You are tripping out, man
Puff the Magic Dragon
Pills/Poisons
Dope, Smack, Crack
Antidotes
100
This drug, often used in procedural sedation can lead to emergence phenomenon
What is Ketamine?
100
Spiderman's lady love Mary Jane was discussing slang terms for marijuana, which of the following is NOT one. 1) Ghanja 2) Trees 3) Reefer 4) Scooby snacks 5) Jolly Green
What are Scooby Snacks? (a term for ecstasy)
100
24 year old male comes in lethargic, slurring words and with unsteady gait. He mentions something about "bars" but his alcohol screen is negative. This is his likely ingestion.
What are benzodiazepenes (sticks or bars usually refer to xanax)
100
This is the active compound Heroin (and many other opiates) is metabolized to after injection/ingestion.
What is morphine
100
N-acetylcysteine is used to to treat this common ingestion.
What is acetaminophen
200
An 18 year old male comes in to the ED after the electric zoo with intense euphoria, increased response to tactile sensation, tachycardia, hallucinations, palpitations and all he can talk about is his female friend Molly.
What is MDMA?
200
Even Dr. Ayayla could not hold down a patient with nystagmus and violent behavior after he smoked marijuana laced with this substance.
What is PCP?
200
This is the overdose most likely associated with the following EKG.
What is TCA
200
Thisis the most common co-ingestion of opiate users.
What is Alcohol
200
A 4 year old boy come in to the emergency department extremely difficult to arouse. He has an anion gap acidosis and kussmaul respiration. He was found in the garage next to an empty plastic jug. This is the appropriate antidote.
What is fomepizole. Will accept alcohol.
300
This the ingredient in some OTC cough syrups that can cause hallucinations.
What is Dextromethorphan?
300
16 year old twins are brought into the ED for hallucinations. Neither have a psychiatric history. Twin A is anxious and paranoid while Twin B is staring at the television. Both are mildly tachycardic and have injected conjunctiva. This twin is more likely to have smoked K2 rather than marijuana.
Who is Twin A
300
A 23 year old medical student is brought in by his friends the week before step 1 with palpitations and anxiety leading to altered mental status. He is tachycardic to 115 and has a b/p of 106/49. His friends report he has been eating less and studying around the clock. What is the most likely OTC cause of his symptoms.
What is caffeine overdose.
300
This opiate must be altered in the body to form a compound that helps with pain. Approximately an equal number of people have nausea or other side effects as cannot process the chemical.
What is Codeine.
300
This is the correct antidote to give to your 46 year old male patient at Brookdale who took the whole bottle of his antibiotics after a positive PPD because he thought he'd get it over with all at once.
What is B6 / pyridoxine for Isoniazid toxicity
400
While urban foraging in Prospect Park, Dr. Morgan mistakenly ingested this mushroom (see picture) causing him to develop vomiting, salivation, diarrhea, micturation, and lacrimation
What is omphalatus species? (or jack-o-lantern mushrooms) Bonus: What edible mushroom do these resemble?
400
"But weed is safe!" says the 19 year old mother of three. These are two of the dangerous chemicals produced when smoking marijuana that you can tell her about.
What are carbon monoxide, acetaldehyde, phenol, creosol and naphthalene.
400
A wealthy Park Sloper who has been having marital problems with his trophy wife comes in complaining of diarrhea and vomiting, hematuria and hair loss as well as metallic taste in his mouth and "garlicky" breath. His wife may have been poisoning him with this.
What is Arsenic
400
Your sickle cell patient respectfully requests 6 mg IV dilaudid for their sickle cell crisis (and 50 mg of benadryl). This is the equi-analgesic dose of IV morphine.
What is 40 mg (approximately 1.5 mg Dilaudid to 10 of Morphine)
400
When an 54 year old female with diabetes on metformin and glipizide comes in AMS with fingersticks of 45 at home and 48 upon arrival, this would be an appropriate treatment for her refractory hypoglycemia.
What is octreotide
500
A 26 year old male presents to your South American ED with nausea and vomiting as well as hallucinations. He is bradycardic in triage and gets an EKG that shows changes consistent with cardiac glycoside overdose however he doesn't take digoxin and his digitalis level is 0. If his hallucinations are the result of intentional recreational activity this is the source of his overdose.
What is cane toad venom. (bufo marinus)
500
A 19 year old male presents to the ED after falling down and striking his head at Sahara East where he had been enjoying a meal and some hookah with his friends. He does not remember the incident, and seems a bit confused, though he is A and O x 3. His pulse is 108 SpO2 is 99 on RA he is normotensive and afebrile with normal respiratory rate. This is a test you might consider (aside from head ct) and atreatment that could significantly reduce his symptomatic period.
What is carboxyhemoglobin, and Oxygen therapy.
500
A 6 year old boy is brought in by his parents with intense vomiting, diarrhea, melena, hematemsis and abdominal pain all over the past 4 hours. He has no sick contacts, no travel and no-one in the family has any medications other than multi-vitamins. This is the potential antidote and toxicity.
What are desferroxamine and iron toxicity. Bonus - What's a quick way to confirm ingestion?
500
a 31 year old presents to the ED lethargic and responsive to tactile stimuli breathing at a rate of 8 breaths per minute. His girlfriend states he made "poppy tea" from 3 lbs of poppy seeds from the health food store. If we could test the tea, this is the active substance we would find at the highest concentration.
What is morphine?
500
After ingesting the plant, a patient has significant EKG changes and is given this as an antidote
What is digibind or dig-FAB
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