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EM/Surg > Mental Status & Toxicology (Exam #3) > Flashcards

Mental Status & Toxicology (Exam #3) Flashcards

1
Q

What mental status finding involves NOT fully alert, drifts to sleep, loses train of thought?

A

Lethargy/Somnolent

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2
Q

What mental status finding involves needing persistent stimulation, confusion?

A

Obtunded

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3
Q

What mental status finding involves needing vigorous and persistent stimulation, moan/mumble?

A

Stuporous/Semicomatose

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4
Q

What mental status finding involves unarousable unresponsiveness?

A

Coma

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5
Q

What are the three components of GCS?

A
  • Eye movement
  • Motor response
  • Verbal response
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6
Q

What posture involves flexor response?

A

Decorticate

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7
Q

What posture involves extensor posturing?

A

Decerebrate

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8
Q

Where is the lesion located for Decorticate posturing? Where is the lesion located for Decerebrate posturing? Which is WORSE?

A
  • Decorticate: cortex/upper midbrain

- Decerebrate = WORSE: brainstem

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9
Q

If a lesion is located in the cortex/upper midbrain, what posturing may be seen?

A

Decorticate

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10
Q

If a lesion is located in the brainstem, what posturing may be seen?

A

Decerebrate

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11
Q

What four conditions can differentiate Delirium from Dementia?

A
  • Short period of time
  • Fluctuates
  • Abnormal vital signs and PE
  • GLOBAL neuro findings
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12
Q

What is the primary RF associated with Delirium? What are three examples?

A

Underlying brain disease (Dementia, PD, CVA)

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13
Q

What is the mnemonic associated with the etiologies of AMS, and what does each letter stand for?

This is trash, I apologize

A

AEIOU TIPS

  • Alcohol
  • Epilepsy, endocrine
  • Infection
  • O2, opioids
  • Uremia
  • Trauma, temp., toxins
  • Insulin
  • Psychosis
  • Stroke, shock
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14
Q

What two PE findings may be indicative of AMS?

A
  • Pupil size

- Skin temp.

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15
Q

What three meds can ALWAYS be started with AMS?

A
  • Thiamine
  • Dextrose
  • Naloxone
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16
Q

What two drug classes should be avoided with AMS? What else should be avoided/used as last resort?

A

Avoid restraints = last resort

  • Benzos
  • AChE-I
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17
Q

What drug can be considered ONLY if the AMS is severe and the patient is a harm to others?

A

Psychotropic drugs (Haldol)

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18
Q

What two developments are seen with physiologic EXCITATION?

A
  • CNS stimulation

- Increase in BP, HR, RR, temp.

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19
Q

What four drug classes are responsible for physiologic EXCITATION?

A
  • Anticholinergics
  • Sympathomimetics
  • Hallucinogens
  • Drug withdrawal
20
Q

What two developments are seen with physiologic DEPRESSION?

A
  • Depressed mental status

- Decrease in BP, HR, RR, temp.

21
Q

What five drug classes are responsible for physiologic DEPRESSION?

A
  • Ethanol, methanol, ethylene glycol
  • Sedative-Hypnotics
  • Opioids
  • Cholinergics
  • Sympatholytics
22
Q

Do Anticholinergics cause physiologic excitation or depression?

A

Physiologic EXCITATION

23
Q

Do Sympathomimetics cause physiologic excitation or depression?

A

Physiologic EXCITATION

24
Q

Do Hallucinogens cause physiologic excitation or depression?

A

Physiologic EXCITATION

25
Q

Does drug withdrawal cause physiologic excitation or depression?

A

Physiologic EXCITATION

26
Q

Does ethanol cause physiologic excitation or depression?

A

Physiologic DEPRESSION

27
Q

Does methanol cause physiologic excitation or depression?

A

Physiologic DEPRESSION

28
Q

Does ethylene glycol cause physiologic excitation or depression?

A

Physiologic DEPRESSION

29
Q

Do Cholinergics cause physiologic excitation or depression?

A

Physiologic DEPRESSION

30
Q

Do Sedative-Hypnotics cause physiologic excitation or depression?

A

Physiologic DEPRESSION

31
Q

Do Sympatholytics cause physiologic excitation or depression?

A

Physiologic DEPRESSION

32
Q

Do Opioids cause physiologic excitation or depression?

A

Physiologic DEPRESSION

33
Q

What four labs should ALWAYS be obtained for toxicology?

A
  • Pregnancy test
  • Glucose
  • Acetaminophen levels
  • Salicylate levels
34
Q

Which toxidrome involves “SLUDGE and Killer B’s”, and what are the 3 B’s? What other sxs may be seen?

A

CHOLINERGICS

  • Salivation, Lacrimation, Urination, Defecation, GI issues, Emesis
  • Bradycardia, Braonchorrhea, Bronchospasms
  • MIOSIS
35
Q

What is the antidote for Cholinergics (2)?

A
  • Atropine

- 2-PAM

36
Q

What is the phrase of sxs/signs associated with Anticholinergics?

A
  • Blind as a bat
  • Mad as a hatter
  • Red as a beet
  • Dry as a bone
  • Hot as a hare
37
Q

What is the antidote for Sympathomimetics?

A

Benzos + supportive

38
Q

Which toxidrome involves dry/flushed skin, dec. BS, tachycardia?

A

Anticholinergics

39
Q

What is the antidote for Opioids?

A

Naloxone + supportive

40
Q

Which toxidrome involves miosis, bradycardia, hypothermia, hypotension?

A

Opioids

41
Q

What is the antidote for Anticholinergics?

A

Physostigmine

42
Q

Which toxidrome involves “fight or flight”?

A

Sympathomimetics

43
Q

What is the “antidote” for Sedative-Hypnotics (2)? What med can be considered, and what is its associated risk?

A

TIME + supportive

- Consider Flumazeril = can induce seizures

44
Q

What is often the first sign associated with Anticholinergic toxicity?

A

Tachycardia

45
Q

Which toxidrome involves diaphoresis and inc. BS?

A

Sympathomimetics

46
Q

Which toxidrome involves variable pupils, NORMAL vital signs, bradypnea, hyperreflexia?

A

Sedative-Hypnotics

EM/Surg (16 decks)

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