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Lab Dx Test3 > toxicology > Flashcards

toxicology Flashcards

1
Q

What considerations should you take into account when you are concerned a patient has ingested something? (4)

A

Dose, Route, time elapsed and intentional vs unintentional

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2
Q

What should always be in your differential diagnosis when you have a pt with AMS (altered mental status)?

A

overdose

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3
Q

9 differential diagnoses for AMS

A

Alcohol, electrolytes/epilepsy, infection, opiates/overdose, uremia, trauma/toxicity/tumor, insulin, psych, stroke (AEIOU-TIPS)

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4
Q

What type of poisoning presents with headache, nausea, dizziness chest pain and is often confused with alcohol intoxication

A

carbon monoxide

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5
Q

baseline carbon monoxide levels of smokers

A

10-15%

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6
Q

blood alcohol level at which stupor and loss of consciousness, Coma, respiratory depression and death may occur

A

BAC>0.3

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7
Q

labs to perform on EtOH poisoning

A

ABG’s (respiratory depression), alcohol level

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8
Q

why is pulse oximetry not used for CO poisoning

A

cannot distinguish carboxyhemoglobin from oxyhemoglobin

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9
Q

blood alcohol level at which slurred speech, ataxia, impaired judgment

A

BAC 0.10-0.20

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10
Q 
what class of drugs are 
 Tricyclics
Elavil
 Pamelor
 Tofranil
 Vivactyl
A

antidepressants

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11
Q 
what type of poisoning presents with sedation
Confusion
 Delirium
 Hallucinations
 Cardiac arrythmia
A

antidepressant OD

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12
Q

what labs needed for antidepressants OD (5)

A

TCA (quanlitative), toxicity screen, salicylate level, acetaminephen level, EKG

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13
Q

What is the most important thing to manage in an overdose Pt?

A

Airway!

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14
Q

What are the ABCDE’s of managing an overdose pt?

A

Airway, Breathing, Circulation, Decontamination (removal of garments), Easily correctable issues

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15
Q

Name 4 easily correctable issues regarding maintaining an overdose pt:

A

hypoglycemia, hypoxia, hypotension, hyper/hypothermia

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16
Q

What is the most common OTC overdose medication and what organ is it toxic to?

A

Acetaminophen, liver

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17
Q

At what dose is Acetaminophen considered toxic?

A

150mg/kg (~7-10 g in adults)

18
Q

How will an acetaminophen overdose present?

A

high LFT (liver function test), tachycardia, nausea/vomiting, hypotension, abd pain, GI bleeding, ultimately liver failure

19
Q

What serum labs do you draw for an acetaminophen OD? (4)

A

CBC, CMP, Arterial Blood gas, acetominophen level

20
Q

What non serum tests do you order for an acetaminophen OD? (4)

A

UA, RUQ US (looking for changes in liver or GB), CT of head, EKG

21
Q

What common things have salicylates in them? (3)

A

asprin, Pepto-bismol, oil of wintergreen

22
Q

How does a Salicylate OD present 1-2 hours after ingestion? (5)

A

tinnitus, vertigo, N/V/D, hyperpyrexia, coma

23
Q

How does a Salicylate OD present after many hours? (4)

A

hypernea, respiratory alkalosis, metabolic acidosis, cerebral edema

24
Q

What labs should you order for a Salicyate OD? (6)

A

Salicylate levels, CBC, CMP, LFT, ABGs, UA

25
Q

At what level is salicylate considered “severe toxicity”:?

A

> 110 mg/dL

26
Q

Name 5 different opioids:

A

codeine, morphine, hydrocodone, oxycodone, heroin

27
Q

How would a pt with an opioid OD present? (2)

A

respiratory depression, pin point pupils

28
Q

What is a good way to differentiate between a cocaine OD and an opioid OD?

A

Opioid= pin point pupils, cocaine does not

29
Q

What is the fastest modality for opioid use and how long does it take for peak effect?

A

IV; 10 mins

30
Q

What is the slowest modality for opioid use and how long does it take for peak effect?

A

dermal application (patch or skin popping); 2-4 hours

31
Q

what labs/tests should be ordered for a pt presenting with and opioid OD? (5)

A

ABG, toxicity screen, CBC, CMP, Abdominal films if you suspect body packing

32
Q

What is the half life of Cocaine?

A

~40-90 mins

33
Q

Name 4 routes for using cocaine:

A

inhalation, intravenous, nasal, oral

34
Q

What are the fastest and slowest methods for using cocaine?

A

Fastest= inhalation (7 sec to onset); Slowest=oral (10 min to onset)

35
Q

How does a pt with a MILD cocaine OD present?(4)

A

euphoria, agitation, tachycardia, hypertension

36
Q

How does a pt with a MODERATE/SEVERE cocaine OD present? (7)

A

stroke, renal ischemia, seizures, ventricle dysrhythmias, apnea, hyperthermia, coma

37
Q

What labs/tests should you order for a cocaine OD? (5)

A

toxicology screen, CBC, UA, CMP, EKG

38
Q

4 types of benzodiazepines

A 
 Valium
 Xanax
 Ativan
 Klonopin
 Librium
 Tranxene
39
Q

what type of poisoning presents with a coma with normal vital signs, Nystagmus, Hallucinations, and/or Slurred speech

A

benzodiazepines

40
Q

what 3 tests are needed in benzodiazepine OD

A

CBC, ABGs, Toxicity screen

Lab Dx Test3 (6 decks)

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