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Test your basic knowledge |
Pediatric Emergency Medicine
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Study First
Subjects
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health-sciences
,
pediatrics
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Ethylene glycol
1) Mechanical ventilation 2) Stomach decompression 3) Saline and dopamine 4) cerebral oedema w/ mannitol 5) monitor for hypokaelamia (common) 6) give benpen if ventilation required to prevent pneumoccal pneumonia complication. Induce controlled hypot
Its done with polyethylene glycol. Indicated in iron - delayed preparations and slow release.
The most common accident in children in from car crashes 50% always make sure your child has an approptiate seat beat - that they are not sitting in the front seat before 12 and that if possible the car has airbags for the child. Always supervise chi
Poisoning causes anorexia - vomiting - lethargy - respiratory/CV collapse. Lab studes show metabolic acidosis with elevated anion gap - elevated serum ammonia - hypocalcemia - kidney failure - and calcium oxalate crystals on urinalysis.
2. What must you do before sending fracture to radiology?
Poisoning treated by alkalinization of the serum to promote renal excretion - correction of hypokalemia - possible hemodialysis.
Immobilize with plaster slab
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
Causes tachypnea - coughing - respiratory distress - cyanosis - N/V - GI discomfort - and mental status changes. Gastric emptying should be avoided. Charcoal is ineffective. Patients should be monitored closely for aspiration.
3. Benzodiazepine overdose antidote
Flumazenil
Poisoning causes tachycardia - hypotension - tachypnea - vomiting - agitation - seizures. Lab studies show hyperglycemia - hypokalemia - acidosis - hypercalcemia - hypophosphotemia - and EKG changes.
Chelation with EDTA or oral succimer should be initiated in children with a serum lead level greater than ___ ug/dL. With levels greater than ___ ug/dL - intramuscular dimercaprol should be added - and the child should be admitted for inpatient treat
Poisoning causes N/V - inebriation - increase in minute ventilation to offset increased anion gap metabolic acidosis - blurred vision/optic disc edema starting 18-24 hours after ingestion.
4. Hydrocarbons
Can cause electrolysis corrosion. Perforate esophageus or cause oesaphageal tracheal fistula. Endoscopy
Hypotension - bronchospasma and upper airway obstruction becasue of oedema
Class of drugs encompassing decongestants - amphetamines - cocaine.
Causes tachypnea - coughing - respiratory distress - cyanosis - N/V - GI discomfort - and mental status changes. Gastric emptying should be avoided. Charcoal is ineffective. Patients should be monitored closely for aspiration.
5. Calcium channel blocker overdose antidote
Poisoning treated by alkalinization of the serum to promote renal excretion - correction of hypokalemia - possible hemodialysis.
Poisoning causes lethargy - CNS depression - N/V - ataxia - respiratory depression - hypotension - hypothermia - and coma. Laboratory studies show hypoglycemia - hypokalemia - elevated anion gap metabolic acidosis.
Objective signs of growth - tidiness - weight -
Calcium chloride
6. Which is better - activated charcoal or gastric lavage.
6 month old rolled from coach to carpet (not developed enough). Have you been particularly stressed and shaken or rough handled your child lately.
CHARCOAL! except for lithium - iron - alcohol - lead.
Release NEUROTOXINS both have antivenom
Has alpha and beta-adrenergic effects. Used to treat pulseless VT/VF - asystole - bradycardia - and shock.
7. Methanol
Abdo XRAY!!!! do it!
Poisoning causes N/V - inebriation - increase in minute ventilation to offset increased anion gap metabolic acidosis - blurred vision/optic disc edema starting 18-24 hours after ingestion.
Has alpha and beta-adrenergic effects. Used to treat pulseless VT/VF - asystole - bradycardia - and shock.
Aspiration pneumonia even if intubated.
8. Ethanol
... blood sugars for hypoglycaemia
Poisoning causes delirium - drowsiness - hallucinations - seizure - flushing - fixed dilated pupils - fever - cardiac dysrhythmias - dry mouth - speech and swallowing difficulties - nausea - and vomiting.
Severe illness - past history of injuries - 18 months or less - inconstent story.
Poisoning causes lethargy - CNS depression - N/V - ataxia - respiratory depression - hypotension - hypothermia - and coma. Laboratory studies show hypoglycemia - hypokalemia - elevated anion gap metabolic acidosis.
9. What are the other treatments for anaphylaxis?
Poisoning causes anticholinergic effects as well as prolonged PR interval - widened QRS complex - QT prolongation - and AV block due to blockage of sodium channels. Hypotension. Pulmonary oedema
Give IM adrenaline - steroids - salbutamol - antihistamine.
Increases the blood pH. Used to treat refractory metabolic acidosis - hyperkalemia - and sodium channel blocker (ex. tricyclic antidepressant) overdose.
Poisoning causes delirium - drowsiness - hallucinations - seizure - flushing - fixed dilated pupils - fever - cardiac dysrhythmias - dry mouth - speech and swallowing difficulties - nausea - and vomiting.
10. What is better for alcohol - charcoal or gastric lavage?
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11. OSCE: What are the five princples of discharging a patient with a fracture?
Class of drugs encompassing decongestants - amphetamines - cocaine.
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
Objective signs of growth - tidiness - weight -
Blocks fast sodium channels - decreases ventricular automaticity and surpresses ventricular arrhythmias. Used to treat pulseless VT/VF - VT with pulses.
12. What is gastric lavage?
Immobilize with plaster slab
... blood sugars for hypoglycaemia
Aspiration pneumonia even if intubated.
Stomach pumping.
13. What are the special features that must be done to correct haemorrhagic shock.
Abdo XRAY!!!! do it!
Poisoning causes anorexia - vomiting - lethargy - respiratory/CV collapse. Lab studes show metabolic acidosis with elevated anion gap - elevated serum ammonia - hypocalcemia - kidney failure - and calcium oxalate crystals on urinalysis.
Poisoning causes nausea - vomiting - anorexia. Serum levels elevated 4-24 hours after ingestion. Late elevation of heaptic transaminases and PT.
1) WARM the blood. 2) monitor serum calcium - potasium - acid base and coagulation in massive transfusion.
14. What else is in the management of snake bite?
Poisoning causes lethargy - CNS depression - N/V - ataxia - respiratory depression - hypotension - hypothermia - and coma. Laboratory studies show hypoglycemia - hypokalemia - elevated anion gap metabolic acidosis.
Croup.
1) sodium bicarbonate 2) hyperventilation 3) diazepam (anticonvuslant) 4) antidysrhytmia (phenytoin)
Give steroids for management of serum sickness. Must do coagulation screen!!!
15. When and how would you do whole bowel irrigation?
Objective signs of growth - tidiness - weight -
Wrap upwards (even though some venom seap up still more painful and lasts longer) Premedicate w/ adrenaline. We give specifically both brown and tigersnake antivenom in victoria. Other states need to use polyvalent because other species too.
Poisoning causes decreased cholinesterase activity.
Its done with polyethylene glycol. Indicated in iron - delayed preparations and slow release.
16. What psychiatric disease defined as childabuse?
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17. When is reduction required in fracture?
Digoxin Fab
The antidote is N-acetylcysteine. Gastric emptying (within 1 hour of ingestion) and activated charcoal administration (within 4 hours of ingestion) may also help.
1) sodium bicarbonate 2) hyperventilation 3) diazepam (anticonvuslant) 4) antidysrhytmia (phenytoin)
Skin or vascular compromise
18. Iron
Antidote is deferoxamine chelation. Charcoal is ineffective.
Persitantly angry. Anxiously attached or ambivalent towards parents. Limited ability to enjoy things. Low self esteem - depressed or unresponsive. Poor social skills and developmental inhibition.
Release NEUROTOXINS both have antivenom
Antidotes are fomepizole or ethanol. Sodium bicarbonate and hemodialysis may also be helpful.
19. Funnel web and red back
Poisoning causes lethargy - CNS depression - N/V - ataxia - respiratory depression - hypotension - hypothermia - and coma. Laboratory studies show hypoglycemia - hypokalemia - elevated anion gap metabolic acidosis.
The most common accident in children in from car crashes 50% always make sure your child has an approptiate seat beat - that they are not sitting in the front seat before 12 and that if possible the car has airbags for the child. Always supervise chi
Can cause electrolysis corrosion. Perforate esophageus or cause oesaphageal tracheal fistula. Endoscopy
Release NEUROTOXINS both have antivenom
20. Lead
Abdo XRAY!!!! do it!
Poisoning causes tachycardia - hypotension - tachypnea - vomiting - agitation - seizures. Lab studies show hyperglycemia - hypokalemia - acidosis - hypercalcemia - hypophosphotemia - and EKG changes.
Cultures but don't delay treat with flucloxacillin IV and cefotaxime IV. Give oxygen and Dopamine. Don't do lumbar puncture until child stabilized.
Poisoning causes irritability - apathy - hyperactivity - abdominal pain - constipation - behavioral problems - developmental delay - and acute encephalopathy.
21. What is the first line investigation in a young child who has consumed alcohol?
Sling for 2-3 weeks. Lump up to one year. No sport for 6 weeks. No xray review.
... blood sugars for hypoglycaemia
Causes temporary atrioventricular node conduction block and interrupts re-entry circuits. Used to treat hemodynamically stable SVTs.
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
22. Salicylates
Neurotoxins - procagulants. Rhabdomyolysins.
'I WOULD CALL POISON HOTLINE'.
Poisoning causes hyperpnea and tachypnea - mixed respiratory alkalosis and metabolic acidosis - fever - N/V - dehydration - tinnitus - agitation - and seizures. Lab studies show hyperglycemia - hypokalemia - prolonged PT/PTT.
Laboratory indices of poisoning include metabolic acidosis with normal PaO2 - myoglobinuria on urine dipstick - and increased blood carboxyhemoglobin.
23. Oedema causing laryngeal obstruction?
Intubate - tracheostromy or nebulized adrenaline.
Flurescence in ultraviolet light.
Causes tachypnea - coughing - respiratory distress - cyanosis - N/V - GI discomfort - and mental status changes. Gastric emptying should be avoided. Charcoal is ineffective. Patients should be monitored closely for aspiration.
Poisoning treated by alkalinization of the serum to promote renal excretion - correction of hypokalemia - possible hemodialysis.
24. Anticholinergics
Poisoning causes delirium - drowsiness - hallucinations - seizure - flushing - fixed dilated pupils - fever - cardiac dysrhythmias - dry mouth - speech and swallowing difficulties - nausea - and vomiting.
Calcium chloride
Poisoning treated with 100% oxygen - or hyperbaric 100% oxygen if poisoning is severe.
Poisoning causes decreased cholinesterase activity.
25. Undisplaced surgical neck of humerous?
Chelation with EDTA or oral succimer should be initiated in children with a serum lead level greater than ___ ug/dL. With levels greater than ___ ug/dL - intramuscular dimercaprol should be added - and the child should be admitted for inpatient treat
Lead poisoning is defined as a serum level greater than ___ ug/dL.
Blocks Na - K - Ca channels and beta-receptors in the myocardium. Also blocks alpha and beta-receptors in the periphery. Slows AV conduction and ventricular conduction. Used to treat hemodynamically stable VT - refractory VF - pulseless VT - and SVT.
Sling for 3 weeks - fracture clinic at 7 days.
26. What is one of the technicalities of childabuse.
Poisoning causes irritability - apathy - hyperactivity - abdominal pain - constipation - behavioral problems - developmental delay - and acute encephalopathy.
Before a child can be examined for child abuse - a parent or legal guardian must give consent
Class of drugs encompassing decongestants - amphetamines - cocaine.
IM adrenaline: vasopressor and bronchodilator.
27. Tricyclic antidepressants
Glucagon prefered - otherwise massive dose of adrenaline.
IM adrenaline: vasopressor and bronchodilator.
Poisoning causes anticholinergic effects as well as prolonged PR interval - widened QRS complex - QT prolongation - and AV block due to blockage of sodium channels. Hypotension. Pulmonary oedema
Antidotes are atropine sulfate and pralidoxime chloride.
28. Mx of critical asthma
Poisoning treated by alkalinization of the serum to promote renal excretion - correction of hypokalemia - possible hemodialysis.
Salbutamol. Methylprednisalone. Nebulized ipratropium. Aminophyline. Mgs04.
Class of medications encompassing atropine - scopolamine - first-generation antihistamines - and tricyclic antidepressants.
Class of drugs encompassing decongestants - amphetamines - cocaine.
29. Amiodarone
Intubate - tracheostromy or nebulized adrenaline.
Can cause electrolysis corrosion. Perforate esophageus or cause oesaphageal tracheal fistula. Endoscopy
The most common accident in children in from car crashes 50% always make sure your child has an approptiate seat beat - that they are not sitting in the front seat before 12 and that if possible the car has airbags for the child. Always supervise chi
Blocks Na - K - Ca channels and beta-receptors in the myocardium. Also blocks alpha and beta-receptors in the periphery. Slows AV conduction and ventricular conduction. Used to treat hemodynamically stable VT - refractory VF - pulseless VT - and SVT.
30. Cyanide
Give IM adrenaline - steroids - salbutamol - antihistamine.
Persitantly angry. Anxiously attached or ambivalent towards parents. Limited ability to enjoy things. Low self esteem - depressed or unresponsive. Poor social skills and developmental inhibition.
Physostigmine may be used as an antidote. Other treatments include gastric emptying - activated charcoal - whole-bowel irrigation - seizure control - and benzodiazepines for agitation.
Discobalt edetate
31. Mx raised intracranial pressure.
Poisoning causes tachycardia - hypertension - fever - large but reactive pupils - sweating - agitation - psychosis - and seizures. Lab studies show hyperglycemia - hypokalemia - EKG changes.
Give steroids for management of serum sickness. Must do coagulation screen!!!
Poisoning treated with 100% oxygen - or hyperbaric 100% oxygen if poisoning is severe.
Neurosurgery if trauma. Give mannitol.
32. What evidence should a doctor give about parental neglect
Has alpha and beta-adrenergic effects. Used to treat pulseless VT/VF - asystole - bradycardia - and shock.
Esmolol
Increases the blood pH. Used to treat refractory metabolic acidosis - hyperkalemia - and sodium channel blocker (ex. tricyclic antidepressant) overdose.
Objective signs of growth - tidiness - weight -
33. Carbon monoxide
Normally treated with sling alone. Seek advice.
Laboratory indices of poisoning include metabolic acidosis with normal PaO2 - myoglobinuria on urine dipstick - and increased blood carboxyhemoglobin.
Poisoning causes nausea - vomiting - anorexia. Serum levels elevated 4-24 hours after ingestion. Late elevation of heaptic transaminases and PT.
Poisoning causes irritability - apathy - hyperactivity - abdominal pain - constipation - behavioral problems - developmental delay - and acute encephalopathy.
34. Lidocaine
Bone scan for occult fracture
Digoxin Fab
... blood sugars for hypoglycaemia
Blocks fast sodium channels - decreases ventricular automaticity and surpresses ventricular arrhythmias. Used to treat pulseless VT/VF - VT with pulses.
35. How may you detect semen?
'I WOULD CALL POISON HOTLINE'.
The antidote is N-acetylcysteine. Gastric emptying (within 1 hour of ingestion) and activated charcoal administration (within 4 hours of ingestion) may also help.
Flurescence in ultraviolet light.
Poisoning causes tachycardia - hypertension - fever - large but reactive pupils - sweating - agitation - psychosis - and seizures. Lab studies show hyperglycemia - hypokalemia - EKG changes.
36. Undisplaced radial shaft fracture
Collar and cuff. Check integrity of nerve.
Skin or vascular compromise
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
Treats hypocalcemia - hyperkalemia - hypermagnesemia - and calcium channel blocker overdose.
37. Signs of psychological maltreatment?
Severe illness - past history of injuries - 18 months or less - inconstent story.
Ind: already intubated. Contr: Corrosives - hydrocarbons or petrochemicals.
Its done with polyethylene glycol. Indicated in iron - delayed preparations and slow release.
Persitantly angry. Anxiously attached or ambivalent towards parents. Limited ability to enjoy things. Low self esteem - depressed or unresponsive. Poor social skills and developmental inhibition.
38. A child has swallowed a battery. Mx
Flurescence in ultraviolet light.
Collar and cuff. Check integrity of nerve.
The most common accident in children in from car crashes 50% always make sure your child has an approptiate seat beat - that they are not sitting in the front seat before 12 and that if possible the car has airbags for the child. Always supervise chi
Can cause electrolysis corrosion. Perforate esophageus or cause oesaphageal tracheal fistula. Endoscopy
39. Atropine
Less than one year and femur fracture. Spiral fractures in a non-ambulatory child
1) sodium bicarbonate 2) hyperventilation 3) diazepam (anticonvuslant) 4) antidysrhytmia (phenytoin)
Antidotes are atropine sulfate and pralidoxime chloride.
Competitive antagonist of mACh receptors. Used to treat bradycardia and AV nodal block.
40. Carbon monoxide
Give IM adrenaline - steroids - salbutamol - antihistamine.
It can be biphasic. You treat them - they get better - then a few hours later it HAPPENS AGAIN! Within 48 hours. So give 3 day coUse of pred - ranitidine -
Class of medications encompassing atropine - scopolamine - first-generation antihistamines - and tricyclic antidepressants.
Poisoning treated with 100% oxygen - or hyperbaric 100% oxygen if poisoning is severe.
41. Management of septicaemia shock
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42. Adenosine
Flumazenil
Causes temporary atrioventricular node conduction block and interrupts re-entry circuits. Used to treat hemodynamically stable SVTs.
Collar and cuff. Check integrity of nerve.
Flurescence in ultraviolet light.
43. Mx severe croup
'I WOULD CALL POISON HOTLINE'.
Nebulized adrenaline and Dexamethasone. Children admitted to a general medical ward should NOT be administer O2 as it masks their true stats.
Aspiration Pneumonia
Poisoning causes tachycardia - hypotension - tachypnea - vomiting - agitation - seizures. Lab studies show hyperglycemia - hypokalemia - acidosis - hypercalcemia - hypophosphotemia - and EKG changes.
44. Sympathomimetics
Nausea vomiting and anorexia.
Aspiration pneumonia even if intubated.
Poisoning causes tachycardia - hypertension - fever - large but reactive pupils - sweating - agitation - psychosis - and seizures. Lab studies show hyperglycemia - hypokalemia - EKG changes.
Poisoning causes decreased cholinesterase activity.
45. Sympathomimetics
Objective signs of growth - tidiness - weight -
ABC - drugs - drawbloods and decontamination. Conscious and serious: 1) nasogastric charcoal or lavage. 2 Bowel irrigation + charcoal. 3) Tracheal intubation.
Class of drugs encompassing decongestants - amphetamines - cocaine.
Poisoning causes N/V - diarrhea - GI bleeding - acute liver failure - seizures - shock - and coma. Lab studies show elevated serum levels 3-5 hours after ingestion - metabolic acidosis - hyperglycemia - increased bilirubin and LFTs - prolonged PT - i
46. What are the side effects of N-acety-p-benzoquinine?
Nausea vomiting and anorexia.
1) CXR 2) measure oxygenation. May get convulsion vomitting hepatorenal toxicity
Aspiration Pneumonia
Rash bronchospasm and hypotension.
47. You must consider abuse in
Before a child can be examined for child abuse - a parent or legal guardian must give consent
Less than one year and femur fracture. Spiral fractures in a non-ambulatory child
Severe illness - past history of injuries - 18 months or less - inconstent story.
Poisoning causes lethargy - CNS depression - N/V - ataxia - respiratory depression - hypotension - hypothermia - and coma. Laboratory studies show hypoglycemia - hypokalemia - elevated anion gap metabolic acidosis.
48. Mx of petroleum overdose
Stomach pumping.
1) CXR 2) measure oxygenation. May get convulsion vomitting hepatorenal toxicity
Give IM adrenaline - steroids - salbutamol - antihistamine.
Poisoning causes N/V - diarrhea - GI bleeding - acute liver failure - seizures - shock - and coma. Lab studies show elevated serum levels 3-5 hours after ingestion - metabolic acidosis - hyperglycemia - increased bilirubin and LFTs - prolonged PT - i
49. Epinephrine
Poisoning causes N/V - diarrhea - GI bleeding - acute liver failure - seizures - shock - and coma. Lab studies show elevated serum levels 3-5 hours after ingestion - metabolic acidosis - hyperglycemia - increased bilirubin and LFTs - prolonged PT - i
Has alpha and beta-adrenergic effects. Used to treat pulseless VT/VF - asystole - bradycardia - and shock.
Nausea vomiting and anorexia.
Chelation with EDTA or oral succimer should be initiated in children with a serum lead level greater than ___ ug/dL. With levels greater than ___ ug/dL - intramuscular dimercaprol should be added - and the child should be admitted for inpatient treat
50. What is the risk of gastrointestinal decompression in a person with decreased conscious state?
Poisoning causes decreased cholinesterase activity.
Aspiration pneumonia even if intubated.
Notify if abuse CONSIDERED. CONSIDERED.
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.