Toxicology PAT 2

Miosis or Mydriasis

100

Tranylcypromine Overdose causes?

Mydriasis

200

Cocaine overdose causes?

Mydriasis

300

Nerve gas attack in a bus causes?

What is the nerve gas agent?

Miosis

Sarin, Soman, VX, Novichok

400

Fentanyl overdose causes?

Miosis

500

This mosquito fogging agent causes?

What is the mosquito fogging agent?

Miosis

Malathione

O2 Sat Gap

100

What is the O2 sat gap?

Pulse oximeter O2 sat > ABG O2 sat

200

What causes an O2 sat gap?

Carboxyhemoglobinemia

Methemoglobinemia

Cyanohemoglobinemia

Sulfahemoglobinemia

300

Causes of carboxyhemoglobinemia?

House Fires

400

Causes of methemoglobinemia?

Sulfa drugs, Benzocaine

500

Causes of cyanohemoglobinemia?

Factory fires, cyanide ingestion

Toxidromes II

100

Toxidrome with uncoupling of oxidative phosphorylation presentation? 

Anion gap metabolic acidosis

Lactic acidosis

Hyperventilation

High venous O2 sat (no oxygen extraction)

Fever

200

Solvent toxidrome presentation?

Confusion

Lethargy

Headache

Incoordination

Derealization

Depersonalization

Sniffing - Type 1 RTA

Ingestion - increased OG

300

Seratonin Toxidrome presentation?

Fever

Delirium

Hyperreflexia / Clonus 

Ocular Clonus

Rigidity

Diarrhea

400

Extrapyramidal Toxidrome presentation?

Fever

Rigidity

Opisthotonus

Trismus

Hyperreflexia

Choreoathetosis

Dystonia

500

Cholinergic Toxidrome presentation?

Salivation

Lacrimation

Urination

Diarrhea

GI Cramping

Emesis

Bradycardia

Bronchorhea

Miosis

Etiology II

100

Toxidrome with uncoupling of oxidative phosphorylation etiology?

Cyanide

Metformin

Salicylate

Isoniazid

Propofol

200

Solvent toxidrome etiology?

AKA 'Paint Thinners'

Toluene

Acetone

Hydrocarbons

Chlorinated Hydrocarbons

Naphthalene

Trichloroethane

300

Seratonin Syndrome etiology?

2 hit mechanism (at least for seratonin over expression)

SSRI

SNRI

MAO-I

Dopamine agonists

Fentanyl

5 HT 3 antagonists

Stimulants

400

Extrapyramidal Toxidrome etiology?

Typical High Potency Antipsychotics

Haldol

Phenothiazines

Rispiridone

Olanzapine

Clozapine

500

Cholinergic Toxidrome etiology?

Organophosphates

Carbamates

Nerve Gas

Novochok

Pilocarpine

Physostigmine

Antidotes II

100

Toxidrome with uncoupling of oxidative phosphorylation antidote?

Dialysis

Cyanide - Hydroxycobolamine

200

Solvent Toxidrome antidote?

Supportive

NaHCO3 / K if Type 1 RTA

Dialysis if elevated OG

300

Seratonin Syndrome antidote?

Benzodiazepine

Cyproheptadine

400

Extrapyramidal Toxidrome antidote?

Benzodiazepine

Benztropine

Dantrolene

500

Cholinergic Toxidrome antidote?

Atropine (central/peripheral muscarinic antagonist)

Pralideoxime (reactivates acetylcholinesterase)