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35 Cards in this Set
- Front
- Back
Mnemonic to remember causes of altered mental status? |
AEIOU TIPS A = alcohol, ingested toxins E = epilepsy, encephalitis, endocrine, lytes I = infection, insulin O = overdose, opiates, oxygen deprived T = trauma, temperature I = insulin, infection P = psychosis S = stroke, shock, space occupying lesions |
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Features of cholinergic drug ingestion? |
: "SLUDGE" (salivation, lacrimation, urination,defecation, GI motility, emesis)
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Features of anticholinergic ingestion? (diphenhydramine, tricyclicantidepressants) |
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Features of sedative-hypnotic ingestion? (benzodiazepines, barbiturates) |
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Signs of opiod ingestion? |
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Signs of sympathomimetic overdose? (cocaine, amphetamines,pseudoephedrine) |
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Cholinergic physiologic effects? |
HR decreased diaphoretic pupils constricted hyperactive abdo |
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anticholinergic physiologic effects? |
HR high, temp high skin dry pupils dilated abdo hypoactive |
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sedative-hypnotic physiologic effects |
HR, BP, RR low altered sensory exam hypoactive bowel |
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opio ingestion physiologic effects |
HR low, BP low, RR low, low temp constricted pupils hypoactive bowel |
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Sympathomimetic ingestion physiologic effects |
HR, RR, BP, temp elevated diaphoretic dilated pupils hyperreflexia hyperactive bowel |
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Common accidental ingestions in toddlers? |
iron acetaminophen |
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How to decontaminate follow toxic ingestion? |
consider: amt, timing, nature of substance, patient characteristics several methods:
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What occurs in nortriptyline toxicity? |
Ingestion of nortriptyline 2.5 mg/kg or higher in a 2-year-old will cause significant symptoms.Peak effect: 7-8 hours after ingestion.
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What occurs in Glipzide toxicity? |
One 10 mg tablet of glipizide can cause significant hypoglycemia in a 2-year-old.Peak effect: 2-3 hours after ingestion, but can last 24 hours.
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DDx of ingestion causing altered mental status and mydriasis? |
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TCA ingestion? |
Agitation, cardiac manifestations (especially hypotension), dilated pupils and dry, hot skinare classic findings in TCA ingestions.
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SSRU ubgestuib> |
serotonin syndrome (profuse sweaty skin, agitation, fever, mentalstatus changes, diarrhea, myoclonus, hyperreflexia, ataxia, and shivering).
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Antihistamine ingestions? |
similar to TCA |
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Decongestant ingestion? |
tachycardia and hypertension, as well as agitation, sweating, fever,mydriasis and seizures.
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iron ingestion? |
severe abdo symptoms followed by shock |
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Beta blocker ingestion |
bradycardia |
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Acetaminophen ingestion |
Initially presents with minimal symptoms (though gastrointestinal symptoms are notuncommon) followed by symptoms of liver toxicity.
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Aspirin ingestion |
Presents with agitation and tachycardia but there is no mydriasis. |
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Opiod ingestion |
Causes sedation and constricted pupils (miosis)
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How to evaluate altered mental status? |
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EKG findings in TCA toxicity? |
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How to manage child with altered mental status? |
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What warrants immediate treatment? |
hypoglycemia hypotension tachycardia |
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How to decontaminate treatments? |
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What else to do? |
consult home safety |
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activated charcoal |
Indicated for ingestions not due to small molecules or heavy metals.Contraindicated in a patient with a loss of protective airway reflexes due to the risk ofaspiration; selective intubation should be considered in such cases. |
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cathartic agents |
A single dose of a cathartic agent may be given with the initial dose of charcoal. |
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Nasogastric lavage |
inconsistent benefit |
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Ipecac |
not first line |