Toxicology

Board Review: Toxicology

A 25 year old female presents with plaquenil overdose. She is hypotensive with a systolic blood pressure of 70. She complains of dizziness. EKG shows QRS widening. You initiate 2L of normal saline but her systolic blood pressure persists in the 70s. What is your vasopressor of choice? 

A. Norepinephrine

B. Epinephrine

C. Dobutamine

D. Phenylephrine.

 

 

 

 

 

 

 

 

 

Answer: B - Epinephrine

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Board Review: Toxicology

A 30 year-old female presents altered and minimally responsive. She was found next to an empty bottle of Valproic Acid. Her blood pressure is 130/80, heart rate is 90, afebrile and without tachypnea or hypoxia. You stabilize her. Depakote level is 550. What is the treatment of the choice? 

A. L-carnitine 

B. Naloxone

C. Carbapenem

D. Fomepizole

E. N-acetylcysteine 

F. Hemodialysis 

 

 

 

 

 

 

Answer: A, L-carnitine

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Back to Basics: Infantile Botulism

This post was inspired by a recent clinical case in our department. A 7 week full term infant s/p spontaneous vaginal delivery with a normal maternal prenatal screen and course presents to your ED for not eating x 12 hours. On exam, you note decreased spontaneous movements, a weak suck and a weak cry noted. Vitals are normal. What's the diagnosis? 

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