boards 10 Flashcards
(47 cards)
immediate collapse at scene of fire
cyanide
what will pulse ox measure in CO
normal - need to measure carboxyhb– PA02 is normal too - oxyhb calculates dissolved o2 which is normal
yellow green gas, pungent odor
chlorine gas
OD with coma miosis, resp depression, bradycardia, hypotenison, AV block
clonidine- mimics opiate- tx fluids, atropine, pressors
mecehanism of cyanide
binds cytochoromes- causes anareobic metab and lactic acidosis - BITTER ALMOND smell
does cyanide get cyanotic?
no, normal Pao2 and O2 sat but acdosis
how do nitrate treat sodium vs cyanokit
create met Hb that binds CN- excreted renally as thiocyante and cyanokit uses hydroxcobalmin b12 precursor to make b12 cyanocobalalin
how does dig work
inhbitis na k atpase, - hyperkalemia, AV blocks, arr- DIGIBIND- binds .5mg dig - start 10 vials of digibind
most common dig tox dysrhythmia, what is pathognomoinc rhythm, most common EKG change
PVC, paroxymal Atrial tachycaric with AV block, Salvador Dali ST segment
tox, etching, rust remover
hydrogen fluoride- deep cutanoues burns, systemic hypocalcemia- skin can appear normal despite deep burn- give Ca gluconate- keep going till pain goes away - intrademal
INH od tox
dec vit b6, dec sz threshold -coma, acidosis
common cause of poisining death in kids
iron, toxic dose 30-40mgkg
iron progressiono f sxs
0-6 GE, dehydration 6-48 - qiuescenet 12-48 acidosis, coma, hepatic injury 2-6 weeks recovery, GI scarring, obstruction —- risk of people doing down DKA pathway bc hgih glucose and sugar
iron tox work up and tx
GI sxs suggest significant exposure - 4 hour Fe level, CHARCOAL Doesnt bind, labs show inc gap glucose WBC - KUB XR - Bezoar pills - TREATMENT - WHOLE BOEL IRRIGATION and deferoxiamine ( if severe)
tox with headache, encephalophathy, anorexia, abd pain
lead - CNS, GI, peripheral neuropathy - wrist drop - serum >50 severe
what is seen on smear with pb
basophilic stippling
are serum levels helpful in lithium OD, how to ttreat
no, patients have sz use benzos/phenobarb, aggressive hydration- DIALYSIS, worst risk in RF or initiation of diuretic
what EKG changes does Li cause
bradycardia, QT prolongation- T wave flatterning
EKG changes to know in tox
PAT AV block - dig, bradycardia QT prolonged, T flat - lithium, TCA - wide QRS with R wave in AVR
hyperthermia and agitation HTN
MAOI- amphetaminses, cheese, wine, fava beans with tyramine
when is methylene blue CI
G6pd deficiency
neuroleptic malignant syndroe- slow onset, AMS, hyperthermia, lead pip rigidity tx?
dantrolene, benzos
antich plants and dig tox plants
deadly nightsahde bellaodnna, henbane, jimsonweed, dig is foxglove oleander, lilly of the valley
nms vs serotonin syndrome
slow onset vs fast onset, lead piipe vs myoclonus- tx cooling and dantrolene vs cooling and cyrproheptadine
