NCAD CE - Household Poisonings

Question 1

T/F: The calcium oxalate crystal contained within the Deffenbachia plant is poisonous.

Answer 1

False. The crystal itself causes microlacerations to the soft-tissue of the oropharynx and laryngopharynx. That is why the patient exhibits swelling, difficulty speaking, numbness, and drooling.

Question 2

What are the main S/S of aloe vera ingestion?

A. Coma
B. Seizure
C. N/V/D
D. Hypoglycemia

Answer 2

C. N/V/D

Question 3

The toxin contained within poinsettia plants is ______.

A. latex
B. cyanide
C. calcium oxalate
D. sodium hypochlorite

Answer 3

A. latex

Pt’s with a latex allergy may present with S/S of allergy or anaphylaxis. Treat according to allergic reaction/anaphylaxis protocols.

Question 4

A study in the Am. Journal of EM regarding 22,793 poinsettia ingestions recorded ____ fatalities.

Answer 4

zero

Question 5

Explain the mechanism of action of the toxin of the foxglove plant.

Answer 5

It is digitalis, and blocks the normal cellular Na-K ATPase. This, in turn, prevents increase of the [Na+]o. In doing so, the Na+-Ca2+ exchange pump ceases to work, and Calcium remains high intracellularly, strengthening cardiac contractility.

Question 6

Common S/S of foxglove toxicity

Answer 6

• N/V/D
• Heart block
• Bradycardia
• Tachycardia (compensatory mechanism)
• Deep STD (‘Dali’s mustache’) Hallmark of ECG

Question 7

Nightshade (“Bella Donna”) contains what toxin?

A. digitalis
B. calcium oxalate crystals
C. cyanide
D. atropine

Answer 7

D. atropine

Question 8

Atropine is a(n) _____ compound.

A. acetylcholinesterase inhibitor
B. anti-cholinergic
C. cardiac glycoside
D. electron transport chain inhibitor

Answer 8

B. anti-cholinergic

Question 9

Explain the anticholinergic toxidrome mnemonic.

Answer 9

Hot as a hare: increased body temperature
Blind as a bat: mydriasis (dilated pupils)
Dry as a bone: dry mouth, dry eyes, decreased sweat
Red as a beet: flushed face
Mad as a hatter: delirium

Question 10

Explain why anticholinergic toxicity prevents sweating.

Answer 10

Eccrine sweat glands are activated by ACh. Anticholinergic drugs such as atropine prevent their activation, thereby stopping a patient from sweating.