Toxicology Flashcards
What is the withdrawal pattern of alcohol
First 24 hrs is the least concerning symptoms beyond 24hrs and up to 48 hrs seizure and alcohol hallucinosis, and Delrium tremens 48-27hrs.
Besides aggression what other defining characteristic can wee see with PCP intoxication?
Rotary Nystagmus
Patient presents with bloody diarrhea and darkly colored stools, elevated LFT’s and creatinine what mineral was consumed?
Fe
What is the antidote for Fe posioning?
deferoxamine
Pts with Fe toxicity should undergo
X-ray imaging and gastric lavagae and bowel irrigation
Patient presents with blue violet/gingiva. He is a pescatarian and only eats shellfish?
Mercury
3 yo presents with headache and fatigue with pallor (MCV 70) and gingival hyperpigmentation.
Sideroblastic anemia
Patient that works in a battery factor presents with paraesthesias in his hands and feet.
Arsenic posioning
This intoxication leads to the formation of oxalate crystals in the urine
ethylene glycol (found in antifreeze and coolants)
______ can be found in anti-freeze also as well as homemade liquors.
Methanol
Methanol can cause damage to this organ due to formic acid accumulation?
Optic nerve damage
Patient rescued from a burning home has the odor of almonds
Cyanide
What are the symptoms of anti-cholinergic toxicity?
Dry as bone, red as a beet, mad as a hatter, blind as a bat, hot as a hare, as full as a flask
Patient presents with clenched jaw poor dentition, and anxious, what drug abuse are you suspecting?
Methamphetamine
Patient with altered mental status, bilateral miosis (pinpoint pupils), respiratory depression, bradycardia, hypotension, hypothermia, and dry mucous membranes.
Opioid
A women with opioid dependence has recently determined that she is pregnant what drug should she start while pregnant?
buprenorphine or methadone; mothers should not abruptly stop opioids because it can lead to pre-term labor, fetal distress, and spontaneous abortion.
How many hours after over dose of acetaminophen can we administer charcoal?
up to 4 hrs
How many hours after over dose of organophosphates can we administer charcoal?
1 hour
True/False activated charcoal can be given to a patient shortly after ingestion Aspirin overdose?
True
True/False opioids cause <2mm pupil constriction whereas other sedative drugs (benzos, barbs) have normal pupillary size?
True
How do we differentiate heat stroke form heat exhaustion
Patients with heat stroke exhibit signs of AMS, fever of >104, and instead of being sweaty this patient’s skin is dry.
what is the treatment for patients with heat exhaustion or heat stroke
fluids and cold water immersion
what is the MCC of death in a patient with hypothermia?
arrythmia
The temperature of mild hypothermia?
90-95 (32-35)
The temperature of moderate hypothermia?
82-90 (28-32)
Severe hypothermia temperature
<82 (28-32)
What is the formula for the amount of fluid that we should replace in the first 24 hrs after a burn?
4ml x body surface burned x weight in (kg). Remember that in the first 8 hrs the first half is administered and the next half over the next 16 hours will administer the other half.
What is the first step in management if you have to do CPR on a patient that recently drowned?
two rescue breaths first
A patient comes to the ED because of muscle stiffness that he noticed on yesterday. The patient is an avid hiker. On exam there is an area of erythema and induration on the dorsal surface of the hand. The area is not necrotic, what spider bite does this patient have?
black widow,
Patient presents with a necrotic/ painful lesion on the dorsum of the hand after a hike yesterday, what spider bite does this patient have?
brown recluse, tx includes debridement
