rigidity SE of..
Fentanyl
Hangmans frscture
C2 pedicels
Jefferson frscture
Burst C1
Sclerotic bone lesion
Think osteosarcoma
Monteggia and galeazzi #
GRUesome MURder
Galeazzi radius fracture ulnur dislocation
Monteggia ulnar fracture radial head dislocation
If VF or pulseless VT witness in monitor then..
Defibrillate straight away
Adrenaline dose IM and IV
IM 0.01ml/kg 1:1000
IV 0.1ml/kg of 1:10000
What is commotio cordis
Sudden death Vf in blunt trauma to anterior chest
Risk with supracondylar fracture
Median nerve and brachial artery
How much percent pseudosubluxation. Ervicso spine 2-3 in <8 y
40%
Acute vestibular neuritis any hearing loss
No
Retinitis pigmentosa assoc with
Bardot-Bielefeld (finger and limb abnormalities)
Usher (SNHL)
How common eczema in NZ kids
15-20%
FLG gene for filaggrin important in
Skin barrier
Fingertip unit steroid =
0.5g covers size of two palms of hand
Thumb and steeple sign on neck X-ray indicate
Thumb - epiglottitis
Steeple - croup