Toxicology Flashcards

1
Q

Pink color urine is associated with what antidote?

A

Defroximine

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2
Q

During overdoses of acetaminophen what compound does our body run out of?

A

Glutathione

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3
Q

What is the goal pH of urine in an aspirin toxicity?

A

Alkalinization of urine to a pH of 7.5 to 8

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4
Q

What is the main treatment of a calcium channel blocker toxicity?

A

Treat symptoms

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5
Q

When do symptoms of beta blocker ingestion present?

A

Within 2 hours

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6
Q

When should you obtain a serum acetaminophen level?

A

4 hours post ingestion or immediately if more time has elapsed

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7
Q

What is the management of iron toxicity?

A

Defloroxamine iv

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8
Q

What toxic ingestion is associated with rhabdomyolysis?

A

Bath salts or spice

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9
Q

What are signs of anticholinergic toxicity?

A

Hot, dry, red

Agitation, urinary retention, dry mouth, hypotension, tachycardia, hypertension, fever

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10
Q

What is the most common dose for activated charcoal?

A

10 to 25 grams PO

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11
Q

What condition does an ecstasy overdose mimic?

A

Malignant hyperthermia

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12
Q

What taxiderm is characterized by dry skin, increased heart rate, dilated pupils, fever, urinary retention, decrease bell sounds, CNS excitation?

A

Anticholinergic

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13
Q

How do you treat the hypotension associated with calcium channel blocker toxicity?

A

Volume and or vasoactive agents

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14
Q

What findings are specific to toxic ingestion of ethylene glycol?

A

Renal failure, cerebral edema, not associated with visual complaints

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15
Q

What cardiac arrhythmia is associated with calcium channel blockers?

A

Second degree AV block

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16
Q

What toxin is found in industrial solvents, gasoline blends, paint strippers, windshield wiper fluid, and hobby adhesives?

A

Methyl alcohol or methanol

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17
Q

What is the management of an ecstasy overdose?

A

Aggressive cooling and dantroline as well as supportive care

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18
Q

How does a bath salt ingestion present?

A

Hypertension, tachycardia, euphoria, alertness, hyperactivity followed by coronary vases spasm gastritis or hyperthermia

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19
Q

What additive inactivated charcoal do we need to be aware of?

A

Sorbitol and its effect on electrolytes

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20
Q

Her males or females more likely to have toxic ingestions during adolescence?

A

Females

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21
Q

What are the two main symptoms of a beta blocker toxicity?

A

Bradycardia and hypotension

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22
Q

What happens when NAPQI levels become too high?

A

Hepatocellular necrosis, irreversible liver failure

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23
Q

What is the best test to order to evaluate for rhabdomyolysis?

A

Serum creatinine kinase

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24
Q

How many hours after acetaminophen ingestion does peak toxicity occur?

A

Greater than 72 hours

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25
Q

What toxidrome is characterized by beady eyes, sunglasses, decrease blood pressure, and respiratory depression?

A

Narcotic

26
Q

What taxiderm is characterized by increased salivation, tearing, urination, defecation, emesis, muscle weakness and fasciculations?

A

Cholinergic

27
Q

What symptoms are specific to ethanol toxicity?

A

Respiratory depression, profound hypoglycemia, lethargy, sedation, vomiting

28
Q

When do you need to give sodium bicarb in a beta blocker ingestion?

A

If formulation ingested possesses MSA as it will cause ventricular arrhythmias

29
Q

What is the presentation of severe iron toxicity

A

Hypertension, drowsiness, metabolic acidosis

30
Q

What is the most commonly abused amphetamine by adolescence and college students?

A

MDMA or ecstasy

31
Q

What is the treatment of a bath salt ingestion?

A

Dantrolene for hyperthermia, monitor for coronary spasms and give morphine or nitroglycerin if present

32
Q

What ingestion will cause changes to a chest radiograph?

A

Iron ingestion

33
Q

What oral symptoms are associated with an ecstasy overdose?

A

Bruxism ( grinding teeth), sweating, dry mouth

34
Q

Why do you give sodium bicarb in TCA overdoses?

A

Blocks sodium channels causing changes to an EKG

35
Q

What are the end products of hepatic metabolism of methanol and ethylene glycol that produce significant toxicity?

A

Alcohol dehydrogenase and aldehyde dehydrogenase

36
Q

Where are alcohols metabolized?

A

Liver

37
Q

What are the three initial signs of calcium channel blocker toxicity?

A

Hypertension, bradycardia or Brady arrhythmias, SA/AV node conduction abnormalities

38
Q

What is the antidote for Tylenol ingestion?

A

An acetyl cysteine or mucumyst

39
Q

How should you act if he ingested agent is unknown?

A

Refer to your taxidromes

40
Q

What serum iron levels indicate mild, moderate, and severe toxicity?

A

Mild less than 300, moderate 300 to 500, severe greater than 500

41
Q

What toxin drone is characterized by diarrhea, dilated pupils, goosebumps, tachycardia, yawning, stomach cramps, hallucinations?

A

Withdrawal

42
Q

What symptoms are present after 24 hours after a Tylenol ingestion?

A

Nausea, malaise, increased liver function test

43
Q

What findings are specific to methanol toxicity?

A

Severe metabolic acidosis and symptoms similar to ethanol

44
Q

Where is Tylenol metabolized?

A

The liver

45
Q

What are late signs of calcium channel blocker toxicity?

A

Arrhythmias, hypoglycemia, shock, seizures, death

46
Q

On the acetaminophen what line suggests the need for treatment?

A

The solid line

47
Q

What medications are calcium channel blockers?

A

Amlodipine, isradipine, nicardipine

48
Q

What taxiderm is characterized by scenic excitation such as confusion, in coordination, agitation, delirium seizures as well as increased blood pressure and heart rate?

A

Sympathomimetic

49
Q

What lab findings on an ABG are associated with salycilate toxicity?

A

Respiratory alkalosis and anion gap metabolic acidosis

50
Q

How do you treat the bradycardia associated with calcium channel blockers

A

Atropine, dopamine

51
Q

How does a salycilate toxicity present?

A

Hyperthermia, tachycardia, vertigo, hyperactivity, hyperventilation, seizures

52
Q

What symptoms are present greater than 72 hours after acetaminophen ingestion?

A

Kragulopathy, and cephalopathy, liver failure

53
Q

What toxin is associated with the ingestion of antifreeze, herbicides, paints?

A

Ethylene glycol

54
Q

How do symptoms present with an iron toxisity?

A

Starts with gastro like symptoms followed by hematemesis and hematochezia.

55
Q

What complicates treatment of a calcium channel blocker ingestion?

A

Several different formulations and concentrations are available such as immediate or sustained release tablets

56
Q

What age group accounts for half of all poisonings?

A

Less than 3 years of age

57
Q

When is hemodialysis required in aspirin toxicity?

A

Levels approaching 100 or severe clinical manifestations

58
Q

What affects do bath salts mimic?

A

Cocaine and amphetamines

59
Q

What treatment is specific to methanol and ethylene glycol toxicity?

A

Ethanol, dialysis

60
Q

What drug class are TCAs in?

A

Anticholinergic

61
Q

Where did the majority of toxic ingestion events occur?

A

In the child’s home

62
Q

Where are calcium channel blockers metabolized?

A

Liver