Insulin was discovered in Toronto
These two individuals were awarded the Nobel Prize in Physiology or Medicine in 1923
Frederick Grant Banting and John James Rickard Macleod
When we say a drug is "anti-cholinergic" we are usually referring to this specific main type of cholinergic receptor:
What is Muscarinic?
A toddler who presents with tachycardia, clenched jaw, agitation, and hyperthermia after ingesting a packet of white powder left over from a yard party the night before has a ____________ toxidrome likely caused by _______________.
What is sympathomimetic due to cocaine or amphetamine?
Relatives of SickKids' founder were instrumental in founding which Ontario university?
Elizabeth (nee Wyllie) McMaster was married to the nephew of William McMaster.
(NB: original building on Bloor St is now RC of Music)
Banting, Best, and friends sold their patent for insulin to the University of Toronto for this sum
$1.00
Organophosphates and coffee both inhibit this enzyme:
What is acetylcholinesterase?
Distinct clinical findings in Neuroleptic Malignant Syndrome (NMS) vs Serotonin Syndrome include:
What is?:
NMS: Characterized by muscle rigidity ("lead pipe rigidity"), hyporeflexia, bradykinesia (slowed movements), ileus
SS: hyperreflexia, myoclonus + tremors, mydriasis, hyperactive bowels
Frederick Banting was finally given a staff appointment at a hospital in Toronto in 1923, the Hospital for Sick Children; the physician-in-chief at that, who also gives his name to a residential tower across the street, was this person:
Who is Alan Brown?
What are:
- degree of hyperglycemia (HHS > DKA)
- serum osmolality (HHS >> DKA)
- ketones/acidosis (DKA)
This derivative of the Calabar Bean can be given as an antidote against the anticholinergic effects of Benadryl:
what is Physostigmine? (from Physostigma venenosum)
The Requiem for a Dream movie poster has probably led many to think that this class of drugs causes mydriasis when in fact they cause miosis:
What are opioids?
The Critical Care Unit at the Hospital for Sick Children opened in this year:
What is 1968?
(NB: Leafs last won Stanley Cup in 1967)
We refer to a DKA patient has having been "corrected" (anion gap closed); for pts with HHS, biochemical resolution/correction is when this happens:
What is serum osmolality < 320mOsm/kg?
In the renaissance, long before Sephora, deadly nightshade berries were used in makeup, with the anti-cholinergic side-effect noted of dilated pupils: the latin name for this plant reflects its lethal and beautifying features and is _________ _____________.
What is atropa belladona?
[bonus; the three fates are Atropos (cut), Clotho (weave), Lachesis (measure)]
You are called to the ER to see a 15-year-old who walked in with blurry vision, respiratory distress, drooling, and acute-onset GI pain with nausea. On exam they have moderate respiratory distress with coughing, have runny eyes and pinpoint pupils, are tachycardic and diaphoretic. They had been on the subway en route to Dupont from Union but got off at Queens Park because they felt too sick. Your next two actions might be:
What is (1) give atropine and pralidoxime and (2) Code Orange...
The building visible from the PICU on 87 Elm St, which currently hosts The Host, was built in 1848 for what purpose?
What is a "house of industry"? (workhouse, poorhouse)
An adolescent presents in a coma; their glucose is undetectably low. One parent is convinced they have an insulinoma; the other parent is worried they may have taken grandma's insulin. You ask the lab to measure ______ and ________.
What is insulin and c-peptide?
This agent reverses the effect of rocuronium (a non-depolarizing neuromuscular blocker which is a competitive antagonist for the nicotinic acetylcholine receptors at the neuromuscular junction) but does not cause cholinergic effects:
What is Sugammadex?
[unlike neostigmine, Sugammadex is a cyclodextrin drug which directly binds/encapsulates rocuronium; it does not inhibit acetylcholinesterase so cholinergic effects are not produced and co-administration of an antimuscarinic agent (glycopyrronium bromide or atropine) is not needed]
Two teenagers are in the ER: one with a buproprion (Wellbutrin) overdose and one with an amitriptyline overdose. Both have a QRS that is 110-120ms. You give ________ and expect a better response from the patient who ingested _______.
What is sodium bicarbonate and amitryptyline.
This SickKids cardiovascular (and orthopedic) surgeon was famous for his intra-atrial baffle innovation; he also carried out a series of bypass surgeries in the 1950s using rhesus monkey lungs as the oxygenators:
Who was William T Mustard?