12878372
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
about 6 years ago
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| Question | Answer |
| 1. Which of the following is a risk assessment? A. 3yo took 2 of grandad’s red pills, vomited one. BP 78/40 and HR 48. B. 14yo was depressed after an argument with his parents about studying and school bullying. He took 12 tablets of ibuprofen from the cupboard. Paracetamol level is 52 mg/L at 4 hours post ingestion and he has been cleared by the mental health team. C. 3yo took 6mg of risperidone 3 hours ago, giving 0.5 mg/kg (above the toxic dose). Has extra-pyramidal signs, confirming the ingestion. Given benztropine. Parents warned abnormal movements may last a few days. Although tachycardic, no risk of arrhythmias. | C. Need age, agent (or likely ones), time of ingestion, clinical picture, and assessment of toxicity expected. Don’t necessarily need treatment, but an opinion on the severity and what to expect is handy. |
| 2. Which of the following is true about toxidromes? A. Pinpoint pupils can be found with opioid, olanzapine and diphenhydramine overdose. B. Serotonin toxicity is associated with Parkinsonian rigidity. C. Cool clammy skin is linked to anti-cholinergic syndrome. D. Secretions are a feature of organophosphate poisoning. E. Naloxone is mainly used to increase level of consciousness in appropriate overdoses. | D. Antihistamines and anticholinergic syndrome give dilated pupils and warm dry skin. Rigidity is associated with neuroleptic malignant syndrome. Serotonin syndrome - look for hyperreflexia and clonus. Naloxone is indicated for respiratory depression (sats <90% RA and/or RR<minimum for age). |
| 3. Which is true about treatments? A. Decontamination with activated charcoal is only useful if the patient arrives within 1 hour. B. Activated charcoal is a good idea if the patient has ingested verapamil, potassium or propranolol. C. Sodium bicarbonate is useful in severe salicylate or tricyclic anti-depressant overdose. D. Dialysis could be indicated for severe salicylate, verapamil or propranolol poisoning. | C. Charcoal can be given after 1 hour if slow release, bezoar, or multiple tablets. No charcoal for metals (K). Cannot dialyse propranolol or verapamil. |
| 4. Which of the following is true about envenomation? A. If positive, Snake Venom Detection Kits indicate envenomation and are unusually false positives. B. Pressure Bandage Immobilisation should be used for snakes, spiders and jellyfish stings. C. Hot water is a good treatment for Physalia (blue bottle) stings. D. Black snakes are as deadly as brown snakes. E. There is an antidote for blue ring octopus envenomation. | C. A randomised trial showed hot water was better than cold for blue bottle stings. SVDK are wrong about 20% of the time and only tell you what type of snake was involved. Envenomation is a clinical or biochemical diagnosis. No PIB for jellyfish. Brown snakes are probably the most deadly. No antidote for blue ring octopus. The tetrodotoxin paralyses the respiratory system, so ventilation is indicated. |
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