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1

Mechanism of iron poisoning

Creates free radicals, lipid peroxidation, which impairs various cell processes, leading to systemic manifestations => abdominal pain, hematemesis, shock and metabolic acidosis.

2

Antidote for iron poisoning

Deferoxamine - binds ferric iron, can be excreted in the urine.

3

Antidote for TCA and aspirin overdose

Sodium bicarbonate

4

Mag sulfate is used for

Patients with torsades induced by prolonged QT interval

5

TOC for lithium toxicity

Hemodialysis

6

Lead poisoning treatment?

Calcium EDTA = lead chelator in moderate to severe lead poisoning. Oral succimer can be used for mild or moderate lead poisoning.

7

Abnormal values of lead must be confirmed by?

Venous blood draw.

8

What is used to treat cardiotoxicity (>100msec) and ventricular arrythmias

Sodium bicarbonate. Allevaites inhibitory action of TCA on sodium channels of the myocardium, improves hypotension and decreases risk of ventricular arrythmias.

9

What are used to treat seizures from tCA overdose

Benzodiazepines

10

How is elemental iron toxic?

Corrosive to GI mucosa, causes abdominal pain, n/v/d and hematemesis within 30 minutes to 6 hours of ingestion. Severely affected patients can develop hypotensive shock and anion gap metabolic acidosis. They can develop respiratory alkalosis to compensate. risk of gastric scarring and pyloric stenosis within 2-8 weeks.

11

Diagnostic findings of iron toxicity

Anion gap metabolic acidosis and radioopagque pills

12

Tx for iron toxicity

Deferoxamine, whole bowel irrigation, supportive

13

Olive shaped mass

Pyloric stenosis

14

What is a common cause of cystitis in young children?

Constipation. Constipation - rectal distension, presses on the bladder which prevents complete voiding. Residual urine is a breeding ground for bacteria.

15

What is the most common type of elbow fracture in children

supracondylar humerus fracture. Occurs in 2-12 year olds. Typical hx is falling onto an extended arm.

16

What does X-ray show for supracondylar humerus fracture

triangular anterior fat pad (lucency) and triangular posterior fat bad (lucency)

17

What is a dangerous complication of supracondylar fractures and how does it present?

Compartment syndrome. Characterized by severe pain, pallor, poikilothermia, parasthesias, and late findings of pulselessness and paralysis.

18

Signs and sx of hypernatremia

Mostly neurologic - letargy, ams, seizures, irritability. Can also cause muscle cramps, muscle weakness, decreased deep tendon reflexes.

19

In patient with recurrent sinopulmonary infections, intermittent diarrhea and anaphylactic reaction, consider what immune problem?

IgA deficiency

20

Osteogenesis Imperfecta teeth

Dentinogenesis Imperfecta - opalescent blue-gray to yellow-brown teeth.discolored dentin shining through transluscent teeth

21

OI inheritence? Mutation fo which gene?

A/D. Mutation of COL1A1.

22

Type of OI

1 (Mild), 2 (fatal perinatal), 3 and 4 (moderate)

23

Borrelia burgdorferi is what kind of organism

Spirochete

24

Criteria for rhematic fever.

JONES - joints (migratory arthritis), heart (carditis), Nodules (subcutaneous), E (erythema marginatum), S sydenham chorea. Minor: fever, elevated CRP/ESR, prolonged PR interval, arthralgias.

25

Osgood Schlatter is?

Traction apophysitis of the tibial tubercle

26

Acute rheumatic fever epidemiology

5-15 year olds, twice as comon in girls

27

What kind of arthritis in ARF

Migratory polyarthritis

28

Name of rash in ARF

Erythema marginatum

29

What is serum sickness like reaction

Usually occurs due to abx (sulfa, beta lactams are the most common)

30

Clinical presentation of serum sickness like reaction

Fever, urticaria, polyarhthralgias 1-2 weeks after drug exposure. Lymphadenopathy, headache, edema can also happen but less common