Falcon Review Pediatrics 2 Flashcards
Activated charcoals is ineffective against what type of poisonings
Hydrocarbons cyanide metals Li acids and bases
What are the stages of acetaminophen toxicity
Stage 1: 1st 24 hours
- Nausea, vomiting, diaphoresis
Stage 2: 24-48 hours
- clinical improvement
Stage 3: 72-96 hours
- peak liver functional abnormalities
Stage 4: 4 days - 2 weeks
- hepatitis resolves
How do you diagnose acetaminophen tox
measure plasma level 4 hours after ingestion.
Use Rumack-matthew Nomogram to plot level and predict hepatoxicity
What is the treatment for acetaminophen tox
Consider activated charcoal with in 1 hour of ingestion
Antidote: N-acetylcysteine (mucomyst)
What are the signs and symptoms of amphetamine toxicity
Diarrhea, palpitations, arrhythmia, syncope, hyper pyrexia, hyperreflexia, may progress to convulsions
What are the signs and symptoms of anti-histamine toxicity
It ranges from drowsiness to restlessness and seizures
anticholinergic effects such as hot as here; blind as a bat; reticent beat; dries the bone; mad as a Hatter.
What is the treatment for antihistamine overdose
Consider activated charcoal within the first hour
What is the most common cause of drug poisoning
Aspirin overdose
Where the signs and symptoms of aspirin overdose
mild: vomiting, fever, lethargy, mental confusion, hyperpnea
Severe: convulsions, coma, respiratory / cardiovascular collapse
chronic: hyperventilation, dehydration, bleeding disorders, seizures, coma
What are the three phases of aspirin toxicity
Phase 1 for 12 hours.
Respiratory alkalosis, sodium and potassium excretion urine.
Phase II within 12 to 24 hours.
Paradoxical acid urea.
Phase III
Metabolic acidosis with dehydration and hypokalemia.
How is salicylate toxicity level determined
Clinical course is predicted by measuring salicylate levels at six hours after ingestion
What is the treatment for salicylate toxicity
Alkalinization of urine to increase excretion
What is the affinity of carbon monoxide
250 times that of oxygen
Greater than what percentage of carbon monoxide is lethal
70%
How effective is using a pulse ox symmetry to determine carbon monoxide poisoning
Poor
Pulse oximetry just measures saturation of hemoglobin whether it is oxygen or carbon monoxide
What are the complications of carbon monoxide poisoning
Behavior change.
Memory loss.
Blindness may occur in 10 to 30% of cases
What are the signs and symptoms of caustics ingestion
burns of mucous membranes and drooling often refusing to swallow
What are the steps to diagnose caustic ingestion
First ensure airway patency then endoscopy to evaluate the extent of damage
Should you treat the caustic ingestion with
No
The burns on the way down then it will burn on the way back up
What are the signs and symptoms of cocaine use
Perforated nasal septum.
Euphoria,
CNS stimulation.
Myocardial infarction
How long may the symptoms be delayed for hydrocarbon ingestion
Up to six hours
What are the signs and symptoms of iron toxicity
Stage one: 30 minutes to six hours.
-After ingestion nausea vomiting diarrhea abdominal pain hemorrhagic gastroenteritis.
Stage II: six to 12 hours.
The honeymoon phase shows improvement.
Stage III.
24 to 48 hours progressive circulatory collapse, hepatorenal failure, bleeding, metabolic acidosis, Coma
Stage IV
1-2 months with G.I. scoring in obstruction
What level of serum iron is considered severe
Greater than 500 mcg/dL
What is the anecdote for iron toxicity
Deferoxamine
What will a peripheral blood smear show for lead toxicity
anemia with basophilic stippling
What is the treatment for lead toxicity
Mild: decrease environmental exposure
Moderate: oral succimer
Severe: intravenous calcium EDTA
What are the signs and symptoms of opiates
Respiratory depression, constricted pupils, bradycardia, hypertension, hypothermia, hyperreflexia, coma
What are the signs and symptoms of organophosphate ingestion
Multi system affect
Muscarinic
Salvation, lacrimation, urination defecation
Nicotinic
Cramps, fasciculations, twitching, weakness, areflexia, paralysis of voluntary muscles
CNS
Anxiety, ataxia, dizziness, headache, convulsions, coma
What is the treatment for organophosphate ingestion
Atropine
Pralidoxime
The signs and symptoms of tricyclic antidepressant overdose
Drowsiness, delirium, was nation, seizure coma, hypertension, arrhythmias including QRS widening and QTc prolongation
What are the treatment options for tricyclic antidepressant overdose
Consider activated charcoal within the first hour
Sodium bicarbonates decreased cardiac toxicity by decreasing free fraction of drug
The most common causes of non-organic failure to thrive
P. A. I. D.
Poverty
Abuse
Ignorance
Depression
What IQ was determined mental retardation
IQ of 70 or less
Defined learning disorder
Academic functioning below what would be appropriate for age, IQ and education
Discrepancy between achievement test and cognitive test
What is the difference between conduct disorder and oppositional defiant disorder
A conduct disorder is more associated with actions; show aggressive behavior towards others, animals, and property
Oppositional defiant disorder is more associated with the attitude they lose control they have negativity, hostility, defiance
What is required to diagnose Tourette’s syndrome
Disorder of multiple severe tics both vocal and motor
Must be before the age of 18 for one year nearly daily without a tic free period Greater than three months
Highly associated with ADHD
What are the signs and symptoms of depression
SIG E CAPS
S leep I nterest (loss): G uilt (worthless): E nergy (lack): C ognition/C oncentration: A ppetite (wt. loss); P sychomotor: agitation (anxiety) or retardations (lethargic) S uicide/death preocp.
What are the signs and symptoms of schizophrenia
Positive symptoms which are treatable include delusions, hallucinations, disorganized speech and behavior
Negative symptoms which are difficult to treat include flat affect, apathy, anhedonia
What is anorexia nervosa
Condition of weight loss resulting from disturbed body image and fear of obesity
What are the signs and symptoms of anorexia nervosa
Weight loss, amenorrhea, bradycardia, hypotension, hypothermia, lanugo hair growth, cardiac fluid and electrolyte disturbances
What is bulimia
Eating disorder characterized by binge eating, induced vomiting, laxative abuse
What are the signs and symptoms of ADHD
Inattention, hyperactivity, impulsivity, symptoms must be present by age 7 and last for six months and occur in more than one setting and impair function
What is autism
Impaired social, communication language, and behavior
Develops before 30 months
What is aspergbers syndrome
Type of autism with more communication and appear more socially aware
What is Rett syndrome
Neurodegenerative disorder affecting females. X-linked dominant
What are the signs and symptoms of Rett syndrome
Loss of milestones.
Acquired microcephaly onset of one year of age
What is Munchhausen by proxy
Patient fabricates or induces an illness in the child. They may be in the healthcare profession or regarded as a model parent
What is strabismus
Misalignment of the eyes “lazy eye”
Transient strabismus is common up to what age
Four months
How is strabismus diagnosed
- Hirschberg test: look for asymmetric corneal reflex
2. covered test: movement of affected eye. With strabismus the eye will wonder when the cover is removed
What is amblyopia
Decreased visual acuity resulting from an unclear image falling on the retina