Brainscape's Knowledge GenomeTM

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


See full index

STEP 3 COPY > Emergency Medicine/ Toxicology > Flashcards

Emergency Medicine/ Toxicology Flashcards

1
Q

What should be done initially on CCS if a pt presents to the ER with acute change in mental status of unclear etiology?

A

Give naloxone, thiamine, dextrose and oxygen and saline while checking toxicology screen

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

When is gastric emptying useful?

A

First hour of overdose

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

What is the best initial step in management of a pt presenting to the ER with acute change in mental status of unclear etiology?

A

Administer nalxone, dextrose, and thiamine

Correct for opioid overdose, hypoglycemia, and alcoholic issue

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

What six things should be done simultaneously for an overdose case on the CCS?

A
  1. specific antidote (or dextrose, thiamine and naloxone)
  2. toxicology screen
  3. charcoal
  4. CBC, chemistry, urinalysis
  5. psychiatric consult (if suicide attempt)
  6. oxygen (for possible carbon monoxide)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the specific antidote for acetaminophen overdose?

A

N-acetyl cysteine (prevents liver toxicity in first 24 hours)

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

What is the specific antidote for aspirin overdose?

A

bicarbonate (to alkalinize urine)

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

What should be avoided in benzodiazepines overdose?

A

flumazenil (will precipitate benzo withdrawal and seizures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the specific antidote for carbon monoxide poisoning?

A

100% oxygen (hyperbaric in some cases)

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

What is the specific antidote for digoxin overdose/ poisoning?

A

digoxin-binding antibodies (digiband)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the specific antidote for ethylene glycol overdose?

A

fomepizole or ethanol (along with dialysis)

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

What is the specific antidote for methanol overdose?

A

fomepizole or ethanol (along with dialysis)

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

What is the specific antidote for methemoglobinemia?

A

methylene blue (with 100% oxygen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the specific antidote for neuroleptic malignant syndrome?

A

bromocriptine or dantrolene

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

What is the specific antidote for opiates overdose?

A

naloxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the specific antidote for organophosphate overdose?

A

atropine and/or pralidoxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the specific antidote for tricyclic antidepressants overdose?

A

bicarbonate (protects the heart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What two diseases/ disorders lowers the amount of acetaminophen needed for toxicity and fatality in overdose?

A
  1. liver disease

2. alcohol abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the symptoms of acetaminophen overdose in the first 24 hours and between 48-72 hours after ingestion?

A

24 hours: nausea and vomiting

48-72 hours: hepatic failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the lowest acetaminophen level in a normal pt in which it is toxic to the patient?

A

10 grams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the lowest acetaminophen level in a normal pt in which it is a fatal to the patient?

A

15 grams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the next best step in management of a pt presenting with acetaminophen ingestion however the amount of ingestion is equivocal?

A

obtain acetaminophen level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

An overdose pt presenting with hyperventilation, respiratory alkalosis followed by metabolic acidosis with elevated anion gap, renal insufficiency, elevated prothrombin time (PT), confusion, fever and tinnitus most likely overdosed on ….

A

aspirin (salicylate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What five things should be done on CCS in a case of aspirin overdose?

A
  1. CBC
  2. chemistry panel
  3. arterial blood gas (ABG)
  4. coagulation study (PT, PTT, INR)
  5. salicylate (ASA) level
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the treatment for aspirin overdose?

A
  1. alkalinize urine (increase excretion)
  2. charcoal (block absorption)
  3. dialysis (if severe)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is used to to alkalinize the urine in overdose cases (salicylates, TCAs, phenobarbital, chlorpropamide)?

A

D5W with 3 amps of bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

On CCS, what three levels should always be checked in an overdose patient?

A
  1. aspirin (salicylate)
  2. acetominophen
  3. alcohol

(high frequency of co-ingestion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

A pt presents to the ER with fatigue, headache, shortness of breath, lightheadedness, and disorientation after a fire or being snowed in and using a wood-burning stove, and feels better when shoveling snow outside most likely suffers from…

A

Carbon Monoxide Poisoning

cant release oxygen to tissue

28
Q

What is the best initial step in management for a patient being rescued from a fire?

A

call ambulance and give 100% oxygen (until obtain carbon monoxide level)

29
Q

A pt presents with nausea, vomiting, diarrhea, seeing yellow halos around objects, blurred vision, arrhythmia, hyperkalemia and encephalopathy most likely suffers from…

A

Digoxin Toxicity

tx: digoxin binding antibodies if severe –> CNS and cardiac abnormalities

30
Q

A pt presents with intoxication, metabolic acidosis with increased anion gap, renal insufficiency, hypocalcemia, and kidney stones most likely suffers from…

A

Ethylene Glycol intoxication

tx: ethanol/ fomepizole and dialysis

31
Q

A pt presents with intoxication, metabolic acidosis with increased anion gap, visual disturbances and retinal hyperemia most likely suffers from …

A

Methanol intoxication

tx: ethanol/ fomepizole and dialysis

32
Q

A pt presents cyanotic with shortness of breath, dizziness, headache, confusion, seizures, normal pO2, chocolate brown colored blood, and a history of nitrate/ anesthetic/ dapsone/ med ending in “caine”/ nitroglycerin use most likely suffers from ..

A

Methemoglobinemia

hemoglobin locked in oxidized state so cant pick up oxygen

33
Q

What are the two diagnostic tests for methemoglobinemia?

A
  1. normal pO2 on arterial blood gas with chocolate brownish blood
  2. methemoglobin level
34
Q

A pt presenting with elevated CPK levels, hyperkalemia, muscle rigidity, hyperthermia, CNS dysfunction (confusions, seizures), arrhythmia, a history of anti-psychotic medication use and possibly rhabdomyolysis most likely suffers from…

A

Neuroleptic Malignant Syndrome

tx: dopamine agonists –> cabergoline/ bromocriptine/ dantrolene

35
Q

A pt presenting with elevated CPK levels, hyperkalemia, muscle rigidity, hyperthermia, CNS dysfunction (seizures, confusion), a history of anesthetic use, and possibly rhabdomyolysis most likely suffers from…

A

Malignant Hyperthermia

tx: dantrolene

36
Q

A pt presents with hyperthermia, excessive sweating, nausea, vomiting, and possibly hyperkalemia and rhabdomyolysis after physically exerting themselves in the summer time most likely suffers from …

A

Heat Exhaustion

37
Q

What is the treatment for heat exhaustion?

A
  1. normal saline IV (at room temp)

2. removal of pt from hot environment

38
Q

A pt presents with hyperthermia, dry skin, confusion, seizures, hyperkalemia, arrhythmia, and possibly rhabdomyolysis after physically exerting themselves in the summer time most likely suffers from …

A

Heat Stroke

39
Q

What is the treatment for heat stroke?

A
  1. removal from heat

2. spraying pt with water/ fanning pt in air conditioned room/ applying ice baths/packs

40
Q

What causes death in opiate toxicity?

A

respiratory depression

41
Q

A crop duster/ pt involved in nerve gas attack presents with salivation, lacrimation, urination, diarrhea and wheezing from bronchospasm most likely suffers from …

A

Organophosphate poisoning

inhibits Acetylcholinesterase so increases ACh activity

42
Q

What is the best initial treatment for organophosphate poisoning?

A
  1. Atropine

2. and remove clothes and was the rest of pt off

43
Q

What is the most effective treatment for organophosphate poisoning?

A

pralidoxime

44
Q

A pt with a history of depression presents after overdose resulting from a suicide attempt with dilated pupils, dry mouth, constipation, urinary retention, and possibly CNS or cardiac abnormalities most likely suffers from …

A

tricyclic antidepressant poisoning

45
Q

What is the most urgent step in management of a pt with suspected tricyclic antidepressant poisoning?

A

obtain EKG (assess for widening of QRS that can lead to ventricular tachycardia or torsade de pointes)

46
Q

What is the next best step in management of a pt with suspected tricyclic antidepressant poisoning who also has widening of the QRS on EKG?

A

give bicarbonate and transfer to ICU

47
Q

A pt presenting with abdominal pain without tenderness, rigidity, and hypocalcemia with a possible visible bump on the skin most likely suffers from …

A

black widow spider bite

tx: antivenin

48
Q

A pt presenting with local necrosis, bullae formation and dark lesions after an insect bite most likely suffers from …

A

Brown recluse spider bite

tx: debriding wound and possible steroids and dapsone

49
Q

What are the four indications for intubating a pt who was involved in a fire (after giving 100% oxygen for possible carbon monoxide poisoning)?

A
  1. hoarsenss
  2. wheezing
  3. stridor
  4. burns inside nose or mouth

(signs of respiratory injury)

50
Q

What is the next best step in management of a pt involved in a fire after giving 100% oxygen and assessing for need for intubation (and performing intubation if needed)?

A

give 4 ml of lactated ringers/ normal saline for each percentage of body with 2nd or 3rd degree burn per kilogram

(give fluids to rehydrate)

51
Q

What is the most urgent step in management of an alcoholic that is found sleeping outside in the winter time?

A

EKG (assess for J-waves of Osborn –> similar to ST segment elevations signifying hypothermia)

52
Q

A pt presenting with a rock hard, painful red eye, corneal haziness and a fixed midpoint pupil most likely suffers from …

A

Acute angle closure glaucoma

ophthalmologic emergency

53
Q

What is the best initial therapy for acute angle closure glaucoma?

A

pilocarpine drops (constrict pupil) with or without mannitol (osmotic diuretic to open angle)

54
Q

Other than pilocarpine and mannitol, what other medical interventions are used to treat acute angle closure glaucoma? (4)

A
  1. acetazolamide (decrease aqueous humor production)
  2. prostaglandin analogs (latanoprost, travoprost)
  3. beta blockers topically (timolol)
  4. alpha agonists (apraclonidine)
55
Q

A pt presents with sudden loss of vision like a curtain is coming down most likely suffers from …

A

retinal detachment

56
Q

What is the best initial steps in management of a pt with suspected retinal detachment? (2)

A
  1. consult ophthalmology

2. dilated retinal exam

57
Q

What is the treatment for retinal detachment? (3)

A
  1. tilt head back
  2. reattach retina (surgery, cryotherapy or injecting expansile gas into eye)
  3. if 1 and 2 fail, then place band around eye to get retina close to sclera
58
Q

What is the diagnostic test for suspected glaucoma?

A

tonometry

59
Q

A pt presents with bilateral watery discharge from eyes and the eyes are itchy and red most likely suffers from …

A

viral conjunctivitis

60
Q

A pt presents with unilateral purulent discharge from eye, red eye and eyelids stuck together most likely suffers from …

A

Bacterial conjunctivitis

tx: topical antibiotics

61
Q

A pt presenting with a red eye and associated photophobia most likely suffers from …

A

uveitis

62
Q

What is the diagnostic test for suspected uveitis?

A

slit lamp exam

63
Q

What is the treatment for uveitis?

A

steroids

64
Q

A pt presents with a red eye and history of trauma/ contact lens use most likely suffers from …

A

Corneal abrasion

65
Q

What is the diagnostic test for suspected corneal abrasion?

A

fluorescein stain (detects abrasion)

STEP 3 COPY (19 decks)

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