Skin infections

Question 1

Most common causes of cellulitis

oupatients

Answer 1

1-strep pyogenes
2-S. aureus
3-other strep-rare

Question 2

Cellulitis causes inpatient

Answer 2

• gram negative organisms: E. Coli, klebsiella, pseudomonas, enterobacter
• S. aureus (Mrsa or Ca-MRSA?)
• Strep

Question 3

Ca-MRSA

Answer 3

bactrim
doxy
clinda

Question 4

what covers strep and ca-MRSA staph?

Answer 4

Clindamycin.

bactrim and doxy will cover staph MRSA but unlikely to also cover strep. would need 2nd agent like Keflex or beta lactam

Question 5

Ipecac good for:

Answer 5

immediate “at home” ingestions of solid** ingestions. not used as routinely in emergency settings because of delay in being able to use charcoal (prolonged vomiting)

Question 6

what is your drug of choice for benzo overdose?

Answer 6

Flumazinole

Question 7

when is gastric lavage used for OD?

Answer 7

when ingestions > 30min ago. pill fragments may be hard to remove

Question 8

activated charcoal for OD

Answer 8

1g/kg mixed with water. repeat doses q 4 hours. 1st dose most effective when combined with a cathartic such as sorbitol

Question 9

Acetaminophen OD S&S

Answer 9

around 24-48 hrs N/V
RUQ pain
hepatotoxicity signs

Question 10

Acetaminophen OD tx

Answer 10

• emesis for recent ingestions: gastric lavage/activated charcoal
• N-Acetylcysteine*** (mucomyst)

Question 11

Salicylate Intoxication S/S

Answer 11

N/v

• Tinnitis, dizziness, HA
• dehydration
• hyperthermia
• apnea, cyanosis, metabolic acidosis
• Elevated LFTs

Question 12

Salicylate treatment

Answer 12

• gastric lavage/charcoal (emesis)

- sodium bicarb IV to correct severe acidosis

Question 13

severe acidosis is

Answer 13

<7.1

Question 14

oxyhemoglobulin dissociation curve. what happens in acidosis

Answer 14

-Right shift

Question 15

oragnophosphate (insectacide) poisoning. Malathion or parathioon. S&S

Answer 15

blurred vision and miosis**
bradycardia**
excessive salvation
mental confusion

Question 16

miosis is

Answer 16

constriction

Question 17

mydriasis is

Answer 17

dilation

Question 18

Drugs that tend to sedate cause

Answer 18

constrictive pupils (miosis)

Question 19

upper drugs tend to:

Answer 19

dilate (mydriasis)

Question 20

Management for insecticide poisoning

Answer 20

wash skin thoroughly

• charcoal if ingested
• Atropine for organophosphate toxicity**

Question 21

Antidepressant toxicity S&S

Answer 21

confusion, hallucinations

• urinary retention
• hypotension, tachy
• hypothermia**
• seizures

Question 22

Management of Antidepressant OD

Answer 22

-ICu if CNS or cardiac toxicity
-gastric lavage/charcoal
-NaHco3 to counter dysrhythmias and maintain pH
-benzodiazepine IV to control seizures***
Serotonin syndrome: treated with dantrolene; clonazepam used to tx rigor, cooling blankets for temperature

Question 23

Narcotic toxicity tx

Answer 23

• emetic contraindicated
• narcan
• stadol

Question 24

Benzo OD S&S

Answer 24

slurred speech

hyporeflexia

Question 25

Transplant failure s/s and treatment

Answer 25

• flu picture

- immediate biopsy

Question 26

Transplant anti-rejection drugs

Answer 26

standard therpy is a calcineurin inhibitor + antimetabolite + steroid

Calcineurin inhibitor: prograft
antimetabolite: cellcept

Question 27

Herpes Zoster wtih eruptions of vesicles, erythema with exudate

Answer 27

typical presentation of zoster