medical error

Question 1

what can you use to treat acetominophen poisoning?

Answer 1

N-acetylcysteine, activated charcoal

Question 2

most common cause of hepatic failure?

Answer 2

APAP toxicity

Question 3

most APAP metabolized by ___ and ___ in adult liver

Answer 3

glucouronidation; sulfation

Question 4

8-10% APAP metabolized to ___ by the ____ system

Answer 4

NAPQI; hepatic cytochrome mixed function oxidase system

Question 5

NAPQI is detoxified by ____

Answer 5

glutathione

Question 6

what does NAPQI do?

Answer 6

covalently bind w/ hepatocytes’ vital proteins and lipid bilayer

Question 7

phase 1 of clinical course?

Answer 7

pallor, malaise, vomit, diarrhea (9-24h)

Question 8

phase 2?

Answer 8

right upper quadrant ab tenderness/tachychardia/hypotension (18-72h)

Question 9

phase 3?

Answer 9

tender hepatic edge/jaundice/GI bleeding (72-96h)

Question 10

phase 4?

Answer 10

resolution (4d-3wk)

Question 11

what does NAC do?

Answer 11

prevent form/accumulate NAPQI, ^ glutathione, anti-inflammatory+antioxidant

Question 12

NAC most effective when ingested….

Answer 12

8hrs within ingestion

Question 13

what are domains in quality of care?

Answer 13

safety, efficiency, access, patient centered, equitable, effectiveness

Question 14

failure of planned action to be completed as intended or use of wrong plan to achieve aim

Answer 14

medical error

Question 15

an undesired outcome resulting from med management rather than underlying condition of patient

Answer 15

adverse event

Question 16

what are characteristics of an error?

Answer 16

non-random, recurrent, circumstances influence error, majority attributable to system/structure deficiency