Pretest with EKG! (and others) Flashcards
organophosphate compounds inhibit __________
acetylcholinesterase,
The treatment for organophosphate toxicity is
atropine and pralidoxime
Atropine-anticholinergic/ inhibits excess acetylcholine.
Pralidoxime- regenerates
acetylcholinesterase
Flumazenil reverses _________
benzodiazepines
GHB vs other sedative/hypnotic overdoses
vs other sedative/hypnotic overdoses, the level of consciousness fluctuates quickly
between agitation and depression.
γ-Hydroxybutyrate
The most useful diagnostic test/treatment in a suspected CO poisoning is
COHb level
mainstay of treatment is the delivery
of oxygen
Acetaminophen concentration must be measured ______ after ingestion and then plotted on the nomogram.
between 4 and 24 hours
_________ is notorious for causing sz refractory to standard therapy
INH
Pyridoxine (vitamin B6) is the treatment
Glyburide is a commonly prescribed __________
sulfonylurea
lasts 24 hours–> Hypoglycemia secondary to sulfonylureas generally requires
hospital admission to monitor for recurrent hypoglycemia
Aspirin overdose acid/ base
A mixed respiratory alkalosis and metabolic acidosis is typically seen in adults
Agents that do not adsorb to charcoal include
ions- lithium
hydrocarbons
metals
ethanol
________ should be used as the first-line
agent for nearly all cocaine toxicities.
Benzos
Opioid withdrawal presents with
mild tachycardia yawning rhinorrhea piloerection NVD diaphoresis myalgias/ arthralgias, anx
Toxic alcohol and serum osmolarity
- If ↑ low molecular weight molecules,
(acetone, toxic ETOH, mannitol)
–>
-↑ osmolarity (more than what is calculated from the regular serum molecules)
osm gap > 50 diagnostic of toxic etoh
acetaminophen od rx
NAC
glutathione precursor to reduce NAPQI (N-acetyl-p-benzoquinoneimine)– the
toxic metabolite of acetaminophen.
most effective within 8 hours of the ingestion, use up to 24
The finding of _________ is considered the hallmark of ethylene glycol ingestion
crystalluria
peritonsillar abscess s/s and rx
muffled voice, trismus, fluctuant mass, deviation of the uvula, odynophagia, and drooling.
needle aspiration or incision and drainage
bull neck, mandibular swelling, tongue swelling, and protrusion
dental cause= ~ 90% of cases
Fournier gangrene rx
necrotizing fasciitis of the perineal and male genitalia
aggressive fluid, surgical debridement, broad-spectrum abx, and possibly hyperbaric O2
impetigo organism and treatment options
S pyogenes
erythromycin- macrolide
cephalexin- cephlosporin
linezolid in resistant cases
Acute chest syndrome
- vaso-occlusive life threatening crisis of the pulmonary vasculature
- commonly seen with sickle cell
- must be cautious with IV fluid (pulm edema)
toxic synovitis
-benign/ self-limiting
-typically responds to
rest/ NSAIDs
-transient synovitis thought to be a postinfectious inflammatory process
Kawasaki disease is defined by the following criteria
fever > 5 days
and 4/5 of:
- cervical LAD > 1.5 cm
- oral mucous membrane involvement (strawberry tongue)
- truncal rash
- nonpurulent conjunctivitis
- edematous hands and feet
4 to 7 day old with severe cyanosis from congenital heart problem. Rx?
The most important next step is prostaglandin bolus followed by a drip to maintain PDA
O2 will close PDA, do not use despite hypoxia
MONA for ACS in the ER
Morphine, Oxygen, Nitroglycerin, Aspirin
endocarditis in the intravenous drug user is usually what valve?
tricuspid valve
The right coronary artery supplies ___________ in 90% of patients
the AV node and inferior wall of the left ventricle
s. Inferior wall MIs are characterized by ST elevation in what leads
2+ of the inferior leads (II, III, aVF)
Leads II, III, aVF show what part of the heart
Inferior wall
Septal Leads
V1, V2
The anteroseptal wall of the heart is supplied by the left anterior
descending coronary artery (LAD)
Lateral leads
I
V5, V6
AVL
Anterior leads
V3, V54
The anteroseptal wall of the heart is supplied by the ________ artery
left anterior descending coronary artery (LAD)
LAD coronary artery MI
ST elevation in leads V1, V2, V3, and V4
The lateral wall of the heart is supplied by the __________
artery
left circumflex coronary (LCA)
LCA MI
ST elevations in leads I, aVL, V5, and V6