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CEN2 > TOX - ENVIRONMENTAL - SUBSTANCE ABUSE > Flashcards

TOX - ENVIRONMENTAL - SUBSTANCE ABUSE Flashcards

1
Q

All patients must be warmed to a minimum of what degree?

A

86F (30C)

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2
Q

What is the final pathology of a submersion injury?

A

Hypoxia due to submersion

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3
Q

What is the main symptom of heat exhaustion? Heat stroke?

A

Heat exhaustion = sweating profusely
Heat stroke = hot and dry

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4
Q

What is the treatment for both heat exhaustion and heat stroke? (4)

A

-Rapid cooling
-Avoid shivering
-IVF/electrolytes
-Check for rhabdo/DIC

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5
Q

Radiation injury is related to what 3 things?

A

Time, distance, shielding

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6
Q

What might be the first sign of petroleum distallates overdose (aka gasoline)?

A

cough

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7
Q

“Nerve agents” - acetylcholinesterase inhibitor that causes too much ACTH buildup. Neuromuscular junction cannot “reset” for next impulse. Leads to paralysis of the diaphragm. AKA acetylcholinergic crisis. Found in insecticides and WMD. Treat with atropine.

A

Organophosphates

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8
Q

S&S of organophosphates OD

A

MUDDLES:
-miosis (constriction of pupil)
-urination
-diaphoresis
-defecation
-lacrimation
-excitation (seizures)
-salavation

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9
Q

Constriction of pupil?
Dilation of pupil?

A

Miosis
Mydriasis

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10
Q

What toxidromes cause miosis (2)?
What cause mydriasis (1)?

A

Miosis = opiates & organophosphates

Mydriasis = stimulants

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11
Q

How long after tylenol ingestion should we get a level?

A

4 hours

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12
Q

What is a (often terminal) finding of carbon monoxide poisioning?

A

Cherry red skin and mucous membranes

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13
Q

What are some sources of CO poisioning? What patient education needs to be done?

A

Anything that burns and gas appliances
Have CO detectors

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14
Q

What may cause “bitter almond” breath?

A

Cyanide Toxicity

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15
Q

What are 3 routes for cyanide toxicity?

A

inhale, oral, IV (nipride)

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16
Q

What is charcol contraindicated in?

A

Iron toxicity

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17
Q

What is tinnitus a symptom of?

A

ASA toxicity

18
Q

What have both anticholinergic and alpha-adrenergic properties?

(alpha cells are on blood vessels, so they vasoconstrict and increase the HR)

A

TCAs (elevil, amitryptline)

19
Q

What is a common anticholinergic? What are 4 symptoms?

A

Atropine

Can’t see, can’t pee, can’t spit, can’t shit

20
Q

3 Cs of TCA OD

A

Cardiac (dysrhythmias)
Convulsions (seizures)
Coma (decreased LOC)

21
Q

Alcohol can cause what to happen to the eyes?

A

Nystagmus

22
Q

This causes increase in catecholamine release from CNS. Symptoms of increased HR/palpitations/CP coming from brain, not heart

A

Cocaine

23
Q

How do we treat symptoms r/t cocaine OD?

A

Benzos (not nitro or BB!)

24
Q

Leads to autonomic instability and causes HTN, tachycardia, disphoresis

A

Delirum Tremens

25
Q

This is r/t alcohol abuse and can lead to Korsakoff psychosis.

A

Werenicke’s encephalopathy

26
Q

What should we give to alcoholics/werenicke’s encephalopathy patients before giving glucose to protect the brain?

A

Thiamine

27
Q

What are some toxic symptoms of lithium? How do we treat?

A

-ataxia
-nystagmus
-renal impairment (renally excreted)
-seizures

Treat with IVF

28
Q

Why do we use digoxin? What can dig toxicity cause (3)?

A

A-fib

-decreased HR
-heart blocks
-“yellow halos”

29
Q

Antidote to coumadin

A

vitamin K

30
Q

Antidote to dilantin

A

supportive (heart rhythm changes)

31
Q

Antidote to CCB

A

calcium chloride/gluconate

32
Q

Antidote to ethylene glycol/methanol

A

10% ethanol

33
Q

Antidote to BB/CCB

A

glucagon

34
Q

Antidote to oral sulfonylureas (metformin/glucophage)

A

octreotide/sandostatin

(this blocks pancreas and causes it to slow down insulin production)

35
Q

Antidote to heparin

A

protamine sulfate

36
Q

Antidote to tylenol

A

mucomyst (PO)/acetylcysteine

37
Q

Antidote to benzos

A

Romazicon/Flumazeril

38
Q

Antidote to carbon monoxide

A

high flow oxygen

39
Q

Antidote to cyanide

A

Cyanide kit:
Amyl nitrate (inhaled)
Sodium nitrate (IV)
Sodium thiosulfate (IV)

40
Q

Antidote to iron

A

deFEroxamine (this may cause pink/red urine)

41
Q

Antidote to salicylates

A

HCO3

42
Q

Antidote to TCAs

A

HCO3

CEN2 (12 decks)

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