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Pediatrics > Poisonings, Accidents, Child abuse > Flashcards

Poisonings, Accidents, Child abuse Flashcards

1
Q

Iron poisoning

  • features
  • dx findings
  • tx
A

Initially:

  • ab pain
  • vomiting
  • diarrhea
  • hypotensive shock
  • metabolic acidosis

Later:

  • hepatic necrosis (days)
  • pyloric stenosis (later)

Dx findings:

  • AG metabolic acidosis
  • radiopaque pills on Xray!

Tx

  • whole bowel irrigation
  • deferoxamine**
  • supportive
  • syrup of ipecac if no evidence gastroenteritis
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2
Q

Tx acetaminophen poisoning

A

Activated charcoal

N acetylcysteine (best 8-16h of ingestion)

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3
Q

When do you gastric lavage EtOH OD?

A

< 2 h

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4
Q

3 phases of salicylate ingestion

A

1

  • respiratory alkalosis from direct stim of respiratory center
  • K and bicarb excreted
  • can look like diabetic ketoacidosis

2
- paradoxical aciduria as alkalosis continues

3

  • metabolic acidosis 2/2 lactic acidosis
  • dehydration
  • hypokalemia
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5
Q

Tx caustics poisoning

A

Flush a lot with water

DO NOT GI lavage or emesis or charcoal

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6
Q

Organophosphate (anticholinesterase) poisoning - sx

A

Muscarinic

  • salivation
  • lacrimation
  • urination
  • defecation
  • emesis

Nicotinic

  • cramps
  • fasiculations
  • twitching
  • weakness
  • areflexia
  • paralysis of voluntary muscles
    • > occurs after Muscarinic effects; not seen in mild poisoning
CNS
- anxiety
- ataxia
- HA
- convulsions
0 coma
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7
Q

Dx organophosphate poisioning

A

decreased RBC cholinesterase

Clinical is best

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8
Q

Tx organophosphate (anticholinesterase) poisoning

A

If ingested:
GI lavage
Activated charcoal

If skin:
wash with water

+ atropine
+ pralidoxime (for nicotinic sx)

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9
Q

Tx antihistamine poisoning

A

Activated charcoal

Whole bowel irrigation if sustained release antihistamine given

Risk death from seizures if no tx

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10
Q

Main systems affected by TCA poisoning

A

CNS

Heart

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11
Q

Tx TCA posioning

A

Activated charcoal to –| more absorption

Na bicarb to prevent dysrhythmias
Tx dysrhythmias not responding with lidocaine

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12
Q

Tx anticholinergic OD

A

Physostigmine sulfate

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13
Q

Tx CO poisoning

A

O2

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14
Q

Tx cyanide poisoning

A

Amyl nitrite

then sodium nitrite

then sodium thiosulfate

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15
Q

Tx ethylene glycol poisoning

A

EtOH

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16
Q

Tx heavy metal poisoning in general

A

Chelators

EDTA

Dimercaprol

Penicillamine

2,3-dimercaptosuccinic acid

17
Q

Tx INH poisoning

A

Pyridoxine

18
Q

Tx methanol poisoning

A

EtOH

19
Q

Tx methemoglobinemia

A

Methylene blue

20
Q

Tx opioid OD

A

Naloxone

21
Q

Tx warfarin poisoning

A

Vit K

FFP

22
Q

Drowning freshwater vs saltwater

A

Freshwater
- may have lung damage 22 hypotonic fluid washing out surfactant

Saltwater
- more prone pulmonary edema

23
Q

Degree burns

A

1 - epidermis

2 - epidermis + dermis

3 - full thickness

24
Q

Fluid resusscitation in burns

A

Ringer’s lactate

25
Q

Hymenal opening size

A

< 5 mm in < 5yo

< 9 mm in < 9 yo

Not diagnostic though

26
Q

If person is sexually assaulted, specimens should be collected to test for?

A 
Acid phsophatase
G/C
Syphilis
Hep B
HIV
27
Q

Why do you get lead lines?

A

Usually at wrists and ankles (calcification because lead inhibits osteoclast activity)

28
Q

Clinical manifestations of foreign body aspiration

A

Signs + Sx

  • hx choking
  • coughing
  • cyanosis
  • sudden onset resp distress
  • AMS

PE

  • focal monophonic wheezing on affected side
  • diminished aeration on affected side

Xray

  • HYPERinflation or atelectasis of affected side
  • foreign body

Pediatrics (17 decks)

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