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Flashcards in Poisonning Deck (88):
1

clue for Phenylcyclidine poisonning(2)

combative bahavior
prominent nystagmus =vertical nystagmus

2

rx of intoxication wtih phenylcyclidine

Benzodiazepines

3

clue for TCA overdose

QRS prolongation(0,19)

4

what's the approriate indication to assess severity of intoxication of TCA

duration of QRS complex

5

rx of TCA intoxication

sodium bicarbonate

6

risk of TCA intoxication(3)

VTAC
hypotension
seizures

7

enumerate anticholinergic effect(6)

ileus
flushed skin
dilated pupils
dry mucous membrane
urinary retention
confusion

8

patient seen after ingestion of 14 acetaminophen first step?(3)

charcoal activated
plasma acetaminophen dans 4 hr
Na cetylcysteine within 8 h

9

patient with anticholinergic symptom dx?

diphenidramine poisonning

10

rx of diphenidramine intoxication?(2)

cholinesterase inhibitor
Physostigmine

11

chemical in the eye next step

flush eye with running water

12

firsr step in foreign body of the eye

search medical care is the first prioritiy

13

firsr step in cut or scrathes of the eye

search medical care is the first prioritiy

14

patient taking fluconazole and moxifloxacin torsades de pointes next step

MGS04

15

quid of torsades de pointes

polymorphic ventricular tachycardia with prolonged QT interval

16

drugs causing prolonged QT syndrome and possibly torsade de pointes(5)

TCA
amiodarone
sotalol
moxifloxacin
fluconazole

17

other condition predisposing to long QT syndrome

hypomagnesemia

18

cause of low magnesemia(2)

malnutrition
alcoholics

19

quid of opiod intoxication(2)

morphin

heroin

20

clue for opiod intox

bradypnee

21

antidote for opiod intoxication

naloxone

22

eye in opiod intox

can cause myosis
but not always

23

why opioid intox can not have myosis

because coingestion can cause normal pupil or even mydriasis

24

opiod taken alone which doesn't cause myosis?(2)

meperidine
propoxyphene

25

triad for cannabis intoxication(3)

increase appetite
dry mouth
conjonctival injection

26

why cocaine can cause motor vehicle accident

decrease concentration

27

clue for benzodiapines intoxication(3)

slurred speech
drowsiness
unsteady gait

28

indication of benzodiazepines(4)

insomnia
seizures
anxiety
alcohol withdrawal

29

alcohol and phenytoin intox(2)

same symptom
plus
nystagmus

30

differenciation between benzodiapines and opiod intox(2)

pupil is normal=
no respiratory distress=
Benzodiazepine

31

quid of NMS

drug induced idiosyncratic reaction

32

clue for NMS(4)

fever
confusion
lead pipe rigidity
high creatine kinase level

33

what cause NMS

antagonist dopaminergic action

34

rx of NMS

dantrolene

35

action of bicarb in rx of antidepressant intox(2)

sodium load will alleviate depressant action on sodium channels by increasing the extra cellular NA+ concentration
2-alkalinazation of serum by decreasing drug avidity for sodium channels

36

when given bicarb sodium in TCA intox

when QRS > 0,10 s

37

drug of choice for alcohol withdrawal

chlordiazepoxide

38

the most serious problem in alcohol withdrawal

delirium tremens

39

symptom of delirium tremens(4)

HTA
agitation
hallucinations
fever

40

quid of chlordiazepoxide

benzodiazepine

41

quid of fluphenazine

typical antipsychotic like haloperidol

42

why fluphen causes hypothermia(2)

by inhibiting the body shivering mechanism
inhibiting autonomic thermoregulation

43

what to do during intake of typical antipsychotic

avoid prolonged exposure to cold

44

clue for opiod intox(4)

everything is decreased
Hypotension
low bowel sound
bradypnea
bradycardia
mioisis

45

what happens in cocaine intox

everything is high++++

46

best clue for opiod intox

respiratory rate

47

clue for Co poisonning

Pinkish skin Hue
headaches
tachypnea
tachycardia

48

rx of co poisonning

hyperbaric O2

49

confirmatory dx

level of carboxyhemoglobin

50

ethylene glycol poisonning why flank pain (2)?

because oxalic acid binds to ca to forl calcium stone
deposition in kidneys

51

why renal failure in ethylene glycol poisonning

glycolic acid injures the renal tubules

52

substances accumulated in ethylene glycol poisonning

oxalic acid
glycolic acid

53

why hypocalcemia in ethylene glycol poisonning

calcium binds to acid

54

why anion gap acidosis in ethylene glycol poisonning

accumulation of oxalic acid and glycolic acid

55

rx of ethylene glycol poisonning (2)

ethanol
or fomepizole

56

action of ethanol
or fomepizole

inhibit alcohol deshydrogenase

57

role alcohol deshydrogenase

metablizes ethylene glycol to acid

58

principle of rx of ethylene glycol poisonning(3)

fomepizole
bicarb sodium to rx acidosis
hemodyalisis in case of renal injury

59

action of caustic substance ingestion

liquefaction necrosis

60

example of liquefaction necrosis

sodium hydroxyde

61

first step in rx of caustic ingestion(2)

decontamination of skin and clothing
IV hydration

62

second thing in rx of caustic ingestion(2)

if no oesophageal perforation and stable patient
perform endoscopy within 12-24 h

63

what to do if perforation is suspected

upper GI xray with contast substance

64

how to Dx perforation in caustic ingestion

xray thorax

65

patient stable and negative xray thorax next step
in caustic ingestion

upper GI endoscopy

66

in any vignette you see ethanol or ethylene glycol next step(2)

calculate
anion gap
osmolar gap

67

clue for methanol intoxication

optic disk heperhemia

68

opiod withdrawal(2)

abdominal cramps
diarrhee
in IV drug user

69

attention a c difficile infection and opiod withdrawal

look for the time 1 day of antibio is not sufficient to develop pseudomembranous colitis
look WBC if they are decreasing no C difficile infection

70

eye in opiod intox

myosis

71

eye in opioid withdrawal

mydriasis

72

drug used to rx NMS(3)

dantrolene
bromocriptine
amantadine

73

bblocker intoxication(4)

Bradychardia
wheezing bronchospasm
hypotension
hypoglycemia
libido problem

74

Med causing same symptom than B blovker minus wheezing(3)

ca blocker
digoxin
cholinergic agent

75

first step in bblocker intox(2)

fluid
atropine

76

second step in bblocker intox

glucagon

77

action of glucagon(3)

increase AMP cyclic
Increase intra cellular calcium
Increase cardiac contractility

78

clue for caustic ingestion(3)

white tongue
heavy salivation
dysphagia

79

what to rule out in any caustic ingestion

oesophageal perforation
stomach

80

consequence of oesophageal perforation

mediastinitis

81

consequence of stomach perforation

peritonitis

82

action of organophosphate

act as cholinergic

83

cholinergic effect(7)

salivation
urination
diarrhee
bronchorrea
bradycardia
Myosis
all glands are secreted

84

antidote of organophosphate

atropine

85

first thing to do in organophosphate intox(2)

remove clothes
wash the body

86

people at risk of organophosphate intox

farmer

87

why remove clothes in organophosphate intox

because of vomiting tou can have absorption of the substance through skin

88

quid of physostigmine in organophosphate intox

cholinestrase inhibitor
will worsen the intox