Poison_Electrolytes_Rheum_UW Flashcards
Mechanism of iron poisoning
Creates free radicals, lipid peroxidation, which impairs various cell processes, leading to systemic manifestations => abdominal pain, hematemesis, shock and metabolic acidosis.
Antidote for iron poisoning
Deferoxamine - binds ferric iron, can be excreted in the urine.
Antidote for TCA and aspirin overdose
Sodium bicarbonate
Mag sulfate is used for
Patients with torsades induced by prolonged QT interval
TOC for lithium toxicity
Hemodialysis
Lead poisoning treatment?
Calcium EDTA = lead chelator in moderate to severe lead poisoning. Oral succimer can be used for mild or moderate lead poisoning.
Abnormal values of lead must be confirmed by?
Venous blood draw.
What is used to treat cardiotoxicity (>100msec) and ventricular arrythmias
Sodium bicarbonate. Allevaites inhibitory action of TCA on sodium channels of the myocardium, improves hypotension and decreases risk of ventricular arrythmias.
What are used to treat seizures from tCA overdose
Benzodiazepines
How is elemental iron toxic?
Corrosive to GI mucosa, causes abdominal pain, n/v/d and hematemesis within 30 minutes to 6 hours of ingestion. Severely affected patients can develop hypotensive shock and anion gap metabolic acidosis. They can develop respiratory alkalosis to compensate. risk of gastric scarring and pyloric stenosis within 2-8 weeks.
Diagnostic findings of iron toxicity
Anion gap metabolic acidosis and radioopagque pills
Tx for iron toxicity
Deferoxamine, whole bowel irrigation, supportive
Olive shaped mass
Pyloric stenosis
What is a common cause of cystitis in young children?
Constipation. Constipation - rectal distension, presses on the bladder which prevents complete voiding. Residual urine is a breeding ground for bacteria.
What is the most common type of elbow fracture in children
supracondylar humerus fracture. Occurs in 2-12 year olds. Typical hx is falling onto an extended arm.
What does X-ray show for supracondylar humerus fracture
triangular anterior fat pad (lucency) and triangular posterior fat bad (lucency)
What is a dangerous complication of supracondylar fractures and how does it present?
Compartment syndrome. Characterized by severe pain, pallor, poikilothermia, parasthesias, and late findings of pulselessness and paralysis.
Signs and sx of hypernatremia
Mostly neurologic - letargy, ams, seizures, irritability. Can also cause muscle cramps, muscle weakness, decreased deep tendon reflexes.
In patient with recurrent sinopulmonary infections, intermittent diarrhea and anaphylactic reaction, consider what immune problem?
IgA deficiency
Osteogenesis Imperfecta teeth
Dentinogenesis Imperfecta - opalescent blue-gray to yellow-brown teeth.discolored dentin shining through transluscent teeth
OI inheritence? Mutation fo which gene?
A/D. Mutation of COL1A1.
Type of OI
1 (Mild), 2 (fatal perinatal), 3 and 4 (moderate)
Borrelia burgdorferi is what kind of organism
Spirochete
Criteria for rhematic fever.
JONES - joints (migratory arthritis), heart (carditis), Nodules (subcutaneous), E (erythema marginatum), S sydenham chorea. Minor: fever, elevated CRP/ESR, prolonged PR interval, arthralgias.
Osgood Schlatter is?
Traction apophysitis of the tibial tubercle
Acute rheumatic fever epidemiology
5-15 year olds, twice as comon in girls
What kind of arthritis in ARF
Migratory polyarthritis
Name of rash in ARF
Erythema marginatum
What is serum sickness like reaction
Usually occurs due to abx (sulfa, beta lactams are the most common)
Clinical presentation of serum sickness like reaction
Fever, urticaria, polyarhthralgias 1-2 weeks after drug exposure. Lymphadenopathy, headache, edema can also happen but less common
Tx for serum sickness like reaction
Removal of offending agent. If severe, steroids
What is osteiod osteoma
Benign bone tumor that usually presents with progressively increasing pain that worsens at night without relation to physical activity. Pain usualy subsides with NSAIDS
What site is most commonly affected in osteoid osteoma
Proximal femur
Diagnostic criteria for KAWASAKi
Warm (fever for >= 5 days) CREAM. C=conjunctivitis bilateral nonpurulent R=rash polymorphouse E=edema/erythema changes of periphearl extremiies A=adenopathy cervical >1.5cm M=mucosal invovlement strawberry tongue/red fissured lips/eyrthema of oropharynx
