Toxicology

Question 1

Pink color urine is associated with what antidote?

Answer 1

Defroximine

Question 2

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

Answer 2

Glutathione

Question 3

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

Answer 3

Alkalinization of urine to a pH of 7.5 to 8

Question 4

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

Answer 4

Treat symptoms

Question 5

When do symptoms of beta blocker ingestion present?

Answer 5

Within 2 hours

Question 6

When should you obtain a serum acetaminophen level?

Answer 6

4 hours post ingestion or immediately if more time has elapsed

Question 7

What is the management of iron toxicity?

Answer 7

Defloroxamine iv

Question 8

What toxic ingestion is associated with rhabdomyolysis?

Answer 8

Bath salts or spice

Question 9

What are signs of anticholinergic toxicity?

Answer 9

Hot, dry, red

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

Question 10

What is the most common dose for activated charcoal?

Answer 10

10 to 25 grams PO

Question 11

What condition does an ecstasy overdose mimic?

Answer 11

Malignant hyperthermia

Question 12

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

Answer 12

Anticholinergic

Question 13

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

Answer 13

Volume and or vasoactive agents

Question 14

What findings are specific to toxic ingestion of ethylene glycol?

Answer 14

Renal failure, cerebral edema, not associated with visual complaints

Question 15

What cardiac arrhythmia is associated with calcium channel blockers?

Answer 15

Second degree AV block

Question 16

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

Answer 16

Methyl alcohol or methanol

Question 17

What is the management of an ecstasy overdose?

Answer 17

Aggressive cooling and dantroline as well as supportive care

Question 18

How does a bath salt ingestion present?

Answer 18

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

Question 19

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

Answer 19

Sorbitol and its effect on electrolytes

Question 20

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

Answer 20

Females

Question 21

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

Answer 21

Bradycardia and hypotension

Question 22

What happens when NAPQI levels become too high?

Answer 22

Hepatocellular necrosis, irreversible liver failure

Question 23

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

Answer 23

Serum creatinine kinase

Question 24

How many hours after acetaminophen ingestion does peak toxicity occur?

Answer 24

Greater than 72 hours

Question 25

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

Answer 25

Narcotic

Question 26

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

Answer 26

Cholinergic

Question 27

What symptoms are specific to ethanol toxicity?

Answer 27

Respiratory depression, profound hypoglycemia, lethargy, sedation, vomiting

Question 28

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

Answer 28

If formulation ingested possesses MSA as it will cause ventricular arrhythmias

Question 29

What is the presentation of severe iron toxicity

Answer 29

Hypertension, drowsiness, metabolic acidosis

Question 30

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

Answer 30

MDMA or ecstasy

Question 31

What is the treatment of a bath salt ingestion?

Answer 31

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

Question 32

What ingestion will cause changes to a chest radiograph?

Answer 32

Iron ingestion

Question 33

What oral symptoms are associated with an ecstasy overdose?

Answer 33

Bruxism ( grinding teeth), sweating, dry mouth

Question 34

Why do you give sodium bicarb in TCA overdoses?

Answer 34

Blocks sodium channels causing changes to an EKG

Question 35

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

Answer 35

Alcohol dehydrogenase and aldehyde dehydrogenase

Question 36

Where are alcohols metabolized?

Answer 36

Liver

Question 37

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

Answer 37

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

Question 38

What is the antidote for Tylenol ingestion?

Answer 38

An acetyl cysteine or mucumyst

Question 39

How should you act if he ingested agent is unknown?

Answer 39

Refer to your taxidromes

Question 40

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

Answer 40

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

Question 41

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

Answer 41

Withdrawal

Question 42

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

Answer 42

Nausea, malaise, increased liver function test

Question 43

What findings are specific to methanol toxicity?

Answer 43

Severe metabolic acidosis and symptoms similar to ethanol

Question 44

Where is Tylenol metabolized?

Answer 44

The liver

Question 45

What are late signs of calcium channel blocker toxicity?

Answer 45

Arrhythmias, hypoglycemia, shock, seizures, death

Question 46

On the acetaminophen what line suggests the need for treatment?

Answer 46

The solid line

Question 47

What medications are calcium channel blockers?

Answer 47

Amlodipine, isradipine, nicardipine

Question 48

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

Answer 48

Sympathomimetic

Question 49

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

Answer 49

Respiratory alkalosis and anion gap metabolic acidosis

Question 50

How do you treat the bradycardia associated with calcium channel blockers

Answer 50

Atropine, dopamine

Question 51

How does a salycilate toxicity present?

Answer 51

Hyperthermia, tachycardia, vertigo, hyperactivity, hyperventilation, seizures

Question 52

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

Answer 52

Kragulopathy, and cephalopathy, liver failure

Question 53

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

Answer 53

Ethylene glycol

Question 54

How do symptoms present with an iron toxisity?

Answer 54

Starts with gastro like symptoms followed by hematemesis and hematochezia.

Question 55

What complicates treatment of a calcium channel blocker ingestion?

Answer 55

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

Question 56

What age group accounts for half of all poisonings?

Answer 56

Less than 3 years of age

Question 57

When is hemodialysis required in aspirin toxicity?

Answer 57

Levels approaching 100 or severe clinical manifestations

Question 58

What affects do bath salts mimic?

Answer 58

Cocaine and amphetamines

Question 59

What treatment is specific to methanol and ethylene glycol toxicity?

Answer 59

Ethanol, dialysis

Question 60

What drug class are TCAs in?

Answer 60

Anticholinergic

Question 61

Where did the majority of toxic ingestion events occur?

Answer 61

In the child's home

Question 62

Where are calcium channel blockers metabolized?

Answer 62

Liver