TOX - ENVIRONMENTAL - SUBSTANCE ABUSE Flashcards

(42 cards)

1
Q

All patients must be warmed to a minimum of what degree?

A

86F (30C)

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2
Q

What is the final pathology of a submersion injury?

A

Hypoxia due to submersion

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3
Q

What is the main symptom of heat exhaustion? Heat stroke?

A

Heat exhaustion = sweating profusely
Heat stroke = hot and dry

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4
Q

What is the treatment for both heat exhaustion and heat stroke? (4)

A

-Rapid cooling
-Avoid shivering
-IVF/electrolytes
-Check for rhabdo/DIC

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5
Q

Radiation injury is related to what 3 things?

A

Time, distance, shielding

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6
Q

What might be the first sign of petroleum distallates overdose (aka gasoline)?

A

cough

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7
Q

“Nerve agents” - acetylcholinesterase inhibitor that causes too much ACTH buildup. Neuromuscular junction cannot “reset” for next impulse. Leads to paralysis of the diaphragm. AKA acetylcholinergic crisis. Found in insecticides and WMD. Treat with atropine.

A

Organophosphates

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8
Q

S&S of organophosphates OD

A

MUDDLES:
-miosis (constriction of pupil)
-urination
-diaphoresis
-defecation
-lacrimation
-excitation (seizures)
-salavation

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9
Q

Constriction of pupil?
Dilation of pupil?

A

Miosis
Mydriasis

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10
Q

What toxidromes cause miosis (2)?
What cause mydriasis (1)?

A

Miosis = opiates & organophosphates

Mydriasis = stimulants

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11
Q

How long after tylenol ingestion should we get a level?

A

4 hours

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12
Q

What is a (often terminal) finding of carbon monoxide poisioning?

A

Cherry red skin and mucous membranes

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13
Q

What are some sources of CO poisioning? What patient education needs to be done?

A

Anything that burns and gas appliances
Have CO detectors

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14
Q

What may cause “bitter almond” breath?

A

Cyanide Toxicity

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15
Q

What are 3 routes for cyanide toxicity?

A

inhale, oral, IV (nipride)

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16
Q

What is charcol contraindicated in?

A

Iron toxicity

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17
Q

What is tinnitus a symptom of?

18
Q

What have both anticholinergic and alpha-adrenergic properties?

(alpha cells are on blood vessels, so they vasoconstrict and increase the HR)

A

TCAs (elevil, amitryptline)

19
Q

What is a common anticholinergic? What are 4 symptoms?

A

Atropine

Can’t see, can’t pee, can’t spit, can’t shit

20
Q

3 Cs of TCA OD

A

Cardiac (dysrhythmias)
Convulsions (seizures)
Coma (decreased LOC)

21
Q

Alcohol can cause what to happen to the eyes?

22
Q

This causes increase in catecholamine release from CNS. Symptoms of increased HR/palpitations/CP coming from brain, not heart

23
Q

How do we treat symptoms r/t cocaine OD?

A

Benzos (not nitro or BB!)

24
Q

Leads to autonomic instability and causes HTN, tachycardia, disphoresis

A

Delirum Tremens

25
This is r/t alcohol abuse and can lead to Korsakoff psychosis.
Werenicke's encephalopathy
26
What should we give to alcoholics/werenicke's encephalopathy patients before giving glucose to protect the brain?
Thiamine
27
What are some toxic symptoms of lithium? How do we treat?
-ataxia -nystagmus -renal impairment (renally excreted) -seizures Treat with IVF
28
Why do we use digoxin? What can dig toxicity cause (3)?
A-fib -decreased HR -heart blocks -"yellow halos"
29
Antidote to coumadin
vitamin K
30
Antidote to dilantin
supportive (heart rhythm changes)
31
Antidote to CCB
calcium chloride/gluconate
32
Antidote to ethylene glycol/methanol
10% ethanol
33
Antidote to BB/CCB
glucagon
34
Antidote to oral sulfonylureas (metformin/glucophage)
octreotide/sandostatin (this blocks pancreas and causes it to slow down insulin production)
35
Antidote to heparin
protamine sulfate
36
Antidote to tylenol
mucomyst (PO)/acetylcysteine
37
Antidote to benzos
Romazicon/Flumazeril
38
Antidote to carbon monoxide
high flow oxygen
39
Antidote to cyanide
Cyanide kit: Amyl nitrate (inhaled) Sodium nitrate (IV) Sodium thiosulfate (IV)
40
Antidote to iron
deFEroxamine (this may cause pink/red urine)
41
Antidote to salicylates
HCO3
42
Antidote to TCAs
HCO3