Pediatrics Flash Cards - Case 24 - 2 yo AMS

Question 1

Mnemonic for altered mental status?

Answer 1

AEIOU-TIPS: [A]lcohol/toxins; [E]pilepsy/encephalitis/endocrine/electrolytes; [I]nfection; [O]verdose, opiates, oxygen deprived; [U]remia (renal failure); [T]rauma, temp; [I]nsulin; [P]sychosis; [S]troke, shock, space occupying lesions

Question 2

Mnemonic for cholinergic poisoning? Example poison?

Answer 2

[e.g. organophosphate] “SLUDGE” (salivation, lacrimation, urination, defecation, GI motility, emesis)

Question 3

Mnemonic for anti-cholinergic poisoning? Examples?

Answer 3

[e.g. TCAs, diphenhydramine] “blind as a bat” (dilated), “dry as a bone” (skin, urine retention) and “red as a beet” (skin), “hot as Hades” (fever), “mad as a hatter” (delirium); TACHY and ILEUS

Question 4

Poison Control number?

Answer 4

1-800-222-1222

Question 5

Rx for Iron overdose?

Answer 5

deferoxamine

Question 6

antidote in dextrose-refractory sulfonylurea overdose? MoA?

Answer 6

octreotide is a somatostatin analog that inhibit insulin release

Question 7

Triad of cardiotoxicity in TCA overdose?

Answer 7

conduction delays, dysrhythmias, and hypotension

Question 8

Tx for TCA overdose that is causing cardiotoxicity?

Answer 8

Alkalinization and sodium loading: Hypertonic bicarb: 1 mEq/kg bolus STAT and q3-5m until QRS narrows and hypotension improves. (Goal is pH of 7.50-7.55) Alk’ing is continued for 12-24 hrs after EKG normalizes d/t drug’s redistribution from tissues.

Question 9

TCAs have anticholinergic or cholinergic effect?

Answer 9

anticholinergic