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Step3 > Emergency med/toxicology > Flashcards

Emergency med/toxicology Flashcards

1
Q

AMS

Ccs tip- what to give

A 
Naloxone
Dextrose 
Thiamine 
Oxygen 
NS
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2
Q

gastric emptying

A

The answer is never gastric emptying

50% removed in the first hour

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3
Q

Ipecac

A

Can never be used in a pt with Ams

Always wrong in children

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4
Q

Charcoal

A

Just give it. Won’t hurt

If you have a toxicology question just give it if you don’t know what to do

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5
Q

What to order on tox screen menu

A 
Antidote
CBC bmp UA
Tox screen
Charcoal 
Psych consult
Oxygen
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6
Q

Antidotes:

Acetaminophen 
Aspirin
Bzd
CO
Digoxin 
Ethylene glycol 
Methanol 
Methemoglobemia
NMS
OpiAtee
Organophosphate 
TCA
A 
N acetyl cysteine
Bicarbonate (alkalanize urine)
Do not give flumazenil; it may precipitate a seizure 
100% oxygen
Dig binding antibodies
Fomepizole or ethanol
Fomepizole or ethanol
Methylene blue
Bromocriptine, dantrolene
Naloxone
Atropine, pralidoxime
Bicarbonate protects the heart
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7
Q

Acetaminophen overdose

A

Give NAC and charcoal. NAC is totally benign and prevents liver toxicity. 10 g is toxic
15g is lethal
Lower levels needed in someone with liver disease or alcohol abuse
Inpt: the specific antidote is more important than adet level but do both on ccs

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8
Q

Aspirin overdose

A

Direct stimulant to the brainstem causing hyperventilation, respiratory alkalosis, which precedes the high AG met acidosis so it’s toxic to the lungs, results in ARDS

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9
Q

ASA overdose feAtures

A 
High AG met acidosis 
Respiratory alkalosis 
Renal insufficiency 
Elevated PT
Confusion
Fever
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10
Q

Asa overdose

What to order on ccs

A 
CBC
BMP
Abg
PT/inr/ptt
ASA level
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11
Q

ASA overdose

Ccs tip

A

Alkalanize the ûrine with D5W with 3 anmps bicarb

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12
Q

Bzd overdose

A

It’s not fatal and let the pt sleep

Do not give flumazenil!

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13
Q

What to order on ccs for all overdoses

A

Aspirin
Acetaminophen
Alcohol level

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14
Q

CO poisoning

A

Mcc death in fires

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15
Q

CO symptoms

A

Shortness of breath
Lightheaded and HA
Disoriented
Severe- met acidosis

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16
Q

CO poisoning, look for the phrase

A

He feels better when he is shoveling snow

17
Q

CO poisoning treatment

A

Call the ambulance

Give 100% oxygen

18
Q

Digoxin overdose symptoms

A

N/v/d/abs pain is most common
Yellow halos and blurred vision
arrhythmia s
Encephalopathy

19
Q

Ethylene glycol and methanol feautures

A 
Increased AG met acidosis 
Renal insufficiency 
Hypocalcemia
Kidney stones 
Visual disturbance 
Retinal hyperemia
20
Q

Methemoglobinia

Very ** important to know

A

Nitrates ( nitroglycerin)

Anesthetics ( ending in-caine)

21
Q

Methemoglobinemia blue box

A

Cyanosis + normAl

po2 ( cause hemoglobin is in an oxidized staTe

22
Q

Malignant hyperthermia

A

History of anesthetic use

23
Q

TCA overdose

Most urgent dtep

A

EKG : to look for wide QRS. Can also lead to v tach or torsades

24
Q

Black widow bite symptoms

A

Abdominal pain but no tenderness
Rigidity
Hypocalcemia.

Treat with antivenin

25
Q

Brown recluse spider

A

Bite has local necrosis bullae and dark lesions

Debridd the wound

26
Q

Burns
Most importantly step
Treatment

MCC death

A

100% oxygen
Then intubate or give fluids
Any respiratory symptoms then intubate
If need fluids, 4 ml of LR or NS for each percentage for each kg

Mcc death; infection

27
Q

Hypothermia

Most urgent step

A

Ekg: J-waves of

Osborn

28
Q

Acute angle glaucoma

Best initial Thera
And
Treatment

A 
Best initial: pilocarpine drops
And
Mannitol
Acetozolamide
Latanopdost, Travoptost ( prostaglandins 
Timolol
Apraclonodine
29
Q

Retinal detachments

Treatment

A

Tilt head back
Reattach retina
If they fail(, then band

30
Q

Red eye conjunctivitis

Viral v bacterial

A

Bilateral itchyb eyes

Unilateral and eyelids stuck together

31
Q

Ginko biloba and omega 3 FA

A

Ginko—> potentiates aspirin

Omega 3 fa—> prolong bleeding time… they also improve mood

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