Toxins

Question 1

commonly abused hydrocarbon can present with severe hypokalemia and renal tubular acidosis?

Answer 1

toluene

Question 2

plant overdose of respiratory failure from nicotinic respiratory overstimulation - nausea, vomiting sympathomimetic effect, tachy, diaphoresis, anxiety, seizures, death

Answer 2

poison hemlock - coniine

Question 3

plant overdose of cardiac dysrhythmias, hypotension, cardiogenic shock

Answer 3

oleander- dig like

Question 4

reversal of warfarin toxicity?

Answer 4

vitamin K and PCC

Question 5

reversal of heparin toxicity?

Answer 5

protamine sulfate

Question 6

reversal of GP 2b/3a inhibitor toxicity?

Answer 6

platelet transfusion

Question 7

nausea, vomiting, AMS after overdose on seizure med with elevated ammonia? tx?

Answer 7

valproic acid overdose

L carnitine

Question 8

Treatment of mg toxicity?

Answer 8

Calcium

Question 9

Fish associated with flushing, HA, palpitations, vomiting

Answer 9

tuna, mahi-mahi, mackerel

- scombroid/histamine-like toxin

Question 10

What toxidrome does jimson weed cause?

Answer 10

Anticholinergic

Question 11

oral chelation for lead poisoning?

Answer 11

succimer

Question 12

what causes acute rejection/type IV sensitivity?

Answer 12

CD8+ T cell mediated process against donor tissue resulting in leuk infiltration of graft vessels

Question 13

what causes chronic rejection?

Answer 13

CD4+ t cell mediated process resulting in proliferation of the vascular intima and fibrosis of the renal vessel

Question 14

type 1 hypersensitivity reaction?

Answer 14

crosslinking of IgE on mast cells or basophils causing histamine release

Question 15

antiepileptic causing hyponatremia, most common at therapeutic doses?

Answer 15

oxcarbazepine

Question 16

contraindication for using dimercaprol in lead poisoning?

Answer 16

diluted in peanut oil, avoid in peanut allergy

Question 17

how long should you monitor TCA overdose for?

Answer 17

until EKG normal for 12-24 hours

Question 18

tx of marine animals with stingers?

Answer 18

hot water immersion, stinger removal

Question 19

acetone causes?

Answer 19

elevated osmolar gap, ketosis without acidosis, pseudorenal failure

Question 20

most common complication of illness caused by rat droppings?

Answer 20

hantavirus

pulmonary complications

Question 21

chemical warfare agent causing ocular, dermal, and pulmonary injuries?

Answer 21

mustard gas

Question 22

decontamination of mustard gas?

Answer 22

household bleach, dilute

Question 23

aerospace manufacturers causes what lung disease?

Answer 23

berylliosis: pneumoconiosis

Question 24

Mining causes what lung disease?

Answer 24

silicosis: mining

Question 25

indications for hemodialysis with salicylate toxicity?

Answer 25

level > 100 mg/dl
coma
rising levels despite alkalinization
renal failure
pulmonary edema
AMS
clinical deterioration
severe acid/base abnormality

Question 26

What lab test is elevated with someone who swallowed paint thinner?

Answer 26

carboxyhemoglobin

From methylene chloride or dichloromethane

Question 27

Vitamin needed for ethylene glycol toxicity?

Answer 27

Thiamine

Question 28

Vitamin needed in methanol toxicity?

Answer 28

Folinic acid

Question 29

intoxication with ethylene glycol labs:

Answer 29

high anion gap metabolic acidosis with absence of ketones or lactate

Question 30

methanol toxicity labs:

Answer 30

anion gap near normal, acidosis

Question 31

isopropanol labs:

Answer 31

osmolar gap 20, anion gap 8, ketonemia