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MJ- Disciplines Exam 4 > Toxicology > Flashcards

Toxicology Flashcards

1
Q

What 3 toxic substances can smell like Garlic?

A
  • Dimethy sulfoxide (DMSO)
  • Arsenic
  • Organophosphates
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2
Q

What toxic substance smells like bitter almonds?

A

Cyanide

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3
Q

What 2 toxic substances smell like rotten eggs?

A
  1. Hydrogen sulfide
  2. Sewer gas

(“SH it smells like rotten eggs”)

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4
Q

What 2 toxic substances smell like acetone?

A
  1. Isopropyl alcohol
  2. Ethanol
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5
Q

What toxic substance smell like shoe polish?

A

Nitrobenzene

(“I get my shoes polished at Night”)

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6
Q

What toxic substance smells like violates?

A

Turpentine

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7
Q

What toxic substance smells like pears?

A

Chloral Hydrate

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8
Q

What toxic substance smells like peanuts?

A

Vacor (rat poison)

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9
Q

What toxic substance smells like carrots?

A

Cicutoxin (water hemlock)

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10
Q

What toxic substance smells fruity?

A

DKA

Isopropanol

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11
Q

What 2 toxic substances smell like mothballs?

A
  • Naphthalene
  • Paradichlorbenzene

(“I Partied too hard so I took a Nap in some mothballs”)

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12
Q

What toxic substance smells like rotten wintergreen?

A

Methylsalicylate

(“He did Meth in Winter”)

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13
Q

How do you calculate an anion gap?

A

Na - (Cl+ HCO3)

(normal= 12 +/- 4)

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14
Q

What can cause an anion gap to be high?

A

MUDPILES:

  • Methanol
  • Uremia
  • DKA
  • Paraldehyde/ Propylene glycol
  • Iron/Isoniazid
  • Lactate
  • Ethylene glycol
  • Salicylates

(Could also be CUTER DIMPLES A= cyanide, toluene, ethanol, rhabdomyolysis, renal tubular acidosis, DKA, Isoniazid, Iron, Methanol, Propylene glycol, Lactic acidosis, Ethylene glycol, Salicylates)

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15
Q

What 4 things could cause an anion gap to be decreased?

A
  • Lithium
  • Bromide
  • Hypoalbuminemia
  • Multiple Myeloma

(“Multiple Bros got Hyped after getting Lit”)

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16
Q

If your osmolar gap is normal (<10), what can you exclude form your Ddx?

A

Can exclude toxic alcohol

17
Q

When is your osmolar gap increased? (“ME DIE”)

A
  • Methanol
  • Ethylene Glycol
  • Diuretics (mannitol)/DKA (acetone)
  • Isopropyl alcohol
  • Ethanol

**A normal osmolar gap can exclude toxic alcohol from ddx*

18
Q

What foreign bodies show up on imaging (radioopaque substances)?

(“CHIPES”)

A
  • Chloral hydrate, calcium, crack cocaine
  • Heavy metals
  • Iodine, iron
  • Phenothiazines, TCA, packets, Play-Doh
  • Enteric coated
  • Solvents, salicylates, sustained release
19
Q

What things can cause bradycardia? (“PACED”)

A
  • Propanolol, poppies, propoxyphene, physiostigmine
  • Anticholiesterase drugs, antiarrhythmic
  • Clonidine, CCBs
  • Ethanol (or other alcohols)
  • Digoxin, Digitalis
20
Q

What can cause Tachycardia (FAST)

A
  • Free base, freon
  • Anticholinergics, antihistamines, anti-pyschotics, amphetamines, alcohol withdrawal
  • Sympathomimetics, solvents, strychnine
  • Theophylline, TCA’s, thyroid hormones
21
Q

Toxicology vital signs- what can cause hypothermia? (“COOLS”)

A
  • Carbon monoxide
  • Opiates
  • Oral hypoglycemics, insulin
  • Liquor (alcohols)
  • Sedative hypnotics
22
Q

Toxicology vital signs- what can cause hyperthermia? (“NASA”)

A
  • Neurologic malignant syndrome, nicotine
  • Antihistamines, alcohol withdrawal
  • Salicylates, sympathomimetics, serotonin syndrome
  • Anticholinergics, antidepressants, anti-psychotics
23
Q

Toxicology vital signs- What can cause Hypotension (“CRASH”)

A
  • Clonidine, calcium channel blockers
  • Rodenticides (containing arsenic, cyanide)
  • Antidepressants, aminophylline, anti-hypertensives
  • Sedative hypnotics
  • Heroin (other opiates)
24
Q

Toxicology vital signs- What can cause Hypertension? (“CT SCAN”)

A
  • Cocaine
  • Thyroid supplement
  • Sympathomimetics
  • Caffeine
  • Anticholinergic, amphetamines
  • Nicotine
25
Q

Toxicology vital signs- What causes rapid breathing? (“PANT”)

A
  • PCP, paraquat, pneumonitis, phosgene
  • ASA
  • Noncardiogenic pulmonary edema, nerve agents
  • noxin-induced metabolic acidosis
26
Q

Toxicology Vital signs- What causes slow breathing? (“SLOW”)

A
  • Sedative hypnotics (barbiturates, benzo)
  • Liquor (alcohols)
  • Opioids
  • Weed (marijuana)
27
Q

Toxicology Vital signs- What can cause Coma? (“LETHARGIC”)

A
  • Lead, lithium
  • Ethanol, ethylene glycol
  • TCAs, thallium, toluene
  • Heroin, hemlock, heavy metals, hepatic encephalopathy, hydrogen sulfide, hypoglycemics
  • Arsenic, antidepressants, antipsychotics, anticonvulsants, antihistamines
  • Rohypnol (sedative hypnotics), risperidone
  • GHB
  • Isoniazid, insulin
  • Carbon monoxide, cyanide, clonidine
28
Q

Toxicology vital signs- Seizure inducing agents (“OTIS CAMPBELL”)

A
  • Organophosphates, oral hypoglycemics
  • Tricyclic antidepressants
  • Isoniazid, insulin
  • Sympathomimetics, strychnine, salicylates
  • Camphor, cocaine, CO, cyanide, chlorinated hydrocarbons
  • Amphetamines, anticholinergics
  • Methylxanthines, methanol
  • PCP, propranolol
  • Benzodiazepine withdrawal, botanicals (water hemlock, nicotine), bupropion, ghB
  • Ethanol withdrawal, ethylene glycol
  • Lithium, lidocaine
  • Lead, lindane
29
Q

What causes Miosis? (“COPS”)

A

oCholinergics, Clonidine, Carbamates

oOpiates, Organophosphate

oPhenothiazine, Pilocarpine, Pontine hemorrhage

oSedative hypnotics

30
Q

What causes Mydriasis? (“SAW”)

A

oSympathomimetic (cocaine, amphetamines)

oAntihistamines, Antidepressants, Anticholinergics (atropine)

oWithdrawal

31
Q

What toxins are accessible to hemodialysis? (“UNSTABLE”)

A
  • Uremia
  • No response to conventional therapy
  • Salicylates
  • Theophylline
  • Alcohols
  • Boric acid, barbiturates
  • Lithium
  • Ethylene glycol
32
Q

What are diaphoretic skin causes? (“SOAP”)

A
  • Sympathomimetics
  • Organophosphates
  • Aspirin
  • PCP
33
Q

What are 2 things that cause red skin?

(on exam)

A

CO

Boric acid

34
Q

What causes blue skin?

(on exam)

A

Methemoglobinemia

MJ- Disciplines Exam 4 (4 decks)

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