Brainscape's Knowledge GenomeTM

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


See full index

MBBS 3: Pediatrics > Poisoning > Flashcards

Poisoning Flashcards

1
Q

What clinical presentations could indicate poisoning?

A

Any child who presents with unexplained symptoms including altered mental status, seizure, cardiovascular compromise, or metabolic abnormality should be considered to have ingested a poison until proven otherwise.

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

What is important in directing interventions?

A

Determination of all substances that the child was exposed to, type of medication, amount of medication, and time of exposure

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

What are the most common agents?

A

Cosmetics
Personal care products
Cleaning solutions
Analgesics
Plants
Foreign bodies
- directly accesible in the childs environment

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

Epidemiology of poisoning in <5 years?

A

Curious
Explore environment using all senses
Prone to mouthing things
Lack of sense of danger

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

Epidemiology of poisoning in adolescence?

A
  1. Usually deliberate ingestion
  2. Deliberate self harm
  3. Exploratory behaviour (recreational drugs)
    Note: Poisoning in middle childhood (age 6–11 years) is rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Routes of poisoning?

A
  1. Ingestion
  2. Inhalation
  3. Ocular exposure
  4. Dermal exposure
  5. Mucous membrane involvement
  6. Parenteral exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

History taking on environment of poisoned patient?

A
  1. witness
  2. time of ingestion
  3. site of ingestion
  4. illness of family member
  5. medication of family members
  6. open containers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

History taking of a poisoned patient?

A
  1. intentionally
  2. past medical history
  3. current medications
  4. known drug allergies
  5. time of symptom onset
  6. prior medical management
  7. substance found in the patients hand or mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

History taking for the poisonous toxin?

A
  1. agents involved
  2. exact ingredient
  3. dose - max
  4. concentration - strength
  5. route of exposure
  6. formulation - enteric coated or extended release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Past medical hx in poisoning?

A
  1. psychiatric illnesses
  2. pregnancy in teens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Social hx in poisoning?

A
  1. social environment (caregivers, visitors, grandparents, recent parties or social gatherings)
  2. social circumstances (new baby, parent’s illness, financial stress)
  3. neglect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical manifestations of odor and causes?

A
  1. alcohol - ethanol
  2. garlic - organophosphate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ocular signs and their causes?

A
  1. miosis - organophosphates
  2. mydriasis - atropine, antihistamines
  3. nystagmus - phenytoin, barbiturates
  4. lacrimation - organophosphates, irritant vapor/gas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cutaneous signs and causes?

A

diaphoresis - Organophosphates, muscarinic mushrooms, aspirin

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

Oral signs and their causes?

A
  1. dry mouth - amphetamine, anticholinergics, antihistamine
  2. burns and dysphagia - corrosives
  3. salivation - Organophosphates, salicylate, corrosives, ketamine
  4. hematemesis - Corrosives, iron, salicylates, NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Intestinal signs and their causes?

A

diarrhea - Antimicrobials, iron, cholinergics

17
Q

Respiratory signs and their causes?

A
  1. depressed resp. - Alcohol, narcotics, barbiturates
  2. increased resp. - aspirin, CO
  3. pulmonary edema - Hydrocarbons, organophosphates
18
Q

Cardiac signs and their causes?

A
  1. tachycardia - atropine, aspirin
  2. bradycardia - organophosphates, beta and calcium channel blockers
  3. hypotension - barbiturates, iron, beta and calcium channel blockers
19
Q

CNS manifestations + causes?

A
  1. ataxia - alcohol, narcotics
  2. coma - sedative, alcohol, narcotics
  3. hyperpyrexia - anticholinergics
  4. muscle fasciculation - organophosphates
  5. peripheral neuropathy - organophosphates
  6. muscle rigidity - cyclic antidepressants
  7. altered behaviour - alcohol, anticholinergics
20
Q

Clinical manifestations of acetaminophen?

A

Nausea, vomiting, pallor, delayed jaundice–hepatic failure (72-96 hr)

21
Q

Clinical features of anticholinergics?

A

Mania, delirium, fever, red dry skin, dry mouth, tachycardia, mydriasis, urinary retention

22
Q

Clinical features of CO?

A

Headache, dizziness, coma, other systems affected

23
Q

Clinical features of iron?

A

Vomiting (bloody), diarrhea, hypotension, hepatic failure, leukocytosis, hyperglycemia, radiopaque pills on KUB, late intestinal stricture,Yersiniasepsis

24
Q

Clinical features of cholinergics?

A

Miosis, salivation, urination, diaphoresis, lacrimation, bronchospasm (bronchorrhea), muscle weakness and fasciculations, emesis, defecation, coma, confusion, pulmonary edema, bradycardia

25
Q

Clinical features of salicylates?

A
26
Q

Clinical features of cyclic antidepressants?

A

Coma, convulsions, mydriasis, hyperreflexia, arrhythmia (prolonged Q-T interval), cardiac arrest, shock

27
Q

Complications?

A

coma
toxicity
metabolic acidosis
heart rhythm aberrations
gastrointestinal symptoms
seizures

28
Q

Ddx of coma?

A

cerebrovascular accident
Asphyxia
Meningitis
Encephalitis
Cerebral malaria

29
Q

Describe pulmonary toxicity?

A

direct toxicity by hydrocarbons
- risk of producing aspiration pneumonia (low viscosity, low surface tension, and high volatility)
- Risk increased when emesis is induced.
- Emesis or lavage shouldnotbe initiated in volatile hydrocarbons ingestions

30
Q

Oral and oesophageal symptoms caused by alkali ingestion?

A
  1. Dysphagia
  2. epigastric pain
  3. oral mucosal burns
  4. low-grade fever.
31
Q

Complications of alkali ingestion?

A
  1. Alkali agents causes full-thickness liquefaction necrosis
  2. When the esophageal lesions heal, strictures form
  3. long-term risk of esophageal carcinoma
32
Q

Oral and oesophageal symptoms of ingestion of acid agents?

A
  1. can injure the lungs (with hydrochloric acid fumes), oral mucosa, esophagus, and stomach.
    - taste sour, children stop drinking, limiting the injury.
  2. produce a coagulation necrosis, limiting deep injury
33
Q

4 foci of treatment of poisoning?

A
  1. supportive care
  2. Decontamination
  3. enhanced elimination
  4. Specific antidotes.
34
Q

Describe supportive care?

A
  1. protecting and maintaining the airway
  2. establishing effective breathing
  3. supporting the circulation
    - If the level of consciousness is depressed and a toxic substance is suspected, glucose (1 g/kg intravenously), 100% oxygen.
35
Q

Describe gastrointestinal decontamination?

A
  1. Gastric lavage
  2. Single dose activated charcoal
    - Activated charcoal has exceptionally high surface area –has the ability to adsorb potentially poisonous substances, reducing their bioavailability and hence toxi­city
36
Q

Describe enhanced elimination?

A
  1. Multiple dose activated charcoal
    - Multiple dose activated charcoal: every 4-6 hr (for 4 doses).
  2. Alkalization of urine
    - achieved by administration of sodium bicarbonate. Increases renal excretion of salicylates, phenobarbitone, methotraxate
  3. Dialysis
37
Q

Investigations?

A
  1. Chest x-ray
    - pneumonitis e.g., hydrocarbon aspiration, noncardiogenic pulmonary edema e.g., salicylate toxicity, or a foreign body.
  2. Abdominal x-ray
    - foreign bodies
    - radiopaque tablets
  3. Upper endoscopy
    - Caustic ingestions
38
Q

Prognosis?

A
  • Most have minimal or no toxicity
  • Intentional ingestionscause higher morbidity and mortality
39
Q

Prevention?

A

Parents educate regarding :
- Safe storage of medications (e.g child-resistant packaging)

MBBS 3: Pediatrics (40 decks)

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