toxicology Flashcards
on the boards
look for pt working in metal trades, manufacture of plastic mining
or JEWELRY presents to ER with
Headache, tachypnea (usually precede by apnea) and tachycardia
breath has an ALMOND odor
on venous blood sample it appears BRIGHT RED
CYANIDE poisoning
almond odor breath
bright red venous blood sample
jewelry store clerk
diagnosis
and cause
cyanide poisoning
its due to inactivation of the mitochondrial cytochrome oxidase
on the boards
treatment for solicylates (ASA) overdose
what if severe?
sodium bicarb (NaHco3-)
alkalinize the serum and urine
if severe tx with hemodialysis
Q
what is the main pathological effect of CO poisoning on the CNS/
bilateral necrosis of the white matter of the cerebrum and BASAL GANGLIA (particularily ** globus pallidus)
treatment for iron poisoning
deferoxamine
binds iron in blood and facilitates its excretion through the urine.
Q
pt presents to ER saying he ingested a shit tone of Acetaminophen 4 hours ago. he says he feels fine and wants to go home
can you send them home?
no
bc liver toxicity/failure starts 1-2 days after ingestion of toxic dose
on the boards
look for pt w/ hx of depression presenting with
agitation, seizures, hypotension, arrhythmias, and anticholinergic symptoms (dilated pupils, hyperthermia, flushing, and urinary retention)
whats the tx
alkalinizatioin of the serum by IV sodium bicarbonate
or
HYPERVENTILATION (for ventilated pt keep PH 7.5-7.8) to reducd cardiac effects
TCA overdose
farmer comes in with lots of mucus fluids coming out of mouth (bronchorrhea) and has bronchospasms. you are worried that this could progress to respiratory failure.
these are common manifestations of what type of toxicity
organophosphate (instecticides)
PARATHION
what can cause symptoms of a cholinergic toxidrome (toxic syndrome)
besides organophosphates toxicity?
carbamates, mushrooms.
tx for cholinergic toxidrome
such as organophosphate insecticides
atropine!!!!! he said this is the main answer
and
pralidoxime (regenerates AChE if given early)
