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