Week 104 - Self-harm

Question 1

What is the presentation of benzodiazepine overdose?

Answer 1

• Drowsiness / coma

* Ataxia

Question 2

Give some examples of benzodiazepines.

Answer 2

Diazepam, Midalozam, Carbamazepine, chlordiazepoxide.

Question 3

What is the treatment for benzodiazepine overdose?

Answer 3

• Activated charcoal (within 1hr)

* Flumazenil

Question 4

What is the presentation of Tricyclic antidepressant overdose?

Answer 4

• Large pupils
• Coma
• Hypothermia
• Arrhythmias and hypotension

Question 5

Give some examples of Tricyclic antidepressants.

Answer 5

Amitryptiline, Butryptiline, Ritalin

Question 6

What is the treatment for tricyclic antidepressant overdose?

Answer 6

No antidote.

Question 7

What is the presentation of paracetamol overdose?

Answer 7

• > 24hrs Anorexia and vomitting

* 3-5 days Abdo pain, abdo bruising, hypo/hyperglycaemia.

Question 8

What is the treatment for paracetamol overdose?

Answer 8

• Activated charcoal (if within 1 hr)

* N-Acetyl Cysteine

Question 9

What is the presentation of opioid overdose?

Answer 9

• Small pupils
• Bradypnoea
• Coma

Question 10

Give some examples of opioids.

Answer 10

Morphine, Codeine, Tramadol

Question 11

What is the treatment for opioid overdose?

Answer 11

Naloxene

Question 12

What is the presentation of Beta-blocker overdose?

Answer 12

Bradycardia

Question 13

What is the treatment for beta-blocker overdose?

Answer 13

Glucagon

Question 14

Week 104 - Self-harm: What is the incidence of suicide in the UK?

Answer 14

15.5/100000 - males

6/100000 - females

Question 15

Week 104 - Self-harm: What is the ratio of suicide between males and females in the UK?

Answer 15

3:1

Question 16

Week 104 - Self-harm: What are the most common forms of suicide in males?

Answer 16

Hanging, oversode, carbon monoxide poisoning.

Question 17

Week 104 - Self-harm: What is the most common form of suicide in females?

Answer 17

Overdose.

Question 18

Week 104 - Self-harm: What are the four theories of social suicide?

Answer 18

• Altruistic
• Fatalistic
• Egotistic
• Anomie

Question 19

Week 104 - Self-harm: What is the altruistic theory of suicide?

Answer 19

Sacrifice for the sake of the group.

Question 20

Week 104 - Self-harm: What is the fatalistic theory of suicide?

Answer 20

Communality control, mass cult suicide.

Question 21

Week 104 - Self-harm: What is the egotistic theory of suicide?

Answer 21

Loss of integration within the community.

Question 22

Week 104 - Self-harm: What is the anomie theory of suicide?

Answer 22

Community in upheaval.

Question 23

Week 104 - Self-harm: What is the rate of self-harm in the UK?

Answer 23

400/100000

Question 24

Week 104 - Self-harm: Which gender has a higher rate of self-harm?

Answer 24

Females

Question 25

Week 104 - Self-harm: Which age-groups are the peak for self harm? (Male/Female)

Answer 25

Female 15-24 | Male 25-34

Question 26

Week 104 - Self-harm: Forced emesis is no longer recommended, what substance is used and in which situation is it absolutely contra-indicated?

Answer 26

* Ipecacuahana syrup. | * Absolutely contraindicated for the ingestion of corrosives, volatile hydrocarbons or rapidly acting proconvulsants.

Question 27

Week 104 - Self-harm: A patient presents following overdose with the following symptoms; Coma, hypertonia, hyper-reflexia, myoclonus, tachycardia, Mydriasis. What is the likely poison?

Answer 27

Tri-cyclic anti-depressants.

Question 28

Week 104 - Self-harm: A patient presents with Coma, Miosis (constricted pupils) and a reduced respiratory rate. What is the likely poison?

Answer 28

Opiates

Question 29

Week 104 - Self-harm: A patient presents with nausea, vomitting, tinnitus, deafness, sweating, hyperventilation, vasodilation and metabolic acidosis. What is the likely poison?

Answer 29

Salicylates (Aspirin)

Question 30

Week 104 - Self-harm: A patient presents with coma, hypotonia, hyporeflexia, hypotension and an absent or extensor plantar response. What is the likely poison?

Answer 30

Benzodiazepines. | Barbiturates.

Question 31

Week 104 - Self-harm: A patient presents with hyperthermia, tachycardia, delerium, agitation and mydriasis. What is the likely poison?

Answer 31

MDMA.

Question 32

Week 104 - Self-harm: Plasma levels for which poison should be measured in all unconscious poisoned patients, why?

Answer 32

* Paracetamol * Symptoms are not apparent, multiple drug ingestion is common, it is important to diagnose paracetamol overdose early when treatment is effective.

Question 33

Week 104 - Self-harm: What is the antidote for paracetamol?

Answer 33

N-acetyl cysteine.

Question 34

Week 104 - Self-harm: What is the antidote for Benzodiazepines?

Answer 34

Flumazenil.

Question 35

Week 104 - Self-harm: What is the antidote for Opiates?

Answer 35

Naloxone.

Question 36

Week 104 - Self-harm: What is the antidote for B-blockers?

Answer 36

Glucagon.

Question 37

Week 104 - Self-harm: What is the antidote for iron?

Answer 37

Desferrioxamine.