Tox Flashcards
Serum iron levels correlating with significant GI toxicity?
> 300
Ferrous fumarate percentage of elemental iron
33%
Ferrous sulfate percentage of elemental iron
20%
Ferrous gluconate percentage of elemental iron
12%
How much whole bowel irrigation for adults? Kids?
2L/hr adults; 250-500 ml/h in kids
Indication for deferoxamine therapy
Serum iron >350 mcg/dL in symptomatic patient (vomiting or shock/seizures/acidosis/ams)
Dosing for deferoxamine
5mg/kg/hr. Can increase to 15mg/kg/hr if no hypotension. Not to exceed 6g in one day
What value of salicylate can you stop treatment
Less than 20
Two classes of threatening snakes
Crotalid: (pit vipers, rattlesnakes, cotton mouth)
Elapids: ( Coral snakes, cobras)
Crotalid venom contains:
Cytolytic-May cause edema, hemorrhage, and necrosis at bite site and systemic. Watch for the following: hemolysis, thrombocytopenia, DIC, vomiting, CV and Resp failure
Elapid venom contains:
Neurotoxic venom producing neurological symptoms (Diplopia, ptosis, respiratory depression, paresthesia). These symptoms tend to be delayed.
Characteristics of central retinal vein occlusion
- Dilated and tortuous veins
- Retinal and macular edema
- Diffuse Retinal Hemorrhages
How many rotations to detorse a testicular torsion?
1.5 open book
Drunk/Obtunded cocktail
Thiamine, folate, Dextrose, +/- Narcan
Osmolal gap equation
Osmolal gap = measured osmolality – 2[Na] – Glucose/18 – BUN/2.8 – EtOH/4.6
Disposition for hypoglycemia secondary to long acting sulfonureas?
Admit due to long half life of sulfonylureas, could cause hypoglycemia 7-10 hours after ingestion
Digoxin Toxicity Treatment
Digibind: 10 vials in acute overdose; 4-6 vials for chronic ingestion
How to treat hyperkalemia in the setting of digoxin toxicity?
Everything but Calcium
Toxic tylenol dosing
140 mg/kg or 7.5g ingesting in 24 hour period
How much NAQ to give in tylenol OD
PO: 140mg/kg then 70 mg/kg q4hr for 17 doses
IV: 150mg/kg IV over 1 hour, then 50 mg/kg IV over 4 hours, then 100 mg/kg over 16 hours
What is Wernicke Korsakoff?
Thiamine deficiency (Vitamin B1) seen in alcoholics, malnourished patients. Check for ataxia, ophthalmoplegia
