Poisoning Overdose

Question 1

What is seen on blood tests and paracetamol overdose?

Answer 1

Raised liver enzymes, prolonged pretty sound in time

Question 2

What is seen on ABG in paracetamol overdose?

Answer 2

Lactic acidosis

Question 3

What is the important complication of paracetamol overdose?

Answer 3

Hepatic necrosis

Question 4

What is seen on ABG in aspirin salicylate overdose?

Answer 4

Initially metabolic acidosis then respiratory alkalosis

Question 5

What symptom of overdose is specific to aspirin salicylate overdose?

Answer 5

Deafness tinnitus

Question 6

Overdose from what drug can cause yellow vision?

Answer 6

Digoxin

Question 7

Poisoning from what can cause confusion, a tight band headache, abnormally pink mucosa and affects members of the same household?

Answer 7

Carbon monoxide

Question 8

What effect does opioid overdose have on our RR, BP and HR?

Answer 8

All low

Question 9

What is the management of opioid overdose?

Answer 9

IV naloxone 
(may need multiple doses)

Question 10

What is the management of carbon monoxide poisoning?

Answer 10

100% hyperbaric oxygen

Question 11

What is the gold standard investigation for carbon monoxide poisoning?

Answer 11

Carboxyhemoglobin

blood test direct spectrophotometric measurement of HbCO

Question 12

What investigation is done for antifreeze ethylene glycol ingestion?

Answer 12

Serum osmolality

Question 13

What is the management of beta-blocker overdose?

Answer 13

Atropine if bradycardic, otherwise glucagon

Question 14

What is the management of iron overdose?

Answer 14

Deferoxamine

Question 15

What is the management of benzodiazepine overdose?

Answer 15

Flumazenil (only if severe)

Question 16

What is the management of heparin overdose?

Answer 16

Protamine sulfate

Question 17

What is the management of antifreeze ethylene glycol ingestion?

Answer 17

Fomepizole

ethanol traditional Tx

Question 18

What is the management of tricyclic overdose?

Answer 18

IV fluids + IV bicarbonate

Question 19

When can activated charcoal be given in the management of overdose?

Answer 19

If within 1hr of ingestion

Question 20

What is the management of the digoxin overdose?

Answer 20

IVpotassium, IV digoxin-specific antibody fragmentsDigibind

Question 21

What is the last line management of hepatic necrosis due to paracetamol overdose?

Answer 21

Liver transplant

Question 22

What is the presentation of anticholinergic toxidrome?

Answer 22

Mydriasis, warm dry skin, urinary retention, agitation, >HR, blurred vision

Question 23

What investigations should be done for paracetamol overdose?

Answer 23

Paracetamol level, FBC, LFTs, U+E, blood glucose, CK, ABG, ECG, clotting screen

Question 24

When are paracetamol levels measured in paracetamol overdose?

Answer 24

Paracetamol level (at 4hr post ingestion

Question 25

Is the management of paracetamol overdose?

Answer 25

NAC n-acetylcysteine | use graph curve normogram

Question 26

Admission is indicated for all deliberate self poisoning - true or false

Answer 26

Yes

Question 27

What is the definition of a staggered overdose?

Answer 27

If all the tablets were not taken within 1 hour

Question 28

In paracetamol overdose, treatment is indicated if on or above the treatment line – true or false

Answer 28

True | Unless staggered overdose always give NAC

Question 29

What is the management of aspirin overdose?

Answer 29

IV bicarbonate, haemodialysis

Question 30

What is the management of warfarin overdose?

Answer 30

Vitamin K, prothrombin complex concentrate

Question 31

What is the management of methanol poisoning overdose?

Answer 31

Fomepizole or ethanol

Question 32

What is the management of cyanide poisoning?

Answer 32

Hydroxocobalamin