Analgesics
What is the treatment for APAP overdose?
NAC
Fresh Cut Hay or Grass
Phosgene
What is the concerning VS abnormality in CCB and Beta-Blocker OD? What is a quick way to differentiate?
Bradycardia. Blood glucose level. CCB= Hyperglycemic, BB= Normoglycemic.
Iron overdose antidote
Deferoxamine
Some type of cleaner fell on my hands and now they burn... how can we tell if its an acid or base based off the necrosis?
Alkali = Liquefactive necrosis
Acid = Coagulative necrosis
What is the one indication for naloxone?
Respiratory depression
Rotten Eggs
Hydrogen Sulfide
Reversal Agent for Heparin
Protamine
30 min after eating all you can eat sushi, I started feeling burning around my mouth and my skin looks sunburnt, but its winter in Rhode Island. What do I have and how can you fix it?
Scromboid. Give antihistamine H1 and H2 blocker
Benadryl overdose, what do you need to evaluate in a patient who is mentating? What do you give as a treatment?
EKGs to evaluate for QRS prolongation. Give sodium bicarb
1. The acid-base disorder seen in ASA overdose
2. The initial treatment
3. The goal of initial treatment
1. Initial respiratory alkalosis (from tachypnea) followed by HAGMA (Lactic acidosis and ketoacidosis from uncoupling of oxidative phosphorylase)
2. Serum and Urine Alkalinization with Sodium Bicarbonate
3. Serum pH 7.45-7.55 and urine pH >7.5
Almonds
Hydrogen Cyanide
What are the two classical pathognomonic findings in digoxin overdose on EKG? What is the most common?
Pathognomonic:
1. Bidirectional Ventricular Tachycardia
2. Downsloping QRS/ST depressions with scooped/sagging/slurred uptick (Salvador Dali)
Most Common: Frequent PVCs
Arsenic Poisoning chelation antidote
Dimercaprol
Patient comes in drooling, salivating, tearful, and with incontinence after working in the Iowa Corn fields, what is the likely toxidrome and toxin? What are the antidotes, in which order do you administer, and when do you stop giving the first antidote?
Muscarinic toxicity from organophosphate poisoning. Give atropine then pralidoxime (if available). Stop giving atropine when oral secretions and VS normalize
Daily Double
There are 6 treatments for toxicologic causes for bradycardia, list 5
Garlic or Fish-like smell
Arsine
What are the treatments for elevated INR on warfarin? What is the cutoff of INR?
INR<10, no active bleed: Hold next 1-2 doses
INR>10, no active bleed: Hold doses and give vitamin K
Serious bleeding at any INR: Hold warfarin, give vitamin K, and give Prothrombin Complex Concentrate (PCC) or Fresh Frozen Plasma (FFP) if PCC not available
Acute lead poisoning antidote
Succimer
Treatment of Hydrofluoric acid exposure of all sites
Calcium gluconate (cutaneous, systemic, ophthalmic, and inhalation)
What is the toxicity in mg/kg of lidocaine both without and with epi? What is the treatment?
Lido without= 5 mg/kg (max 300 mg)
Lido with= 7 mg/kg (max 500 mg)
Lipid Emulsion Therapy
What smell? (Two odorless gasses, rely on detectors)
Carbon Monoxide & Radon
Reversal agent for Eliquis & Xarelto?
Reversal agent for dabigatran?
- Andexanet Alfa
- Idarucizumab
I ate at an oceanside seafood restaurant on my vacation in Florida for lunch and a few hours later on my Sunday funday extravaganza. Someone spilled their margarita on ice on my leg and it burned me! What is my diagnosis doc? How do you fix it?
Ciguatera Poisoning. IV fluids. Antiemetics for GI symptoms. Atropine for bradycardia. Gabapentin or pregabalin for paresthesias and pain.
Mannitol no longer recommended as it shows no improved benefit to outcome and improvement than normal saline in a RCT
What is the most concerning sequela of a patient huffing gas to get high? What is the theorized mechanism that causes this?
"Sudden Sniffing death"
Cardiac dysrhythmia from sensitization of the myocardium to increased catecholamines