Poisonning Flashcards by martineau louine

clue for Phenylcyclidine poisonning(2)

combative bahavior

prominent nystagmus =vertical nystagmus

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rx of intoxication wtih phenylcyclidine

Benzodiazepines

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clue for TCA overdose

QRS prolongation(0,19)

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what’s the approriate indication to assess severity of intoxication of TCA

duration of QRS complex

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rx of TCA intoxication

sodium bicarbonate

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risk of TCA intoxication(3)

VTAC
hypotension
seizures

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enumerate anticholinergic effect(6)

ileus
flushed skin
dilated pupils
dry mucous membrane
urinary retention
confusion

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patient seen after ingestion of 14 acetaminophen first step?(3)

charcoal activated
plasma acetaminophen dans 4 hr
Na cetylcysteine within 8 h

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patient with anticholinergic symptom dx?

diphenidramine poisonning

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rx of diphenidramine intoxication?(2)

cholinesterase inhibitor

Physostigmine

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chemical in the eye next step

flush eye with running water

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firsr step in foreign body of the eye

search medical care is the first prioritiy

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firsr step in cut or scrathes of the eye

search medical care is the first prioritiy

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patient taking fluconazole and moxifloxacin torsades de pointes next step

MGS04

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quid of torsades de pointes

polymorphic ventricular tachycardia with prolonged QT interval

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drugs causing prolonged QT syndrome and possibly torsade de pointes(5)

TCA
amiodarone
sotalol
moxifloxacin
fluconazole

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other condition predisposing to long QT syndrome

hypomagnesemia

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cause of low magnesemia(2)

malnutrition

alcoholics

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quid of opiod intoxication(2)

morphin

heroin

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clue for opiod intox

bradypnee

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antidote for opiod intoxication

naloxone

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eye in opiod intox

can cause myosis

but not always

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why opioid intox can not have myosis

because coingestion can cause normal pupil or even mydriasis

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opiod taken alone which doesn’t cause myosis?(2)

meperidine

propoxyphene

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triad for cannabis intoxication(3)

increase appetite dry mouth conjonctival injection

why cocaine can cause motor vehicle accident

decrease concentration

clue for benzodiapines intoxication(3)

slurred speech drowsiness unsteady gait

indication of benzodiazepines(4)

insomnia seizures anxiety alcohol withdrawal

alcohol and phenytoin intox(2)

same symptom plus nystagmus

differenciation between benzodiapines and opiod intox(2)

pupil is normal= no respiratory distress= Benzodiazepine

quid of NMS

drug induced idiosyncratic reaction

clue for NMS(4)

fever confusion lead pipe rigidity high creatine kinase level

what cause NMS

antagonist dopaminergic action

rx of NMS

dantrolene

action of bicarb in rx of antidepressant intox(2)

sodium load will alleviate depressant action on sodium channels by increasing the extra cellular NA+ concentration 2-alkalinazation of serum by decreasing drug avidity for sodium channels

when given bicarb sodium in TCA intox

when QRS > 0,10 s

drug of choice for alcohol withdrawal

chlordiazepoxide

the most serious problem in alcohol withdrawal

delirium tremens

symptom of delirium tremens(4)

HTA agitation hallucinations fever

quid of chlordiazepoxide

benzodiazepine

quid of fluphenazine

typical antipsychotic like haloperidol

why fluphen causes hypothermia(2)

by inhibiting the body shivering mechanism | inhibiting autonomic thermoregulation

what to do during intake of typical antipsychotic

avoid prolonged exposure to cold

clue for opiod intox(4)

``` everything is decreased Hypotension low bowel sound bradypnea bradycardia mioisis ```

what happens in cocaine intox

everything is high++++

best clue for opiod intox

respiratory rate

clue for Co poisonning

Pinkish skin Hue headaches tachypnea tachycardia

rx of co poisonning

hyperbaric O2

confirmatory dx

level of carboxyhemoglobin

ethylene glycol poisonning why flank pain (2)?

because oxalic acid binds to ca to forl calcium stone | deposition in kidneys

why renal failure in ethylene glycol poisonning

glycolic acid injures the renal tubules

substances accumulated in ethylene glycol poisonning

oxalic acid | glycolic acid

why hypocalcemia in ethylene glycol poisonning

calcium binds to acid

why anion gap acidosis in ethylene glycol poisonning

accumulation of oxalic acid and glycolic acid

rx of ethylene glycol poisonning (2)

ethanol | or fomepizole

action of ethanol | or fomepizole

inhibit alcohol deshydrogenase

role alcohol deshydrogenase

metablizes ethylene glycol to acid

principle of rx of ethylene glycol poisonning(3)

fomepizole bicarb sodium to rx acidosis hemodyalisis in case of renal injury

action of caustic substance ingestion

liquefaction necrosis

example of liquefaction necrosis

sodium hydroxyde

first step in rx of caustic ingestion(2)

decontamination of skin and clothing | IV hydration

second thing in rx of caustic ingestion(2)

if no oesophageal perforation and stable patient | perform endoscopy within 12-24 h

what to do if perforation is suspected

upper GI xray with contast substance

how to Dx perforation in caustic ingestion

xray thorax

patient stable and negative xray thorax next step | in caustic ingestion

upper GI endoscopy

in any vignette you see ethanol or ethylene glycol next step(2)

calculate anion gap osmolar gap

clue for methanol intoxication

optic disk heperhemia

opiod withdrawal(2)

abdominal cramps diarrhee in IV drug user

attention a c difficile infection and opiod withdrawal

look for the time 1 day of antibio is not sufficient to develop pseudomembranous colitis look WBC if they are decreasing no C difficile infection

eye in opiod intox

myosis

eye in opioid withdrawal

mydriasis

drug used to rx NMS(3)

dantrolene bromocriptine amantadine

bblocker intoxication(4)

``` Bradychardia wheezing bronchospasm hypotension hypoglycemia libido problem ```

Med causing same symptom than B blovker minus wheezing(3)

ca blocker digoxin cholinergic agent

first step in bblocker intox(2)

fluid | atropine

second step in bblocker intox

glucagon

action of glucagon(3)

increase AMP cyclic Increase intra cellular calcium Increase cardiac contractility

clue for caustic ingestion(3)

white tongue heavy salivation dysphagia

what to rule out in any caustic ingestion

oesophageal perforation | stomach

consequence of oesophageal perforation

mediastinitis

consequence of stomach perforation

peritonitis

action of organophosphate

act as cholinergic

cholinergic effect(7)

``` salivation urination diarrhee bronchorrea bradycardia Myosis all glands are secreted ```

antidote of organophosphate

atropine

first thing to do in organophosphate intox(2)

remove clothes | wash the body

people at risk of organophosphate intox

farmer

why remove clothes in organophosphate intox

because of vomiting tou can have absorption of the substance through skin

quid of physostigmine in organophosphate intox

cholinestrase inhibitor | will worsen the intox