Emergency Medicine Flashcards
What’s the first initial step to overdose tx if you don’t know what the toxin is and it’s within 2 hours after ingestion?
Gastric lavage
What’s the best initial management of altered mental status of unclear etiology?
Naloxone and glucose
What’s the antidote for acetaminophen toxicity within 24 hours?
N-acetylcysteine
Is there an antidote for acetaminophen toxicity after 24 hours?
No
What dx presents with tinnitus, hyperventilation, respiratory alkalosis progressing to metabolic acidosis, altered mental status, and increased anion gap?
Aspirin OD
What diagnostic test is best for TCA toxicity?
EKG
What will the EKG show in TCA toxicity?
Widened QRS
Can the widened QRS from TCA toxicity cause Torsades?
Yes
What’s the tx for caustic ingestion?
Flushing out with water
What acid/base derangement is caused by CO poisoning?
Lactic acidosis
Carboxyhemoglobin vs methemoglobin?
CarbOxy: from CO
Metheme: nitrates, anesthetics, dapsone
T/F: both carboxy and methemoglobin give normal O2 on blood gas?
True
What color is carboxyhemoglobin?
Red
What color is methemoglobin?
Brown
What’s the best treatment for methemoglobinemia?
100% O2 and then methylene blue
What 2 poisonings present with salivation, lacrimation, polyuria, diarrhea, bronchospasm, and respiratory arrest?
- Organophosphate
2. Nerve gas
Is acetylcholine inhibited or increased by organophosphates and nerve gas?
Increased
What’s the antidote for ACh toxicity?
Atropine
What toxicity presents with nausea, vomiting, abdominal pain, yellow halos around objects, hyperkalemia, and cardiac rhythm disturbance?
Digoxin
What’s the antidote for digoxin toxicity?
Digoxin-specific antibodies
What’s the antidote for lead poisoning?
Succimer, EDTA, or dimercaprol
How does mercury poisoning present?
Nervousness, jitteriness, twitchiness, pulmonary toxicity
What agents can be used to remove mercury from the body?
Dimercaprol and succimer
How are methanol and ethylene glycol toxicities treated?
Fomepizole and dialysis
Which causes retinal and which causes renal toxicity: methanol vs ethylene glycol?
Methanol: retinal “it’ll meth up your eyes”
Ethylene glycol: renal
What animal bite can present with hemolysis, respiratory paralysis, ptosis, dysphagia, and diplopia?
Snake bite
What animal bite may present with a sudden sharp pain such as “I stepped on a nail?”
Spider bite
Which type of spider bite presents with abdominal and muscle pain, and hypocalcemia?
Black widow
What’s the tx for black widow bite?
Calcium & antivenom
What type of spider bite presents with local skin necrosis, bullae, and blebs?
Brown recluse
What’s the tx for brown recluse bite?
Debridement, steroids, dapsone
How are dog, cat, and human bites managed?
Amoxicillin/clav plus tetanus booster if >5 years since last injection
Which head injury has a lens shaped hematoma on CT?
Epidural
“The contact lens goes on the outside layer of the eye”
Do heatstroke, NMS, and malignant hyperthermia all have elevated body temp and elevated CPK and potassium?
Yes
What’s the most common cause of death in patients with hypothermia?
Cardiac arrhythmia
T/F: do not give steroids or antibiotics in drowning victims?
True
What is high altitude pulmonary edema?
Pulmonary edema with normal ejection fraction
At what altitude does HAPE occur?
5,000m (16,400ft)
What 3 drugs treat hemodynamically stable Vtach?
- Amiodarone
- Lidocaine
- Procainamide
What drugs is used as part of the treatment for asystole, Vfib, etc?
Epinephrine
