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laughing your way peds > Poisons > Flashcards

Poisons Flashcards

1
Q

Treatment for acetaminophen ingestion <4hrs

A

Activated charcoal

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2
Q

Tx for acetaminophen ingestion > 4 hrs

A

Acetaminophen level and plot on nomogram

If more than 140 mg/kg ingested then give N acetylcistine even without getting level

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3
Q

When can lfts become elevated after acetaminophen ingestion

A

3-4 days after

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4
Q

How do you manage salicylate ingestion

A

Activated charcoal

And sodium bicarbonate to alkalinize the urine

The acidosis is caused by a respiratory alkalosis

Address hypokalemia and consider glucose

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5
Q

How do you calculate anion gap

A

Sodium - (chloride + bicarb)

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6
Q

What level of ethanol do you worry for coma, respiratory depression and death

A

Greater than 0.4 g/dl

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7
Q

What do you monitor for in a pt with ethanol toxicity

A

Hypoglycemia and electrolyte imbalance

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8
Q

How does methanol toxicity present

A

Abdominal pain, vomiting, inebriation, severe metabolic acidosis, increased anion gap, cns depression

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9
Q

Where can you find methanol

A

Windshield washer fluid, cooking fuel, perfumes

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10
Q

Tx for methanol toxicity

A

Ethanol

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11
Q

Presentation of organophosphate

A 
Cholinergic effect (parasympathetic)
Dumbbels
Diarrhea
Urination
Miosis
Beonchospasm
Bradycardia
Emesis
Lacrimation
Salivation
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12
Q

What are the two categories of cholinergic effects and how are they treated

A

Muscarinic - salivation, lacrimation, diarrhea, wheezing, bradycardia. Tx atropine

Nicotinic- weakness, paralysis, fasiculations. Tx with pralidoxime

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13
Q

What are anticholinergic effects (sympathetic system) and what’s a MED example

A

Blind as a bat, red as a beet, hot as a hare, dry as a bone, mad as a hatter and the heart runs alone

TCA, Benadryl

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14
Q

Findings in Ekg for tca intoxication

A

Widened qrs complex

Tx this with sodium bicarb boluses until qrs less than 100 msec

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15
Q

How does ingestion with hydrocarbons present

A

N/V, cough or wheezing

Lab findings will show hypoxemia

XRAY will show diffuse bilateral infiltrates

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16
Q

Tx for carbon monoxide poisoning

A

High flow oxygen even with normal pulse ox

17
Q

Buzzword for cyanide poisoning

A

Smell of almonds

18
Q

3 phases of ethylene glycol

A

1: náusea, vomiting, tachy, hypertension, metabolic acidosis and calcium oxalate crystals in urine
2: coma and cardiorrespiratorio failure due to acidosis and hypocalcemia
3: 1-3 days renal failure due to tubular necrosis with pt needing dialysis

19
Q

What poisoning gives you garlic smell breath

A

Organophosphate

20
Q

What gives you wintergreen odor on breath

A

Salicylate ingestion

21
Q

Radio opaque materials on X-ray

A

Chips

Chloral hydrate 
Heavy metals
Iron 
Phenothiazines 
Slow release enteric coated materials
22
Q

What parts of body do alkali substances affect

A

Esophagus

23
Q

What parts of body do acidic substances affect

A

Esophagus and stomach

24
Q

Symptoms for lead level between 10-20 mcg/dl

A

Mild cognitive delay

25
Q

Intervention for lead levels between 10-20 mcg/dl

A

Education, environmental control and monitoring

26
Q

Symptoms for lead level greater than 70 mcg/dl

A

Severe toxicity, headaches, encephalopathy, lead lines on gingival and or anemia

27
Q

Tx for lead levels greater than 70

A

Chelation

28
Q

What are ways that kids are exposed to lead

A

Eat paint chips or exposed to household dust or soil

29
Q

Phase 1 of iron ingestion

A

Within 6 hrs vomiting (often bloody), diarrhea, abdominal pain

30
Q

Phase 2 iron ingestion

A

Quiescent and improvement over next 6-24 hrs

31
Q

Phase 3 iron ingestion

A

Multi system, shock and organ failure

Metabolic acidosis, coagulopathy, cardiovascular collapse

32
Q

Phase 4 iron ingestion

A

recovery. GI obstruction can be caused due to scarring and structures

33
Q

Lab findings in iron ingestion

A

Serum iron > 350, WBC > 15k, glucose > 150

34
Q

Indications for chelation with deferoxamine for iron ingestion

A

Severe symptoms along with anion gap acidosis, iron > 500, significant number of pills visible on abdominal XRAY

laughing your way peds (26 decks)

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