Clinical toxicology

Question 1

Salicylates signs and symptoms- mild

Answer 1

Tinnitus

Question 1

Salicylates signs and symptoms- severe

Answer 1

Lethargy, convulsion, coma, metabolic acidosis

Question 2

Salicylates treatment

Answer 2

Urine alkalization with NaHCO3
Vitamin K1/ fresh frozen plasma (for bleeding)

Question 3

Minimum serum acetaminophen level (indicates a high risk for liver injury)

Answer 3

150-200 mg/L

Question 4

Paracetamol/Acetaminophen Moa

Answer 4

Depletion of glutathione causing hepatic necrosis due to its toxic metabolite, NAPQI

Question 5

Paracetamol/Acetaminophen treatment

Answer 5

N-acetylcysteine

Question 6

Warfarin moa

Answer 6

Inhibition of Vitamin K-related clotting factors (II, VII, IX)

Question 7

Warfarin principal manifestation

Answer 7

Bleeding

Question 8

Warfarin treatment

Answer 8

Vitamin K

Question 9

Principal manifestation of heparin

Answer 9

Bleeding

Question 10

Heparin treatment

Answer 10

Protamine sulfate (act as base)

Question 11

1 mg protamine = 1000 IU Heparin

Question 12

This cause gray baby syndrome

Answer 12

Chloramphenicol

Question 13

Chlorampenicol treatment

Answer 13

Charcoal Hemoperfusion

Question 14

Vancomycin causes

Answer 14

Red man or red neck syndrome

Question 15

Vancomycin prevention

Answer 15

Prolonging the infusion to 1-2 hours or increasing the dosing interval

Question 16

Digoxin signs and symptoms - mild

Answer 16

Nausea, vomiting, anorexia, confusion

Question 17

Digoxin signs and symptoms- severe

Answer 17

Cardiac dysarrhythmias

Question 18

Digoxin treatment

Answer 18

Lidocaine or phenytoin
Digoxin-specific fab antibodies (Digibind)

Question 18

Digoxin treatment

Answer 18

Lidocaine or phenytoin
Digoxin-specific fab antibodies (Digibind)
Potassium chloride

Question 19

Malignant hyperthermia

Answer 19

Succinylcholine

Question 20

Histamine release (anaphylactic shock)

Answer 20

Tubocurarin

Question 21

DOC for anaphylactic shock

Answer 21

Epinephrine

Question 22

DOC for malignant hyperthermia

Answer 22

Dantrolene

Question 23

Other treatment for succinylcholine & tubocurarine

Answer 23

Neostigmine/ pyridostigmine

Question 24

Methylxanthine signs and symptoms

Question 25

Other treatment for succinylcholine & tubocurarine

Answer 25

Neostigmine/ pyridostigmine

Question 25

Methylxanthine signs and symptoms

Answer 25

Seizures, Cardiac dysrhythmias

Question 26

Methylxanthine treatment

Answer 26

Ipecac syrup Activated charcoal Hemoperfusion & hemodialysis Consider b-blockers for manifestations

Question 27

DOC for mania and bipolar disorders

Answer 27

Lithium

Question 28

Lithium treatment

Answer 28

Ipecac syrup, Na polystyrene sulfonate, WBI, hemodialysis)

Question 29

TCA signs and symptoms

Answer 29

Anticholinergic Cardiopulmonary toxicity CNS manifestation

Question 30

TCA treatment

Answer 30

Physostigmine

Question 31

DOC for anticholinergic signs and symptoms

Answer 31

Physostigmine

Question 32

DOC for cardiopulmonary toxicity

Answer 32

NaCHO3

Question 33

DOC for CNS manifestations

Answer 33

Phenytoin and Bzd

Question 34

Isoniazid signs and symptoms

Answer 34

Peripheral neuropathy Hepatitis

Question 35

Isoniazid management

Answer 35

Pyridoxine (1mg) Activated charcoal (limit GI absorption) BZD (seizures)

Question 36

Isoniazid treatment

Answer 36

Vitamin b6

Question 37

Beta-blockers signs and symptoms

Answer 37

Hypotension Bradycardia AV block bronchospasm

Question 38

Beta-blockers treatment

Answer 38

Glucagon Epinephrine

Question 39

CCB principal manifestations

Answer 39

Hypotension

Question 40

CCB treatment

Answer 40

Calcium chloride IVP glucagon

Question 41

Potassium signs ad symptoms

Answer 41

Cardiac irritability Dysrhythmia Peripheral weakness

Question 42

Potassium treatment

Answer 42

calcium Chloride NaHCO3, Glucose, Insulin

Question 43

Antagonize the cardiac effect of hyperkalemia

Answer 43

calcium Chloride

Question 44

For an intracellular shift of K

Answer 44

NaHCO3, Glucose, Insulin

Question 45

Potassium last measure

Answer 45

Hemodialysis