OnlineMedEd: Surgery: Trauma - "Toxic Ingestion"

Question 1

The two alcohols with anion gap are ___________.

Answer 1

ethylene glycol and methanol

Question 2

How can osmolar gap help guide you to the diagnosis of toxic alcohol ingestion?

Answer 2

Alcohols will raise the measured osmolarity but not affect the factors that normally go into the osmolarity formula: Na, BUN, and glucose.

Osmolar gap

Question 3

For alcohol ingestion, the treatment is one of two things: _______________.

Answer 3

supportive (for no anion gap: ethanol or isopropyl) or fomepizole (for anion gap: ethylene glycol or methanol)

Question 4

Isopropyl alcohol is in ______________.

Answer 4

rubbing alcohol

Question 5

If you can’t diagnose ethylene glycol ingestion based on history, then you can ______________.

Answer 5

shine a wood’s lamp on their urine (which will cause it to glow)

Question 6

___________ causes blindness.

Answer 6

Methanol (from moonshine)

Question 7

When do you draw acetaminophen levels in the Rumack nomogram?

Answer 7

4 hours and 16 hours

Question 8

What is the treatment for acetaminophen toxicity?

Answer 8

N-acetylcysteine

Question 9

Review the signs and symptoms of salicylate toxicity?

Answer 9

• Tinnitus
• Respiratory alkalosis
• Anion gap metabolic acidosis
• Hyperpyrexia
• Obtunded
• Nausea and vomiting

Question 10

Aspirin toxicity is treatable with ____________.

Answer 10

alkalinization of the urine and diuresis

Question 11

To diagnose carbon monoxide poisoning, draw a _____________.

Answer 11

carboxy hemoglobin

Question 12

Carbon monoxide toxicity is treatable with ______________.

Answer 12

100% oxygen

Question 13

Which medication can cause cyanide toxicity?

Answer 13

Sodium nitroprusside

Question 14

How do you treat cyanide toxicity?

Answer 14

Thiosulfate

Question 15

Describe the diagnosis of cyanide toxicity.

Answer 15

• History: smoke inhalation or nitroprusside
• PE: cherry-red tongue or skin
• Lab: lactic acidosis

Question 16

Review the mnemonic for organophosphate toxicity.

Answer 16

BB SLUDGE
•Bronchospasm
• Bradycardia
•Sialorrhea 
•Lacrimation
•Urination
•Diarrhea
•GI upset
•Eye constriction (miosis) / Emesis

Question 17

The two treatments for organophosphate toxicity are _____________.

Answer 17

atropine and pralidoxime