Overdose in Adolescence

Question 1

aspirin toxic syndrome how?

Answer 1

respiratory alkalosis first

then acidosis

Question 2

Side effects of escitalopram?

Answer 2

Long QT

serotonin syndrome

Question 3

risk of flumazonil?

Answer 3

risk of acute withdrawal: seizures and you can’t stop them as flumazonil blocks it.

Question 4

when to give activated charcoal?

Answer 4

paracetomol overdose within 4h

Question 5

why be careful with activated charcoal?

Answer 5

aspiration and altered conscious state dangerous

Question 6

what can precipitate serotonin syndrome?

Answer 6

amphetamines

tramadol

Question 7

serotonin syndrome

Answer 7

increased temp

increased reflexes, clonus lower>upper

Question 8

how to measure QT for long QT?

Answer 8

if it’s longer than half of the RR interval

Question 9

tachy or brady better to have long QT?

Answer 9

tachy

Question 10

danger of long QT?

Answer 10

can progress to Torsades de Pointes (>500ms)

Question 11

intubation criteria?

Answer 11

GCS

Question 12

mood vs. affect

Answer 12

mood - pervasive (last few weeks)

affect - objective what you see when you examine

Question 13

components of mental state exam?

Answer 13

appearance
attitude 
mood/affect
language
though content
perception
cognition
insight
judgement

Question 14

adolescent taking antidepressants risk?

Answer 14

risk of increased suicidality in first 4 weeks

Question 15

diazepam side effects?

Answer 15

disinhibition
euphoria
dysphoria

Question 16

benzodiazepam withdrawal?

Answer 16

depressed mood

increased anxiety

Question 17

adjuvant tests for assessing overdoses?

Answer 17

pupils - narcotics
paracetomol levels
pH
ETOH
BSLs