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Rosh/ITE > Tox/ID > Flashcards

Tox/ID Flashcards

1
Q

Sulfonylurea toxicity treatment

A

Octreotide

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2
Q

Bleeding on enoxaparin

A

Protamine

Enoxaparin = Lovanox (LMWH)

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3
Q

1 carrier of rabies in US

A

Bats

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4
Q

Poisoning associated with peppery taste

A

Scromboid

Treat with antihistamines

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5
Q

Poisoning that is associated with sensation of tooth looseness

A

Ciguatera

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6
Q

Exposure that bypasses decon and is evaluated immediately for systemic toxicity

A

Chlorine gas (full dispersed)

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7
Q

Etomidate dose and side effects

A

0.3 mg/kg

Myoclonus, respiratory depression

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8
Q

Abx that directly inhibits toxin synthesis

A

Clindamycin

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9
Q

Most common cause of type II nectrotizing infections

A

Group A strep

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10
Q

Organism that increases risk for cholangiocarcinoma

A

Clonorchis sinensis

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11
Q

CNS lymphoma dx

A

Single solid or ring enhancing lesion with mass effect

Brain biopsy to definitively diagnose

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12
Q

PML dx

A

Focal white matter changes on MRI with NO mass effect
Definitive requires brain biopsy
Caused by JC virus

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13
Q

Most common acute SE of Beta agonist

A

Tachycardia

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14
Q

Dental pain with pseudomembrane, gingival ulcers

A

Acute necrotizing ulcerative gingivitis

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15
Q

Tinea that requires systemic antifungals

A

Capitis and unguium

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16
Q

Abx therapy for dental abscess

A

Clinda + levo

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17
Q

EPS

A

Due to dopamine antagonist
Hours to days after initiation
Treat with anticholinergic: diphenhydramine or benztropine

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18
Q

Beta blocker overdose

A

Brady, hypotension, AMS, seizures
Brochospa and hypoglycemia
Give glucagon (bypasses beta receptors and increases HR)

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19
Q

Treat black widow bite

A

Benzos

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20
Q

End point of treatment for organophosphates/nerve gas

A

Decreased respiratory secretions

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21
Q

Treatment for valproic toxicity

A

L-carnitine

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22
Q

Scalded skin syndrome

A

Staph
Flaccid blisters and/or diffuse erythema worse over intriginous areas
Nikolski +
Mucous membranes SPARED

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23
Q

Propylene glycol

A

Used to dilute IV benzos

Causes anion gap metabolic acidosis

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24
Q

Diseases that need airborne precautions (N95)

A

TB, measles, VZV, COVID

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25
Q

Treat bupivicaine OD with?

A

Intralipids

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26
Q

Treat altitude sickness

A

O2, descent, Dexamethasone

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27
Q

Max dose lido with epi

A

7 mg/kg; 500mg max

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28
Q

1 risk of encephalitis in West Nile virus

A

Age

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29
Q

Granuloma inguinale

A

Caused by Klebsiella

Beefy red, painless genital ulcer

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30
Q

Hallucinations associated with psych vs ingestion

A

Auditory for psych

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31
Q

Treat cerebral gas emboli

A

Hyperbaric chamber

Can occur in hydrogen peroxide tox, CO poisoning, rapid ascent

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32
Q

Reducing sodium in hyperNa

A

10-12mEq/L for first 24 hours

Unless it is a acute; goal is 140mEq/L in 24 hours

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33
Q

Toxoplasmosis has affinity for where

A

Basal ganglia

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34
Q

Chemical exposure that smells like grass or hay

A

Phosgene

Can see severe respiratory compromised but is often delayed

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35
Q

Chemical exposure that smells like pears

A

Chloral hydrate

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36
Q

Amanita phalloides ingestion

A 
Aka deathcap 
Dysentery 6-24 hrs after ingestion
False recovery (elevated ALT/AST)
Multi organ failure
PenG, NAC, Cimetidine, VitC
37
Q

Treat benzocaine OD

A

Methylene blue

Causes methhemoglobinemia

38
Q

Bugs with +Faget sign

A 
(Sphygmothermic dissociation)
Yellow fever (flavivirus)
Typhoid
Tularemia 
Brucellosis
Colorado tick fever
Legionella
Mycoplasm
39
Q

Transplant infections in month 1 vs 1-6 vs 6+

A

1: staph, pseudomonas, strep
1-6: V, EBV, listeria, hepatitis, PJP, aspergillosis
6+: CMV, EBV, HSV, Hep, VZV, fungal

40
Q

Elapidae toxicity

A

Coral snake
Neurotoxic: salivation, dysarthria, diplopia, ptosis, miosis, dysphagia, and seizure
Admit for obs

41
Q

Centruroides toxicity

A 
bark scorpions
oculomotor abnormalities (such as rotary nystagmus) and muscle spasms
42
Q

Crotalidae toxcitiy

A

Pit vipers

Coagulopathy

43
Q

Loxosceles

A

Brown recluse
Erythema progressing to necrotic eschar
Phospholipases (sphingomylinase D)

44
Q

Treat lice

A

Permethrin

45
Q

Metabolic changes in tumor lysis syndrome

A

hyperuricemia
hyperkalemia
hyperphosphatemia
Hypocalcemia

46
Q

Metabolic changes in sarcoidosis

A

Hypercalcemia/hypercalceuria

Low PTH

47
Q

Treat cannibinoid hyperemsis syndrome

A

Capsaicin, haldol
Hot showers
Stop smoking

48
Q

Ethylene glycol toxicity: labs, treatment

A 
High anion gap acidosis, osmolar gap
No elevation in lactate or ketones
Calcium oxalate leading to ARF (elevated creatinine)
Dialysis if ethylene glycol levels >50
Supplement thiamine
49
Q

Labs and sx of methanol toxicity

A

Anion gap metabolic acidosis
Snowfield vision
Optic disc hyperemia or retinal edema; snowy field vision, b/l putaminal hemorrhages
Give fomepizol/alcohol

50
Q

Isopropyl alcohol toxicity

A

Breaks down to acetone
Ketosis without acidosis
Normal anion gap
Elevated osmolar gap

51
Q

Hot and cold temp reversal

A

Pathognomonic for scromboid

52
Q

Arsine gas toxicity

A

Causes RBC hemolysis
IVF, exchange transfusion
Smells like garlic

53
Q

Rigid chest syndrome is a side effect of what pain killer?

A

Fentanyl

54
Q

Highest risk infection causes in solid organ transplant 1d-1m

A

Staph, MRSA, pseudomonas, strep

55
Q

Highest risk infection causes in solid organ transplant 1m-6m

A

CMV, EBV, viral hepatitis, listeria, pneumocystis, aspergillosis, candida

56
Q

Highest risk infection causes in solid organ transplant >6m

A

CMV, EBV, hep virus, VZV, strongyloides, TB, toxoplasmosis

57
Q

Bacteria associated with lung abscess most commonly

A

Peptostreptococcus, prevotella, bacteroides and fusobacterium
*usually mouth bacteria

58
Q

TB drugs contraindicated in pregnancy

A

Streptomycin

Pyrazinimide given only if MDRTB

59
Q

Erlichiosis

A

Lone Star Tick
Fever, headache, malaise, N/V/D, rash 30%
Leukopenia, thrombocytopenia and elevated transaminases
Doxy

60
Q

First marker of acute radiation injury

A

Decreased absolute lymphocyte count

61
Q

C. Botulinum infection

A

Raw honey, puncture wounds, heroin
B/L cranial neuropathies, descending paralysis, vision changes
Aminoglycosides are contraindicated

62
Q

Gonococcecemia

A

Systemic N. Gonorrhea
Migratory polyarthralgias, tenosynovitis skin lesions
Skin lesions can develop necrotic centers

63
Q

Manage asymptomatic hydrocarbon ingestion

A

Aka gas

Obs 6 hours, take CXR

64
Q

Hydrocarbon toxicity

A

Most effect in lungs: can displace O2, cause widespread collapse
Sensitized myocardium to catecholamines, avoid epi

65
Q

Treat E. Faecalis UTI

A

Amoxicillin

66
Q

Copperhead snake

A

Crotalinae family
Most common venomous snake in US
Heat sensitive pit between eye and nose
Elliptical eyes, triangle head, long folding fangs

67
Q

Most common cause of viral gastroenteritis

A

Norovirus

68
Q

Sympathomimetic Mushroom toxicity

A

(Amita muscaria)

NAC

69
Q

Pentad of TTP

A

Fever, anemia, thrombocytopenia, neuro, aki

Plasma exchange

70
Q

Tick paralysis

A

Sudden weakness, loss of coordination and tendon reflexes

Ascending if awake

71
Q

Most common cause of food borne infection

A

Salmonella, campy

72
Q

Treat Ventricular arrhythmias 2/2 hydrocarbon ingestion

A

Esmolol

Hydrocarbon cause oversensitzation to catecholamines

73
Q

Treat pityriasis rosea

A

Topical steroids

74
Q

Treat methemoglobinemia

A

Methylene blue

75
Q

Fire/smoke exposure sequels

A

CO poisoning: O2

Cyanide poisoning: acidosis, give hydroxocobalamin

76
Q

Zika virus

A

S. America, Caribbean, pacific islands

Fever, rash, arthrgias, conjunctivitis

77
Q

TCA overdose

A

Blocks fast Na channels
QRS prolongation, RAD with terminal R in aVR
Myoclonus and seizures due to GABA antagonism
Bicarb at QRS >100ms with end point narrow QRS

78
Q

TOA

A

Complication of PID
Discharge, adnexal mass
Cefotetan + doxy

79
Q

Measles rash

A

Maculopapular

Starts head down-spares palms and soles

80
Q

Rhabdo

Labs and treatment

A

Increased urine myoglobin (not rbcs)
HyperK, acidosis, high phosphate, low Ca
IVF and urine alkalinozation

81
Q

Abx that can cause serotonin syndrome

A

Linezolid

82
Q

Arsenic poisoning

A

Garlic taste, GI sx

83
Q

Most common cause of erythema multiforme

A

HSV

84
Q

Treat wide complex tachycardia in cocaine OD

A

Sodium bicarb

Due to Na channel blockade, not ventricular

85
Q

Need to supplement in methanol tox

A

Folinic acid

B/c of Formaldehyde and formic acid byproducts

86
Q

Valproic acid toxicity

A

N/V/CNS depression
Isolated hyperammonium
Treat with l-carnitine

87
Q

For iron ingestion

A

Whole bowel irrigation

88
Q

Silo Farmers Disease

A

Decomposing grain -> NO -> methemoglobinemia
Methylene blue

Rosh/ITE (16 decks)

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