Poisoning

Question 1

C/f of clostridium myonecrosis

Answer 1

Gas gangrene characterized by crepitus

Question 2

SpO2 85% room air but ABG paO2:N. Diagnosis?

Answer 2

Methemoglobinemia

Question 3

How does patient have methemoglobinemia?

Answer 3

Dapsone
Nitrites
Topical anesthetics

Question 4

Methylene blue is C/I for…..

Answer 4

G6PD

High dose vit C given instead

Question 5

Mgt of lead poisoning

Answer 5

Mild-moderate: oral succimer

Severe: Ca-EDTA

Question 6

Arsenic poisoning vs lead poisoning

Answer 6

Both have peripheral neuropathy and glove stocking distribution
Arsenic: skin changes

Lead: microcytic anemia with basophilic stippling

Question 7

TCA action on heart (4)

Answer 7

1. Inhibit fast sodium channels in His Purkinje system and myocardium
2. Decrease conductive velocity
3. Increase repolarization
4. Prolong absolute refractory period

Question 8

How does TCA prolong absolute refractory period? (3)

Answer 8

Decrease Bp
QRS prolongation
Ventricular arrythmias -v tach,V fib

Question 9

Effect of alkalinzation of serum for TCA overdose

Answer 9

Increase ph and extracellular sodium

Decrease the avidity for sodium channels

Question 10

Burning rubber or plastic indoors can cause……..

Answer 10

Cyanide poisoning

If burning wood: CO poisoning

Question 11

Rx for cyanide toxicity (2)

Answer 11

Hydroxocobalamin

Sodium thiosulfate

Question 12

Hypothermia can be a sign of………

Answer 12

Opioid intoxication

Question 13

Iron toxicity within 2-3 weeks can cause…..

Answer 13

Pyloric stenosis

Question 14

Isopropyl alcohol poisoning features (3)

Answer 14

1. Absent ciliary reflex
2. Disconjugate gaze
3. CNS depression

Question 15

Severe hypothermia is …..Fahrenheit

Mild is……

Answer 15

<82 F (27 C)

90-95F (32-35C)