Lisa Critical Care 1/poisoining - Brs/ucla

Front 1

3 yo collapses that you witness, wha'ts order of cardiopulmonary arrest:
-pulse, airway, rescue breaths,

Back 1

1) open airway
2) giv rescue breaths
3) start chest compressions

Front 2

-What's earliest sign of brain herniation after head trauma/injury?
-which type of hematoma has crescentric density?
-which type of hematoma is most severe?

Back 2

bradycardia
-crescentric: subdural - it's also most severe

Front 3

What's cushing triad, and when does it appear?

Back 3

late sign of increased intracranial pressure

Front 4

what makes a drowning patient have a poor prognosis?

Back 4

-age < 3
-submersion > 5 min
- need for CPR > 25 min; need for continued CPR in ER;
-water Temp > 10 degrees Celcius
-

Front 5

what's the acid base disturbance w/ salycilate overdose?

Back 5

metabolic acidosis and respiratory alkalosis

Front 6

13 yo w/ F, chills, vomiting, dairrhea and weakness, hypotension, bounding pulses and warm extrem has what kind of shock?

Back 6

septic shock;* boudning pulses, warm extremities - found in initial stage of septic shock

Front 7

what's basophilic stippling seen with ?

Back 7

lead poisoining

Front 8

what toxin has a bitter almond odor and what's treatment?

Back 8

cyanide:
TX: amyl nitrate, Na Nitrate

Front 9

what toxin has garlic odors (2 ), miosis, sweat, and what's treatment?

Back 9

1) organophosphates (pesticides)/cholinergic --> atropine pralodoxime
2) also arsenic

Front 10

what toxin has acetone odor and treatment?

Back 10

salicylate-->charcoal, Na Bicarb/lavage

Front 11

toxin has wintergreen odor?

Back 11

methyl salicylate

Front 12

toxin causes dilation, dry skin, and what's treatment?

Back 12

Anticholinergics:
-antihistamines: diphenydramine
-atropine --> physostigmine
-give ativan
-TCA: tx: charcoal/Na bicarb

Front 13

what toxins causes miosis?

Back 13

POOP:
-Phencyclidine
-organophosphates
-Opiates
-phenothiazines

Front 14

what causes miosis and sweating, what's tx?

Back 14

cholinergic, organophosphates (insecticides)
tx: atropine (ASTOPine), pralodxime, charcoal
-cholinergic: DUMBELLS: dirrhea, urination, miosis, bronchorhea/spasm, emesis, salivation

Front 15

what causes miosis and dry skin and tx?

Back 15

opiates: morphine-->naloxone

Front 16

what causes dilation and sweating? and tx?

Back 16

1) stimulants (ampehetamines, cocaine, theophylline)
-amphetamine --> lorazepam
2) serotonin syndrome

Front 17

what 2 overdoses causes nystagmus?

Back 17

dilatnin
phencyclidine (PCP)

Front 18

what toxins causes retinal hemorrhaes

Back 18

carbon monoxide
-methanol

Front 19

what toxins cause FEVER?

Back 19

CATS PATT
-Cocaine
-Amphetamines
-Thyroxine
-Salicylates
-phencyclidine
-Anticholiergics, TCA, Theophylline

Front 20

Antidotes for :
-Acetaminophen
-Benzodiazepines?
-digitalis
-lead, mercury, arsenic, copper?

Back 20

-Acetaminophen - N acetylcystine
-Benzodiazepines - flumazenil
-digitalis- digabind
-lead, mercury, arsenic, copper? D penicillamine

Front 21

what causes dystonia?

Back 21

diphenydramine, benztropine

Front 22

antidote?
-iron-
-isoniazid
-methanol, etylene glycol
-narcotics
-Beta blockers?

Back 22

-iron- deferoxamine
-isoniazid - pyrodxine
-methanol, etylene glycol-->ethanol, fomepizole
-narcotics-Naloxone
-Beta blockers- glucagon

Front 23

when can you use charcoal or gastric lavage after ingestion?

Back 23

gastric lavage only w/in first hour of ingestion;
-charcoal only used for non metal ingestion ?? time frame depends on drug; best if used w/in first hour; depends on drug - up to 12 hours (half life of drug) etc.
- no charcoal for kids w/ LOC!!!

Front 24

if a bat is found in room of kid, what do you do next?

Back 24

give rabies IG and start series of 5 rabies vaccine injections regardless if you find the bat or not!!! b/c its considered a contact; tx needs to be started w/in 10 days of exposure

Front 25

which spider bites cause blister--> ulcer, local rxn, necrosis?
- and which one causes M. spasms and coma?
-which one causes F, V, hemolysis?
and whats tx?

Back 25

Brown recluse: Violin on back:
-local rxn: redness w/ central blister or pustule, necrosis (if > 2 cm in 48 hr, iv antbx), F, V, hemolysis;
-local wound care
*Black widow- worse!!: 2 red markings underside, -leading cause of death from spider bites
-swelling, puncture marks,- M. spasm, coma,
Tx: antivenom

Front 26

how manage a 10 mo toddler who fell down 6 stairs, cried x 10 min, vomited, now sleepy (also nap time)?

Back 26

observe in office, if kid remains well, tolerates fluids, her neuro exam is normal, send mom home w/ instructions on head injury

Front 27

what toxin causes N, V, drowsiness, slurred speech, lethargy-->pulmonary edema, cerbal edema and renal failure?

Back 27

eythlene glycol, TX: ethanol, fomepizole

Front 28

what drug/abuse causes ataxia, tremor, decreased seizure threshold, myopathy, peripheral neuropathy?

Back 28

toluene:hydrocarbons (benzen, camphor, insecticides; mineral seal oil, furniture polish, turpentine, kerosene, gas)

Front 29

? how treat dog bite? what's bug?

Back 29

amox-clavulanate - for Pasteruella multocida, s. aureus, st. intermedius; most unprovoked

Front 30

what's best predictor/prognosis of brain injury/concussion?

Back 30

duration of signs and sx > brain inury - best predictor of severity of concussion

Front 31

3 yo boy > car accident, has blood in L external canal, blod behind intact R tympanic membane, clear d/c from nares, what kind of head injury/ bone fracture did he get ?
-how do you dx?

Back 31

temporal skull fx (basilar skull fx) ;
-can also get: -battle sign (posterior auricular bruising) , raccoon eyes, hemotympanum (CSF leak)
-head CT**