3.
Amanita phalloides (mushroom) poisoning
Paracetamol toxicity – common in Europe
and North America
Reye's syndrome
Acute fatty liver of pregnancy
Wilson's disease
Shock
Malignant disease of the liver
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3
4. Hemolysis,
Elevated Liver
enzymes, Low Platelets
Severe, life-threatening
complication of PET
Delivery - only known
treatment
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4
11. Results
from astrocyte swelling
rather than a leaky blood
brain barrier (vasogenic
cerebral edema)
Corticosteroids are not
recommended
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11
13. Gold
standard for measuring and
monitoring ICH
› < 25 mm
Hg
Neuroimaging
- not reliable in
diagnosing early ICH
› To exclude other problems
(e.g., intracranial bleeding or stroke)
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13
14. Requires
correction of
underlying coagulopathy
Portal of entry for infectious
organisms
Can precipitate intracranial
hemorrhage
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14
21. Propofol
and benzodiazepines
are most commonly used
Propofol decreases cerebral
blood flow and lowers
intracranial pressure
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21
25. Recombinant
factor VIIa
› when FFP has failed to correct
PT/INR
› Volume overloaded
Given
before invasive procedures
with a high risk of bleeding
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25
27. Checked
every 1–2 hrs
High risk for hypoglycemia
Hyperglycemia exacerbate
intracranial hypertension
Insulin infusions - glucose levels
< 50 mg/dL
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27
28. CPP
= Mean arterial pressure – ICP
Correct hypovolemia before
vasopressors
› Norepinephrine preferred to
dopamine
› Hydrocortisone improve the
vasopressor response to
norepinephrine
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28
29. Exacerbates
ICP
Treat aggressively with cooling
blankets, fans, or other
noninvasive devices
NSAIDs and acetaminophen are
not recommended
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29
30. Urine
sodium
› low (10 mEq/L) in prerenal azotemia
and functional renal failure
(hepatorenal syndrome)
› high in acute tubular necrosis
Casts
and renal tubular cells in the
urine suggest ATN
IV fluid challenge (1L) to exclude
prerenal azotemia
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30