Toxins USMLE2

  1. N/V at 2 hours elevated liver enzymes
    Acetaminophen. Dx with blood level and tx with N-acetylcystein w/i 8-10 hours
  2. Contact with batteries, detergen, drain cleaners
    Alkali agents. Clinical dx. Tx with milk/water then NPO
  3. Delerium Miosis fever
    dry as a bone, mad as a hatter, blind as a bat. Anticholinergics. Tx with physostigmine
  4. White stripes on fingernails, capillary leaks, seizures
    • Arsenic. Dx with blood level.
    • Tx: lavage and dimercaprol
  5. Tinnitus, respiratory alkalosis. metabolic anion gap acidosis with normal serum OSM
    • Aspirin. Blood level.
    • Tx: bicarb and dialysis
  6. rapid onset weakness, ataxia, drowsness
    • Benzodiazepine. Blood-level
    • Tx: Flumazenil
  7. Bradycardia, heart block, obtundation, high K, low glucose
    • B-blockers, clinical dx
    • glucagon and IV calcium
  8. dyspnea, confusion coma cherry red
    • Carbon Monoxide
    • Dx: carboxyhemoglobin level
    • Tx: O2
  9. Quick onset almond scented breath and coma
    • Cyanide
    • Dx: Blood level
    • Tx: amyl nitrite or Na thiosulfate
  10. anion gap metabolic acidosis with high serum OSM. Also calcium oxalate crystals in urine
    • Ethylene glycol.
    • Tx: ethanol drip, fomepizole
  11. Comiting, cloody diarrhea, acidosis. CXR shows radioopaque tablets
    • Iron
    • Tx: deferoxamine
  12. Confusion peripheral neuropathy
    • Isoniazid
    • Tx: Pyridoxine
  13. Microcytic anemia with basophilic stippling. Purple lines on gums
    • Lead
    • Tx: EDTA, penicillamine
  14. Erthism = decreased memory, insomnia, timidity delirium
    • Mercury
    • Tx: Ipecac, Dimercaprol
  15. Torsades de pointes
    • Quinidine
    • Tx: IV mg 2+
  16. Anticholinergic sx. QRS>100, torsades de points
    • Tricyclics
    • Tx: bicarb drip
  17. CNS depression, miosis
    • Opioids
    • Tx: naloxone
Card Set
Toxins USMLE2
EM Toxins