Poisonings

Question 0

Anticholinergic agents (atropine)

Answer 0

Mad as a hatter dry as a bone red as a beet blind as a bat hot as a hare
Drowsiness, halluc., seizure, flushed, fixed dilated pupils (mydriasis), dry mouth, n/v
Physostigmine

Question 1

APAP

Answer 1

N/V, anorexia, jaundice, abdominal pain, liver failure
LFTs, prothrombin time, serum apap
N-acetylcysteine

Question 2

Iron (as a toxin)

Answer 2

N/v, diarrhea, GI bleeding, acute liver failure, seizure, coma
Serum iron level, metabolic acidosis, radio opaque bodies on XR
Deferoxamine chelation

Question 3

Organophosphate poisoning (ACHe inhibitors)

Answer 3

Salivation, lacrimation, urination, defecation, muscle fasciculations, confusion, bradycardia, reactive meiosis
Atropine and pralidoxime

Question 4

Salicylates

Answer 4

Tachypnea, metabolic acidosis + respiratory alkalosis, tinnitus, seizure

Question 6

Lead poisoning

Answer 6

Irritability, anorexia, developmental delay, abdominal pain, acute encephalopathy, lead lines on gingiva
EDTA, oral succimer, dimercaprol BAL when Pb > 45ug/dL
Basophilic stippling - hypochromic microcytic anemia
Confirmed by venous lead levels after capillary lead level screens