Emergency Medicine

Question 1

What’s the first initial step to overdose tx if you don’t know what the toxin is and it’s within 2 hours after ingestion?

Answer 1

Gastric lavage

Question 2

What’s the best initial management of altered mental status of unclear etiology?

Answer 2

Naloxone and glucose

Question 3

What’s the antidote for acetaminophen toxicity within 24 hours?

Answer 3

N-acetylcysteine

Question 4

Is there an antidote for acetaminophen toxicity after 24 hours?

Answer 4

No

Question 5

What dx presents with tinnitus, hyperventilation, respiratory alkalosis progressing to metabolic acidosis, altered mental status, and increased anion gap?

Answer 5

Aspirin OD

Question 6

What diagnostic test is best for TCA toxicity?

Answer 6

EKG

Question 7

What will the EKG show in TCA toxicity?

Answer 7

Widened QRS

Question 8

Can the widened QRS from TCA toxicity cause Torsades?

Answer 8

Yes

Question 9

What’s the tx for caustic ingestion?

Answer 9

Flushing out with water

Question 10

What acid/base derangement is caused by CO poisoning?

Answer 10

Lactic acidosis

Question 11

Carboxyhemoglobin vs methemoglobin?

Answer 11

CarbOxy: from CO
Metheme: nitrates, anesthetics, dapsone

Question 12

T/F: both carboxy and methemoglobin give normal O2 on blood gas?

Answer 12

True

Question 13

What color is carboxyhemoglobin?

Answer 13

Red

Question 14

What color is methemoglobin?

Answer 14

Brown

Question 15

What’s the best treatment for methemoglobinemia?

Answer 15

100% O2 and then methylene blue

Question 16

What 2 poisonings present with salivation, lacrimation, polyuria, diarrhea, bronchospasm, and respiratory arrest?

Answer 16

1. Organophosphate

2. Nerve gas

Question 17

Is acetylcholine inhibited or increased by organophosphates and nerve gas?

Answer 17

Increased

Question 18

What’s the antidote for ACh toxicity?

Answer 18

Atropine

Question 19

What toxicity presents with nausea, vomiting, abdominal pain, yellow halos around objects, hyperkalemia, and cardiac rhythm disturbance?

Answer 19

Digoxin

Question 20

What’s the antidote for digoxin toxicity?

Answer 20

Digoxin-specific antibodies

Question 21

What’s the antidote for lead poisoning?

Answer 21

Succimer, EDTA, or dimercaprol

Question 22

How does mercury poisoning present?

Answer 22

Nervousness, jitteriness, twitchiness, pulmonary toxicity

Question 23

What agents can be used to remove mercury from the body?

Answer 23

Dimercaprol and succimer

Question 24

How are methanol and ethylene glycol toxicities treated?

Answer 24

Fomepizole and dialysis

Question 25

Which causes retinal and which causes renal toxicity: methanol vs ethylene glycol?

Answer 25

Methanol: retinal "it'll meth up your eyes" | Ethylene glycol: renal

Question 26

What animal bite can present with hemolysis, respiratory paralysis, ptosis, dysphagia, and diplopia?

Answer 26

Snake bite

Question 27

What animal bite may present with a sudden sharp pain such as "I stepped on a nail?"

Answer 27

Spider bite

Question 28

Which type of spider bite presents with abdominal and muscle pain, and hypocalcemia?

Answer 28

Black widow

Question 29

What's the tx for black widow bite?

Answer 29

Calcium & antivenom

Question 30

What type of spider bite presents with local skin necrosis, bullae, and blebs?

Answer 30

Brown recluse

Question 31

What's the tx for brown recluse bite?

Answer 31

Debridement, steroids, dapsone

Question 32

How are dog, cat, and human bites managed?

Answer 32

Amoxicillin/clav plus tetanus booster if >5 years since last injection

Question 33

Which head injury has a lens shaped hematoma on CT?

Answer 33

Epidural "The contact lens goes on the outside layer of the eye"

Question 34

Do heatstroke, NMS, and malignant hyperthermia all have elevated body temp and elevated CPK and potassium?

Answer 34

Yes

Question 35

What's the most common cause of death in patients with hypothermia?

Answer 35

Cardiac arrhythmia

Question 36

T/F: do not give steroids or antibiotics in drowning victims?

Answer 36

True

Question 37

What is high altitude pulmonary edema?

Answer 37

Pulmonary edema with normal ejection fraction

Question 38

At what altitude does HAPE occur?

Answer 38

5,000m (16,400ft)

Question 39

What 3 drugs treat hemodynamically stable Vtach?

Answer 39

1. Amiodarone 2. Lidocaine 3. Procainamide

Question 40

What drugs is used as part of the treatment for asystole, Vfib, etc?

Answer 40

Epinephrine