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Laughing Your Way > Toxins > Flashcards

Toxins Flashcards

1
Q

Dose of activated charcoal

A

0.5-1 g/kg (max/adult 25-100g)

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2
Q

When charcoal is a poor choice

A

Cyanide
Alcohol/alkaline/kerosene
Lithium
Heavy metals

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3
Q

Acetaminophen overdose

A

> 140 mg/kg

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4
Q

Most important predictor of outcome regarding acetaminophen toxicity

A

Level at 4-10hr post ingestion

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5
Q

First step of acetaminophen ingestion

A

Activated charcoal (if within first 4 hours)

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6
Q

Management of acetaminophen ingestion is > 140 mg/kg

A

NAC

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7
Q

Reason NAC is beneficial in acetaminophen toxicity/overdose

A

Replenishes depleted glutathione stores

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8
Q

“Wintergreen” breath odor
Tinnitus
Respiratory alkalosis (1)
HAGMA (2)

A

Salicylate toxicity

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9
Q

Management for salicylate toxicity

A

1) activated charcoal
2) sodium bicarbonate
3) treat hypoglycemia +/- glucose

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10
Q

Anion gap

A

Na - (Cl + HCO3)

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11
Q

Examples of methanol

A

Windshield water fluid
Cooking fuel
Perfumes
Antifreeze

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12
Q

Sign/Symptoms of methanol toxicity

A

HAGMA
CNS depression
Abdominal pain, vomiting
Inebriation

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13
Q

Blurred vision
“Snow field” vision
Edema of optic disc

A

Methanol toxicity

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14
Q

Management of methanol toxicity

A

Ethanol
(EtOh dehydrogenase antagonist - slows conversion of methanol to formaldehyde)

Sodium bicarbonate

4-MP (FDA approved in Europe)

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15
Q

Anti-freeze

A

Ethylene glycol

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16
Q

Drunk
No odor
HAGMA

A

Ethylene glycol toxicity

17
Q

3 phases of ethylene glycol toxicity

A

1) N/V, tachycardia, HTN, met acidosis, Ca oxylate crystals leaving to hypoCa

2) coma and cardiorespiratory failure

3) ATN

18
Q

Management for ethylene glycol toxicity

A

Fomepizole
(Prevents breakdown of ethylene glycol to its toxic metabolites - oxalic and glycolic acid)

19
Q

Salivation/sweating
Lacrimation
Urination
Defecation/diarrhea
Gastrointestinal
Emesis

A

Organophosphate toxicity

20
Q

Mechanism of action for organophosphate

A

Acetylcholinesterase inhibitor

21
Q

Symptoms of muscarinic cholinergic

Management

A

Salivation
Lacrimation
Diarrhea
Wheezing
Bradycardia

Tx: atropine

22
Q

Symptoms of nicotinic cholinergic

Management

A

Weakness
Paralysis
Muscle fasciculations

Tx: pralidoxime

23
Q

Mechanism of action for TCAs

A

Anticholingeric

24
Q

Cardiac toxicity of TCAs

Management

A

Prolonged QRS

Tx: NaBicarb until QRS < 100 msec

25
Q

Depressed sensorium
Bradycardia
Hypotension
Diaphoresis

Management

A

Beta blocker ingestion

Tx: glucagon (if symptomatic)

26
Q

Sudden flu-like symptoms
Afebrile
Singed nasal hairs

Management

A

Carbon monoxide toxicity

Tx: 100% high flow oxygen

27
Q

Mechanism of action for carbon monoxide toxicity

A

Competitively bonds Hgb (much higher affinity than O2)
Lowers O2 carrying capacity

Normal SpO2 (pulse Ox cannot distinguish between carboxyHgb and OxyHgb)

28
Q

Metabolic acidosis
Smell of almonds
Untreated CO poisoning with oxygen

Management

A

Cyanide poisoning

Tx: hydroxycobalamin. Na thiosulfate, nitrate

29
Q

Dishwasher detergent
Drain cleaner
deep liquefication necrosis
Respiratory/GI distress

Management

A

Alkaline ingestion

Tx: supportive +/- endoscopy

30
Q

Lead level (mcg/dL)
Repeat screening (venous)
Management

A

5-14: repeat 3 mo. History, screen

15-44: repeat 4 wks. Above + Xray (pica)

45-70: repeat 48 hr. Above + chelation (PO succimer) +/- admission

>

  1. Repeat now. Admit. Whole bowel irrigation. IM dimercaprol followed by IV edetate Ca disodium)
31
Q

Symptoms of lead poisoning

A

Headache
Lethargy
Microcytic anemia (basophilic stippling)
Burton lines on teeth
Lead lines on Xray (marked linear increases in density of metaphysis)

32
Q

Lab values seen in severe iron ingestion

A

Serum Iron > 350
WBC > 15k
Glucose > 150

33
Q

Management for iron ingestion

A

Chelation (severe symptoms)
Deferoxamine (turns urine pink-red)

34
Q

Pigmentation and rash
Cutting teeth prematurely (early eruption)
Low birthweight

A

PCB ingestion

35
Q

Begins in face/extremities
Leaves scars
Lesions are same stage
Delirium

A

Smallpox

36
Q

Begins centrally
Scarring rare
Lesions in varying stages

A

Varicella

37
Q

Starts as pruritic papule
Progresses to central bullous lesion
Becomes necrotic
Forms central black painless Escobar

A

Cutaneous anthrax

38
Q

Toxin-induced distal RTA (type 1)

A

Toluene

39
Q

Osmolal gap without HAGMA

A

Isopropyl alcohol

Laughing Your Way (34 decks)

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