Tox

Question 1

Toxidrome: sweating, drooling, vomiting, HTN, pinpoint pupils

Answer 1

cholinergic OD (organophosphates) - tx w/ atropine + pralidoxime

Question 2

confirm CO poisoning w/ what test

Answer 2

COHb level

Question 3

toxidrome: AMS, fever, tachycardia, dilated pupils, flushed face, dry mucous membranes

Answer 3

anticholinergic

Question 4

toxidrome: AMS, fever, tachycardia, dilated pupils, diaphoresis

Answer 4

sympathomimetic

Question 5

INH OD sxs

Answer 5

seizures refractory to benzos

Question 6

DM med commonly causing refractory hypoglycemia

Answer 6

glyburide (sulfonylurea) - antidote is octreotide

Question 7

OD: N/V, diaphoresis, fever, tinnitus

Answer 7

aspirin - then causes respiratory alkalosis -> metabolic acidosis

Question 8

tx for cocaine toxicity

Answer 8

benzos

Question 9

withdrawal: agitation, vomiting, diaphoresis, piloerection, body aches

Answer 9

opioid

Question 10

drug use: cool sweaty skin, nystagmus, myoclonic jerks

Answer 10

PCP - can tx w/ chemical sedation

Question 11

osmolar gap, what does it indicate?

Answer 11

osmolar gap = measured - calculated

>50 indicates presence of toxic alcohols

Question 12

tx for ingestion w/ EKG of wide QRS + terminal R in aVR

Answer 12

sodium bicarb -> narrows the QRS (expect TCA OD)

Question 13

ingestion: metabolic acidosis + crystalluria

Answer 13

ethylene glycol

Question 14

fomepizole treats what ingestions?

Answer 14

methanol or ethylene glycol (blocks alcohol dehydrogenase)

Question 15

ingestion: GI + CNS disturbances w/ breath smelling like acetone + ketones in urine

Answer 15

isopropyl alcohol (ketosis w/o acidosis)

Question 16

tx for salicylate tox

Answer 16

1. activated charcoal
2. IV fluids
3. sodium bicarb (alkalizes serum + urine to keep salicylic acid out of brain + inc urinary excretion)

Question 17

tox: abd pain, N/V/D, hematemesis

Answer 17

iron OD - tx w/ deferoxamine

Question 18

anticholinergic antidote

Answer 18

physostigmine

Question 19

tox: Vfib in young healthy person after sudden exercise

Answer 19

butane (hydrocarbon)

Question 20

tox: pupil dilation, sweating, fever, HTN + hyponatremia

Answer 20

MDMA (amphetamine + serotonin release)

Question 21

tx for stuffer

Answer 21

activated charcoal, polyethylene glycol

Question 22

tox: cyanosis w/ pulse ox reading lower than ABG sat

Answer 22

methemoglobinemia - tx w/ methylene blue