Intoxications and Deficiencies Flashcards
Pyridoxine B6 deficiency
Can be caused by taking isoniazid. Get numb/tingling legs, less propriocep and vib, absent DTRS
OP poisoning
Phosphorus binds to acetylcholinesterase, you get a cholinergic overload. Get sweaty and pinpoint pupils (parasymp?), give atropine and parlidoximine (muscarinic and nicotnic antag)
Avoid contact!
Also Soman/Sarin do the same think
Muscle weak, dyspnea, miosis, h/a, burred vision, maybe long term issues
PCP ingestion
Garrulous, widely dilated pupils, could also look like cocaine…but nystagmus
Pseudotumor cerebri
Vitamin A excess => this, with normal MRi or small /slit ventricles, dx w/ LP
shunt/optive nerve sheath fenestration to preserve vision!
Carbon monoxide exposure
Headache and nausea, and then getting forgetful, in the winter
Globus pallidus necrosis weeks after? Yikes!
Thiamine deficiency
Alcoholic who is confused/unsteady w/ nystagmus in all directions and abducens weakeness
Give thaiamine before glucose if any combo of weird eye movements!
Vitamin E deficiency
Post colectomy, if you get spinal and cerebellar signs (ataxic gait, no standing w/ feet together, less ankle refle, less proprio)
Lead poisoning
Extensor muscle weakness, autonomic sx (abd pain, constipation)
Wrist drop/foot drop, milk microcytic anemia!
Phenytoin excess
Cerebellar signs aka unsteadiness, slurred speech, horizontal nystagmus, limb dysmetria!
b12 deficiency
subacute combined degeneration! paresthesias in hands/feet, atropic gastritis, hyporeflex, babinski sign, less vibration and position sense! Shiny tongue!
Manganese intoxication
Too much TPN? Then you get mang in the basal gang increased signal on T1, see in cirrhosis as well. Cogwheeling, tremors, stiffness (like parkinsons)
Hyponatremia
Most common lyte abnomrality, seizure and unreponsiveness
Arsenic poisoning
Total body rash, n/v, tinnitus, ova patches on neck, increaased pigmentation in axilla, decreased sensation to pinprick over the feet, gray lines on nails
Delirium tremens
Alcoholism with fever/flu, agitation, disoreientation, total body tremmor, rhabdo
Ethylene glycol
Sweet smelling, drug of abuse/assaultCan get periph/cranial nerve dysfn (like locked in)
Low bicarb, increased ion gap, crystals in urine!
