Envenomations
Bites & Stings
Poisons
Heavy Metals
Acids & Alkali
100
Patient presents after being bit by a snake, he is unsure of what kind of snake that it was. There are two bite marks on his leg, there is local swelling and continued bleeding despite compression. He is found to be thrombocytopenic. The class of snakes he was bit by is

Crotaline (Pit vipers aka copperhead, rattlesnake, cottonmouth)

100

A young boy presents to the emergency department in respiratory distress after being stung multiple times while playing outside. The family is unsure what he was stung by but notes his father has to carry an epipen. What was he stung by

Wasps, Bees

100

The active ingredient in the party drug shrooms is also known as

Psilocybin

100

Acute ingestion of this metal odorless and tasteless metal will lead to "rice water" diarrhea, and may mimic Guillain Barre. Chronic ingestion will lead to keratosis, melanosis, anemia, malignancies of the skin, bladder, and kidney.

Arsenic

100

A patient presents while unconscious after mixing ammonia and bleach. What was inhaled

Chlorine

200

An unconscious patient presents after free diving in the barrier reef. Bystanders report that the patient complained of perioral tingling and some mild weakness before rapidly decompensating. The patient was envenomated by what animal

Blue Ringed Octopus

200

A patient presents after being bit by a spider while carrying firewood into their house. The bite is erythematous and the patient is noted as tachycardic and hypertensive. The spider he was bit by is also known as

Black widow (alpha-latrotoxin)

200

A patient presents to the ED with AMS, flushed skin, dilated pupils, and inability to urinate after smoking some leaves in her backyard, what did she smoke

Jimson Weed

200

An adult presents to the emergency department after recently starting a job restoring an old home. He reports that he has been feeling ill with multiple episodes of diarrhea, but today he has been having trouble walking. He says his foot keeps dropping. What metal are his symptoms related to?

Lead

200

A patient presents with alkaline burns on his hands after working in construction without gloves. What substance was he working with

Cement

300

While working a locums job in Australia, a patient presents in cardiac arrest after being stung by some of the local wildlife, there is a cross hatched pattern seen where the patient was stung. What were they stung by

Box Jelly Fish

300

While working in the Sunset State, a patient presents with severe epigastric abdominal pain after being stung by an animal. What was the patient stung by

Arizona Bark Scorpion

300

The poison found in the south american poison dart frog is known as

Batrachotoxin

300

Patient comes to the ED with a headache and muscle aches. He recently started a new job as a welder. What metals are responsible for his symptoms?

MgO2, Zinc, Copper, Chromium

300
Patient presents a few hours after working using rust remover, he is having severe hand pain. What acid did he work with

Hydrofluoric Acid

400

Patient presents with diplopia and dysphagia after being bit by a snake. The class of snakes they were bit by are

Elapidae (Coral snakes)

400

The great Steve Irwin unfortunately met his end on the other end of a sting. The sting from this animal typically causes what kind of shock

Hemorrhagic

400

The active toxin in Fugu poisoning has a mechanism of action of

Sodium channel blockade

400
What lab values would you expect to see in fume fever?

Leukocytosis, elevated lactate dehydrogenase

400

Despite placing a patient with from the previous prompt in surgical gloves with calcium, he is still having severe pain, what other treatment could you do

Intraarterial Calcium

500

A patient presents with hypotension and severe pain after accidentally grabbing a fish with multiple dorsal spines. This fish is found in the coastal regions of the Indo-Pacific. What fish is it

Stonefish

500

A young girl presents to the emergency department after being found unable to walk, she is also starting to have some difficulty breathing. The family lives in the outskirts of Spokane, Washington. What action must be taken to find the most likely etiology

Roll the patient over to assess for ticks

500

A child presents to the emergency department actively seizing roughly 6 hours after ingesting some mushrooms in his backyard. EMS has given multiple rounds of ativan without success. The toxin ingested is known as

Gyromitrin

500

A patient presents after having ingested a large amount of gasoline within the last hour in an apparent suicide attempt. The patient is currently conscious and able to protect his airway. What agent that has fallen out of favor recently should not be given

Ipecac

500

A child presents after drinking drain cleaner out form under the sink in their home's kitchen. What alkali agent was the patient exposed to and what kind of necrosis does this cause

Lye, Liquefactive Necrosis