tox

Question 1

name toxins that can cross placenta

Answer 1

lead, mercury, PCBs, insecticides

Question 2

name a toxin the placenta wont transfer

Answer 2

cadmium

Question 3

name some things that you should not try to get out with charcoal

Answer 3

CALM- cyananide, alcohol.alkaline ingestiion/kerosene, zLithium, heavy metals

Question 4

time frame for gastric lavage

Answer 4

60 minutes

Question 5

acetaminophen dose of tox

Answer 5

140 mg/kg- dont need to wait for level if this is the amount taken

Question 6

wintergreen means what ingestion

Answer 6

salicylate

Question 7

name an ingestion that can give you fever that isnt a sympathomimetic

Answer 7

salicylate

Question 8

define severe blood alcohol

Answer 8

> 0.3 g/dL, 300mg/dL, or 3%

Question 9

level for potential lethality of alcohol

Answer 9

> 0.4 (or 4%)

Question 10

where does methanol live

Answer 10

windshield wiper, cooking fuel, perfumes, antifreeze

Question 11

symptom picture for methanol tox

Answer 11

abd pain, vomiting, inebriation, metabolic acidosis, AG, CNS depression, blurred vision (snow field vision) and optic disk edem a

Question 12

how to cope with blindness from methanol

Answer 12

ethanol, OR 4 methylpyrazole, or sodium bicarb

Question 13

what clinical exam would organophosphates look like

Answer 13

lethargy, respiratory distress, sweaty, wheezing, urinating, muscle twitching, drooling

Question 14

are organophosphates anti or + cholinergic

Answer 14

+

Question 15

cholinergic presentation SLUDGE

Answer 15

salivation/sweat, lacrimation, urination, defecation, GI, emesis (faucets ON)

Question 16

muscarinic side effects and antidote

Answer 16

salivation, lacrimation, diarrhea, wheezing, bradycardia– atropine

Question 17

nicotinic side effects and treatmen

Answer 17

this is neuromuscular junction- muscle fasciculations, weakness. these need pralidoxime

Question 18

time frame for dysythmias in TCA ingestion

Answer 18

24 hours

Question 19

what do you see in the heart for TCA on EKG

Answer 19

wide QRS

Question 20

taking TCAs makes what test unreliable

Answer 20

allergy testing

Question 21

tine to observe post hydrocarbon

Answer 21

6 hours

Question 22

how to suss out cyanide from CO poisoning

Answer 22

cyanide wont get better with oxygen

Question 23

treatment for cyanide poisoning

Answer 23

tydroxycobalamin, sodium thiosulfate, nitrate

Question 24

which injures esophagus instead of stomach- alkali or acid

Answer 24

alkali

Question 25

what lead level requires chelation

Answer 25

70 mcg/dL

Question 26

lead level where you report and confirm in 3 mohths

Answer 26

5-14

Question 27

when do you confirm lead level in 4 weeks

Answer 27

15-44 mcg

Question 28

when do you confirm lead within 48 hours

Answer 28

45-70

Question 29

what level of iron ingestion is toxic

Answer 29

40 mg/kg of elemental

Question 30

4 phases of toxic iron ingestions

Answer 30

1) in 6 hours, GI stuff 2) better for 6-24 hours 3) metabolic acidosis, coagulopathy, CV collapse 4) GI obstruction

Question 31

management of iron ingestion

Answer 31

check. 4 hours post ingestion. some kids get chelation if there is severe symptoms and AG acidosis, serum iron concentrations L>500 mcg/dL, lots of pills on belly fiolm

Question 32

severe iron ingestion- what iron, WBC, and glucose do you see

Answer 32

iron >350, WBC >15k, glucose >150

Question 33

stop treatment with deferoxamine chelation therapy when

Answer 33

clinical improvement and the urine isnt pink anymore