POISON: UW + mehl organoph/marijuana 03-28 (2)

Question 1

Organophosphate poisoning. common exposure?

Answer 1

Pesticides: farm/fiel workers, pediatric ingestion, suicide attempt

Nerve agents: multiple patients with similar symptoms; NERVE GAS; chemical weapon

Question 2

Organophosphate poisoning. Nerve gas characteristic?

Answer 2

Gas colorless, tasteless, often has slight FRUITY ODOR

Question 3

Organophosphate poisoning. manifestation.
MUSCARINIC abbreviation?

Answer 3

DUMBELS
Diarrhea
Urination
Miosis
Bronchospasm, bronchorrhea, brady
Emesis
Lacrimation
Salivation

Question 4

Organophosphate poisoning. manifestation. NICOTINIC manifest?

Answer 4

Muscle weakness, paralysis, fasciculations

Question 5

Organophosphate poisoning. Management. First?

Answer 5

ABC

Question 6

Organophosphate poisoning. Management. skin/clothes?

Answer 6

REMOVE clothes - may be contaminated

Irrigate skin - skin can absorb

Question 7

Organophosphate poisoning. Management. drugs?

Answer 7

ATROPINE –> just then pralidoxime

Question 8

Organophosphate poisoning. Management. Atropine - what symptoms?

Answer 8

Reverse muscarinic (DUMBELS)

Question 9

Organophosphate poisoning. Management. Pralidoxime - what symptoms?

Answer 9

Reverse both, muscarinic and nicotinic

Question 10

Organophosphate poisoning. Confirmatory test?

Answer 10

RBC acetylcholine esterase activity

Question 11

Agitation + vomiting + watery eyes + pupil 1 mm + incr. bowel sounds –>?

Answer 11

Organophosphate poisoning.

Question 12

Marijuana intox. CP?

Answer 12

tachycardia, tachypnea, dry mouth, conjunctival injection, increased appetite

Question 13

Marijuana intox. other effects?

Answer 13

Slow reaction time

Impaired coordination, attention, concentration, short-term memory

Question 14

Marijuana intox. Impaired cognition, judgment, coordination can last much longer than acute euphoric effect –> this can lead to automobile accidents

Answer 14

.

Question 15

Marijuana intox. management?

Answer 15

supportive

Question 16

Mehl. organophosphate.

Vignette will either be backpacker in his/her 20s picking fruit on a farm, or someone who drank fluid in a suicide attempt.

NBME Q asks how toxicity could best be prevented -> answer =?

Answer 16

wearing gloves,” where “wearing mask” is wrong answer. So acquisition occurs mostly through skin.

Question 17

Mehl. organophosphate - does what?

Answer 17

The phosphate group binds to acetylcholinesterase, inhibiting it.

Question 18

Mehl. organophosphate. Tx? 2 drugs

Answer 18

USMLE wants atropine first, followed by pralidoxime as Tx (discussed below).

Question 19

DRUG ABUSE part yra prie psycho.

Answer 19

.