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Y3 - Emergency Medicine Finals > Toxicology > Flashcards

Toxicology Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

o Inherent ability of a substance to cause harm, injury,
or death to a biologic material

A

TOXICITY

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2
Q

Any agent that is capable of producing deleterious or
harmful effects in biological system, seriously injuring
function or producing death

A

POISON

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3
Q

Bradycardic
Hypothermic
Bradypneic

A

Alcohol

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4
Q

Tachypneic
Hyperthermic

A

Salicylates

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5
Q

Hyperthermic
Hypertensive

A

Nicotine

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6
Q

BITTER ALMOND

A

Cyanide

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7
Q

PEARS

A

Chloral hydrate

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8
Q

Garlic smell

A

Organophosphate, arsenic

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9
Q

Oil of wintergreen

A

Methylsalicylate

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10
Q

Fruity

A

DKA, isopropanolol

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11
Q

in seizure that can’t be medicated
by the usual anticonvulsants

A

Isoniazid overdose INTRACTABLE SEIZURES

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12
Q

HEMATEMESIS

A

Iron ingestions

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13
Q

PROTRACTED COUGHING o

A

Hydrocarbon

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14
Q

INABILITY TO SWALLOW
or drooling

A

Caustic

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15
Q

Meclizine, Promethazine

A

ANTIEMETICS/ANTIDIZINESS

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16
Q

ANTIDEPRESSANTS

A

Imipramine, Nortryptyline

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17
Q

ANTIARRHYTHMICS

A

Quinidine, Procainamide

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18
Q

ANTIPSYCHOTICS

A

Chlorpromazine, Clozapine

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19
Q

ANTIHISTAMINE

A

Diphenhydramine, Hydroxyzine

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20
Q

Very evident in young adults who presents with hypertension and
tachycardia and looks agitated

A

DRUGS WITH SYMPATHOMIMETIC EFFECTS DRUGS

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21
Q

Consciousness: depressed
Pupils: pinpoint
Respiration: depressed

And hypotension, bradycardia

A

OPIOID SYNDROME (CPR – TRIAD)

22
Q

SIGNS AND SYMPTOMS of DRUGS WITH SYMPATHOMIMETIC EFFECTS

A

Goosebumps
• Delusions/Paranoia • Pupil dilation
Temperature • Seizures • Sweating • Hypertension
Tachycardia

23
Q

o For Phenothiazine overdose(+) Blue/deep purple – when sulfuric acid and
ferric chloride to 2ml of patient’s acidified urine

A

FORREST TEST

24
Q

Brown urine

A

Chloroquine

25
Q

ORANGE TO RED
ORANGE

A

o Rifampin, Mercury, Chronic lead poisoning

26
Q

Copper sulfate or Methylene blue, what urine color?

A

Greenish blue

27
Q

Pink urine

A

Ampicillin or Cephalosporin

28
Q

Agents potentially visible on abdominal radiographs (COINS):

A

Chloral hydrate, cocaine packets, calcium
o Opium packets
o Iron, other heavy metals such as lead, arsenic, mercury
o Neuroleptic agents
o Sustained-release or enteric-coated agents (salicylate)

29
Q

METABOLIC ACIDOSIS, elevated anion gap

A

Methanol, metformin • Cyanide, carbon monoxide
Ethylene glycol • Isoniazid, iron • Toluene • Diabetic ketoacidosis • Alcoholic ketoacidosis • Generalized seizure-producing
• Lactic acidosis toxins • Aminoglycosides, other uremic
• ASA or other salicylates agents
• Paraldehyde, phenformin

30
Q

initial dose of 400mcg IV every 3mins or 10-100 mcg/kg/dose
IV, IM, SC every 3 minutes for 3 doses

A

Naloxone

31
Q

100mg IV followed by D50-50 50-100ml o For possible alcohol intoxication to prevent Wernicke’s encephalopathy

A

Thiamine: (Vitamin B complex if pure thiamine not available)

32
Q

In organophosphate poisoning, presence of muscle weakness/fasciculations requires which antidote?

A

Pralidoxime

As atropine has no effect on the neuromuscular junction and muscle weakness, oximes are used clinically to reverse neuromuscular blockade by reactivating the inhibited acetylcholinesterase before aging. Benzodiazepines for patients with agitation and seizures

33
Q

You have a 23 years old male coming in at the ED with complaints of difficulty of breathing after ingestion of an unknown substance. What will be your first step in the management of this patient?
a. Get Adequate History
b. Secure Venous access and initiate hydration
C. Give Antidote
D. Maintain Adequate Airway

A

Resuscitation is the first priority in any poison patient

34
Q

Miosis

A

opioids, organophosphates, phenothiazines, clonidine intoxication)

35
Q

Nystagmus/ataxia

A

anticonvulsant and ethanol toxicity

36
Q

Bronchorrhea/crepitations/hypoxia

A

organophosphate toxicity

37
Q

Hypersalivation

A

cholinergic toxidrome

38
Q

Tremor/fasciculations

A

lithium toxicity

39
Q

Lead pipe” rigidity

A

neuromuscular malignant syndrome)

40
Q

Flushing/warm, dry skin

A

anticholinergic toxicity

41
Q

Warm, moist skin

A

sympathomimetic toxicity

42
Q

Activated charcoal dose

A

Adults 50 grams orally, children 1 gram/kg orally

43
Q

Multidose activated charcoal

A

Initial dose: 50 grams (1 gram/kg children), repeat dose of 25 grams (0.5 gram/kg children) every 2hours

44
Q

Causes bradypnea

A

Sedative-hypnotics (barbiturates, BZD)
Liquor -alcohol
Opioids
Marijuana

45
Q

Hypotension
Brdypnea
Hypothermia

A

Sedative-hypnotics

46
Q

Hypertensive toxins/drugs

A

Cocaine
Thyroid supplements
Sympathomimetics
Caffeine
Anticholinergics, amphetamines,
Nicotine

(also causes tachycardia except nicotine which causes hyperthermia)

47
Q

Tachypneic
Tachycardia

A

PCP

48
Q

Hyperthermic but hypotensive

A

Antidepressants

49
Q

Hypothermics

A

CO2
Oral hypoglycemics, insulin

Liquor (all low except BP)

Sedative-hypnotics (all low except HR)

Also bradypneic, bradycardic (propoxyphene, physostigmine), hypotensive(heroin):
Opioids

50
Q

Rodenticides containing arsenic, cyanide causes

A

Hypotension

51
Q

Cholinergic effects

Organophosphate/carbamate pesticides

A

D - diarrhea
U - urination
M - miosis, muscle fasc
B - bradycardia, bronchoconst, bronchorrhea
E - emesis
L - lacrimation
L - lethargy
S - salivation

52
Q

Commonly used pesticides

A

Malathion
Parathion
Diazinon
Trichlorfon

Y3 - Emergency Medicine Finals (2 decks)

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