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ER, ICU, Surgery 4
Toxicology Part 2
| Question | Answer |
|---|---|
| What is the most sensitive test for MS? | MRI brain (head and orbits). Remember, though, that MS is a clinical diagnosis. |
| What type of bite/sting can rearly cause acute pancreatitis? | Scorpion |
| What is the tx for a scorpion bite? | Antivenin, atropine (counteracts cholinergic fx of venom), and phenobarbital |
| Name 3 organisms responsible for infection in mammalian bites. | Staph, Pasturella multocida, and rabies virus |
| Do all pts with alkali fluid ingestion require hospitalization? | Nope! If they have little or no injury, you can d/c them and have them f/u outpt. You ain't got to go home, but you got to get the hell outta here! |
| What are the s/s of organophosphate poisoning? | DUMBBELSS: diarrhea, urination, miosis, bronchospasm, bradycardia, emesis and excitation of skeletal m, lacrimation, sweating, salivation, and abdominal cramping. Leaky stuff! |
| What complication of iron poisoning can be seen 2-8 weeks after ingestion? | Bowel obstruction (GI scarring at gastric outlet; vomiting is presenting sx) |
| What is the tx for lead poisoining in adults? In kids? | Adults: EDTA or succimer. Kids: dimercaprol or EDTA. |
| What is the next step in the mgmt of a pt that presents to the ER with organophosphate poisoning? | Remove clothes (the pts, not yours). Gown and glove up. Give atropine and pralidoxine. |
| What classic toxic ingestion mgmt options should not be chosen in pts presenting with alkaline fluid ingestion? | NG tube, anti-emetic, or neutralizing agents |
| A COPD pt comes to the ER with tachycardia and hypotension. During the evaluation, he begins to have seizures. What is the most likely etiology? | Theophylline toxicity |
| Name my antidote!: arsenic | dimercaprol, succimer, penicillamine |
| Name my antidote!: anticholinesterases, organophosphates | atropine, pralidoxime |
| Name my antidote!: carbon monoxide (cherry red lips) | 100% O2, hyperbaric O2 |
| Name my antidote!: copper | penicillamine |
| Name my antidote!: iron | deferoxamine |
| Name my antidote!: mercury | diMERCaprol |
| Name my antidote!: t-pa | aminocaproic acid |
| Name my antidote!: acetaminophen | n-acetylcysteine |
| Name my antidote!: anticholinergics (atropine) | physostigmine |
| Name my antidote!: benzos | flumazenil |
| Name my antidote!: beta blockers | glucagon, calcium, insulin, dextrose, atropine |
| Name my antidote!: CCBs | almost same as beta blockers: glucagon, calcium, insulin, dextrose |
| Name my antidote!: cocaine | supportive care, benzos, ccbs |
| Name my antidote!: cyanide | nitrates, hyroxocobalamin |
| Name my antidote!: caustics (acids, alkali) | Copius irrigation, activated charcoal (NO antiemetics or neutralizers!) |
| Name my antidote!: ethylene glycol (antifreeze) | ethanol, dialysis |