Eye, Hematology, Psych, Toxicity Emergencies Flashcards
(33 cards)
Treatment of chemical ocular injury
Topical anesthetic (Proparicaine)
Irrigation (NS/LR via Morgan Lens until pH of 7)
Erythromycin Ointment
Atropine Eye drops
History of sudden, painless, complete monocular vision loss. dx?
Central retinal artery occlusion
What is seen on eye exam of Central retinal artery occlusion?
cherry red spot with disc pallor
boxcarring
“steamy” or hazy cornea
perilimbal conjunctival injection
fixed mid-dilated pupil
Acute angle closure glaucoma
Treatment of Central retinal artery occlusion
Ocular massage
Acetazolamide 500mg IV or Timolol drop to reduce IOP
Flashes of light and floater then “curtain/shadow” over visual field =
Retinal detachment
Retinal detachment treatment
Rest head on pillow with side of detachment down (side opposite deficit)
First line tx for Acute Angle Closure Glaucoma
Timolol 0.5% 1 drop
Treatment of orbital cellulitis
IV Ampicillin/sulbactam (Unasyn)
Periorbital vs orbital cellulits
orbital has vision changes and in older children
periorbital usually just erythema and edema and in infants and toddlers
What is Nikolsky sign? What derm condition is it seen in?
Bullae spread and skin sloughs with lateral pressure
Seen in Stevens-Johnsons Syndrome and Toxic Epidermal Necrolysis (SJS = BSA30%)
Treatment of minor and major Erythema Multiforme
Minor: Topical steroids, oral antihistamines, oral antivirals
Major: IV fluids, Prophylactic Abx, Analgesics, Antihistamines, IVIG, Corticosteriods, (may require transfer to burn center)
When should anemic patient get transfusion with PRBCs?
Hgb less than 7g/dl
End organ ischemia
Blood loss of 1500mL
When is platelet or FFP indicated in Thrombocytopenia?
less than 50,000mcL and actively bleeding
less than 10,000mcL prophylactically
Pathophysiology of DIC
clot everywhere and then severe bleeding everywhere
systemic activation of coagulation and fibrinolysis by some pathology
Dx studies of DIC
low platelets, prolonged PT/PTT, elevated BUN/Cr
2 labs elevated in Rhabdo
CPK (5-10x nml)
Myoglobin in urine
Common cause of neutropenic fever
chemotherapy
Poisoning that causes dilated pupils and increased HR
anti-cholinergics, sympathomimetics (cocaines, amphetamines), hallucinogenics
Poisoning that causes pin point pupils
cholinergics and opioids
Poisoning that causes hypotension
opioids and sedatives (Benzos, Barbs, antihistamines), anti-depressants
Toxidrome that causes asterixis
Tylenol
Toxidrome that causes seizures
TCA
Signs of cholinergic toxicity
“SLUDGE” = salivation, lacrimation, urination, defecation, GI cramping, emesis
