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CSPI > TOXICDROMES > Flashcards

TOXICDROMES Flashcards

1
Q

WHICH TOXICDROME OCCURS < 12 HOURS?

A

SS

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2
Q

SS SYM?

A

HYPERRELEXIA, CLONUS, MYDRIASIS, HYPERACTIVE BS

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3
Q

WHICH TOXICDROME OCCURS 1-3 DAYS?

A

NMS

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4
Q

NMS SYM?

A

LEAD PIPE RIGIDITY, HYPOREFLEXIA, NORMAL PUPILS, NORMAL OR DECREASED BS

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5
Q

Drugs That Cause Seizures

A 
(“Otis Campbell”)
Organophosphates
TCAs, trazodone, theophylline, tramadol
Insulin, INH, iron, ibuprofen, imipenem
Sulfonylureas, salicylates
Carbamazepine, Camphor, cocaine, cyanide, caffeine
Amphetamines, antihistamines
Meperidine, mushrooms
Propranolol, penicillin, propoxyphene
Bupropion, baclofen, Benadryl
Etoh withdrawal
Lead, lidocaine, lindane, lithium, levaquin
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6
Q

Nicotinic Effect

A

Days of the week

Somnolence
Mydriasis
Tremors/tachycardia
Weakness
Th htn (hypertension)
Fasiculation
Seizures
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7
Q

Muscarinic Effect

A

(Dumbels)

Diarrhea
Urination
Miosis/Muscle weakness
Bradycardia, bronchospasm, bronchorrea
Emesis
Lacrimation
Salivation
Sweating
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8
Q

Drugs Needing MDAC

A

(“Plenty Charcoal To Quickly Sequester Drugs”)

Phenobarbitol, phenytoin
Carbamazepine, Chlorinated hydrocarbons 	
Theophylline
Quinine, Quinidine
Salicylate
Dapsone, depakote, digoxin, digitoxin
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9
Q

Causes of Anion Gap Metabolic Acidosis

A

(“MUDPILES CAT”)

Metformin, Methanol
Uremia
DKA
Phenformin, Paraldehyde, Propylene glycol
INH, Iron
Lithium, Lead, Lactate
Ethylene Glycol
Salicylate, Starvation

Carbon monoxide, Cyanide
Alcoholic ketoacidosis
Toluene

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10
Q

Drugs that form concretions

A

Requiring whole bowel irrigation - (“BIGMESS”)

Barbituates
Iron
Glutethimide

Metals
Extended release, Enteric coated
Sustained release
Stuffers

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11
Q

Substances Not Well Absorbed by Charcoal/AC

A 
(FLIPPA)
	Fluoride
	Lithium
	Iron
	Potassium
Pesticides
	Alcohols
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12
Q

Serotonin Syndrome

A 
My Hyper Dog Is The Dumbest Animal Around Here
	Myoclonus
	Hyperreflexia
	Diaphoresis
	Incoordination
	Tremor
	Diarrhea
	Agitation
	AMS
	Hyperthermia
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13
Q

Drugs that can be Dialyzed

A 
I STUMBLED
Isopropanol
Salicyates
Theophylline
Uremia
Methanol
Barb/Bromides
Lithium
EG
Depakote
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14
Q

Radiopaque

A 
CHIPES
Chloral hydrate
Heavy metals
Iron, Iodine
Phenothiazines
Enteric coated pills
Solvents, halogenated
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15
Q

Substances Causing Methemoglobinemia

A 
ABCD N
Anesthetic, Azo, Aniline dyes
Bactrim, Bromates
Chloroquine, Chlorates
Dapsone
Nitrates/Nitrites, Naphthalene, Nitroglycerine
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16
Q

A 67 year old female presents to the ED anxious, tremulous, nausea, vomiting, dehydrated and seizures. LABS as follows: Na 131, CO2 18, KCL 3.8, PO4 1.5 mg/dl, BS 100. The patient was afebrile, HR 130’s, BP 90/50. Hemodialysis was recommended. The patient was recently started on furosemide.
Which of the following medications could have caused this presentation with chronic intoxication?
A. theophylline
B. lithium
C. valproic acid (Depakote®) D. digoxin

A

A

17
Q

In which of the following scenarios would hemodialysis not be indicated?
A. Serum iron level 500 ug/dl , CO 2 – 17, BP 80/55
B. Ethylene Glycol Level 50 mg/dl , CO 2 – 14, Bun 35 & Cr 1.8 , comatose C. Theophylline level > 40 ug/ml, 68 years old with CHF & Liver disease
D. Valproate level > 1,000ug/ml , Ammonia level -120 , AST -100 , ALT 150

A

A

18
Q

An adult hiking in the woods looking for herbal plants that could be used in medicine came across a plant and dug it up and consumed both the leaves and roots in a salad. He arrived in the Emergency room experiencing weakness, dizziness, as well as hypotension and tachycardia. Earlier
1. A 67 year old female presents to the ED anxious, tremulous, nausea, vomiting, dehydrated and seizures. LABS as follows: Na 131, CO2 18, KCL 3.8, PO4 1.5 mg/dl, BS 100. The patient was afebrile, HR 130’s, BP 90/50. Hemodialysis was recommended. The patient was recently started on furosemide.
General Management Principles
Laboratory and Ancillary Testing
symptoms of intense vomiting, abdominal cramping and headache had
improved. Which plant could have caused these symptoms? A. Foxglove
B. Pokeweed
C. Dogbane
D. Jimson Weed

A

B

19
Q

Which of the following could cause headache, nausea, vomiting, respiratory depression, pulmonary edema, myocardial sensitization hepatic and renal injury could occur?
A. methane
B. carbon dioxide C. butane
D. Freon

A

D

20
Q

A farmer was spraying the fence row when the sprayer hose broke and he delayed showering. His symptoms included: Vomiting, throat irritation as well as mild conjunctivitis and dermal irritation. Which of the following could have caused his symptoms?
A. Round up or Vantage B. Malathion
C. Diquat
D. Imidacloprid

A

A

21
Q 
Patient presents HR 145
BP 140/85
Pupils dilated
Skin flushed, hot and dry Bowel sounds decreased Urinary retention Agitated
T 101 F
What drug would have been ingested?
A. cocaine
B. nicotine
C. benztropine (Cogentin) D. bethanechol (Urecholine)
A

C

22
Q

Which of the following drugs would not cause widening of the QRS?
A. amitriptyline B. lidocaine
C. digoxin
D. lamotrigine

A

C

23
Q

A caller reports that she has been taking her high dose vitamin six times a day accidently for the last 3months. She is now experiencing fatigue, headaches, bone pain, alopecia, and skin lesions. Which vitamin could be responsible for her symptoms?
A. Vitamin D B. Vitamin C C. Vitamin A D. Vitamin B

A

C. Vitamin A

24
Q 
A 45 year old female presented in the ED with complaints of dizziness, tremor, paresthesias, and slurred speech. She states she unintentionally took her newly prescribed smoking cessation medication twice this morning. Her vitals and initial labs are as follows:
HR 95
BP 100/72
RR 18
Temp 98.7
UDS- positive for amphetamines
What is the medication she is taking?
A. Tramadol (Ultram®)
B. Venlafaxine (Effexor®)
C. Bupropion (Wellbutrin®) D. Cyclobenzaprine (Amrix®)
A

C

25
Q 
A 42 year old female presents to the emergency department via ambulance with altered mental status. Pt has a history of hypertension, hypercholesterolemia, and bipolar disorder. During the course of the call the RN mentions that patient has had multiple episodes of urinary incontinence of large volumes (>3 liters). Urine osmolality is 200 mOsm/kg and a sodium of 158 mEq/L.
A. Acetaminophen
B. Lithium
C. Lasix
D. Brexpiprazole (Rexulti)
A

C

26
Q

Two mushroom foragers presenting to the ED with a 2 day history of GI complaints and new onset anuria over 1-4 days.
What is the most likely cause of their symptoms?
A. Psilocybe cyanescens
B. Amanita muscaria
C. Amanita smithiana
D. Coprinopsis atramentaria

A

C

27
Q

Which of the following causes a personality changes, hallucinations, delirium, insomnia, irritability, fatigue, memory loss, erethism ?
A. Lead
B. Arsenic
C. Mercury D. Chromium

A

C

28
Q

58 year old female presents to the ED with complaints of confusion, weakness, and abdominal pain. Patient has a history of hypertension, atrial fibrillation, and type II diabetes. Pt is not clear on her medication list. Family brought in several bottles of medications which she could have taken.
Selected labs: Na 144
K 3.5
Cl 106 Glucose 161 CO2 14
pH 7.07 lactate 1
Which of the following medications is the most likely cause of her current presentation?
A. Metformin (Glucophage) B. Empagliflozin (Jardiance) C. Glyburide
D. Lantus

A

B

29
Q

WHAT CLINICAL EFFECTS ARE SEEN IN ANTICHOL BUT NOT SYMPATHOMIMETIC? A. HYPERREFLEXIA OF LOWER EXTREMEIES B. FIXED AND DILATED PUPILS C. DRY MUCOUS MEMBRANES D. INCREASED HEART RATE E. HTN

A

C.

CSPI (31 decks)

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