Toxicology

Question 1

Sulfonurea antidote?

Answer 1

Octreotide

Question 2

Beta Blocker antidote?

Answer 2

Glucagon

Question 3

Benzodiazipine antidote?

Answer 3

Flumazenil

Question 4

Tricyclic antidote

Answer 4

Sodium Bicarbonate

Question 5

Isoniazid antidote

Answer 5

Pyridoxine

Question 6

Cholinergic Toxidrome?

Answer 6

WET
Organophosphate poisoning/Fungus/Sarin Gas/Novochok

Bradycardic/bronchospasm/bronchorrhea
Comatose
Sweating/crying/drooling/urination/diarrhoea/vomiting/tummy cramp “SLUDGE”
Little pupils

Rx: Atropine

Question 7

Anticholinergic Toxidrome

Answer 7

Bella Donna, Atropine, Antihistamines, TCAs

Mad as hatter (agitated/vigilant)
Hot as hades (Hyperthermic)
Blind as bat (Mydriasis)
Red as beet
Dry as bone (Dry mucouse membrane)
Bowel and bladder lose their tone (retention)
Heart goes alone (tachycardia)

Question 8

Antidote to Ethylene Glycol

Answer 8

Fomipazole
Ethanol
Sodium bicarbonate
Dialysis

Question 9

Antidote to methemoglobinemia

Answer 9

Methylene Blue

Question 10

Calcium Channel Blocker

Answer 10

Calcium gluconate
Calcium chloride
Then high dose insulin and titrate as a pressor

Question 11

Antidote to hypertensive crisis?

Answer 11

Nitroprusside

Question 12

Colchicine antidote?

Answer 12

Nil antidote
Charcoal decontamination

High mortality

Question 13

Contraindication to charcoal?

Answer 13

PHAILS
Pesticide - Petrol
Hydrocarbon - Heavy Metal - more than one Hour
Acid, Alkali, Alcohol
Iron
Lithium
Solvents

—

Question 14

One Pill can Kill?

Answer 14

Colchicine

Sulfonurea

Question 15

Two Pills can kill?

Answer 15

(ONE PILL Colchicine/Sulfonurea)

Then

Na Sodium Channel (TCA, Poropanolol, Chloroquine, Hydroxychloroquine, Atropine)
Ca Channel Blocker
Theophylline
Opiods
Amphetamine/Ecstacy

Question 16

Extradural vs. Subdural in Emergency Medicine?

Answer 16

Extradural - Trauma - Lentiform (Lens/Lemon shaped/Biconvex) - confined via periosteum
Occur
Arterial
Injury, Loss of conciousness, recovery, progressive worsening “Lucid Interval”

Vs.

Falls, NAI,
“Banana shaped” as occur in subdural (aka crossing sutures)
gradual GCS with increasing mass effect

Question 17

Neurogenic Shock?

Answer 17

Spinal lesion above T5
Imbalanced parasympathetic drive

Hypotensive
Vasodilated
Bradycardic
Inadequate cardiac output

Weeks to resolve

Question 18

Signs of anaphylaxsis?

What changes with insect sting?

Answer 18

Respiratory or Cardiac in setting of exposure/urticaria/angioedema/GI Sx

Insect sting + GI Sx is sufficeient for

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Uniphasic 95%
Biphasic (rebound) 5% - more often if needed more adrenaline/fluids

Protracted - Adrenaline infusion for days in PICU