Environmental and Toxicology

Question 1

Why should Beta Blockers not be used in cocaine, amphetamine, or other alpha adrenergic stimulant overdose?

Answer 1

Leads to Alpha adrenergic system being unopposed.

This leads to increased hypertension and reduces coronary blood flow, let ventricular function, cardiac output, and tissue perfusion

Question 2

Appropriate drugs to administer during a hypertensive crisis caused by stimulant abuse

Answer 2

Vasodilators (nitroglycerine)
Diuretics
alpha blockers

Question 3

Digoxin EKG findings

Answer 3

ST depression
T wave inversion
PR interval prolongation (toxicity)

Question 4

Salicylate toxicity (Aspirin) presentation

Answer 4

Initial= Hyperventilation
(Respiratory Alkalosis)

Mild= headache, vertigo, tinnitus, confusion, sweating
Severe= seizure, agitated, restless, base/electrolyte imbalance

Question 5

Heatstroke present with what elevated enzymes

Answer 5

CPK or CK, SGOT, SGPT, and LDH

Question 6

When giving blood transfusion, what reaction can happen within minutes?

Answer 6

Acute hemolytic reaction

shortest onset

rapid destruction of donor red blood cells

Question 7

Types of transfusion reactions

Answer 7

Acute hemolytic
Delayed hemolytic (5-10 days)
Anaphylactic (30 minutes)
Febrile nonhemolytic (30-90mins) most common
Circulatory overload (think CHF- not moving fluid)

Question 8

TCA overdose EKG presentation

Answer 8

prolonged QT interval
QRS widening
RBB
first degree heart block

Question 9

Digoxin toxicity medication/treatment

Answer 9

Digibind

Question 10

Digoxin toxicity presentation

Answer 10

fatigue, nausea, vomiting, visual disturbance (yellow, green halo around object), dizziness, confusion

Question 11

Osborn waves/J waves are associated with

Answer 11

Hypothermia (below 86 F/ 30 C)

Question 12

Treatment for Ethylene glycol

Answer 12

Fomepizol

Prevents formation of toxic metabolites

IV ethanol( as well)

Question 13

Digitalis toxicity can be exacerbated by?

Answer 13

Beta Blockers

toxicity can lead to bradycardia/ tachycardia depending on amount consumed

Question 14

Antidote for Benzodiazepine overdose

Answer 14

Romazicon (really known as Flumazenil)

competitive benzodiazepine receptor antagonist

Question 15

Iron poisoning treatment?

Answer 15

Deferoxamine

Question 16

Noted with improvement in treating iron ingestion

Answer 16

Urine output appears pink in color/ “vin-rose urine

Question 17

Romazicon can cause what?

Answer 17

SEIZURES, adverse cardiac effects, and death

Typically not used due to cons out weighting pros

Question 18

Treatment for Heparin overdose

Answer 18

Protamine Sulfate

Question 19

Rewarming techniques to avoid the dangers of the afterdrop phenomenon when managing a hypothermic patient

Answer 19

Active internal

Question 20

Pralidoxime chloride is administered for

Answer 20

organophosphate