Plants

Question 1

What are the toxalbumins in castor bean and jequiry bean plant and what is the treatment

Answer 1

Ricin in castor, Abrin in jequiry

Gastric decontam, consider WBI, replace GI losses with ivf, lyte replacement

Question 2

What is major presenting feature in castor bean ad jequirity bean ingestion

Answer 2

Fever

Also delayed GI symptoms, liver and kidney failure, seizure, coma, death

Question 3

Clinical presentation of water hemlock ingestion

Answer 3

Seizures refractory to treatment
Delirium, agitation, mydriasis, hypersalivation
Rapid onset after ingestion
Tachycardia, dysrhythmias, hyper or hypotension

Question 4

Treatment of water hemlock ingestion

Answer 4

Aggressive gastric Decontamination

Treat status epilepticus

Question 5

Presentation and treatment of azalea ingestion

Answer 5

Bradycardia and progressive paralysis
Av blocks
Salivation
Treat w GI Decon, atropine for Brady, pace the av blocks

Question 6

Treatment for person presentation with headache, ataxia altered mental status, cardiovascular instability after ingesting an insanely large quantity of pear seeds

Answer 6

Hydroxycobalamin or cyanide antidote kit

Question 7

How does poison hemlock present

Answer 7

Similar to nicotine toxicity. Hypertension, tachycardia, seizures, salivation, bronchorrhea and salivation early. Late weakness, resp muscle paralysis, bradycardia and death

Question 8

Presentation of Jim son weed ingestion and treatment

Answer 8

Anticholinergic toxidrome (atropine, scopolamine, hyoscamine)
Treat with iv fluids, cooling, gastric decontam, benzos, physostigmine if benzos not effective (can cause av block, asystole)

Question 9

Management of mushroom ingestion

Answer 9

Observe for early onset symptoms 4-6 hours
If no early symptoms have pt return for delayed symptoms
Monitor glucose
Atropine if symptomatic Brady or bronchorrhea
Benzos to control agitation
Pyridoxine for delayed onset seizures