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Miscellaneous USMLE Step 3 > Section 7: Toxicology > Flashcards

Section 7: Toxicology Flashcards

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USMLE® Step 1 flashcards
1
Q

Antidote to acetaminophen toxicity

A

N-acetyl cysteine

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2
Q

Antidote to aspirin toxicity

A

Bicarbonate to alkalinize the urine

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3
Q

Antidote to carbon monoxide toxicity

A

100 percent oxygen, hyperbaric in some cases

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4
Q

Antidote to digoxin toxicity

A

Digoxin-binding antibodies

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5
Q

Antidot to ethylene glycol toxicity

A

Fomepizole or ethanol

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6
Q

Antidote to methanol toxicity

A

Fomepizole or ethanol

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7
Q

Antidote to methemoglobinemia

A

Methylene blue

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8
Q

Antidote for neuroleptic malignant syndrome

A

Bromocriptine

Dantrolene

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9
Q

Antidote to opiate toxicity

A

Naloxone

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10
Q

Antidote to organophosphate toxicity

A

Atropine

Pralidoxime

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11
Q

Antidote to TCA toxicty

A

Bicarbonate protects the heart

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12
Q

Antidote to phenothiazines

A

Diphenhydramine

Benztropine

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13
Q

Antidote to lead

A

EDTA (ethylenediaminetetraacetetic acid)

Dimercaprol (BAL)

Succimer

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14
Q

Antidote to warfarin

A

Fresh frozen plasma (FFP)

Vitamin K

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15
Q

Antidote to anticholinergics

A

Physostigmine

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16
Q

Antidote to arsenic, mercury

A

Dimercaprol (BAL)

Succimer

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17
Q

Antidote to beta-blockers

A

Glucagon

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18
Q

Antidote to atropine

A

Physostigmine

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19
Q

Antidote to cyanide

A

Sodium nitrite

Thiosulphate

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20
Q

Antidote to heparin

A

Protamine sulfate

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21
Q

Antidote to nitrites

A

Methylene blue

22
Q

Antidote to iron

A

Deferoxamine

23
Q

A 14-year-old boy is hospitalized for acute cholinergic toxicity after having been exposed to pesticides in a local orchard. Without treatment, what neuromuscular effects might he have experienced?

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 1992-1995). McGraw-Hill. Kindle Edition.

A

Muscle fasciculations, weakness, and paralysis.

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 1992-1995). McGraw-Hill. Kindle Edition.

24
Q

Hyperthermia.

List likely toxin/drug ingested

A
  • Amphetamines
  • Anticholinergics
  • ASA
  • Cocaine
  • Neuroleptics
  • Nicotine
  • PCP
  • SSRIs
  • Thyroid medication.

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2002-2003). McGraw-Hill. Kindle Edition.

25
Q

Hypothermia.

List likely toxin/drug ingested

A
  • Alcohol
  • Barbiturates
  • Carbon monoxide
  • Sedative-hypnotics.

Use the mneumonics CABS

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Location 2004). McGraw-Hill. Kindle Edition.

26
Q

Tachycardia

List likely toxin/drug ingested

A
  • Amphetamines
  • Anticholinergics
  • Cocaine
  • PCP
  • Thyroid medication
  • TCAs

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2005-2006). McGraw-Hill. Kindle Edition.

27
Q

Bradycardia

List likely toxin/drug ingested

A
  • β-blockers
  • Calcium channel blockers (CCBs)
  • Cholinergics
  • Clonidine
  • Digitalis
  • Opiates
  • Parasympathomimetics.

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2007-2008). McGraw-Hill. Kindle Edition.

28
Q

Tachypnea

List likely toxin/drug ingested

A
  • Organophosphates (eg, pesticides)
  • Salicylates.

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Location 2009). McGraw-Hill. Kindle Edition.

29
Q

Respiratory depression

List likely toxin/drug ingested

A
  • Barbiturates
  • Benzodiazepines
  • Opiates

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2010-2014). McGraw-Hill. Kindle Edition.

30
Q

** Hypertension**

List likely toxin/drug ingested

A
  • Amphetamines
  • Anticholinergics
  • Cocaine
  • PCP

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2010-2014). McGraw-Hill. Kindle Edition.

31
Q

Hypotension

List likely toxin/drug ingested

A
  • Alcohol
  • β-blockers
  • CCBs
  • Digitalis
  • Opiates
  • Organophosphates
  • Sedative-hypnotics
  • TCAs.

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2010-2014). McGraw-Hill. Kindle Edition.

32
Q

List the likely toxin or drug based on the breath odor

  • Violets
  • Pear
  • Bitter almonds
  • Garlic
  • Mothballs

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2017-2023). McGraw-Hill. Kindle Edition.

A
  • Violets: Turpentine
  • Pear: Chloral hydrate
  • Bitter almonds: Cyanide
  • Garlic: Arsenic, DMSO, organophosphates
  • Mothballs: Camphor, naphthalene

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2017-2023). McGraw-Hill. Kindle Edition.

33
Q

List the likely toxin or drug based on the pupilary constriction (miosis)

A
  • Clonidine
  • Opiates
  • Pontine bleed
  • Sedative-hypnotics

Use “COPS”

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2025-2033). McGraw-Hill. Kindle Edition.

34
Q

List the likely toxin or drug based on the pupilary dilatation (mydriasis)

A
  • Amphetamines
  • Anticholinergics
  • Cocaine

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2025-2033). McGraw-Hill. Kindle Edition.

35
Q

List the likely toxin or drug based on pulmonary edema

A
  • Cocaine
  • Ethylene glycol
  • Opiates
  • Organophosphates
  • Salicylates
  • Toxic inhalations (chlorine, nitric oxide, phosgene)

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2025-2033). McGraw-Hill. Kindle Edition.

36
Q
  • List the likely toxin or drug based on increased bowel movement
  • List the likely toxin or drug based on decreased bowel movement
A
  • Increased: Sympathomimetics, opiate withdrawal
  • Decreased: Anticholinergics, opiate toxicity

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2025-2033). McGraw-Hill. Kindle Edition.

37
Q

List the likely toxin or drug based on the following skin findings:

  • Needle tracks
  • Diaphoresis
  • Jaundice
  • Alopecia
  • Cyanosis

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2036-2045). McGraw-Hill. Kindle Edition.

A
  • Needle tracks: Opiates
  • Diaphoresis: Organophosphates, salicylates, sympathomimetics
  • Jaundice: Acetaminophen (after liver failure), mushroom poisoning
  • Alopecia: Arsenic, chemotherapeutic agents, thallium
  • Cyanosis: Drugs causing methemoglobinemia (eg, aniline dyes, “caine” anesthetics, chlorates, dapsone, nitrates/nitrites, sulfonamides)

Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2036-2045). McGraw-Hill. Kindle Edition.

38
Q

List the symptoms and signs of cholinergic toxicity

A
  • Diarrhea
  • Urination
  • Miosis
  • Bradycardia
  • Bronchospasm
  • Emesis
  • Lacrimation
  • Salivation

Usemenumonic: DUMBBELS

39
Q

Examples of cholinergics

A
  • Muscarine-containing mushrooms
  • Organophosphates
  • Pilocarpine
  • Pyridostigmine
40
Q

List the symptoms and signs of anticholinergic toxicity

A
  • Fever
  • Skin flushing
  • Dry mucous membrane
  • Psychosis
  • Mydriasis
  • Tachycardia
  • Urinary retention

“Hot as a hare, red as a beet, dry as a bone, mad as a hatter, blind as a bat”

41
Q

Examples of anticholinergics

A
  • Antihistamines
  • Antipsychotics
  • Atropine
  • Jimson weed
  • Scopalamine
  • TCAs
42
Q

List the symptoms and signs of opioid toxicity

A
  • Coma
  • Respiratory depression
  • Miosis
  • Bradycardia
  • Hypothermia
  • Diminished bowel sounds
43
Q

Examples of opioids

A
  • Heroin
  • Morphine
  • Oxycordone
44
Q

List the symptoms and signs of sedative-hypnotic toxicity

A
  • CNS depression
  • Respiratory depression
  • Coma
45
Q

Examples of sedative-hypnotics

A
  • Alcohol
  • Barbiturates
  • Benzodiazepines
46
Q

List the symptoms and signs of hallucinogenic toxicity

A
  • Disorientation
  • Panic
  • Seizures
  • HTN
  • Tachycardia
  • Tachypnea
47
Q

Examples of hallucinogenics

A
  • Amphetamines
  • Cocaine
  • PCP
48
Q

List the symptoms and signs of extrapyramidal medications toxicity

A
  • Tremors
  • Torticollis
  • Trismus
  • Rigidity
  • Oculogyric crisis
  • Opisthotonus
  • Dysphosia
  • Dysphagia
49
Q

Examples of extrapyramida medications

A
  • Haloperidol
  • Meteclopramide
  • Phenothiazines
50
Q

Carbon monoxide levels are monitored via co-oximetry. Management of carbon monoxide poisoning includes administering 100% oxygen. Hyperbaric oxygen therapy may be indicated. List the circumstances for which hyperbaric oxygen is indicated

A
  • Loss of consciousness
  • Age > 50 years
  • Metabolic acidosis
  • Carboxyhemoglobin levels > 25%
  • Cerebellar findings on neurologic exam

Miscellaneous USMLE Step 3 (11 decks)

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