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Step 2 CK (primary set) > Poisonning > Flashcards

Poisonning Flashcards

1
Q

clue for Phenylcyclidine poisonning(2)

A

combative bahavior

prominent nystagmus =vertical nystagmus

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2
Q

rx of intoxication wtih phenylcyclidine

A

Benzodiazepines

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3
Q

clue for TCA overdose

A

QRS prolongation(0,19)

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4
Q

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

A

duration of QRS complex

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5
Q

rx of TCA intoxication

A

sodium bicarbonate

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6
Q

risk of TCA intoxication(3)

A

VTAC
hypotension
seizures

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7
Q

enumerate anticholinergic effect(6)

A 
ileus
flushed skin
dilated pupils
dry mucous membrane
urinary retention
confusion
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8
Q

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

A

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

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9
Q

patient with anticholinergic symptom dx?

A

diphenidramine poisonning

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10
Q

rx of diphenidramine intoxication?(2)

A

cholinesterase inhibitor

Physostigmine

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11
Q

chemical in the eye next step

A

flush eye with running water

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12
Q

firsr step in foreign body of the eye

A

search medical care is the first prioritiy

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13
Q

firsr step in cut or scrathes of the eye

A

search medical care is the first prioritiy

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14
Q

patient taking fluconazole and moxifloxacin torsades de pointes next step

A

MGS04

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15
Q

quid of torsades de pointes

A

polymorphic ventricular tachycardia with prolonged QT interval

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16
Q

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

A 
TCA
amiodarone
sotalol
moxifloxacin
fluconazole
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17
Q

other condition predisposing to long QT syndrome

A

hypomagnesemia

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18
Q

cause of low magnesemia(2)

A

malnutrition

alcoholics

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19
Q

quid of opiod intoxication(2)

A

morphin

heroin

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20
Q

clue for opiod intox

A

bradypnee

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21
Q

antidote for opiod intoxication

A

naloxone

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22
Q

eye in opiod intox

A

can cause myosis

but not always

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23
Q

why opioid intox can not have myosis

A

because coingestion can cause normal pupil or even mydriasis

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24
Q

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

A

meperidine

propoxyphene

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25
Q

triad for cannabis intoxication(3)

A

increase appetite
dry mouth
conjonctival injection

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26
Q

why cocaine can cause motor vehicle accident

A

decrease concentration

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27
Q

clue for benzodiapines intoxication(3)

A

slurred speech
drowsiness
unsteady gait

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28
Q

indication of benzodiazepines(4)

A

insomnia
seizures
anxiety
alcohol withdrawal

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29
Q

alcohol and phenytoin intox(2)

A

same symptom
plus
nystagmus

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30
Q

differenciation between benzodiapines and opiod intox(2)

A

pupil is normal=
no respiratory distress=
Benzodiazepine

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31
Q

quid of NMS

A

drug induced idiosyncratic reaction

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32
Q

clue for NMS(4)

A

fever
confusion
lead pipe rigidity
high creatine kinase level

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33
Q

what cause NMS

A

antagonist dopaminergic action

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34
Q

rx of NMS

A

dantrolene

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35
Q

action of bicarb in rx of antidepressant intox(2)

A

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

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36
Q

when given bicarb sodium in TCA intox

A

when QRS > 0,10 s

37
Q

drug of choice for alcohol withdrawal

A

chlordiazepoxide

38
Q

the most serious problem in alcohol withdrawal

A

delirium tremens

39
Q

symptom of delirium tremens(4)

A

HTA
agitation
hallucinations
fever

40
Q

quid of chlordiazepoxide

A

benzodiazepine

41
Q

quid of fluphenazine

A

typical antipsychotic like haloperidol

42
Q

why fluphen causes hypothermia(2)

A

by inhibiting the body shivering mechanism

inhibiting autonomic thermoregulation

43
Q

what to do during intake of typical antipsychotic

A

avoid prolonged exposure to cold

44
Q

clue for opiod intox(4)

A 
everything is decreased
Hypotension
low bowel sound
bradypnea
bradycardia
mioisis
45
Q

what happens in cocaine intox

A

everything is high++++

46
Q

best clue for opiod intox

A

respiratory rate

47
Q

clue for Co poisonning

A

Pinkish skin Hue
headaches
tachypnea
tachycardia

48
Q

rx of co poisonning

A

hyperbaric O2

49
Q

confirmatory dx

A

level of carboxyhemoglobin

50
Q

ethylene glycol poisonning why flank pain (2)?

A

because oxalic acid binds to ca to forl calcium stone

deposition in kidneys

51
Q

why renal failure in ethylene glycol poisonning

A

glycolic acid injures the renal tubules

52
Q

substances accumulated in ethylene glycol poisonning

A

oxalic acid

glycolic acid

53
Q

why hypocalcemia in ethylene glycol poisonning

A

calcium binds to acid

54
Q

why anion gap acidosis in ethylene glycol poisonning

A

accumulation of oxalic acid and glycolic acid

55
Q

rx of ethylene glycol poisonning (2)

A

ethanol

or fomepizole

56
Q

action of ethanol

or fomepizole

A

inhibit alcohol deshydrogenase

57
Q

role alcohol deshydrogenase

A

metablizes ethylene glycol to acid

58
Q

principle of rx of ethylene glycol poisonning(3)

A

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

59
Q

action of caustic substance ingestion

A

liquefaction necrosis

60
Q

example of liquefaction necrosis

A

sodium hydroxyde

61
Q

first step in rx of caustic ingestion(2)

A

decontamination of skin and clothing

IV hydration

62
Q

second thing in rx of caustic ingestion(2)

A

if no oesophageal perforation and stable patient

perform endoscopy within 12-24 h

63
Q

what to do if perforation is suspected

A

upper GI xray with contast substance

64
Q

how to Dx perforation in caustic ingestion

A

xray thorax

65
Q

patient stable and negative xray thorax next step

in caustic ingestion

A

upper GI endoscopy

66
Q

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

A

calculate
anion gap
osmolar gap

67
Q

clue for methanol intoxication

A

optic disk heperhemia

68
Q

opiod withdrawal(2)

A

abdominal cramps
diarrhee
in IV drug user

69
Q

attention a c difficile infection and opiod withdrawal

A

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

70
Q

eye in opiod intox

A

myosis

71
Q

eye in opioid withdrawal

A

mydriasis

72
Q

drug used to rx NMS(3)

A

dantrolene
bromocriptine
amantadine

73
Q

bblocker intoxication(4)

A 
Bradychardia
wheezing bronchospasm
hypotension
hypoglycemia
libido problem
74
Q

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

A

ca blocker
digoxin
cholinergic agent

75
Q

first step in bblocker intox(2)

A

fluid

atropine

76
Q

second step in bblocker intox

A

glucagon

77
Q

action of glucagon(3)

A

increase AMP cyclic
Increase intra cellular calcium
Increase cardiac contractility

78
Q

clue for caustic ingestion(3)

A

white tongue
heavy salivation
dysphagia

79
Q

what to rule out in any caustic ingestion

A

oesophageal perforation

stomach

80
Q

consequence of oesophageal perforation

A

mediastinitis

81
Q

consequence of stomach perforation

A

peritonitis

82
Q

action of organophosphate

A

act as cholinergic

83
Q

cholinergic effect(7)

A 
salivation
urination
diarrhee
bronchorrea
bradycardia
Myosis
all  glands are secreted
84
Q

antidote of organophosphate

A

atropine

85
Q

first thing to do in organophosphate intox(2)

A

remove clothes

wash the body

86
Q

people at risk of organophosphate intox

A

farmer

87
Q

why remove clothes in organophosphate intox

A

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

88
Q

quid of physostigmine in organophosphate intox

A

cholinestrase inhibitor

will worsen the intox

Step 2 CK (primary set) (22 decks)

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