Poison_Electrolytes_Rheum_UW

Question 1

Mechanism of iron poisoning

Answer 1

Creates free radicals, lipid peroxidation, which impairs various cell processes, leading to systemic manifestations => abdominal pain, hematemesis, shock and metabolic acidosis.

Question 2

Antidote for iron poisoning

Answer 2

Deferoxamine - binds ferric iron, can be excreted in the urine.

Question 3

Antidote for TCA and aspirin overdose

Answer 3

Sodium bicarbonate

Question 4

Mag sulfate is used for

Answer 4

Patients with torsades induced by prolonged QT interval

Question 5

TOC for lithium toxicity

Answer 5

Hemodialysis

Question 6

Lead poisoning treatment?

Answer 6

Calcium EDTA = lead chelator in moderate to severe lead poisoning. Oral succimer can be used for mild or moderate lead poisoning.

Question 7

Abnormal values of lead must be confirmed by?

Answer 7

Venous blood draw.

Question 8

What is used to treat cardiotoxicity (>100msec) and ventricular arrythmias

Answer 8

Sodium bicarbonate. Allevaites inhibitory action of TCA on sodium channels of the myocardium, improves hypotension and decreases risk of ventricular arrythmias.

Question 9

What are used to treat seizures from tCA overdose

Answer 9

Benzodiazepines

Question 10

How is elemental iron toxic?

Answer 10

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.

Question 11

Diagnostic findings of iron toxicity

Answer 11

Anion gap metabolic acidosis and radioopagque pills

Question 12

Tx for iron toxicity

Answer 12

Deferoxamine, whole bowel irrigation, supportive

Question 13

Olive shaped mass

Answer 13

Pyloric stenosis

Question 14

What is a common cause of cystitis in young children?

Answer 14

Constipation. Constipation - rectal distension, presses on the bladder which prevents complete voiding. Residual urine is a breeding ground for bacteria.

Question 15

What is the most common type of elbow fracture in children

Answer 15

supracondylar humerus fracture. Occurs in 2-12 year olds. Typical hx is falling onto an extended arm.

Question 16

What does X-ray show for supracondylar humerus fracture

Answer 16

triangular anterior fat pad (lucency) and triangular posterior fat bad (lucency)

Question 17

What is a dangerous complication of supracondylar fractures and how does it present?

Answer 17

Compartment syndrome. Characterized by severe pain, pallor, poikilothermia, parasthesias, and late findings of pulselessness and paralysis.

Question 18

Signs and sx of hypernatremia

Answer 18

Mostly neurologic - letargy, ams, seizures, irritability. Can also cause muscle cramps, muscle weakness, decreased deep tendon reflexes.

Question 19

In patient with recurrent sinopulmonary infections, intermittent diarrhea and anaphylactic reaction, consider what immune problem?

Answer 19

IgA deficiency

Question 20

Osteogenesis Imperfecta teeth

Answer 20

Dentinogenesis Imperfecta - opalescent blue-gray to yellow-brown teeth.discolored dentin shining through transluscent teeth

Question 21

OI inheritence? Mutation fo which gene?

Answer 21

A/D. Mutation of COL1A1.

Question 22

Type of OI

Answer 22

1 (Mild), 2 (fatal perinatal), 3 and 4 (moderate)

Question 23

Borrelia burgdorferi is what kind of organism

Answer 23

Spirochete

Question 24

Criteria for rhematic fever.

Answer 24

JONES - joints (migratory arthritis), heart (carditis), Nodules (subcutaneous), E (erythema marginatum), S sydenham chorea. Minor: fever, elevated CRP/ESR, prolonged PR interval, arthralgias.

Question 25

Osgood Schlatter is?

Answer 25

Traction apophysitis of the tibial tubercle

Question 26

Acute rheumatic fever epidemiology

Answer 26

5-15 year olds, twice as comon in girls

Question 27

What kind of arthritis in ARF

Answer 27

Migratory polyarthritis

Question 28

Name of rash in ARF

Answer 28

Erythema marginatum

Question 29

What is serum sickness like reaction

Answer 29

Usually occurs due to abx (sulfa, beta lactams are the most common)

Question 30

Clinical presentation of serum sickness like reaction

Answer 30

Fever, urticaria, polyarhthralgias 1-2 weeks after drug exposure. Lymphadenopathy, headache, edema can also happen but less common

Question 31

Tx for serum sickness like reaction

Answer 31

Removal of offending agent. If severe, steroids

Question 32

What is osteiod osteoma

Answer 32

Benign bone tumor that usually presents with progressively increasing pain that worsens at night without relation to physical activity. Pain usualy subsides with NSAIDS

Question 33

What site is most commonly affected in osteoid osteoma

Answer 33

Proximal femur

Question 34

Diagnostic criteria for KAWASAKi

Answer 34

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