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Pediatric Boards > [MS] Emergency Care > Flashcards

[MS] Emergency Care Flashcards

1
Q

What is the initial management for patients who present with poisonings?

A

ABCDs

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2
Q

What are the poisonings associated with pinpoint pupils?

A

Cholinergics/Clonidine
Opiates/Organophosphates
Phencyclidine
Sedatives

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3
Q

What are the poisonings associated with dilated pupils?

A

Anticholinergics
Antihistamines
Antidepressants
Amphetamine (Cocaine)

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4
Q

What poisonings cause diaphoresis?

A

Sympathomimetics
Organophosphates
Aspirin (Salicylates)
PCP

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5
Q

What poisonings cause the skin to appear red?

A

Carbon Monoxide

Boric Acid

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6
Q

What poisonings typically cause blue-colored skin?

A

Cyanide

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7
Q

What is the regimen for giving activated charcoal to a poisoned patient?

A

Use within the first hour at the dose of 1gm/kg (MAX: 50-100gm)

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8
Q

In what ingestion situations is activated charcoal ineffective or contraindicated?

A

Caustic agents, hydrocarbons, electrolytes, metals, cyanide, alcohols, lithium, camphor, and phosphorous

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9
Q

What are the symptoms associated with salicylate poisoning?

A

Abdominal pain, nausea, vomiting, tachypnea, tinnitus, vertigo, agitation, confusion, coma

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10
Q

What kinds of ingestions should concern someone for salicylate poisoning?

A

OTC Cold Medicine, Antidiarrheal Medicine, and Topical Analgesics

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11
Q

What is the metabolic derrangement seen in salicylate poisoning?

A

pH - normal to high
pCO2 - low
HOC3 - low

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12
Q

What medication enhances salicylate clearance?

A

IV Sodium Bicarbonate to alkalinize the urine

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13
Q

What are the effects seen in tricyclic antidepressant medication overdose?

A

Coma, Seizures, Widened QRS, and Prolonged QT

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14
Q

What is the treatment for tricyclic antidepressant poisoning?

A

IV Sodium Bicarbonate to resolve the hypotension and the QRS widening

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15
Q

What drugs can cause the anticholinergic syndrome?

A

Antihistamines, antidepressants, atropine, antispasmodics, anti-Parkinson drugs

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16
Q

What are the symptoms of the anticholinergic toxidrome?

A

Dry as a bone, red as a beet, blind as a bad, mad as a hatter, and hot as a hare

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17
Q

What is akathisa?

A

Subjective feeling of restlessness

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18
Q

What is the presentation and treatment for an acute dystonic reaction?

A

Presents with twisted necks and protruding tongues. Treated with benzotropine or diphenhydramine.

19
Q

What laboratory findings separates an acute dystonic reaction from neuroleptic malignant syndrome?

A

An elevated CK

20
Q

What medication is used to treat malignant hyperthermia?

A

Dantrolene

21
Q

What are the varying degrees of iron ingestion?

A

Mild - 20mg/kg
Moderate - 40mg/kg
Severe - 60mg/kg

22
Q

What are the four stages of iron toxicity?

A

GI stage - 30 mins to 6 hours
Stability - 6 hours to 24 hours
Systemic toxicity - 12 hours to 24 hours
Pyloric scarring - 2 to 6 weeks

23
Q

What is the treatment for iron ingestion/toxicity?

A

Supportive. Use IV Deferoxamine if the iron level is greater than 500.

24
Q

What is the treatment for lead poisoning?

A

Succimer or EDTA chelation

25
Q

What toxidrome presents with vomiting that is only relieved with hot showers several times per day?

A

Cannabinoid hyperemesis syndrome

26
Q

What is the characteristic late finding associated with methanol ingestion?

A

Toxic optic neuropathy leading to blindness

27
Q

What is the treatment of methanol ingestion?

A

IV Fomepizole

28
Q

What are the three stages of ethylene glycol poisoning?

A

CNS manifestations within 6 to 12 hours.
Hypocalcemic problems within 12 to 36 hours.
Acute renal failure within 24 to 72 hours.

29
Q

What is the treatment for ethylene glycol ingestion?

A

IV Fomepizole or Ethanol

30
Q

What is the treatment for cat bite victims?

A

Amoxicillin-Clavulanate, or Clindamycin plus Bactrim for allergic patients.

31
Q

What is the causative organism in Cat Scratch Disease?

A

Bartonella henselae

32
Q

What is the presentation of a Brown Recluse spider bite?

A

Hemorrhagic blister that develops into a large ulcer

33
Q

What are the symptoms of a Black Widow spider bite?

A

Chest tightness, vomiting, abdominal pain, sweating, agitation, and hypertension

34
Q

What are the percentages of burns for children over 14 years of age?

A 
Head/Neck - 9%
Each upper limb - 9%
Trunk/Abdomen - 18% front and 18% back
Each lower limb - 18%
Perineum - 1%
35
Q

What is the Parkland formula?

A

Use 4mL/kg/%TBSA burned and give 50% of that within the first 8 hours, and the remaining for the next 16 hours.

36
Q

What is the concussion grading system?

A

Grade I - no LOC with symptoms less than 15 min
Grade II - no LOC with symptoms more than 15 min
Grade III - positive LOC

37
Q

When should athletes return to play post-concussion?

A

Once asymptomatic for one week

38
Q

Describe the Salter-Harris fractures.

A 
I - Through the growth plate
II - Growth plate and metaphysis
III - Growth plate and epiphysis
IV - Growth plate, metaphysis, and epiphysis
V - Crush injury
39
Q

What is the radiographic sign of a Greenstick fracture?

A

Incomplete fracture with an intact cortex on one side

40
Q

What is the mechanism of a nursemaid’s elbow?

A

Axial traction on an extended and pronated arm

41
Q

How do you fix a nursemaid’s elbow?

A

Supinate the forearm and flex the elbow, or hyperpronate the arm

42
Q

What is the treatment for a hyphema?

A

Topical steroids, cycloplegic eye drops, protective eye shield, and bed rest with the head of the bed elevated

43
Q

What is the dose of epinephrine used in pediatric resuscitation?

A
  1. 01mg/kg (1:10,000 [0.1mL/kg]) IV/IO

0. 1mg/kg (1:1,000 [0.1mL/kg]) ET

Pediatric Boards (15 decks)

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