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Poisoning Flashcards

0
Q

Give the antidote to the ff toxin/poison:

Black widow spider

A

Latrodectus antivenin

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1
Q

SUBSTANCES POORLY ADSORBED BY ACTIVATED CHARCOAL

A 
Alcohols
		Caustics: alkalis and acids
		Cyanide
		Heavy metals (e.g., lead)
		Hydrocarbons
		Iron
		Lithium
  • Charcoal is most likely to be effective when given within 1hr of ingestion
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2
Q

Give the antidote to the ff toxin/poison:

Botulinum toxin

A

Botulin antitoxin

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3
Q

Give the antidote to the ff toxin/poison:

Calcium channel antagonists

A

Glucagon and/or insulin and glucose

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4
Q

Give the antidote to the ff toxin/poison:

Dystonic reactions

A

Diphenhydramine and/or benztropine

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5
Q

Give the antidote to the ff toxin/poison:

Fluoride, calcium channel blockers

A

Calcium salts

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6
Q

Give the antidote to the ff toxin/poison:

Heparin

A

Protamine

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7
Q

Give the antidote to the ff toxin/poison:

Methotrexate, trimethoprim, pyrimethamine

A

Folinic acid

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8
Q

Give the antidote to the ff toxin/poison:

Rattlesnake envenomation

A

Crotab-specific Fab antibodies

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9
Q

Give the antidote to the ff toxin/poison:

Sodium channel blockade (tricyclic antidepressants, type 1 antiarrhythmics)

A

Sodium bicarbonate

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10
Q

What poison/toxin is associated with the following PE finding?

Odor of Bitter almonds

A

Cyanide

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11
Q

What poison/toxin is associated with the following PE finding?
Odor of acetone

A

Isopropyl alcohol, methanol, paraldehyde, salicylates

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12
Q

What poison/toxin is associated with the following PE finding?
Odor of Alcohol

A

Ethanol

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13
Q

What poison/toxin is associated with the following PE finding?
Odor of Wintergreen

A

Methyl salicylate

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14
Q

What poison/toxin is associated with the following PE finding?
Odor of Garlic

A

Arsenic, thallium, organophosphates, selenium

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15
Q

Toxin associated with the ff OCULAR SIGNS:

Miosis

A

Opioids (except propoxyphene, meperidine, and pentazocine), organophosphates and other cholinergics, clonidine, phenothiazines, sedative-hypnotics, olanzapine

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16
Q

Toxin associated with the ff OCULAR SIGNS:

Mydriasis

A

Atropine, cocaine, amphetamines, antihistamines, TCAs, carbamazepine, serotonin syndrome, PCP, LSD, post-anoxic encephalopathy

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17
Q

Toxin associated with the ff OCULAR SIGNS:

Nystagmus

A

Phenytoin, barbiturates, sedative-hypnotics, alcohols, carbamazepine, PCP, ketamine, dextromethorphan

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18
Q

Toxin associated with the ff OCULAR SIGNS:

Lacrimation

A

Organophosphates, irritant gas or vapors

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19
Q

Toxin associated with the ff OCULAR SIGNS:

Retinal hyperemia

A

Methanol

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20
Q

Cutaneous signs manifested with ingestion of the ff toxins:

Organophosphates, salicylates, cocaine and other sympathomimetics, serotonin syndrome, withdrawal syndromes

A

Diaphoresis

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21
Q

Cutaneous signs manifested with ingestion of the ff toxins:

Thallium, arsenic

A

Alopecia

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22
Q

Cutaneous signs manifested with ingestion of the ff toxins:

Boric acid, elemental mercury, cyanide, carbon monoxide, disulfuram, scombroid, anticholinergics

A

Erythema

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23
Q

Cutaneous signs manifested with ingestion of the ff toxins:

Methemoglobinemia (e.g., benzocaine, dapsone, nitrites, phenazopyridine), amiodarone, silver

A

Cyanosis (unresponsive to oxygen)

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24
Oral signs manifested with ingestion of the ff toxin: Organophosphates, salicylates, corrosives, ketamine, PCP, strychnine
Salivation
25
Oral signs manifested with ingestion of the ff toxin: Corrosives, oxalate-containing plants
Oral Burns
26
Oral signs manifested with ingestion of the ff toxin: Lead, mercury, arsenic, bismuth
Gum lines
27
GI symptom associated with ingestion of the ff toxin: Antimicrobials, arsenic, iron, boric acid, cholinergics, colchicine, withdrawal
Diarrhea
28
GI symptom associated with ingestion of the ff toxin: Arsenic, iron, caustics, NSAIDs, salicylates
Hematemesis
29
Cardiac signs associated with ingestion of the ff toxins: Sympathomimetics (e.g., amphetamines, cocaine), anticholinergics, antidepressants, theophylline, caffeine, antipsychotics, atropine, salicylates, cellular asphyxiants (cyanide, carbon monoxide, hydrogen sulfide), withdrawal
Tachycardia
30
Cardiac signs associated with ingestion of the ff toxins: β-Blockers, calcium channel blockers, digoxin, clonidine and other central α2 agonists, organophosphates, opioids, sedative-hypnotics
Bradycardia
31
Cardiac signs associated with ingestion of the ff toxins: Sympathomimetics (amphetamines, cocaine, LSD), anticholinergics, clonidine (early), monoamine oxidase inhibitors
Hypertension
32
Cardiac signs associated with ingestion of the ff toxins: β blockers, calcium channel blockers, cyclic antidepressants, iron, phenothiazines, barbiturates, clonidine, theophylline, opioids, arsenic, amatoxin mushrooms, cellular asphyxiants (cyanide, carbon monoxide, hydrogen sulfide), snake envenomation
Hypotension
33
CNS signs associated with ingestion of the ff toxins: Alcohol, anticonvulsants, benzodiazepines, barbiturates, lithium, dextromethorphan, carbon monoxide, inhalants
Ataxia
34
CNS signs associated with ingestion of the ff toxins: Opioids, sedative-hypnotics, anticonvulsants, cyclic antidepressants, antipsychotics, ethanol, anticholinergics, clonidine, GHB, alcohols, salicylates, barbiturates
Coma
35
CNS signs associated with ingestion of the ff toxins: Sympathomimetics, anticholinergics, antidepressants (especially TCAs, bupropion, venlafaxine), isoniazid, camphor, lindane, salicylates, lead, organophosphates, carbamazepine, tramadol, lithium, ginkgo seeds, water hemlock, withdrawal
Seizures
36
CNS signs associated with ingestion of the ff toxins: Sympathomimetics, anticholinergics, LSD, PCP, hallucinogens, lithium, dextromethorphan, steroids, withdrawal
Delirium/psychosis
37
CNS signs associated with ingestion of the ff toxins: Lead, arsenic, mercury, organophosphates
Peripheral neuropathy
38
SCREENING LABORATORY CLUES IN TOXICOLOGIC DIAGNOSIS ANION GAP METABOLIC ACIDOSIS (MNEMONIC = MUDPILES)
``` Methanol, metformin   Uremia*   Diabetic ketoacidosis   Paraldehyde, phenformin   Isoniazid, iron, massive ibuprofen   Ethylene glycol, ethanol   Lactic Acidosis (i.e. cyanide, carbon monoxide)   Salicylates ```
39
SCREENING LABORATORY CLUES IN TOXICOLOGIC DIAGNOSIS ELEVATED OSMOLAR GAP
Alcohols: ethanol, isopropyl, methanol, ethylene glycol
40
SCREENING LABORATORY CLUES IN TOXICOLOGIC DIAGNOSIS HYPOGLYCEMIA (MNEMONIC = HOBBIES)
``` Hypoglycemics, oral: sulfonylureas, meglitinides   Other: quinine, unripe ackee fruit   Beta Blockers   Insulin   Ethanol   Salicylates (late) ```
41
SCREENING LABORATORY CLUES IN TOXICOLOGIC DIAGNOSIS RADIOPAQUE SUBSTANCE ON KUB (MNEMONIC = CHIPPED)
``` Chloral hydrate, calcium carbonate   Heavy metals (lead, zinc, barium, arsenic, lithium, bismuth, as in Pepto-Bismol)   Iron   Phenothiazines   Play-Doh, potassium chloride   Enteric-coated pills   Dental amalgam ```
42
COMMON AGENTS CAUSING SEIZURES (MNEMONIC = CAPS)
Camphor, carbamazepine, carbon monoxide, cocaine, cyanide Aminophylline, Amphetamine, anticholinergics, antidepressants (cyclic) Pb (lead) [also lithium], pesticide (organophosphate), phencyclidine, phenol, phenothiazines, propoxyphene Salicylates, strychnine
43
Triad of altered mental status, autonomic instability, and neuromuscular hyperactivity (hyperreflexia, tremors, clonus in the lower extremities more than the upper extremities)
serotonin syndrome
44
Two antidotes are useful in treating cholinesterase inhibitor poisoning (organophosphates and carbamates)
atropine and pralidoxime - DUMBBELS - Clinical manifestations of organophosphate and carbamate toxicity relate to the accumulation of acetylcholine at peripheral nicotinic and muscarinic synapses and in the CNS
46
Give the antidote: | Acetaminophen/Paracetamol
N-Acetylcysteine PO | *Most effective if given within 8 hr of ingestion
47
Give the antidote: | Anticholinergics ie ipatropium
Physostigmine IV/IM Note: Do not use if conduction delays on ECG may cause Bradycardia, asystole, seizures, bronchospasm, vomiting, headache
48
Give the antidote: | Benzodiazepines
Flumazenil IV
49
Give the antidote: | β-Blockers
Glucagon IV
50
Give the antidote: | Calcium channel blockers
``` Insulin IV (Follow serum potassium and glucose closely) Calcium salts IV ```
51
Give the antidote: | Carbon monoxide
Oxygen inhalational
52
Give the antidote: | Cyanide
Amyl nitrate inhalational Sodium nitrate IV Sodium thoisulfate IV Hydoxocobalamin IV (adults)
53
Give the antidote: | Digitalis
Digoxin-specific Fab antibodies (Digibind; Digifab) IV
54
Give the antidote: Ethylene glycol Methanol
Fomepizole IV Infuse slowly over 30 min; increase doses to q4h if being dialyzed If Fomepizole is not available, treat with an ethanol infusion
55
Give the antidote: | Iron
Deferoxamine IV
56
Give the antidote: | Isoniazid (INH)
Pyridoxine IV
57
Give the antidote: | Lead and other heavy metals (e.g., arsenic, inorganic mercury)
1. BAL (dimercaprol) deep IM - *Local injection site pain and sterile abscess, nausea, vomiting, fever, salivation, nephrotoxicity - Caution: Prepared in peanut oil; contraindicated in patients with peanut allergy 2. Calcium disodium EDTA IV 3. Dimercaptosuccinic acid (succimer, DMSA, Chemet) PO
58
Give the antidote: | Methemoglobinemia
Methylene blue, 1% solution IV
59
Give the antidote: | Opioids
Naloxone IV
60
Give the antidote: | Organophosphates
1. Atropine IV/ET - Tachycardia, dry mouth, blurred vision, urinary retention 2. Pralidoxime (2PAM) IV - Nausea, dizziness, headache, tachycardia, muscle rigidity, bronchospasm (rapid administration)
61
Give the antidote: | Salicylates
Sodium bicarbonate IV * Follow potassium closely and replete as necessary * Avoid severe alkalosis (pH >7.55)
62
Give the antidote: | Sulfonylureas
Octreotide IV/SC
63
Give the antidote: | Tricyclic antidepressants
Sodium bicarbonate *Indications: QRS widening (>100 ms), hemodynamic instability Avoid severe alkalosis (pH >7.55) Follow potassium

Core Pediatrics (20 decks)

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