Term
|
Definition
Apnea-> mental status changes->coma
Sz, miosis, bradycardia, hypotension |
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Term
| Complications of EtOH induced chronic liver dz |
|
Definition
| Bleed d/o, esophageal varices, portosystemic encephalopathy, hepatorenal sx, spontaneous bacterial peritonitis |
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Term
|
Definition
| Early resp alkalosis-> central resp center shut->metabolic acidosis |
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Term
| Clinical presentation of CN poisoning |
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Definition
| Agitation, Sz, ↓mental status, resp. depression, brady->tahcy->bradycardia, ↑BP->↓BP, pulmonary eema, bitter almond odor/breath, gastritis, cherry red skin -> cyanosis |
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Term
| Poisons that may cause latent GI bleeding |
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Definition
| ASA, iron, coumadin, mercuric salts, alkali/acids caustics, lung acting anticoag, rodenticids |
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Term
| Toxins cause pulmonary edema |
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Definition
| Opioids, ASA, cocaine, ed/hyp, CO, Dig, BB, CCB, chlorine N2O3, organophosphates, ethylene glycol |
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Term
| Drugs to avoid in heterocyclic antidepressants tox |
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Definition
| Phenytoin (↑ V.ectopy), BB & CCB (↓BP), Ipecac (coma), Type 1A (auinidine, procain) & 1C (flecainide), flumazenil, physostigmine (cardiotoxic, asystole |
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|
Term
| ↑anion gap metab acidosis + calcium oxalate crystals in U/A |
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Definition
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|
Term
| Botulism MC initial symptom |
|
Definition
| Visual disturbance - abducens (VI) n. palsy |
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|
Term
| Antidote for organophosphates (SLUDGE) |
|
Definition
| ❑ Atropine: 2-4 mg IV 5min ❑ 2-PAM if weakness, 25-50 mg/kg/IV up to 1 grm |
|
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Term
|
Definition
| physostigmine or pilocarpine |
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|
Term
| Alcohol w/osmolal gap & anion gap |
|
Definition
|
|
Term
| Sinus brady in a suspected poisoning |
|
Definition
| Dig, cyanide, organophosphates, carbonates?,βB,CCB |
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|
Term
| Antidote for phenothiazines (neuroleptic durgs w/antiemetic properties and also used in CHF) |
|
Definition
| ❑ Diphenidramine 50mg ❑ Bentropine 2mg IM |
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|
Term
| What med ingestion will cause hypoglycemia |
|
Definition
| •Oral hypoglycemics •ASA •EtOH •Propranolol |
|
|
Term
| Hydrocarbons aspiration hazard depends on 2 physical properties |
|
Definition
| • Low viscosity (most imp. factor)-measures in SSV (saybolt seconds univ.), ↓# = ↑mortality •high volatility |
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Term
|
Definition
|
|
Term
| Urine alkalinization indications |
|
Definition
| •Barb tox •Salicylate (bolus & drip) •TCA •Chloramphenicol |
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|
Term
|
Definition
| NON cardio pulmonary edema |
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|
Term
| Blood vs urine alkalinization |
|
Definition
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|
Term
| Ethylene glycol & methanol antidote |
|
Definition
| Ethanol 10%/D5W 800 mg/kg load, then 1-1.5 ml/kg/hr |
|
|
Term
| A welder w/fever, shaking chills, salivation, HA, cough, resp distress - Dx? |
|
Definition
| Metal fume fever - resolves 24-48 hrs |
|
|
Term
| What causes metal fume fever |
|
Definition
| Zinc, copper, Mg, carmium, nickel, brass, Fe, manganesse, tin |
|
|
Term
|
Definition
| Gastric dilation, ileus, GI hemorrhage, platelet dysfunction |
|
|
Term
| Indications for hemodialysis in ASA toxicity |
|
Definition
| • Levels >90-100mg/dL •CNS depression • Rising levels despite tx • Renal, hepatic or pulm failure • Severe cardiac toxicity • Severe acid/base disturbance |
|
|
Term
| Toxidrome of cholinergics |
|
Definition
| DUMBLES (or SLUDGE): Dirrhea, Urination, Miosis, Bradycardia, Bronchospasms, Bronchorrhea, Lacrimation, Emesis, Salivation, Seizures. Also, coma resp, failure, muscle fasciculation |
|
|
Term
| Toxins causing latent HTN |
|
Definition
| PCP, MAOI, phenylpropanolamine, cacaine, amphetamines |
|
|
Term
|
Definition
| Valium/Ativam, phenobarbs |
|
|
Term
| Rx to avoid in TCA's w/seizures |
|
Definition
| ❑ Dilantin - ↑incidence of dysrhythmias ❑ Romozicin - ↑ seizures risk ❑ Procainamide - worsen quinidine-like tox ❑ Ipecac - rapid onset seizures & coma |
|
|
Term
|
Definition
| ❑ 1/2 awakening dose as load, then 2/3 of awakening dose/hr diluted in D5W or NS |
|
|
Term
| Anion gas w/Astra analyzer values |
|
Definition
| •Normal Astra 7 mEq; ↑AG=>11mEq/L •Normal test = 12; ↑AG >16 |
|
|
Term
| EKG changes in poisoned pt |
|
Definition
| • Prolonged QT • Wide QRS • Sinus brady |
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|
Term
| Opioid intoxications w/out miosis |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Fruit-like breath in poisoning |
|
Definition
| Nitrites, isopropil alcohol |
|
|
Term
| Bitter almonds breath in poisoning |
|
Definition
|
|
Term
| Pear-like breath in poisoning |
|
Definition
|
|
Term
| Rotten eggs breath in poisoning |
|
Definition
| Hydrogen sulfide (used in refineries) |
|
|
Term
| Garlic breath in poisoning |
|
Definition
| Arsenic, phosphorus, organophosphates, tellurium |
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|
Term
|
Definition
|
|
Term
| DDx in ↑osmolar gap & normal AG |
|
Definition
| Ethanol, isopropyl alcohol, glycerol, mannitol, sorbitol, acetone |
|
|
Term
| Toxic metabolite of methanol |
|
Definition
| Formic acid -Blind drunk: produces optic papillitis & retinal edema |
|
|
Term
| Fab frag indications in Dig toxicity |
|
Definition
| V-Fib, V-Tach, sinus brady, resistant to atropine, K+ >5.5, potentially lethal intox |
|
|
Term
| What specific lab in a suspected organophosphate exposure |
|
Definition
| Serum cholinesterase level expected <10% of normal |
|
|
Term
| Si/Sx of carboxyhemoglobin |
|
Definition
| HA, N/A, flu-like, syncope, tachypnea, coma, Sz, CV collapse, resp failure |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| N-acetylcysteine 140 mg/kg, then PO 70 mg/kg q4 hrs x 17 |
|
|
Term
|
Definition
| Methanol, ethyl alcohol, isopropyl, glycerol, mannitol, ethylene gly, DKA, lactic acidosis |
|
|
Term
|
Definition
| Methanol, ethyl alcohol, isopropyl, glycerol, mannitol, ethylene gly, DKA, lactic acidosis |
|
|
Term
|
Definition
| Ethanol, HD, Leukovorin 50 mg IV q 4 hrs x 24 |
|
|
Term
| When consider whole bowel irrigation |
|
Definition
| Lithium, iron, heavy metal, sustained release drugs, body stuffers/packers |
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|
Term
|
Definition
| • NAPQI • Metabolized by glutathione |
|
|
Term
| Young make with nystagmus & very bizarre, aggressive behavior |
|
Definition
|
|
Term
| Leading cause of toxin related deaths in USA |
|
Definition
|
|
Term
| Which poisoning cause latent renal failure |
|
Definition
| CCl4, mercuric salts, APA, colchicine, ethylene glycol |
|
|
Term
| Toxic metabolite of isopropyl alcohol ingestion |
|
Definition
| Acetone - CNS depre, ↓BP, hemorrhagic gastritis |
|
|
Term
|
Definition
|
|
Term
| 2 MC sympathomimetics toxins |
|
Definition
|
|
Term
|
Definition
| EDTA, calcium disodium edelate |
|
|
Term
|
Definition
| Steven-Johnson Sx, mucocutaneous membrane bullae |
|
|
Term
| CNS complications of opioids |
|
Definition
| Traumatic mononeuritis - MC painful weakness; Sz, brain abscess, transverse muelitis |
|
|
Term
| Activated charcoal not useful in? |
|
Definition
| Lithium, alkalis, acids, heavy metals, iron |
|
|
Term
| What to avoid in organophosphate poisoning |
|
Definition
| Opioid (↓resp depre), physostigmine, succinyl (prolonged paralysis), sympathomimetics |
|
|
Term
| Poisoning assos. w/fever in children |
|
Definition
| Anticholinergics, ASA, amphetamines, LSD, phenothiazines, TCA |
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|
Term
|
Definition
|
|
Term
|
Definition
| Macrolide, cipro, cimetidine, alopurinol, propranolol, OCP's |
|
|
Term
|
Definition
| •Usually elderly •Altered MS • Met acidosis > resp alkalosis •non-cariogenic pulmonary edema |
|
|
Term
|
Definition
| Deferoxamine 15 mg/kg/hr IV |
|
|
Term
| Drugs that ↑1/2 life of phenytoin |
|
Definition
| Cimetidine, phenothiazine, INH, disulfram, dicumarol, chloramphenicol |
|
|
Term
| HD in poisoned pt - indications |
|
Definition
| Ethylene glycol, EtOH, methanol, lithium w/CNS alteration, ASA if: >100 mg/dL, Sz, CNS changes, evere met acid |
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