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Flashcards in Toxicology Deck (56):
1

If you see metabolic acidosis + respiratory alkalosis, you should think of this poisoning

salicylate poisoning

2

classic blood gas abnml with salicylate poisoning

metabolic acidosis + respiratory alkalosis

3

key difference in presentation between ethylene glycol and methanol poisonings

ethylene glycol: results in oxalic crystals in the urine and hurts the kidneys
methanol: results in formic acid and causes blindness

4

toxic alcohol resulting in blindness

methanol

5

toxic alcohol resulting in renal failure

ethylene glycol

6

radiopaque toxins (5)

***COINS***
1. chloral hydrate
2. opiate packets
3. iron and Hg, As, Li, Ca
4. neuroleptics
5. SR/enteric coated meds
also solvents like CCl4

7

poisonings that activated charcoal won't work for (3)

ions/metals
acids/bases
alcohols

8

this common household object can be 17% EtOH

mouthwash

9

toxin that smells like rotten eggs

hydrogen sulfide

10

toxin that smells like almonds

cyanide

11

toxin that smells like garlic

arsenic

12

Morning Glory poisoning symptoms

hallucinations, mydriasis, perspiration, bronchorrhea, salivation, hyper or hypothermia, diarrhea

13

Treatment to reduce thyroid uptake of radioactive iodine?

Potassium iodine

14

Fish associated with scombroid poisoning?

tuna, mackerel, bonito, mahi-mahi, bluefish, sardines, anchovies

15

Fish associated with cigautera poisoning?

barracuda, snapper, grouper, amberjack, moray eels, triggerfish, parrotfish

16

bidirectional v tach is pathognomic for what toxicity?

digoxin toxicity

17

digoxin toxicity causes what characteristic, unique EKG abnormality?

bidirectional v tach

18

what is unique about digoxin toxicity related hyperkalemia?

do NOT give calcium - it can cause a "stone heart" from excessive intracellular calcium and cardiac tetany

19

what is the treatment for digoxin toxicity?

atropine
digiFab
mag, potassium
consider PHYT, lidocaine

20

first lab abnml in radiation poisoning

leukopenia

21

treatment for cesium radiation poisoning

prussian blue

22

EKG findings in TCA OD

sinus tach, prolonged PR, QRS, and QT intervals

23

Symptoms of scorpion sting

local pain, restlessness, hyperactivity, roving eye movements, and respiratory distress. More severe signs include seizures, drooling, wheezing, hyperthermia, cyanosis, GI hemorrhage, respiratory distress and death from shock or respiratory paralysis

24

envenomation associated with metallic taste

rattlesnake

25

systemic symptoms of brown recluse spider bite

fever, chills, malaise, weakness, nausea, vomiting, joint pain, petechial morbilliform rash, intravascular hemolysis, hematuria, and renal failure

26

fish that cause scombroid

tuna, mackerel, and bonito

27

fish that cause ciguatera

barracuda, grouper, and snapper

28

what do you need to avoid when treating a patient with ciguatera poisoning?

opioids - may interact with toxin and cause hypotension

29

toxic dose of acetaminophen?

150mg/kg in adults
200-250mg/kg in kids

30

toxicity of ethelyne glycol vs methanol?

ethylene glycol: metabolized into oxalic acid, will crystals in urine and possible ARF
methanol: metabolized into formic acid, injures the eyes

31

normal serum osmolality

285-295

32

treatment of organophosphate poisoning

atropine if wet/killer Bs
pralidoxime for for weakness (works at nicotinic skeletal muscle receptors)

33

Coral snake vs king snake?

red on black, venom lack;
red on yellow, kill a fellow.

34

ricin poisoning

inhalational: sudden onset of fever, chest tightness, cough, dyspnea, nausea, and arthralgias, progressing to cyanosis, pulmonary edema and respiratory failure

35

Tularemia: symptoms and treatment

fever, malaise, pneumonia
tx: streptomycin, doxy, cipro

36

aerosolized toxin that smells of "newly mown hay"? symptoms?

phosgene - ocular and nasal irritation, resp symptoms, pulmonary edema

37

inhalational anthrax - presentation

initial mild symptoms followed by abrupt onset resp distress, cyanosis, diaphoresis 1-6 days later. may see widened mediastinum on CXR.

38

inhalational anthrax ppx

cipro or doxy

39

staph enterotoxin b symptoms

sudden onset of fever, chills, headache, myalgias and nonproductive cough

40

pneumonic plague symptoms

The initial presentation includes respiratory symptoms, fever, cough and myalgia. The clinical course is rapidly progressive with bloody sputum, dyspnea, cyanosis, circulatory collapse and a bleeding diathesis.

41

The initial presentation includes respiratory symptoms, fever, cough and myalgia. The clinical course is rapidly progressive with bloody sputum, dyspnea, cyanosis, circulatory collapse and a bleeding diathesis.

pneumonic plague

42

toxin with sudden onset of fever, chills, headache, myalgias and nonproductive cough

staph enterotoxin b

43

initial mild symptoms followed by abrupt onset resp distress, cyanosis, diaphoresis 1-6 days later. may see widened mediastinum on CXR.

inhalational anthrax

44

treatment of plague
ppx?

tx: doxy or streptomycin or cipro
ppx: doxycycline or cipro

45

what is hydrogen sulfide

mustard gas
causes superficial skin burns, eye irritation, and resp tract irritation

46

ingestions where multidose activated charcoal may be helpful?

phenobarbital, carbamazepine, theophylline, and dapsone

47

carbamezepine toxicity

can cause resp compromise, altered mental status, vomiting, drowsiness, slurred speech, nystagmus, hallucinations, hypotension, coma, dystonic reactions, seizures
has some anticholinergic properties
false positive for TCAs on UDS

48

symptoms and management of hydrofluoric acid burns?

used in glass etching, metal cleaning, and electronics manufacturing
hypocalcemia, hypomag, and hyperkalemia
treat with topical, intra-arterial, IV calcium gluconate

49

Symptoms of lithium toxicity

coarse tremor, ataxia, dysarthria, vomiting, diarrhea, cardiovascular changes and renal dysfunction.
Later signs: impaired consciousness, muscle fasciculations, myoclonus, seizures, coma and death.

50

Amanita phalloides ingestion

white mushroom that can kill. classically:
stage I: 6-24hrs of no sxs
II: V/D 12-24hrs
III: seeming recovery
IV: 2-4d later with liver and renal failure

51

ectasy/MDMA intoxication

hyponatremia, concentrated urine, altered mental status
may see serotonin syndrome

52

toxic alcohol resulting in large ketosis

isopropyl alcohol

53

toxins causing miosis

COPS
cholinergics/clonidine
opiates
phenothiazines
sedatives

54

toxins causing mydriasis

AAAs
antihistamines
anticholinergics
atropine
sympathomimetics

55

toxins causing hypoglycemia

HOBBIES
hypoglycemics
oral hypoglycemics
beta blockers
insulin
ethanol
salicylates

56

nerve agents

sarin and venom x (VX)
act as organophosphates