MTB step 3 EM tox

Question 1

gastric emptying

Answer 1

1 hour 50% pill removed 1-2 hrs 15% 2 hrs: useless never acid or base no ipecac if AMS or kid intube and lavage: 1-2 hrs, no rsp naloxone, dextrose, thiamine

Question 2

AMS with unknown causes

Answer 2

naloxone, thiamine, dextrose

Question 3

charcoal

Answer 3

give, doesn’t harm

Question 4

overdose orders

Answer 4

tox screen, carcoal, CBC, chemistry, urinalysis psych consult oxygen for CO

Question 5

acetaminophen antidote

Answer 5

n-acetyl cysteine

Question 6

aspirin antidote

Answer 6

bicarb to alk urine

Question 7

benzo antidote

Answer 7

do not give flumazenil, may cause seizure

Question 8

CO antidote

Answer 8

100% O2, hyperbaric in some cases

Question 9

digoxin antidote

Answer 9

digoxin binding AB

Question 10

ethylene glycol antidote

Answer 10

fomepizole or etoh

Question 11

methanol antidote

Answer 11

fomepizole or etoh

Question 12

methemoglobinemia antidote

Answer 12

methylene blue

Question 13

NMS antidote

Answer 13

bromocryptine, dantrolene

Question 14

organophosphates antidote

Answer 14

atropine, pralidoxime

Question 15

TCA antidote

Answer 15

bicarb protect heart

Question 16

tylenol overdose course

Answer 16

first 24 hrs: NV 48-72 hrs: liver failure

Question 17

tylenol when NAC

Answer 17

first 24 hrs helps

Question 18

tylenol level

Answer 18

10 G toxic 15 G lethal lower if etoh or liver dz

Question 19

aspirin overdose

Answer 19

hyperventilate, can cause ARDS met acidosis, krebs cycle backup lactic acid resp alk inc PT vit K factors seizure, coma fever

Question 20

aspirin overdose tests

Answer 20

CBC, chem, abg, PT/PTT/INR, ASA level

Question 21

asa overdose tx

Answer 21

3 amps bicarb

Question 22

bicarb tx what overdoses

Answer 22

asa, TCA, phenobarbital, chlorprpamide

Question 23

overdose pt order what levels

Answer 23

etoh, asa, tylenol on all bc coingest

Question 24

he feels better when shoveling snow when snowed in

Answer 24

CO poison

Question 25

digoxin overdose sx

Answer 25

GI, yellow halos vision, arrhythmia PR prolongation, encephalopathy

Question 26

inc digoxin levels

Answer 26

hypoK but dig causes hyperK

Question 27

ethylene glycol present

Answer 27

renal insuff, hypoCa, kidney stones

Question 28

methanol present

Answer 28

visual, retinal hyperemia

Question 29

methemoglobinemia sx

Answer 29

cyanosis, SOB, dizzy, HA, confusion, seizures nitrate, anesthetics, dapsone, lidocaine, benzocaine, bupivicaine. nitroglycerin

Question 30

dx methemoglobinemia

Answer 30

nrl pO2, with brown blood methemoglobin level

Question 31

tx methemoglobinemia

Answer 31

100% O2 methylene blue restores Hb to nrl state

Question 32

tx NMS/malignant hyperthermia

Answer 32

cabergoline or bromocriptine, dantrolene

Question 33

heat exhaustion

Answer 33

sweating, n/v nrl saline (room temp) and put in cold enviroment

Question 34

heat stroke

Answer 34

dry skin, AMS spray with water, ice pack/baths

Question 35

organophosphates

Answer 35

crop duster, nerve-gas attack salivation, tearing, urination, diarrhea, wheezing from bronchospasm

Question 36

organophosphates tx

Answer 36

best initial atropine most effective: pralidoxime remove clothes and wash body

Question 37

TCA overdose

Answer 37

die seizure or arrhythmia dilated pupils, dry mouth, constipation, urinary retention

Question 38

TCA ekg

Answer 38

widening QRS-\>vtach torsades

Question 39

black widow bite

Answer 39

abd pain, rigidity, hypoCa like perfed bowel, but w/o tenderness tx antivenin

Question 40

brown recluse spider bite

Answer 40

local necrosis, bullae, dark lesions debriding wound steroids and dapsone

Question 41

burn who intubate

Answer 41

hoarseness, wheezing, stridor, burn inside nose or mouth

Question 42

burn fluids

Answer 42

4 ml for each percent, each KG

Question 43

hypothermia ekg

Answer 43

j-waves of osborn ST elevation

Question 44

acute angle glaucoma

Answer 44

red eye, fixed midpoint pupil pilocarpine drops, manitol acetazolamide dec production prostaglandin lantaprost, travoprost timolol apraclonidine

Question 45

retinal detachment

Answer 45

curtain coming down tild head back, tx surg, cryotherapy, inject gas

Question 46

conjunctivitis viral

Answer 46

bilateral watery discharge, itchy

Question 47

conjunctivitis bacterial

Answer 47

unilateral, purlulent, eyelids stuck tx topical

Question 48

uveitis

Answer 48

photophobia slit lamp steroids

Question 49

abrasion

Answer 49

fluorescein stain do not patch caused by contact lenses