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77 Cards in this Set
- Front
- Back
most common category of exposure according to the AAPCC
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analgesics
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seizure, hypoglycemia, bradycardia, low blood pressure from grandma's house =
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beta blockers (i.e. propanol)
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topical benzocaine results in ...
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methemoglobinemia
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CV drug overdose from grandpa, hyperkalcemia =
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digitoxin
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brown recluse spider bites produces
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dermonecrotic skin lesion
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what affects cytochrome system?
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carbon monoxide
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clinical scenario:
~gas exposure ~presentation: oral secretions, salivation, lacrimation, miosis, sweating, nausea, wheezing, and copious sputum, weakness |
sarin
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counsel for pregnant woman using lisinopril (ACE inhibitor)
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fetus may have hypotensive effects from drug
~tell mom to stop using the drug |
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salicylate elimination curve?
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Figure C
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cause for homelessness and seizures
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withdrawal from alcohol
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location of renal failure from suspected toxicant + reactive metabolites
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proximal convoluted tubule
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clinical scenario:
presentation: confused, agitated, picking at things in the air HR 150bts/min, dilated pupils, flushed, dry skin, absent bowel sounds |
anticholinergic toxidrome
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diquat toxicity
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renal
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black widow spider bite
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enhances ACh release
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clinical scenario:
facial grimacing, dystonia, gyric movements of eyes and tongue, conscious |
benztropine mesylate
(antidote for dystonia by anticholinergic mechanism) |
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clinical scenario:
abdominal pain, gastroenteritis 2 wks into illness: hair comes out in clumps, eyebrow lost hair, weak, sensorimotor polyneuropathy |
ferric hexacyanoferrate (thallium poisoning)
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arisolachia fangchi associated with ...
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kidney damage and renal cancer
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clinical scenario: alcoholic runs out of alcohol
decreased consciousness, vomiting, gastric bleeding, no anion gap acidosis -- ketoisis and osmolar gap |
isopropanol
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antifreeze poisoning, anion gap (methanol)
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fomepizole treatment
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clinical scenario:
agitation, confusion, hyperreflexia, tremors, inducible clonus, diaphoresis, ocular clonus, fluctuations in HR and BP, normal WBC, CK |
fluoxetine and dextromethorphan
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clinical scenario:
apparent hepatitis, all viral Ag and Ab markers are negative. Liver biopsy: centrilobular necrosis |
dose-related hepatic toxicity
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distal renal tubular acidosis, cerebral atrophy (on MRI) and hepatotoxicity...
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toluene abuse
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What characteristic of a chemical or drug makes it more amenable to removal by hemodialysis?
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MW of <500 daltons
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clinical scenario: exposure to unknown gas
cough, difficulty breathing, pulmonary edema, no upper airway or mucous membrane irritation, no tearing or throat irritation |
phosgene
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BAL can be administered with calcium disodium EDTA for what kind of poisoning?
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lead
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clinical scenario: child treat with lindane lotion for head lice and wrapped in plastic wrap. Developed toxicity
In addition to dermal decontamination, what other treatment is indication? |
benzodiazepine (i.e. lorazepam or diazepam)
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clinical scenario: works in a lead smelter, notices during pregnancy a lactation increase in bld lead level.
Source of lead mobilization? |
deep bone compartment
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clinical scenario: ingests cyclic antidepressant
sinus tachycardia, wide QRS, long QT, Vtach, hypotension Treat with? |
sodium bicarbonate
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Patient has acute onset of cranial nerve dysfunction and symmetric and descending paralysis
characteristic of? |
botulism
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muscle rigidity, hyperthermia, recent use of haloperidol, elevated CK (>1,000U/L), Tach
signs consistent with? |
NMS
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after an hour of indigestion, GI decontamination is...
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not likely to be much of a benefit
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What is the preferred method for confirmation of positive drug test?
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gas chromatography-mass spectrometry (GC/MS)
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clinical scenario: bite on foot
swollen, less muscle strength, no piloerection, no rigidity, bite site discolored |
crotalinae (pit vipe) snake envenomation
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Patients of Mediterranean descent with a history of G6PD deficiency should avoid...
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methylene blue
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clinical scenario: overdose of multiple medicines, cocaine body packs, lead, sustained release meds
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1. whole bowel irrigation
2. protection of airway (due to risk of aspiration) |
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clinical scenario: took medicine for cold, anxiety and mood effects
confused, agitated, ocular clonus, hyperreflexis, diaphoretic, suspect serotonin toxicity caused by... |
paroxetine and dextromethorphan
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Most likely category of pharmaceutical deaths
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sedative/hypnotics/antipsychotics
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clinical scenario: infant born with myelomeningocele
exposed to ? |
valproic acid or carbamazepine
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ciguatera fish poisoning causes...
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cold/hot temperature sensation reversal
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When patient presents with hepatitis (neg for infection) periportal necrosis, heavy inflammatory infiltrate sparing the centrilobular zones....
course of action? (exclude...) |
exclude cytochrome P450 (centrilobular necrosis)
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Both _____ and _________ influence the risk of structural defects
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timing
dose of teratogen exposure |
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acute ingestion of metal salts causes...
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gastroenteritis
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hyperkeratotic eruption of palms and soles is caused by ...
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arsenic poisoning
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Most likely toxic etiology of elevated anion gap metabolic acidosis
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salicylates
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Prominent detoxifier to free radical metabolites
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glutathione
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Agent increases incidence of primary liver cancer in dose related fashion
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ethanol
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The setting regulations for allowable concentration of toxins in environmental media or acceptable daily intake of toxins depends heavily on what parameter?
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highest NOEL modified by appropriate safety factors
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clinical scenario: sudden onset of gastroenteritis followed by shock, 5 hours later
administer? which route? |
BAL, intramuscularly
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childhood lead poisoning characterized by ...
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colic-like abdominal pain
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Ipecac has potential for ...
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abuse
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What may cause a false positive for marijuana on urine drug screens?
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efavirenz
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Recently started on ziprasidone and haloperidol can indicate what?
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NMS
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if a child develops ___________ from a snake bite, it is possible it will recur in __________.
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coagulopathy, 2 weeks
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_______ and _______ cause cellular hypoxia as an underlying mechanism of toxicity
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carbon monoxide and cyanide
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Clinical toxicity of organophosphate insecticides...
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excessive secretions
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poisoned with toxin that causes severe abdominal pain, profuse watery diarrhea and possible death from shock
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arsenic trioxide
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certain non-steroidal pain medication may give a _______ for benzodiazepines on some immunoassays
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false-positive
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the hazard of a chemical ...
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cannot be changed
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__________ is an effective antidotes for INH poisons and it is dosed on a __________ basis according to the estimated amount of INH ingested
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pyridoxine (B6) , gram for gram
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Use N-acetylcysteine for what overdoes?
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acetaminophen
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Liver biopsy of patient with 40 yr occupation exposure to cadmium =
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normal lobular architecture and hepatocytes
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Testicular toxin that impairs fertility
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ethanol
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Overdose of diarrhea medicine composed of naroctic belladonna alkaloids might cause...
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cyclic coma
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increase excretion of 2,4D- with urinary alkalinization with ...
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sodium bicarbonate (ion trapping)
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acetaminophen exhibits _______ order kinetics through overdose situations
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first order
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Iron causes what kind of toxic damage (mechanism)?
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O2 radical damage
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Pyrethroid insecticide toxicity
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paresthesia amenable by Vitamin E
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antidotal mechanism of atropine for poisoning by ACEi like nerve gases
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bind to toxin after its absorption
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clinical scenario: agitated delirium after "pharming" party
antidote? |
diazepam
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herbacide glyphosphate = (toxic or non toxic)
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non toxic
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clinical scenario: neck contorted to side for several hours after "pharming" party
antidote? |
diphenhydramine
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clinical scenario: ingests bottle of 100 enteric-coated aspirin tablets
What happens? treatment? |
prolonged absorption. Treat with sodium bicarbonate
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Pulmonary edema associated with ...
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heroin overdose or serious salicylate intoxication
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Amanita mushrooms exert their toxic mechanism via inhibition of...
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RNA polymerase II
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Butane, propane, and nitrous oxide may cause hypoxia by displacing ....
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alveolar O2
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A toxidrome of miosis, respiratory depression, and coma may be seen with...
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fentanyl patch abuse
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Transition metal association with O2 radical damage...
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Mn, Fe, Ch
manganese, iron, chromium |