Term
| In ER toxicology the smell of bitter almonds on breath is suggestive for what? |
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Definition
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Term
| Turpentine has what odor on breath? |
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Definition
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Term
| Organophosphates (normally from ingestion of pesticides) give the breath what odor? |
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Definition
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Term
| Chloral hydrate yields what odor to breath? |
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Definition
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Term
| The mneumonic COPS can be used to remember the causes for pupillary constriction. What are these categories? |
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Definition
Clonidine
Opiates
Pontine bleeds
Sedative-hypnotics |
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Term
| What three broad classes of drugs/meds cause pupillary dilation? |
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Definition
Amphetamines
Anticholinergics
cocain |
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Term
| Anticholinergics have what effect on bowel activity? |
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Definition
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Term
| Overdose on salicylates and organophosphates can both cause what in regards to skin? |
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Definition
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Term
| Why might an O.D. on acetaminophen cause jaundice? |
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Definition
| liver failure (mushroom poisoning may also cause jaundice) |
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Term
| Arsenic and thallium, much like chemotherapeutic agents, have what effect on hair? |
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Definition
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Term
| What are the symptoms of cholinergic overdose? (DUMBBELS) |
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Definition
Diarrhea
Urination
Miosis (pupillary constriction)
Bradycardia
Bronchospasm
Emesis
Lacrimation
Salivation |
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Term
| What five categories of cholinergics does USMLE3 include? |
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Definition
| organophosphates, pilocarpine, pyridostigmine, muscarine-containing mushrooms |
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Term
| What type of drug/med overdose is described as "Hot as a stove, red as a beet, dry as a bone and mad as a hatter"? (fever, sking flushing, dry mucosa, pyshcosis, mydriasis, tachycardia, urinary retention) |
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Definition
| anticholinergics (TCAs, atropine, scopolamine, antihistamines, Jimson weed) |
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Term
| What are the descriptions of extrapyramidal signs? |
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Definition
| Parkinsonian sx: tremor, torticollis, trismus (lock jaw), rigidity, oculogyric crisis, opisthotonos, dysphonia, dysphagia |
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Term
| What bacteria may cause infection with a puncture wound through a rubber-soled shoe? |
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Definition
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Term
| What three agents commonly cause EPS? |
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Definition
| phenothiazines, haloperidol, metoclopramide |
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Term
| What is the first-line treatment for any toxic ingestion? |
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Definition
| activate charcoal (1g/kg) |
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Term
| Aside from activated charcoal, whole bowel irrigation can be used to help clean out the GI tract with what agent? |
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Definition
| polyethylene glycol with electrolytes |
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Term
| What emetic medication is used in the case of toxic ingections? |
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Definition
| ipecac (30cc for adultes, 15cc for kids) |
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Term
| What are the indications for ipecac use in toxic ingestion? |
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Definition
| ingestion was recent (30-60 minutes), pt is awake and coperative, ingestion of substance was substantial/significant |
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Term
| What are the contraindications for ipecac utilization? |
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Definition
| AMS, reduce/absent gag reflex, agents which are easily aspirated |
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Term
| What one criteria is added for the use of gastric lavage to those of ipecac utilization? |
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Definition
| pt is able to be placed in L lateral decubitus position |
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Term
| When pts are to be treated by alkalinization how is this done? |
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Definition
| D5W with 2-3 ampules of NaHCO3 |
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Term
| Charcoal perfusion (siphoning off blood to be filtered by activated charcoal before re-infusing) is useful in what cases of toxic ingestion? |
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Definition
| aminophylline, barbituates, carbamazepine, digoxin |
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Term
| What medication is used in cases of acetominphen OD? |
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Definition
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Term
| What antidote is used for anticholinesterases and organophosphates? |
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Definition
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Term
| What antidote is used for atropine? |
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Definition
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Term
| What antidote is used for benzo overdose? |
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Definition
| flumazenil (antagonizes benzo receptors) |
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Term
| What antidote is used for B-blocker overdose? |
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Definition
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Term
| What are the three treatments for cyanide? |
|
Definition
| amyl nitrite pearls, sodium nitrite, sodium thiosulfate |
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Term
| What treatment is used in digoxin toxicity? |
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Definition
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|
Term
| What medication is used to reverse heparin overdose? |
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Definition
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|
Term
| What chelator is used to treat iron toxicity? |
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Definition
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|
Term
| Isoniazid is countered with what medication? |
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Definition
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Term
| What medication is used to treat lead poisoning? |
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Definition
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Term
| What medication is used to treat phenothiazines (atypical antipsychotics) overdose? |
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Definition
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Term
| What two interventions are taken for salicylate toxicity? |
|
Definition
| sodium bicarbonate and dialysis |
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|
Term
| What treatment is used for TCA overdose? |
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Definition
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|
Term
| What two interventions are used to reverse the anticoagulation effects of warfarin? |
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Definition
| vit K and fresh frozen plasma |
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Term
| When does delerium tremens set in from alcohol withdrawl and what is its mortality? |
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Definition
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Term
| What vitamine should be given to withdrawing alcoholics before glucose? |
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Definition
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Term
| What are the symptoms of barbiturate withdrawl? |
|
Definition
| anxiety, seizures, delirium, tremor, cardiac/respiratory depression |
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Term
| What medication is used to treat barbiturate overdose? |
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Definition
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Term
| What heart rate regulating drugs should be avoided in pts suffering from cocain withdrawl? |
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Definition
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Term
| What type of cranial fracture is assumed when a pt has Battle sign (hemorrhage/ecchymosis around mastoid process) or raccoon eyes? |
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Definition
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|
Term
| What Glasgow coma score is indicative for intubation? |
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Definition
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Term
| What emergent condition should be suspected in a pt with muffled heart sounds and JVD? |
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Definition
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Term
| What type of EKG finding is seen in hypothermia between the QRS complex and T wave? |
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Definition
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Term
| The front and back torso, if both entirely burned, would constitute what percentage of body area? |
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Definition
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Term
| How can a 1st degree and 2nd degree burn be diferentiated by clinical appearance? |
|
Definition
| A 1st degree burn is red and painful, but without blisters |
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Term
| What is the rough approximation for fluid resuscitation of burn victims? |
|
Definition
| 4cc/kg/% BSA (1st half in 8 hours, and 2nd half in next 16) |
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Term
| Which type of electrical burn (at same voltage) generates more tissue damage? |
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Definition
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|
Term
| Which type of arrhythmia is more common with AC current? |
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Definition
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|
Term
| Which type of arrhytmia is more common with DC current? |
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Definition
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Term
| Burn victims exhibiting myoglobinuria should have what initial intervention? |
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Definition
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Term
| What is the antibiotic of choice for tetanus? |
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Definition
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Term
| For pts who are symptomatic for tetanus toxoid what intervention (aside from antibiotics) should be made? |
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Definition
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Term
| What are the three most likely culprits causing infection from a dog bite? |
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Definition
| alpha-hemolytic strep (strep pneumonia and Viridans group), S. aureus, Pasteurella multocida |
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Term
| What two antibiotics should be used in the case of dog bites? |
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Definition
| amoxicillin/clavulanate or 1st-gen cephalosporin |
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Term
| What bacterium is of primary concern in cat bites? |
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Definition
| P. multocida (treat with amoxicillin/clavulanate) |
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Term
| Which group of bacteria are the most commonly implicated in human bites? |
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Definition
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|
Term
| What antibiotics should be used for human-bite wounds? |
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Definition
2nd or 3rd gen cephalos
dicloxacillin w/ PCN
amox/clav |
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Term
| What is remarkable about the clinical examination of a corneal abrasion? |
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Definition
| Pain out of proportion to exam (very painful) |
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Term
| What is the tx for corneal abrasion? |
|
Definition
| topical solution antibiotics (gentamicin, sulfacetamide, bacitracin) |
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Term
| What are the clinical differences between viral conjunctivitis vs bacterial? |
|
Definition
Viral: usually bilaterally with watery dischage
bacterial: usually unilateral with purulent discharge and foreign body sensation |
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Term
| What antibiotics should be used for staph or strep conjunctivitis? |
|
Definition
| 10% sulfacetamide or aminglycoside |
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