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Hugh's MD2 Surgery > Overdose in Adolescence > Flashcards

Overdose in Adolescence Flashcards

1
Q

What are some useful tests in assessing overdoses?

A

Pupils - narcotics

ABG - pH, PaO2

Paracetamol levels

Blood glucose

ECG

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2
Q

What is the metabolic effect of aspirin?

A

Respiratory alkalosis > Metabolic acidosis

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3
Q

What is the antidote to paracetamol?

A

N-Acetylcysteine

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4
Q

What is the antidote to benzodiazepenes?

A

Flunazenil

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5
Q

What should you be cautious of when reversing benzodiazepene with flunazenil?

A

Benzo withdrawal > Seizures > requires more benzo > flunazenil will block it

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6
Q

When must charcoal be administered by?

A

Within 4 hours

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7
Q

What is escitalopram?

A

An SSRI

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8
Q

What are some clinical signs of serotonin syndrome?

A

Brisk reflexes

Clonus and stiff LL

Tachycardia

Confusion

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9
Q

What is a quick way to assess the QT interval?

A

Is it longer than half the RR interval

(start of the Q wave to the end of the T wave)

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10
Q

What is torsades to pointes?

A

VT due to prolonged QT

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11
Q

What is a prolonged QTc?

A

>440ms in men

>460ms in women

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12
Q

What are the indications for intubation?

A

GCS is <=8

Sats in the 80s and not responding to O2

Hypercapnia

Burns

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13
Q

What is the difference between affect and mood?

A

Mood is pervasive, how the person has felt recently

Affect is the objective finding on the examination eg frightened or sad or happy

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14
Q

What are the components of the mental state exam?

A

Appearance

Attitude towards the interview

Mood and affect

Language

Thought content

Perception

Cognition

Insight and judgement

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15
Q

What must you be wary of when starting on antidepressants in adolescents?

A

Suicidallity often increases in the first 4 weeks of treatment

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16
Q

What should you be wary of with benzodiazepenes?

A

Euphoria and subsequent come down

Disinhibition

17
Q

What are some withdrawal symptoms from anti-depression?

A

Dysuphoria

Anxiety

Dizziness

Headache

18
Q

What do you want to know about in a person whose overdosed?

A

Planned vs impulsive

Intention to die

First episode versus history of deliberate self harm

History of impulsivity

Alcohol/substance use disorder

19
Q

How does alcohol interact with suicide?

A

Alcohol is a depressant and may precipitate an attempt

Alcohol increases impulsivity

20
Q

What is the pnemonic for suicide risk assessment?

A

S - sex - male

A - Age - <19, >40

D - Depression

P - Previous attempt

E - EtOH

R - Rational thinking lost

S - Separated (break-up/widowed)

O - Organised plan

N - No support

S - Stated intent

Hugh's MD2 Surgery (29 decks)

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