Emergency and Toxicology – Set 4

What this deck covers

Emergency and Toxicology – Set 4 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. What makes this more than a rash
2. How the farm sting does its harm
3. Helping a bitten child at camp
4. Why toddlers are poisoned
5. Breathless after waking at the scene
6. First drug after a party cake
7. The feature that does not belong
8. Bitten by a horned desert snake
9. Where to ask about unknown tablets
10. No better at five minutes
11. Blood results hours after the sting
12. Enzyme behind a blistered forearm
13. One medicine that slips through
14. Goes grey when picked up
15. Finding why perfusion is poor
16. Black snake and drooping eyelids
17. Plan after chewing grandad’s pills
18. Needing more for the same high
19. Wheeze left after adrenaline
20. High pressure three hours on
21. Cold hands while antivenom is mixed
22. A tenfold infusion error
23. Still shocked a quarter-hour on
24. Another scorpion, another picture
25. Six hours on, still unclotted
26. Tablets gone within the hour
27. Why not reverse the sedative
28. How long to watch a recovered girl
29. Frothy pink sputum after a sting
30. Heavy eyelids after a snakebite
31. Fever syrup every two hours
32. When to send the mast cell test
33. Using antivenom the right way
34. A sister’s epilepsy tablets
35. Slate-grey after a throat spray
36. What he must carry on leaving
37. Sleepy again ninety minutes later
38. Easing a burning toe
39. Fang marks and nothing else
40. Two days after grandma’s tablets
41. Weals and wheeze return at 5 hours
42. Which child is most at risk
43. Weakening breaths after a snakebite
44. One pill that could harm her
45. What the nursery must be told
46. The specific remedy for her sting
47. Ashen and breathless after a sting
48. Wheeze during antivenom
49. Fits that lorazepam cannot stop
50. Arranging review once recovered

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: A known trigger followed by a rapid onset, Their livers cannot metabolise medicines at this age, A dry mouth with hot, flushed skin, IV hydrocortisone and chlorphenamine, then reassess, All three are well adsorbed, Neurotoxic envenoming from an elapid, Inhaled or nebulised salbutamol, Idarucizumab, Fresh frozen plasma and cryoprecipitate instead, 2 hours, then home with an antihistamine, Paracetamol is toxic only after a single large dose, Drooling, sweating, wheeze and a slow heart rate, A delayed sedative reaction to the naloxone itself, Fresh frozen plasma.

Clinical pearls from this deck

• No ABC problem, no anaphylaxis; any ABC problem after an allergen, treat as anaphylaxis.
• Scorpion venom opens sodium channels and floods the body with both halves of the autonomic system.
• Snakebite first aid is mostly about what not to do.
• Crawl, climb, grab, mouth: the toddler route to poisoning.
• Opioid overdose can flood the lungs even after naloxone.
• Think thigh, IM, 1 mg/mL: 150, 300, 500 by age.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all emergency and toxicology case decks · pediatric reference values.