Toxicology

Question 1

PTSD nightmare med?

Answer 1

prazosin

Question 2

Tylenol has 4 stages

Answer 2

First is first 24 hours and mailaise and n/v

II is 2-3 days and is LFTs PT and bill is up with RUQ tenderness

III is jaundice, hep encephalopathy, bleeding and renal failure and DEATH

III is recovery, 4 days-2 weeks

Question 3

Beta blocker toxic tx?

Answer 3

Fluids for hypotension, Atropine for heart rate

Glucagon activates adenylate cyclase and more calcium

Calcium

Insulin and glucose to fix myocite metabolism

Question 4

Calcium channel blocker tx?

Answer 4

Same as beta

fluids, atropine, glucagone, calcium, insulin and glucose

Question 5

Almond breath in obtunded patient?

Tx?

Answer 5

Cyanide poison

Tx with sodium thiosulfate and hydroxocobalamin

Makes stuff you can pee out

Nitrate can be done to make methemoglobinemia to bind it

Question 6

Delayed symptom of cyanide tox?

Answer 6

Parkinsonism

Question 7

When is methemoglobinemia a good thing?

Answer 7

When treating cyanide poisoning. You give nitrates to induce it to bind it up

Question 8

EKG changes with Dig toxciity??

Answer 8

Prolonged PR interval

PVCs

Atrial tach with AV block!!!

Question 9

isoniazid tx? Signs of toxic?

Answer 9

Neuropathy and hepatotoxicity

Vitamin B6

Question 10

Methanol and ethylene glycol tox tx?

Answer 10

Fomepizole, dialysis or booze

Question 11

Salicylate tox symtpms?

Answer 11

Tinnitus, hyperthermia (uncoupled oxidative phosphorylation), Respiratory alkalosis

Mixed resp all with metabolic acidosis with anion gap

Question 12

Salicylate poison tx?

Answer 12

Charcoal
Dialysis
Sodium bicarb for acidosis

Question 13

Sulfonyureas have long half life, so what?

Answer 13

So need to hospitalize if hypoglycemic and coming to ER because juice won’t fix it

Question 14

TCA ovedose tx?

Cardiotoxicity
Anticholinergic
CNS tox

Answer 14

Dizepam

Sodium bicarb

Question 15

what do you do 15 years after ingestion of alkali

Answer 15

EGD to look for squamous cells stuff

Question 16

First thing you do if organophosphate poisoning?

Answer 16

ATROPINE

Second thing is pralidoxime

Question 17

Iron to is GI phase first, then latent, then shock with met acidosis, then hepatotoxicity then bowel obstruction

Answer 17

oh ok

Question 18

Treatment of anemia with peripheral neuropathy?

Answer 18

Think lead poisoning

Kids: succimer or IF SEVERE dimercaprol orEDTA (dimercaprol is also for mercury, so think for some metals it is used!)

Adults give succimer

Question 19

Mercury poisoning. Signs?

Answer 19

Lots of swordfish, mental status change, tremor

Dimercaprol

Question 20

Arsenic toxicity?

Answer 20

Dimercaprol, succimer, penicillamine

Question 21

TPA overdose tx?

Answer 21

aminocaproic acid

Question 22

Body packing toxicity treatment?

Answer 22

Polethylene glycol to get it out fast

Question 23

COPD patient comes in with tacky and hypotension? Can have seizure. What is it?

Answer 23

Theophylline