Tox

Question 1

Are comprehensive drug screens helpful?

Answer 1

not helpful, take too long

Question 2

Coma Cocktail

Answer 2

50 cc of 50% glucose IV (amp of D50), Naloxone (lasts about 45 mins), Thiamine 100mg IV

Question 3

Antidote for benzos

Answer 3

flumazenil

Question 4

antidote for cyanide

Answer 4

lilly kit

Question 5

Antidote for anticholinergics

Answer 5

physostigmine

Question 6

antidote for beta blockers

Answer 6

glucagon

Question 7

antidote for TCAs

Answer 7

Na Bicarb

Question 8

Anion gap equation, and normal range

Answer 8

Na- (Cl + HCO3); normal is 5-15

Question 9

Charcoal does not work with?

Answer 9

Iron
Lithium 
Cyanide
Pesticides 
Acids and Alkalis

Question 10

What are the radiopaque pills you can see on KUB?

Answer 10

Chloral hydrate 
Heavy metals 
Iron 
Phenothiazines; packets of drugs 
Enteric coated pills 
Salicylates

Question 11

What other substances have the anticholinergic toxidrome?

Answer 11

antihistamines, antipsychotics, TCAs, Carbamazepine, Cyclobenzaprine
Plants: Jimson weed and Belladonna

Question 12

Major difference between antichol toxidrome and sympathomim toxidrome?

Answer 12

antichol: flushed dry skin, absent bowel sounds and distended bladder
sympathomim: normal skin or sweating, normal bowel sounds, bladder not distended

Question 13

What toxins have cholinergic effects

Answer 13

pesticides, chemical warfare agents

Question 14

sympathomimetic tx

Answer 14

benzo’s, cooling, iv fluids, charcoal

Question 15

Opiates classic triad

Answer 15

respiratory decreased
depressed LOC
Miosis

Question 16

What med can be used to tx serotonin syndrome

Answer 16

benzos

Question 17

Acetaminophen toxic values in adults and kids

Answer 17

7.5g in adults

150 mg/kg in kids

Question 18

Acetaminophen sx

Answer 18

typically few sx in 24 hrs, then malaise, nausea, RUQ pain

Question 19

Aspirin Sx’s

Answer 19

early/mild: tachycardia, tinnitus, n/v, abd ain, tachypnea, diaphoresis

late/severe: coma, seizures, resp depression, no-cardiogenic pulmonary edema, dehydration, shock.

Question 20

TCA EKG changes

Answer 20

first: sinus tach
terminal R wave in aVR
widened QRS
ventricular tachycardia

Question 21

How do you know if deferoxamine is working

Answer 21

“vin rose” urine

Question 22

Digoxin symptoms

Answer 22

n/v/d, bradyarrythmias, hyperkalemia, CNS sx’s, EKG with specific findings

Question 23

PE signs of alcohol withdrawal

Answer 23

tongue wag, tremor, tachycardia, low grade temperature

Question 24

Early GI symptoms within 2 hours from eating mushrooms is reassuring, true or false

Answer 24

true , delayed symptoms over 6 hrs associated with liver, kidneys, CNS damage

Question 25

Amantia phalloides and Lepiota is associated with?

Answer 25

liver failure

Question 26

Amanita smithiana associated with?

Answer 26

renal failure

Question 27

Loxosceles - Brown Recluse Spider causes

Answer 27

Dermonecrosis Painless bite, firm skin lesion, blister, eschar fever, chills, n/v, arthralgias

Question 28

Lacrodectus - Widow Spiders

Answer 28

Pinprick bite, pain spreads fast, muscle cramps | HTN, tachy/tachy, n/v, HA