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PME3 > PME3 tox > Flashcards

PME3 tox Flashcards

1
Q

What are the steps in the Primary Survey for general management approach?

A

Scene safety: assess and ensure no ongoing harm. Airway: anticipate airway loss, suction as necessary. Breathing: support ventilations if necessary. Circulation: assess for dysrhythmias, shock, and adequacy of circulation. Disability: consider 4 Hs & 4 Ts. Exposure: decontamination and isolate emesis.

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2
Q

What should be included in the Secondary Survey for general management approach?

A

Detailed history taking, including medications, allergies, and past medical history. Physical examination tailored to the clinical presentation.

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3
Q

What does the Reassessment involve in the general management approach?

A

Continuous monitoring of patient’s response to interventions. Reevaluate and adjust management plans based on patient’s progress and any deterioration.

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4
Q

What are the clinical features of Anticholinergic Toxidrome?

A

Agitated delirium, tachycardia, hyperthermia, dilated pupils, dry flushed skin, urinary retention.

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5
Q

What are the common causes of Anticholinergic Toxidrome?

A

Antipsychotics, antihistamines, tricyclic antidepressants, benztropine, atropine, carbamazepine.

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6
Q

What is the management for Anticholinergic Toxidrome?

A

Physostigmine as an antidote. Supportive care, including cooling measures for hyperthermia and sedation if necessary.

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7
Q

What are the clinical features of Opiate Toxidrome?

A

Decreased conscious state, bradypnoea/apnoea, miosis, ventilatory failure.

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8
Q

What are the common causes of Opiate Toxidrome?

A

Heroin, morphine, other opiates.

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9
Q

What is the management for Opiate Toxidrome?

A

Naloxone administration. Ventilatory support and monitoring of respiratory function.

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10
Q

What are the clinical features of Mixed Cholinergic Toxidrome?

A

Brady- or tachycardia, hypo- or hypertension, miosis or mydriasis, sweating, salivation, bronchospasm, muscle weakness.

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11
Q

What are the common causes of Mixed Cholinergic Toxidrome?

A

Organophosphates, carbamates, chemical warfare agents.

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12
Q

What is the management for Mixed Cholinergic Toxidrome?

A

Atropine and oximes as antidotes. Supportive care including ventilatory support.

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13
Q

What are the clinical features of Sympathomimetic Toxidrome?

A

Hypertension, tachycardia, agitation, mydriasis, sweating.

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14
Q

What are the common causes of Sympathomimetic Toxidrome?

A

Amphetamines, cocaine.

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15
Q

What is the management for Sympathomimetic Toxidrome?

A

Beta blockers (e.g., propranolol) for specific conditions. Supportive care focusing on cardiovascular and neurological stability.

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16
Q

What are the clinical features of Serotonin Syndrome?

A

Altered mental state, autonomic dysfunction, hyperthermia, sweating, hyperreflexia, clonus/myoclonus.

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17
Q

What is the management for Serotonin Syndrome?

A

Supportive care, including cooling for hyperthermia. Benzodiazepines for seizures and agitation.

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18
Q

What should be monitored in Serotonin Syndrome?

A

Monitoring for and managing complications like hyperkalaemia.

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19
Q

What are the clinical features of Tricyclic Antidepressant (TCA) Overdose?

A

Rapid CNS deterioration, seizures, QRS prolongation, terminal R wave in aVR.

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20
Q

What is the management for Tricyclic Antidepressant (TCA) Overdose?

A

Sodium bicarbonate for sodium channel blockade. Amiodarone for refractory ventricular tachycardia or fibrillation.

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21
Q

What should be monitored in Tricyclic Antidepressant (TCA) Overdose?

A

Early airway management and supportive care.

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22
Q

What are the clinical features of Monoamine Oxidase Inhibitor (MAOI) Overdose?

A

Agitation, confusion, seizures, hyperthermia, sympathomimetic toxicity.

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23
Q

What is the management for Monoamine Oxidase Inhibitor (MAOI) Overdose?

A

Aggressive cooling for hyperthermia.

24
Q

What additional management is considered for Monoamine Oxidase Inhibitor (MAOI) Overdose?

A

Benzodiazepines for seizures.

25
Q

What should be avoided in the management of Monoamine Oxidase Inhibitor (MAOI) Overdose?

A

Consideration for GTN in significant hypertension. Avoidance of beta blockers due to risk of unopposed alpha agonism.

26
Q

What are the challenges in managing Cardiovascular Toxidromes?

A

Compound dysrhythmias, high likelihood of refractory presentations, electrolyte and metabolic disturbances.

27
Q

What is the initial management for Cardiovascular Toxidromes?

A

Early 12-lead ECG and serial monitoring.

28
Q

What supportive care is important for Cardiovascular Toxidromes?

A

Specific antidotes like atropine, calcium gluconate, sodium bicarbonate as appropriate.

29
Q

What are the clinical features of Box Jellyfish envenomation?

A

Severe pain, skin necrosis, cardiovascular collapse.

30
Q

What is the management for Box Jellyfish envenomation?

A

Vinegar application, antivenom, analgesia, and magnesium administration.

31
Q

What are the clinical features of Irukandji Syndrome?

A

Delayed severe pain, hypertension, tachycardia.

32
Q

What is the management for Irukandji Syndrome?

A

Vinegar application, analgesia, magnesium, GTN.

33
Q

What are the clinical features of Stonefish and Stingray envenomation?

A

Immediate extreme pain, systemic symptoms including seizures and paralysis.

34
Q

What is the management for Stonefish and Stingray envenomation?

A

Hot water immersion, pain relief, wound stabilization, and transport for surgical care.

35
Q

What are the clinical features of Ciguatera Fish Poisoning?

A

Nausea, vomiting, diarrhea, cramps, tingling, dizziness, respiratory paralysis.

36
Q

What is the management for Ciguatera Fish Poisoning?

A

Symptomatic management, symptoms typically resolve in days to weeks.

37
Q

What are the clinical features of Pufferfish (Tetrodotoxin) Poisoning?

A

Similar to ciguatera fish poisoning.

38
Q

What is the management for Pufferfish (Tetrodotoxin) Poisoning?

A

Symptomatic management.

39
Q

What are the clinical features of heat-related illnesses?

A

Muscle cramps, nausea, vomiting, dizziness, headache, confusion, seizures.

40
Q

What is the management for heat-related illnesses?

A

Rapid cooling, rehydration, monitoring and treating complications like hyperkalaemia.

41
Q

What are the clinical features of Anticholinesterase Pesticides Poisoning?

A

Altered consciousness, respiratory failure, seizures, bradycardia, bronchorrhoea, fasciculations.

42
Q

What is the management for Anticholinesterase Pesticides Poisoning?

A

Atropine, pralidoxime, decontamination, supportive care.

43
Q

What are the clinical features of Paraquat poisoning?

A

GI corrosive injury, multiple organ failure, pulmonary fibrosis.

44
Q

What is the management for Paraquat poisoning?

A

Supportive care, antioxidants, hemodialysis in severe cases.

45
Q

What are the clinical features of Glyphosate poisoning?

A

Mild GI symptoms.

46
Q

What is the management for Glyphosate poisoning?

A

Symptomatic and supportive care.

47
Q

What are the clinical features of opioid overdose?

A

CNS depression, respiratory depression, miosis.

48
Q

What is the management for opioid overdose?

A

Naloxone, supportive care.

49
Q

What are the clinical features of benzodiazepine overdose?

A

CNS depression, respiratory depression, hypotension.

50
Q

What is the management for benzodiazepine overdose?

A

Flumazenil (with caution), supportive care.

51
Q

What are the clinical features of psychostimulant (amphetamines, cocaine) overdose?

A

Hypertension, tachycardia, agitation, hyperthermia, mydriasis.

52
Q

What is the management for psychostimulant (amphetamines, cocaine) overdose?

A

Benzodiazepines, cooling measures, supportive care.

53
Q

What are the clinical features of carbon monoxide toxicity?

A

Headache, dizziness, confusion, cherry red skin, respiratory failure.

54
Q

What is the management for carbon monoxide toxicity?

A

Removal from exposure, 100% oxygen, hyperbaric oxygen therapy.

55
Q

What are the clinical features of cold injuries (chilblains, trench foot, frostbite, hypothermia)?

A

Tissue damage, numbness, pain, blistering, systemic hypothermia symptoms.

56
Q

What is the management for cold injuries (chilblains, trench foot, frostbite, hypothermia)?

A

Gradual rewarming, pain management, supportive care.

57
Q

What are the 4 H’s & T’s

A

Hypoxia, Hypokalaemia/hyperkalaemia, Hypothermia/hyperthermia, Hypovolaemia, Tension pneumothorax, Tamponade, Toxins

PME3 (1 decks)

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