End of Toxicology

Question 1

Clinical features of aspirin overdose?

Answer 1

Nausea, vomiting, tinnitus, hyperpyrexia

Question 2

Lab abnormalities of aspirin overdose?

Answer 2

Respiratory alkalosis initially then metabolic acidosis

Question 3

What is the nomogram with aspirin overdose?

Answer 3

Done nomogram

Question 4

What can you give to help aspirin patient?

Answer 4

Alkalinize the urine

Question 5

What is the iatrogenic form of cyanide?

Answer 5

Metabolite of sodium nitroprusside, so caution it may accumulate in the elderly

Question 6

What does nitroprusside do?

Answer 6

Decreases preload and after load (NTG only does preload)

Question 7

What does cyanide do?

Answer 7

Inhibits cytochrome oxidase system, you convert to anaerobic metabolism as a result.

Question 8

What is the result of cyanide anaerobic metabolism?

Answer 8

accumulation of lactic acid and decreased oxygen metabolism

Question 9

What are the symptoms of cyanide poisioning?

Answer 9

• Skin early cherry red then late cyanotic
• Bitter almonds
• Cyanide levels NOT useful

Question 10

What is in the Lilly Cyanide Antidote Kit?

Answer 10

• Amyl Nitrate pearls
• Sodium nitrate
• Sodium thiosulfide

Question 11

Why give nitrate in cyanide OD?

Answer 11

Met Hemoglobin production and cyanide can not bind.

Question 12

Why give sodium thiosulfate?

Answer 12

Sulfur donor binds to cyanide

Question 13

How does amphetamine overdose look?

Answer 13

HTN, seizures, tachycardia

Question 14

Digoxin causes what symptoms?

Answer 14

N/V, yellow/green haze, halo vision

Question 15

What do you give with digoxin overdose?

Answer 15

Digibind, antibodies bind active drug rendering it inactive

Question 16

Which CCB are negative inotropes?

Answer 16

Verapamil & Diltiazem

Question 17

Antidote for CCB?

Answer 17

Glucagon- positive inotrope and chronotrope

Question 18

What does iron do to the body?

Answer 18

Direct corrosive effects of the mucosa and cellular dysfunction and acidosis

(local and systemic)

Question 19

4 stages of Iron OD?

Answer 19

• Immediate: corrosive, emesis, bloody diarrhea
• Latency: 12 hours improvement
• Relapse: coma, shock, seizures, death
• Late: scarring, strictures, obstructions

Question 20

Treatment for iron od? How do you know if its worked

Answer 20

Desferozamine, follow the urine. it should go from orange to pink to normal color

Question 21

What are the fat soluble vitamins?

Answer 21

ADEK

Question 22

What is a nephrocap?

Answer 22

More water soluble vitamins in the multivitamin

Question 23

What does brown recluse venom do? Treatment?

Answer 23

similar to NE, vasoconstrictor. Give dapsone (abx)

Extravagate

Question 24

What does brown recluse bite look like?

Answer 24

Community acquired MRSA, give PO bacterium for it

Question 25

Which snake is most venomous?

Answer 25

Pit vipers, they have triangular heads

Question 26

Why are elapidae not as venomous?

Answer 26

They strangle their prey, more round head

Question 27

Keep extremity where?

Answer 27

Below the level of heart

Question 28

Do you use tourniquet with snake bite?

Answer 28

no, want blood flow to prevent gangrene

Question 29

When do you give tetanus immunoglobulin?

Answer 29

After stepping on nail, they will die before they develop antibodies to the normal vaccine

Question 30

What do we usually give snake bite victims?

Answer 30

Polyvalent antivenoms