Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ER > Toxidromes > Flashcards

Toxidromes Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
0
Q

What are the findings in a pt with stimulant overdose?

A

Vitals signs: tachycardia tachypnea hyperthermia HTN
Eye: mydriasis
Skin: diaphoretic
MSE: agitated, hallucination, paranoia, Sz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are examples of stimulants?

A

Cocaine, amphetamines, pseudo ephedrine, caffeine, theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are eg of anticholinergic meds?

A 
Antihistamines
Antidepressants: TCA
Antipsychotics: phenothiazine
Atropine
Antispasmodics
Belladonna alkaloids: Jimson weed
Mushrooms
Deadly nightshade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the features of anticholinergic intoxication?

A

Vitals: tachycardia, tachypnea , HTN, hyperthermia
Eyes: mydriasis
MSE: agitation, hallucination, delirium
Skin: dry and flushed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are eg of hallucinogens?

A

LSD
Ecstasy
Amphetamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the smell of almonds assoc with?

A

Cyanide poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the mnemonic for drugs causing an incr HR?

A

F reebace cocaine
A nticholinergics
S ympathomimetica
T heophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What’s the mnemonic for drugs causing decr HR?

A 
P ropranolol
A nticholinesterase drugs
C lonidine
E thanol
D igoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mnemonic for drugs causing miosis?

A

C holinergics, clonidine
O piates, organophosphates
P henothiazines
S edatives (barbiturates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mnemonic for drugs causing mydriasis?

A

A ntihistamines
A ntidepressants
A nticholinergics
S ympathomimetics (amphetamines,PCP, cocaine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q 
Blind as a bat
Hot as hare
Red as a beet
Dry as a bone
Mad as hatter 
This is a mnemonic for remembering the symptom complex assoc with what toxin? And what does each statement mean?

Mad as hatter

A 
Mydriasis
Hyperthermia
Flushing
Decr sweat, decr urine
Delirium, hallucinations

These are assoc with anticholinergics (phenothiazine, antihistamines)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is considered a potentially toxic dose of acetaminophen?

A

Acutely:

  • Minimum dose of 150 mg/kg
  • In adolescents and adults: 7.5g

Chronic dose:
150mg/kg/day for >2d
4gm/d for >2d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the mx of acute overdose of acetaminophen?

A
  • Prevent further absorption with activated charcoal if within 1/2hr to 1hr of ingestion
  • acetaminophen levels: 4hrs s/p ingestion (peak concentration)
  • rumack Matthew nomogram to set likelihood of hepatic damage and need for tx w/ n-acetylcysteine (NAC) or acetylcysteine (mucomist)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the effect of toxic ingestion a of ibuprofen?

A

Usu very Rarely serious.
Serious toxicity >400mg/kg
Symptoms mostly GIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is iron ingestion concerning?

A 
Yes!! Very serious toxicity can occur! 
Eg: pre-natal vits, fe supp
Toxic dose of elemental fe are:
- 20mg/kg GI symptoms
- 50mg/kg signif toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the features of Fe toxicity?

A

0-6hrs: GIT stg- nausea, d&v, abd pain, hematemesis, bloody diarrhea, direct damage to GIT mucosa
6-12: stability
W/in 48h: cvs collapse, metab acidosis (high anion gap)
2-3d: hepatic failure
2-6 wks: GIT and pyloric scarring

I 1 is indigestion
R 2 is recovery
O 3-4 oh my gosh
N 5 narrowing

16
Q

How to dx fe toxicity?

A
  • abd dx: tablets may be visible, fluid and chewable tabs are not
  • serum fe level 4h s/p intake: 500 severe toxicity
17
Q

How to tx fe toxicity?

A

Chelation with IV deferoxamine for

  1. mod-severe symptoms regardless of fe level
  2. Serum fe level >350 mcg/dl
  3. Pills on radiograph
18
Q

If someone ingested oil of winter green( a baking product) what type if toxicity wud u be concerned about?

A

Salicylate toxicity

19
Q

For salicylate ingestion what dose wud be concerning for acute toxicity?

A

150mg/kg

20
Q

What are some acute signs of salicylate toxicity?

A

Nausea, vomiting, tinnitus, hyperventilation (respiratory alkalosis)
Dehydration, hypoK, metabolic acidosis (it uncouples oxidative phosphorylation),
Serious toxicity: hyperthermia, agitation, confusion, coma, renal failure, death(from pulmonary/cerebral edema, electrolyte imbalance, cvs collapse)

21
Q

What’s the monitoring and mx for acute salicylate toxicity?

A

Monitoring: q2 to 4h monitoring of salicylate levels, ABG, chem, coags

Tx: activated charcoal (drug may form a bezoar in stomach), fluid hydration, correct electrolyte disturb (hypoK), raise urine pH w/ IV bicarbonate, hemodialysis
*there is no nomogram to reference

22
Q

What are the features of acute TCA toxicity? When do symptoms usu occur?

A

Symptoms usu w/in 30mins to 6h
*CNS features are more prominent in children
*mnemonic: tri-C A
C -coma
C -cadiac dysrhythmia: incr HR, HTN, decr BP, wide QRS and prolonged Qt
C -convulsions
A -acidosis

23
Q

What is the monitoring and tx for Axute TCA ingestion?

A

W/u: chem(hypoK), ABG, ECG, urine preg, utox (usu co-ingestions), acetaminophen/salicylate/etoh levels

Tx: protect airway, activated charcoal, alkalinize serum w/ Na-bicarb (7.45-7.55) to prevent dysrhythmia, monitor, EKG monitoring, tx dysrhythmia w/ lidocaine

24
Q

What is the mechanism by which carbon monoxide poisoning is pathological?

A

Carbon monoxide has a higher affinity for Hb than O2. Once it binds to one of the 4 spots on Hb it creates carboxy-Hb which doesn’t readily release O2. O2 dissociation curve shifts to the left. So in the presence of adequate O2 the tissues are unable to use it!

25
Q

What is the typical presentation of carbon monoxide poisoning?

A

*Family with flu like symptoms in winter!!!
Flu like symptoms: headache, dizziness, nausea, malaise
Visual changes, weakness, syncope, vomiting, ataxia, Sz, coma, death
*cherry red skin

26
Q

What is the w/u and tx of carbon monoxide poisoning?

A

W/u: CO [ ] because pulse ox will be normal!!
Tx: high flow O2 (1/2 life is 5h on room air and 30-90 mins on 100% O2), tx anemia, ?use of hyperbaric O2 (in pregnant/neonatal pt’s)

27
Q

What is the mx of an ingested button battery in the nose, ear or esophagus vs in the stomach? What’s the concern?

A

Button batteries can cause mucosal burns w/in 1h of ingestion and full thickened burns w/in 4h by caustic leakage if it’s contents or by electrical current. If in the E, N or esoph remove stat if in stomach wait and watch for passage in stool w/ q3d X-rays.

28
Q

A child as ingested perfume and or mouthwash and presents w/ N&V, ataxia, slurred speech, resp depression and hypothermia. What would be you concern? What are other features of this?

A

Ethanol toxicity!
Can also cause Sz and coma
*in children <5 can also cause hypoglycemia, due to inhibition of hepatic gluconeogenesis

29
Q

What is the w/u and tx in a suspected ethanol toxicity?

A

W/u: ethanol level, osmolar gap (an incr >10 identifies an unknown alcohol ingestion)

Tx:
ABCs, IVF, tx hypoglycemia, reward as needed, +/- screen for other toxins (ethanol may mask other toxicities)

30
Q

What is a good screening tool to identify a toxic ingestion of alcohols? If abnormal what are the common offenders?

A

Serum osmolality:
2x Na (mmol/L) + glucose (mg/dl)/18 + BUN (mg/dL)/2.8
Normal is <10
Mnemonic for augmented osmolality gap: MAE DIE
Methanol, acetone, ethanol, diuretics(mannitol, sorbitol), isopropranolol, ethylene glycol

31
Q

In a pt with calcium channel blocker toxicity, what is the tx?

A

Insulin and glucose

ER (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions