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RACP Written > Emergency Medicine > Flashcards

Emergency Medicine Flashcards

1
Q

What drugs cause anticholinergic syndrome?

A

antihistamines, TCA, benztropine

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2
Q

What PLANTS cause anticholinergic syndrome?

Adam and Eve- angels eating an apple

A

plants: datura (thorn apple) or brugmansia (angel trumpet)

Adam and Eve- angels eating an apple

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3
Q

What are the 6 features of anticholinergic syndrome?

A

THINK DRY AND TACHY
Red as a beet for cutaneous vasodilation
Dry as a bone for anhidrosis
Hot as a hare for hyperthermia
Blind as a bat for nonreactive mydriasis (dilated pupils)
Mad as a hatter for hallucinations and delirium and finally
Full as a flask for urinary retention

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4
Q

What is the antidote for anticholinergic syndrome?

A

Antidote: physostigmine
Supportive: benzodiazepine

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5
Q

What meds cause a cholinergic crisis?

A

acetylcholine, pilocarpine, Organophosphates/ pesticides

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6
Q

What are the 8 signs of cholinergic syndrome?

A

Think secretions!!
DUMBBELS
Diarrhoea
Urination
Miosis
Bronchorrea, bradycardia (this is what kills you/ killer ‘B’)
Emesis
Lacrimation
Salivation

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7
Q

What is the treatment for cholinergic syndrome?

A

Remember, cause MIOSIS so treatment is ATROPINE to DILATE pupils. Also does other things.

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8
Q

What are examples of sympathometics?

A

‘Party drugs’: - Cocaine, (met) Amphetamines, Ecstasy/ MDMA

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9
Q

What are the symptoms of sympathetic syndrome?

A

HTN, tachycardia
Dilated pupils
Agitations, sweating
Hyperthermia: urgent attention

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10
Q

What is the treatment for sympathometic syndrome?

A

benzodiazepine and IV hydration

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11
Q

What can cause serotonin syndrome?

A

Tramadol, SSRI, SNRI, anti-emetic, MAOI

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12
Q

What are the signs/symptoms of serotonin syndrome?

A

Shivering
Hyperreflexia and myoclonus
Increased temperature
Vital sign instability
Encephalopathy
Restless
Sweating

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13
Q

What is the treatment for serotonin syndrome?

A

Benzodiaziepine. NOTE IF ACUTE DYSTONIC REACTION, then benztropine

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14
Q

What are the common drugs that can cause hypoventilation?

A

Narcotics or clonidine
Nacrotic will have tachycardia, clonidine will have brady

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15
Q

What drugs can cause hyPOglycemia (and name antidote)

A

Insulin and sulfonulurea. Treat with Octreotide. THINK CONGENITAL HYPOINSULINISM

Also beta blockers have the potential for this, use glucagon in poisoning

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16
Q

Treatment for anaphylaxis. DOSE and strength of Adrenaline

A

0.01 mL/kg of 1:1000 (maximum 0.5 mL)
or 10micrograms/kg

17
Q

Average lifespan of platelets?

A

10 days

18
Q

Predisposition to bone marrow failure associated with dyskeratosis congenita results primarily from a defect in what critical cellular process

A

Telomere maintenance

19
Q

What contirbutes the most to serum osmolality

A

Sodium

20
Q

What formula can be used to estimate the correct size of an uncuffed endotracheal tube for use in children?

A

(Age/4) +4

21
Q

Earliest gestation where pupils respond to light?

A

32 weeks

22
Q

Hymen shape in newborn vs pre-puberty

A

Annular – most common in newborns/infants.

Crescentic - during the preschool and early primary school years the hymen is commonly observed to have a crescentic shape.

Follows alphabetical order. Fimbriated is redundant, and common in puberty/neonatal due to oestrogen

23
Q

Is it hard to obtain reflexes in viral myositis?

A

Yes, due to pain with dorsiflexion and tight muscles.

24
Q

What does GHB do?
Gamma Hydroxybutyrate

A

the patient may have a period of euphoria that is rapidly followed by a period of profoundly depressed level of consciousness (hence its reputation as a date rape drug).

25
Q

When do tics resolve by? What is the treatment if they are distressing?

A

By adolescence, use Clonidine

26
Q

Features on lymph node exam indicative of malignancy

A

supraclavicular nodes, large nodes >2cm in diameter, fixed and non-tender ‘matted’ nodes

27
Q

% of kids with recurrence of febrile seizure within a year of their first?

A

30-40%

28
Q

Risk factors for febrile seizures

A

Younger age (<12 months) of first seizure onset is associated with a recurrence risk close to 50%.

Family history of febrile seizure (first degree relative) is associated with approximately 25% increments in the absolute risk of a recurrent febrile seizure.

Low temperature at the time of the seizure.

Short duration of illness before seizure.

The presence of all four risk factors are associated with about 76% chance of seizure recurrence compared to ~4% chance without any risk factors.

29
Q

Time frame within which a coin should be removed from oesophagus?

A

24 hours

30
Q

Course of illness for Parvovirus B19

A

The illness begins with nonspecific prodromal symptoms, such as fever, coryza, headache, nausea, and diarrhoea. Two to five days later, the classic erythematous malar rash appears (the so-called slapped cheek rash) with relative circumoral pallor. This facial rash is often followed by a reticulated or lacelike rash on the trunk and extremities. By the time the rash develops, viraemia has resolved and the child usually feels well. The rash is thought to be immunologically mediated.

Can get arthrlagia

31
Q

Which 2 illness resolve on the appearance of a rash

A

Roseola (HHV 6)
B19

32
Q

Age at which most children can consent (post understanding etc etc)

A

Nelsons says 14

33
Q

Efficacy of seasonal influenza vaccine?

A

The seasonal influenza vaccine does usually have an efficacy of about 40-50%

34
Q

What family of syndromes does Cowden belong to

A

PTEN mutation

35
Q

Macrocephaly, GDD and trichilemmomas- syndrome?

A

Cowden.
Autism or developmental delay
Dermatologic features including lipomas, trichilemmomas, oral papillomas, or penile freckling.
Vascular features, such as arteriovenous malformations or hemangiomas
Gastrointestinal polyps
Pediatric-onset thyroid cancer or germ cell tumors

36
Q

What condition are trichilemmomas pathopgenumoc for?

A

Cowden syndrome
Benign tumour originating from the outer root sheath of the hair follicle. Looks like a skin coloured wart.

Cows have warts or trichelemomas.

RACP Written (18 decks)

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