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what is the leading cause of nonpharmacologic ingestion fatality in the US
organophosphate poisoning (organophosphates bind irreversibly to cholinesterase of neurons and erythrocytes, leading to failure to terminate the effects of ACh at the receptor sites)
what does the mnemonic "dumb bels" stand for?
diarrhea/defecation
urination
miosis
bradycardia
bronchorrhea
emesis/excitation of the muscles
lacrimation
salivation

these are the signs/sx's of cholinergic excess
how would you make the diagnostic confirmation of organophosphate poisoning?
decreased serum pseudocholinesterase and erythrocyte cholinesterase levels
tx of organophosphate poisoning?
supportive care and the use of one of the following:

atropine (antagonizes muscarinic receptor)

OR

pralidoxime (cholinesterase-reactivating oxime; esp useful for patients with significant muscle weakness)
most common bacterial pathogens causing otitis media
S. pneumoniae, non-typeable H influenza, Moraxella catarrhalis
tx and complications of acute OM
initial tx: amoxicillin
if resistant: change to amoxicillin-clavulanate, cefuroxime or ceftriaxone

complications: mastoiditis, temporal bone osteomyelitis, facial nerve palsy, epi/subdural abscess, meningitis,etc
what is the therapy for narcosis in a newborn (newborn respiratory depression due to maternal pain control)?
IV, IM, subcutaneous, or endotracheal administration of naloxone (Narcan)
having a stepping response after 3 months of age OR a moro reflex after 6 mo OR asymmetrical tonic neck reflex after 6 mo is likely due to what condition?
cerebral palsy
digital clubbing, recurrent sinusitis, growth retardation and fat malabsorption are clues to the dx of __________.
cystic fibrosis
what are some causes of nonphysiologic jaundice?
septicemia, biliary atresia, hepatitis, galactosemia, hypothyroidism, cystic fibrosis, congenital hemolytic anemia, drug-induced hemolytic anemia, antibodies directed at the fetal RBC
high levels of unconjugated bilirubin may lead to K______
kernicterus (an irreversible neurologic syndrome resulting from brain cell deposits)
define pulsus paradoxus
BP that varies more widely w/ respiration than normal. a variance of greater than 10 mmHg b/w inspiration and expiration suggets obstructive airway dz, pericardial tamponade, or constrictive pericarditis
differentiate b/w immediate and late-phase rxn
immediate: airway inflammation resulting from mast cell activation

late phase rxn: occurs 2-4 hrs after acute response, characterized by infiltration of inflammatory cells into the airway parenchyma
t or f. since the sweat chloride test is high sensitivity, a negative result almost always means that the pt does not have cystic fibrosis.
F. a neg test does not preclude CF
name the condition that is nearly pathognomonic for CF in the newborn period
meconium ileus