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Medstudy Pediatrics > Emergency Medicine & Toxicology > Flashcards

Emergency Medicine & Toxicology Flashcards

1
Q

When to use IV Deferoxamine?

A

Iron level > 500 ug/dL
Moderate symptoms

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2
Q

Anticholinergic toxidrome symptoms

A

Dry flushed skin
Hyperthermia
Mydriasis
Urinary retention
Tachycardia, hypertension.

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3
Q

Anticholinergic toxidrome meds

A

Atropine
Antihistamine
TCA
Oxybutynin

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4
Q

Cholinergic toxidrome symptoms

A

DUMBELS:
Diarrhea
Urination
Miosis
Bradycardia
Lacrimation
Salivation.

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5
Q

Cholinergic toxidrome meds

A

Organophosphates
Nicotine

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6
Q

Opioid toxidrome symptoms

A

CNS depression
Miosis
Resp depression
Hypotension

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7
Q

Sympathomimetic toxidrome symptoms

A

Hallucination seizure, tachycardia, hypertension, rhabdomyolysis

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8
Q

Sympathomimetic toxidrome meds

A

Cocaine
Amphetamine
Pseudoephedrine

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9
Q

Radioopaque substances in x-ray

A

Chloral hydrate
Calcium.
Heavy metals.
Iron.
Salicylate
Phenothiazines
Sustained release tablets

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10
Q

Prolonged QRS is seen in

A

TCA poisoning

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11
Q

Elevated serum osmolal gap

A

Methanol
Ethylene glycol
Isopropyl alcohol

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12
Q

High anion gap

A

Mudpiles
Methanol, uremia, DKA, propylene glycol, iron, INH, lactate, ethanol, salicylate, cyanide and CO

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13
Q

Activated charcoal contraindications

A

Risk of aspiration
G.I. obstruction.
Hydrocarbon & caustic ingestion.
Iron, metals & cyanide ingestion.
Alcohol ingestion.

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14
Q

What is the toxic metabolite of acetaminophen?

A

N acetyl p benzoquinone imine
(NAPQI)

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15
Q

What is the minimal toxic dose of acetaminophen in children?

A

150mg/kg

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16
Q

Stages of acetaminophen toxicity

A

S1 (24hrs): N&V
S2 (72hrs): RUQ pain, labs affected
S3 (96hrs): fulminant hepatic failure, and coagulopathy
S4 (4-14d): Recovery or death

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17
Q

What to do if patient presented with acetaminophen ingestion

A

1- activated charcoal during the first hour
2- acetaminophen livers four hours after ingestion

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18
Q

Name of graph used in acetaminophen toxicity

A

Rumack Matthew Nomogram

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19
Q

Name of graph used in acetaminophen toxicity

A

Rumack Matthew Nomogram
Appropriate for SINGLE overdose

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20
Q

What is the level of significant salicylate toxicity?

A

300mg/kg

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21
Q

Most specific finding of salicylate toxicity

A

Tinnitus

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22
Q

How & when to alkalinize urine after salicylate indigestion?

A

NaHCO
If level is > 39mg/dL

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23
Q

Ferric chloride turns urine _____ if salicylates are present

A

Brown or purple

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24
Q

Ibuprofen toxic dose

A

> 400mg/kg

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25
Q

Triad of opioid poisoning

A

Coma
Respiratory depression.
Pinpoint pupils

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26
Q

Opioid antidote

A

Naloxone

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27
Q

Which beta blocker cause in his symptoms and why?

A

Propranolol
Highly lipids soluble

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28
Q

Which beta blocker causes torsade de pointes?

A

Sotalol

29
Q

Beta blocker ingestion symptoms

A

Hypoglycemia
Ventricular dysarrhythmia

30
Q

CCB & BB
Effect on glucose

A

CCB: hyperglycemia
BB: hypoglycemia

31
Q

Clonidine toxic dose

A

1 pill can kill!!!

32
Q

Clonidine antidote

A

Naloxone
Atropine/dopamine helps with bradycardia

33
Q

TCA antidote

A

Physostigmine
Not used for treatment

34
Q

Specific findings of serotonin syndrome

A

Myoclonus

35
Q

Neuroleptic malignant syndrome is a drug reaction to which type of medication?

A

Antipsychotics

36
Q

Treatment for acute dystonic reaction

A

Anticholinergic agent (diphenhydramine)

37
Q

Glipizide toxic dose

A

One pill can kill!!!

38
Q

Tx of methemoglobinemia

A

Methylene blue and O2

39
Q

Burton lines are seen with which type of poisoning

A

Lead

40
Q

Basophilic tippling is seen in smear of:

A

Lead poisoning

41
Q

Lead poisoning treatment

A

Calcium disodium edetate
Dimercaprol

42
Q

Carbon monoxide treatment

A

High flow oxygen

43
Q

Cyanide treatment

A

Oxygen and hydroxycobalamine

44
Q

Alkaline agents cause _____ necrosis

A

Liquefication

45
Q

Acidic agents cause _____ necrosis

A

Coagulation

46
Q

Hydrocarbon inhalation cause death by

A

Ventricular arrhythmia

47
Q

Benzene is associated with which type of anemia

A

Aplastic anemia

48
Q

Toluene causes ____

A

RTA

49
Q

Hydrocarbon treatment

A

Oxygen and inhaled beta agonist

50
Q

Methanol ingestion causes

A

Blindness

51
Q

Visual complaint.
Abdominal pain.
Metabolic acidosis with high an iron gap, but no lactic acidosis.
Is a triad of what?

A

Methanol ingestion

52
Q

Methanol antidote is

A

Fomepizole
+ folic acid to enhance metabolism of toxic metabolites

53
Q

Which organ is affected the most by ethylene glycol ingestion

A

Kidneys

54
Q

Treatment of ethylene glycol ingestion

A

IV fomepizole
NaHCO

55
Q

Treatment of organophosphate poisoning

A

Atropine and pralidoxime

56
Q

Object in esophagus, child is asymptomatic

A

Wait for 24 hours to see if it will pass into stomach

57
Q

Object in stomach, child is asymptomatic

A

Follow up in four weeks unless symptomatic

58
Q

Is Sofi button batteries cause which type of necrosis?

A

Liquefication necrosis

59
Q

Button battery in esophagus, child is asymptomatic

A

Remove immediately

60
Q

Button battery and stomach, patient is symptomatic, complication?

A

Perforation or aortoenteric fistula

61
Q

Most common organism in cat bite

A

pasteurella multocida
Staph A

62
Q

Bite prophylaxis duratuon is _____
If wound is infected, Duration is ____

A

5 days
7-10 days

63
Q

Indication of antibiotic, prophylaxis in human bites

A

Wound undergoing closure
Wound close to joints
Wounds with poor circulation
Crush injuries.
Immunocompromised patients

64
Q

Which burn is painless

A

Full thickness burns

65
Q

What’s the most common cause of death in submersion injury?

A

Cerebral edema resulting from hypoxia

66
Q

What to do if a patient has cardiac tamponade causing vascular compromise

A

Pericardiocentesis

67
Q

What to do if a patient has pneumothorax, causing respiratory compromise

A

Needle thoracostomy

68
Q

White mediastinum indicates which injury

A

Aortic injury

Medstudy Pediatrics (2 decks)

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