Week 1

Question 1

When to give Fomepizol

Answer 1

Toxic alcohols- ethylene glycol and methenol
+ anion gap
+ osm gap

Question 2

Treatment for cocaine toxidrome

Answer 2

benzos

Question 3

Treatment for organophosphate poisoning

Answer 3

pralidoxime (2-pam)
diazepam
atropine

Question 4

_____________ is useful in aspirin overdose

Answer 4

urine alkalinization

Question 5

_________ is rx used for Tylenol overdose

Answer 5

NAC

Question 6

Lidocaine is a sodium channel blocker, and toxicity resulting from overdose can cause __________.
Rx is __________

Answer 6

ventricular arrhythmia

IV fat emulsion (Intralipid)

Question 7

Reversal of warfarin involves treatment with? (3)

Answer 7

fresh frozen plasma (FFP)
vitamin K
prothrombin concentrate complex (PCC).

Question 8

Treatment for ACE inhibitor induced angioedema is?

Answer 8

antihistamines
glucocorticoids
epinephrine

Question 9

Bleach ingestion rx

Answer 9

Household bleach is a weak alkali with a pH of 11. Even in large ingestions it rarely causes significant damage. Supportive care is the most appropriate management.

Question 10

Acute loss of consciousness in a sewer
“rotten egg” odor
severe metabolic acidosis
elevated lactate.

Answer 10

Hydrogen sulfide poisoning

Question 11

Metformin Overdose

Answer 11

causes lactic acidosis

rx: supportive

Question 12

Isoniazid causes_______________ depletion, which can lead to intractable seizures.

Answer 12

vitamin B6 (pyridoxine)

rx: Treatment is IV adminstration of vitamin B6; 1 gm per 1 gm of INH toxicity.

Question 13

Serious Mushroom Ingestion

Answer 13

s/s start 6 hours after ingestion (s/s of poisoning that occur < 6 hours do not exclude potential for life-threatening toxicity)

Question 14

The differential diagnosis for peripheral vertigo includes the following:

Answer 14

benign paroxysmal positional vertigo
vestibular neuritis
Menieres disease
perilymphatic fistula
acoustic neuroma,
*aminoglycoside toxicity

Question 15

Lindane Use and Black Box warning

Answer 15

Lindane- patients who cannot tolerate or have failed first-line treatment with safer medications for the treatment of scabies and lice.

Seizures and deaths have been reported following lindane use

Question 16

OSM gap

Answer 16

Normal less than 10

gap= Serum OSM- calculated OSM

Question 17

***Methanol buzz word

Answer 17

Blindness

Question 18

***Ethylene Glycol buzz word

Answer 18

Kidney Stones, AKI

Question 19

Do pressers work in an acidotic patient?

Answer 19

Not really

No one knows why it doesn’t work. Dr. Segal has his PhD on this topic. Methylene blue might work instead

Question 20

***Which anti-psychotic causes the most QT prolongation

Answer 20

Ziprasidone

Question 21

***What does Sodium Nitrate do

Answer 21

Induces met-hemaglobanemia

Given for cyanide poisoning, makes CO poisoning worse

Question 22

Quick test of Cyanide posionig and physiology

Answer 22

Decouples the electron transport chain
therefor you dont consume oxygen
blood gas will have high PaO2

Question 23

***Cyanide Rx

Answer 23

• sodium nitrate*- IV
• amylnitrate*- inhalation route (no longer produced)
• sodium thiosulphate- IV,

*causes met-hemaglobanemia and hypo-tension. Makes CO poison worse

Question 24

Hydroxycocalamine

Answer 24

Cyanide rx- Cobolt has a higher affinity for cyanide vs cells
Causes yellow coloring in pt
minimal SE, similar to B12

Question 25

CO Poison

Answer 25

10-15% of hemoglobin binding--> s/sx HA, lethargy, syncope, NV, cherry red skin Rx: 100% O2 on non-rebreather

Question 26

**What is the MOA of hyperbaric chambers that makes it helpful?

Answer 26

Delayed neurological sequela, improved basal ganglia fxn (in some studies)