Posioning Flashcards
hyperventilation, tinnitus, deafness, vasodilatation, sweating - which drug OD?
Aspirin
Treatment for aspirin overdose?
Sodium bicarbonate, haemodialysis
Drug OD that may require dialysis?
Salicylates, lithium
Monitoring in aspirin overdose?
Monitor plasma-salicylate level, pH, electrolytes
Coma, respiratory depression, pinpoint pupils - which OD?
Opioid
Sx of paracetamol OD
Sx: N&V, RUQ pain (hepatic necrosis, worst 3-4d after overdose)
drowsiness, ataxia, dysarthria, nystagmus (occasionally respiratory depression and coma) - which drug OD?
Benzodiazepine
Treatment for benzo OD?
Flumazenil
Initial treatment for TIA
Tx: aspirin 300mg for 2w
Management for ischaemic stroke
Dx: CT then MRI with diffusion
Tx:
≤4.5h and no contraindication to thrombolysis: thrombolysis (alteplase) then aspirin 300mg for 2w
>4.5h or contraindication to thrombolysis: aspirin 300mg for 2w
Secondary prevention: clopidogrel 75mg for life
Doses in status epilepticus
Buccal midazolam 10mg
IV lorazepam 0.1mg/kg
Community tx of meningitis?
Benzylpenicillin or cefotaxime (give IM before urgent transfer to hospital then IV)
Sx overlap with subarachnoid haemorrhage
Verbal response component of GCS?
- Oriented
- Confused
- Words
- Sounds
- None
Motor response of GCS?
- Obeys commands
- Localises
- Withdraws
- Abnormal flexion (decorticate)
- Abnormal extension (decerebrate)
- None
cardiac arrest management
CPR 30:2 (attach defibrillator)
Assess rhythm
Shockable (VF or pulseless VT) - 1 shock
Non-shockable (PEA or asystole) - no shock
CPR 30:2 for 2m
Assess rhythm…
Adrenaline 1mg of 1:10,000 IV (repeat every 3-5m)
Amiodarone 300mg IV (after 3 shocks)
Reversible causes of cardiac arrest:
‘The H’s’ - hypoxia, hypovolaemia, hypo-/hyper-kalaemia, hypothermia
‘The T’s’ - thrombosis, tension pneumothorax, tamponade, toxins
1, V5, V6 leads - which ACS?
Left circumflex artery
Lateral MI
V1-V4 leads?
anterior MI (anterior/septal)
LAD
II, III, avF - which MI and which artery is affected?
Inferior MI
Right coronary artery (RCA)
Seconary prevention - ‘BADS’
ACS
BB - bisoprolol 2.5mg PO
ACEi - ramipril 1.25mg PO
Dual antiplatelets - aspirin 75mg and clopidogrel 75mg PO
Statin - atorvastatin 80mg PO
Acute treatment of ACS?
“MONAC”
Morphine 10mg IV and metoclopramide 10mg IV
O2 if hypoxic (<94%)
Nitrates
Aspirin 300mg PO
Clopidogrel 300mg PO
Treatment of NSTEMI
GRACE score
Low risk - nil
High risk - consider glycoprotein IIb/IIIa (eptifibatide or tirofiban) and coronary angiography
Fondaparinux or UH
Narrow complex tachycardia?
1 vagal manouvres
#2 adenosine 6mg IV (12mg, 12mg)
Broad complex tachycardia?
Regular
Amiodarone 300mg IV over 10-20 mins (then 900 mg over 24 hours)
Irregular (torsades de pointes)
Magnesium sulphate 2g IV
Treatment of bradycardia?
1 atropine 500mcg IV (repeat to max 3 mg)
#2 transcutaneous pacing
Pulmonary oedema treatment?
Oxygen 15L
Diamorphine 1.25-5mg IV
Furusemide 20-50mg IV
GTN
Where does testicular cancer spread to?
Lateral aortic
The testes (and ovaries in women) drain to the lateral aortic nodes, also known as the para-aortic nodes. These cannot be palpated upon physical examination but can be seen on a computed tomography scan performed for staging. The presence of nodal metastasis is part of the grading of testicular cancer using the Royal Marsden staging system.
What is guttate psoriasis?
Occurs after strep URTI infection
Salmon pink lesions
Which lung cancer is associated with hypercalcaemia?
Squamous cell
Subarachnoid haemorrhage tx?
Endovascular coiling
Subdural haemorrhage tx?
burr hole drainage
Causes of Hyperglycaemia
Steroids, antipsychotics, thiazides, beta blockers, tacrolimus
o Beta blockers reversing agent?
Atropine (low HR), glucagon (low BP)
Haemodialysis indicated in overdoses of BLAST drugs?
-Barbiturates
- Lithium
- Alcohol
- Salicylates
- Theophylline
