TOXICITY

Question 1

ETHYLENE GLYCOL POISONING ANTIDOTE

Answer 1

1) FOMEPIZOLE or ETHANOL - To inhibit alcohol dehydrogenase
2) NaBICARB - Alleviate acidosis
3) HEMODIALYSIS - Prevent severe acidosis/end-organ damage

Question 2

MOST COMMON side effect of FLUPHENAZINE (high potency typical anti-psychotic)

Answer 2

HYPOTHERMIA

Question 3

COMMON CAUSES OF PRIAPISM:

Answer 3

1) Sickle cell disease + Leukemia
2) Perineal/genital trauma
3) Neurogenic lesions - spinal cord injury, cauda equina,
4) MEDS - TRAZODONE, PRAZOSIN

Question 4

What is the management plan for CAUSTIC INGESTION of Na or KOH (lye)? - WHITE HEAVY SALIVA DROOLING, UNABLE TO SWALLOW

Answer 4

IMMEDIATE ENDOSCOPY (within 12-24hrs to assess severity) 
Since this causes immediate injury + liquefaction necrosis + perforation

Question 5

DROWSINESS (AMS) + SLURRED SPEECH + HYPOTENSION + UNSTEADY GAIT (ATAXIA) = ? Intoxication?

What is the antidote?

Answer 5

BZ INTOX

FLUMAZENIL - Competitive antagonist of GABA/BZ-R

Question 6

What is the antidote for ACUTE OPIOID INTOXICATION (PINPOINT PUPILS/miosis+ RESPIRATORY DEPRESSION + ALTERED MENTAL STATUS)?

Answer 6

NALOXONE

Question 7

What is FETAL HYDANTOIN SYNDROME? What are the 2 most commonly associated medications?

Answer 7

FACE: Small body size, microcephaly, cleft lip/palate

Extremities: Digital hypoplasia, hirsutism
Dvlm delay

2 MOST COMMON: AED- PHENYTOIN + CARBAMAZEPINE

Question 8

How do you distinguish between FETAL HYDANTOIN and FETAL ALCOHOL SYNDROME?

Answer 8

FETAL HYDANTOIN: + Cleft palate/ hirsutism (excess hair)

FETAL ALCOHOL: - Cleft palate/ hirsutism

Question 9

Why should BZs should be used with caution in elderly?

Answer 9

**POLYPHARMACY

Cognitive impairment + Falls + Paradoxical AGITATION

Question 10

ENCEPHALOPATHY + OCULAR DYSFN (Sluggish constriction to light) + GAIT ATAXIA = ? What is the antidote?

Answer 10

WERNICKE ENCEPHALOPATHY (VitB1 deficiency 2/2 malnutrition, chronic alcoholism): Wobbly + Eye + encephalopathy

THIAMINE BEFORE or with Glc (since thiamine = important cofactor for energy metabolism)

Question 11

What are prevention factors that can decrease the risk of SUDDEN INFANT DEATH SYNDROME?

Answer 11

• Smoke avoidance
• Pacifier use
• Sleeping in supine position with firm bedding
• Room sharing without bed sharing