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Miscellaneous USMLE Step 3 > Section 7: Toxicology > Flashcards

Section 7: Toxicology 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
**Hypothermia**. List likely toxin/drug ingested
* 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
**Tachycardia** List likely toxin/drug ingested
* 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
**Bradycardia** List likely toxin/drug ingested
* 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
**Tachypnea** List likely toxin/drug ingested
* 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
**Respiratory depression** List likely toxin/drug ingested
* 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
** Hypertension** List likely toxin/drug ingested
* 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
Hypotension List likely toxin/drug ingested
* 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
**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.
* 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
List the likely toxin or drug based on the pupilary constriction (miosis)
* 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
List the likely toxin or drug based on the pupilary dilatation (mydriasis)
* 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
List the likely toxin or drug based on pulmonary edema
* 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
* List the likely toxin or drug based on increased bowel movement * List the likely toxin or drug based on decreased bowel movement
* 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
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.
* 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
List the symptoms and signs of cholinergic toxicity
* Diarrhea * Urination * Miosis * Bradycardia * Bronchospasm * Emesis * Lacrimation * Salivation Usemenumonic: **DUMBBELS**
39
Examples of cholinergics
* Muscarine-containing mushrooms * Organophosphates * Pilocarpine * Pyridostigmine
40
List the symptoms and signs of anticholinergic toxicity
* 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
Examples of anticholinergics
* Antihistamines * Antipsychotics * Atropine * Jimson weed * Scopalamine * TCAs
42
List the symptoms and signs of opioid toxicity
* Coma * Respiratory depression * Miosis * Bradycardia * Hypothermia * Diminished bowel sounds
43
Examples of opioids
* Heroin * Morphine * Oxycordone
44
List the symptoms and signs of sedative-hypnotic toxicity
* CNS depression * Respiratory depression * Coma
45
Examples of sedative-hypnotics
* Alcohol * Barbiturates * Benzodiazepines
46
List the symptoms and signs of hallucinogenic toxicity
* Disorientation * Panic * Seizures * HTN * Tachycardia * Tachypnea
47
Examples of hallucinogenics
* Amphetamines * Cocaine * PCP
48
List the symptoms and signs of extrapyramidal medications toxicity
* Tremors * Torticollis * Trismus * Rigidity * Oculogyric crisis * Opisthotonus * Dysphosia * Dysphagia
49
Examples of extrapyramida medications
* Haloperidol * Meteclopramide * Phenothiazines
50
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
* Loss of consciousness * Age \> 50 years * Metabolic acidosis * Carboxyhemoglobin levels \> 25% * Cerebellar findings on neurologic exam

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