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Pediatric Emergency Medicine

Subjects : 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. 45; 70
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.
Class of drugs encompassing decongestants - amphetamines - cocaine.
Neurosurgery if trauma. Give mannitol.
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

2. 20
Give IM adrenaline - steroids - salbutamol - antihistamine.
Objective signs of growth - tidiness - weight -
Lead poisoning is defined as a serum level greater than ___ ug/dL.
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. Lead
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
Retinal haemorrhages in unexplained headinjury.Must be assessed by opthalmologist. Do coagulation as this can manifest as bruising.
Poisoning causes lethargy - irritability - confusion - dizziness - headache - nausea - irregular breathing - cyanosis - progression to coma/death.
Poisoning causes irritability - apathy - hyperactivity - abdominal pain - constipation - behavioral problems - developmental delay - and acute encephalopathy.

4. What evidence should a doctor give about parental neglect
Objective signs of growth - tidiness - weight -
Flumazenil
Poisoning causes irritability - apathy - hyperactivity - abdominal pain - constipation - behavioral problems - developmental delay - and acute encephalopathy.
Antidotes are fomepizole or ethanol. Sodium bicarbonate and hemodialysis may also be helpful.

5. What is a side effect of charcoal?
Poisoning causes bradycardia - hypotension - decreased respiratory rate - pinpoint pupils - somnolence - and coma.
Causes BAD constipation. Upsets fluid and electrolyte balance.
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
Class of medications encompassing atropine - scopolamine - first-generation antihistamines - and tricyclic antidepressants.

6. What is gastric lavage?
Laboratory indices of poisoning include metabolic acidosis with normal PaO2 - myoglobinuria on urine dipstick - and increased blood carboxyhemoglobin.
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
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 -
Stomach pumping.

7. What are the three features of anaphylaxis
Hypotension - bronchospasma and upper airway obstruction becasue of oedema
Before a child can be examined for child abuse - a parent or legal guardian must give consent
Cultures but don't delay treat with flucloxacillin IV and cefotaxime IV. Give oxygen and Dopamine. Don't do lumbar puncture until child stabilized.
Normally treated with sling alone. Seek advice.

8. Sympathomimetics
Poisoning causes tachycardia - hypertension - fever - large but reactive pupils - sweating - agitation - psychosis - and seizures. Lab studies show hyperglycemia - hypokalemia - EKG changes.
Flurescence in ultraviolet light.
Poisoning causes bradycardia - hypotension - decreased respiratory rate - pinpoint pupils - somnolence - and coma.
Salbutamol. Methylprednisalone. Nebulized ipratropium. Aminophyline. Mgs04.

9. Anticholinergics
Stomach pumping.
Class of medications encompassing atropine - scopolamine - first-generation antihistamines - and tricyclic antidepressants.
Esmolol
1) CXR 2) measure oxygenation. May get convulsion vomitting hepatorenal toxicity

10. Iron
Poisoning treated by alkalinization of the serum to promote renal excretion - correction of hypokalemia - possible hemodialysis.
Antidote is deferoxamine chelation. Charcoal is ineffective.
Increases the blood pH. Used to treat refractory metabolic acidosis - hyperkalemia - and sodium channel blocker (ex. tricyclic antidepressant) overdose.
Munchausen's by proxy

11. What are the terminal signs of acute laryngeal obstruction?
Neurosurgery if trauma. Give mannitol.
Nebulized adrenaline and Dexamethasone. Children admitted to a general medical ward should NOT be administer O2 as it masks their true stats.
Discobalt edetate
Cyanosis and irregular respiratory effort

12. what makes you suspicious of non-accidental injury.
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.
Blood glucose level for hypoglycaemia!!
Less than one year and femur fracture. Spiral fractures in a non-ambulatory child

13. Organophosphates
Poisoning causes irritability - apathy - hyperactivity - abdominal pain - constipation - behavioral problems - developmental delay - and acute encephalopathy.
Poisoning causes salivation - lacrimation - urination - defecation - gastric cramping - emesis - small but reactive pupils - sweating - muscle fasciculations - confusion - and coma.
Poisoning causes decreased cholinesterase activity.
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.

14. Hydrocarbons
Its done with polyethylene glycol. Indicated in iron - delayed preparations and slow release.
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.
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

15. Amphetamine antidote
Cyanosis and irregular respiratory effort
Give IM adrenaline - steroids - salbutamol - antihistamine.
Esmolol
Stomach pumping.

16. Oedema causing laryngeal obstruction?
Antidotes are fomepizole or ethanol. Sodium bicarbonate and hemodialysis may also be helpful.
It can cause fatal bronchioloitis obliterans
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
Intubate - tracheostromy or nebulized adrenaline.

17. Ethanol
It can cause fatal bronchioloitis obliterans
Poisoning causes lethargy - CNS depression - N/V - ataxia - respiratory depression - hypotension - hypothermia - and coma. Laboratory studies show hypoglycemia - hypokalemia - elevated anion gap metabolic acidosis.
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.
Esmolol

18. Legal requirement in childabuse
Esmolol
Antidotes are fomepizole or ethanol. Sodium bicarbonate and hemodialysis may also be helpful.
Poisoning causes irritability - apathy - hyperactivity - abdominal pain - constipation - behavioral problems - developmental delay - and acute encephalopathy.
Notify if abuse CONSIDERED. CONSIDERED.

19. Opiates
Antidote is naloxone.
Less than one year and femur fracture. Spiral fractures in a non-ambulatory child
Neurotoxins - procagulants. Rhabdomyolysins.
Croup.

20. What are the side effects of N-acety-p-benzoquinine?
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
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
Rash bronchospasm and hypotension.
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.

21. What else is in the management of snake bite?
Glucagon prefered - otherwise massive dose of adrenaline.
Hypotension - bronchospasma and upper airway obstruction becasue of oedema
Treatment includes ethanol to block metabolism - sodium bicarbonate to correct metabolic acidosis - and folate to hasten metabolite elimination.
Give steroids for management of serum sickness. Must do coagulation screen!!!

22. Calcium channel blocker overdose antidote
Has alpha and beta-adrenergic effects. Used to treat pulseless VT/VF - asystole - bradycardia - and shock.
IM adrenaline: vasopressor and bronchodilator.
Blocks fast sodium channels - decreases ventricular automaticity and surpresses ventricular arrhythmias. Used to treat pulseless VT/VF - VT with pulses.
Calcium chloride

23. What is the most important investigation in suspected alcohol poisoning in young person?
Causes BAD constipation. Upsets fluid and electrolyte balance.
Blood glucose level for hypoglycaemia!!
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 N/V - anorexia - stomach pain - GI bleeding - mental status changes/coma/seizures if massive ingestion. Lab studies will show elevated serum levels 4 hours after ingestion - along with elevated transaminases - elevated alkaline phosp

24. Carbon monoxide
Blood glucose level for hypoglycaemia!!
Laboratory indices of poisoning include metabolic acidosis with normal PaO2 - myoglobinuria on urine dipstick - and increased blood carboxyhemoglobin.
... blood sugars for hypoglycaemia
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

25. Organophosphates antidotes
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
Ind: already intubated. Contr: Corrosives - hydrocarbons or petrochemicals.
Antidotes are atropine sulfate and pralidoxime chloride.
CHARCOAL! except for lithium - iron - alcohol - lead.

26. Sodium Bicarbonate
Antidote is naloxone.
Croup.
Competitive antagonist of mACh receptors. Used to treat bradycardia and AV nodal block.
Increases the blood pH. Used to treat refractory metabolic acidosis - hyperkalemia - and sodium channel blocker (ex. tricyclic antidepressant) overdose.

27. What is one of the technicalities of childabuse.
The antidote is N-acetylcysteine. Gastric emptying (within 1 hour of ingestion) and activated charcoal administration (within 4 hours of ingestion) may also help.
Severe illness - past history of injuries - 18 months or less - inconstent story.
Before a child can be examined for child abuse - a parent or legal guardian must give consent
Causes temporary atrioventricular node conduction block and interrupts re-entry circuits. Used to treat hemodynamically stable SVTs.

28. What is the most common caUse of acute laryngeal obstruction?
Digoxin Fab
Poisoning causes bradycardia - hypotension - decreased respiratory rate - pinpoint pupils - somnolence - and coma.
Poisoning causes lethargy - irritability - confusion - dizziness - headache - nausea - irregular breathing - cyanosis - progression to coma/death.
Croup.

29. Anticholinergics
Nausea vomiting and anorexia.
Poisoning treated by alkalinization of the serum to promote renal excretion - correction of hypokalemia - possible hemodialysis.
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.
Poisoning causes delirium - drowsiness - hallucinations - seizure - flushing - fixed dilated pupils - fever - cardiac dysrhythmias - dry mouth - speech and swallowing difficulties - nausea - and vomiting.

30. Management of septicaemia shock

31. Methanol
Neurosurgery if trauma. Give mannitol.
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.
Ind: already intubated. Contr: Corrosives - hydrocarbons or petrochemicals.
Discobalt edetate

32. How do snake bites damage?
Calcium chloride
Before a child can be examined for child abuse - a parent or legal guardian must give consent
Antidotes are atropine sulfate and pralidoxime chloride.
Neurotoxins - procagulants. Rhabdomyolysins.

33. Digoxin antedote
Digoxin Fab
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!!!
Physostigmine may be used as an antidote. Other treatments include gastric emptying - activated charcoal - whole-bowel irrigation - seizure control - and benzodiazepines for agitation.

34. Methanol
Treatment includes ethanol to block metabolism - sodium bicarbonate to correct metabolic acidosis - and folate to hasten metabolite elimination.
Lead poisoning is defined as a serum level greater than ___ ug/dL.
1) WARM the blood. 2) monitor serum calcium - potasium - acid base and coagulation in massive transfusion.
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 -

35. Mx raised intracranial pressure.
Instructions on plaster care - analgesia for home. Greensticks by GP - all others at fracture clinic.
Salbutamol. Methylprednisalone. Nebulized ipratropium. Aminophyline. Mgs04.
Neurosurgery if trauma. Give mannitol.
Class of drugs encompassing decongestants - amphetamines - cocaine.

36. What are the special features that must be done to correct haemorrhagic shock.
Notify if abuse CONSIDERED. CONSIDERED.
Causes BAD constipation. Upsets fluid and electrolyte balance.
Hypotension - bronchospasma and upper airway obstruction becasue of oedema
1) WARM the blood. 2) monitor serum calcium - potasium - acid base and coagulation in massive transfusion.

37. Iron
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
Class of medications encompassing atropine - scopolamine - first-generation antihistamines - and tricyclic antidepressants.
Less than one year and femur fracture. Spiral fractures in a non-ambulatory child
Treatment includes ethanol to block metabolism - sodium bicarbonate to correct metabolic acidosis - and folate to hasten metabolite elimination.

38. What is better for alcohol - charcoal or gastric lavage?

39. Epinephrine
Laboratory indices of poisoning include metabolic acidosis with normal PaO2 - myoglobinuria on urine dipstick - and increased blood carboxyhemoglobin.
Has alpha and beta-adrenergic effects. Used to treat pulseless VT/VF - asystole - bradycardia - and shock.
The antidote is N-acetylcysteine. Gastric emptying (within 1 hour of ingestion) and activated charcoal administration (within 4 hours of ingestion) may also help.
Ceftriaxone

40. Mx severe croup
Poisoning causes decreased cholinesterase activity.
Poisoning treated with 100% oxygen - or hyperbaric 100% oxygen if poisoning is severe.
Nebulized adrenaline and Dexamethasone. Children admitted to a general medical ward should NOT be administer O2 as it masks their true stats.
Aspiration Pneumonia

41. What psychiatric disease defined as childabuse?

42. Management of near drowning.
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 delirium - drowsiness - hallucinations - seizure - flushing - fixed dilated pupils - fever - cardiac dysrhythmias - dry mouth - speech and swallowing difficulties - nausea - and vomiting.
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
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.

43. Tricyclic antidepressants
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.
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
Poisoning causes tachycardia - hypotension - tachypnea - vomiting - agitation - seizures. Lab studies show hyperglycemia - hypokalemia - acidosis - hypercalcemia - hypophosphotemia - and EKG changes.
Physostigmine may be used as an antidote. Other treatments include gastric emptying - activated charcoal - whole-bowel irrigation - seizure control - and benzodiazepines for agitation.

44. Acetaminophen
Sling for 2-3 weeks. Lump up to one year. No sport for 6 weeks. No xray review.
Antidotes are atropine sulfate and pralidoxime chloride.
Poisoning treated by alkalinization of the serum to promote renal excretion - correction of hypokalemia - possible hemodialysis.
The antidote is N-acetylcysteine. Gastric emptying (within 1 hour of ingestion) and activated charcoal administration (within 4 hours of ingestion) may also help.

45. Which is better - activated charcoal or gastric lavage.
The antidote is N-acetylcysteine. Gastric emptying (within 1 hour of ingestion) and activated charcoal administration (within 4 hours of ingestion) may also help.
Flumazenil
Poisoning causes tachycardia - hypotension - tachypnea - vomiting - agitation - seizures. Lab studies show hyperglycemia - hypokalemia - acidosis - hypercalcemia - hypophosphotemia - and EKG changes.
CHARCOAL! except for lithium - iron - alcohol - lead.

46. Displaced surgical neck of humerous
Objective signs of growth - tidiness - weight -
Give IM adrenaline - steroids - salbutamol - antihistamine.
Croup.
Normally treated with sling alone. Seek advice.

47. Atropine
Immobilize with plaster slab
Bone scan for occult fracture
Antidote is deferoxamine chelation. Charcoal is ineffective.
Competitive antagonist of mACh receptors. Used to treat bradycardia and AV nodal block.

48. Middle Clavicle fracture management?
Sling for 2-3 weeks. Lump up to one year. No sport for 6 weeks. No xray review.
Poisoning causes decreased cholinesterase activity.
Glucagon prefered - otherwise massive dose of adrenaline.
Skin or vascular compromise

49. Theophylline
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 lethargy - CNS depression - N/V - ataxia - respiratory depression - hypotension - hypothermia - and coma. Laboratory studies show hypoglycemia - hypokalemia - elevated anion gap metabolic acidosis.
Poisoning causes tachycardia - hypotension - tachypnea - vomiting - agitation - seizures. Lab studies show hyperglycemia - hypokalemia - acidosis - hypercalcemia - hypophosphotemia - and EKG changes.
Physostigmine may be used as an antidote. Other treatments include gastric emptying - activated charcoal - whole-bowel irrigation - seizure control - and benzodiazepines for agitation.

50. What is the most appropriate examination in a child with suspected lead ingestion?
IM adrenaline: vasopressor and bronchodilator.
Poisoning causes bradycardia - hypotension - decreased respiratory rate - pinpoint pupils - somnolence - and coma.
Abdo XRAY!!!! do it!
Poisoning causes lethargy - irritability - confusion - dizziness - headache - nausea - irregular breathing - cyanosis - progression to coma/death.