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24 Cards in this Set
- Front
- Back
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Skin lesions in anthrax
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(From contact with infected animals, hides, hair, wool, meat, bone)
- Pruritic papule ("spider bite") - Central vesicular/bullous lesion - Central black painless eschar, surrounding erythema, edema, induration - Regional LAD, fever, malaise, HA |
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Brown recluse spider bite (Loxosceles laeta)
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Eschar with painful surrounding erythema, edema
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Franciscella tularensis (tularemia) symptoms
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- Abrupt fever, chills, HA, malaise, fatigue
- Progressive, tender, localized LAD - Red, painful papule at site of inoculation |
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Yersinia pestis (bubonic plague)
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- Abrupt fever, chills, weakness, HA
- Tender, enlarging LAD |
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Hallucinogenics (LSD, phencyclidine, psilocybin, MDMA, MDEA)
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- (UP) Hyperthermia, tachycardia, HTN, tachypnea
- (WIDE) Mydriasis (dilated), *nystagmus - (HYPER) Hallucinations, agitation - Diaphoresis |
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Stimulants (cocaine, amphetamines, pseudoephedrine, theophylline, caffeine)
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- (UP) Hyperthermia, tachycardia, HTN, tachypnea
- (WIDE) Mydriasis (dilated) - (HYPER) Agitation, hallucinations, paranoia, seizures - Diaphoresis |
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Anticholinergics (antihistamines, TCAs, antispasmodics, phenothiazines, atropine, belladonna/Jimson weed)
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- (UP) Hyperthermia, tachycardia, HTN, tachypnea
- (WIDE) Mydriasis (dilated) - (HYPER) Agitation, hallucinations, delirium - (BONE, BEET) Dry, *flushed |
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Opioids (morphine, heroin, oxycodone, hydromorphone, diphenoxylate)
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- (DOWN) Hypothermia, bradycardia, hypotension, bradypnea
- (NARROW) Miosis (pinpoint) - (CHILL) Sedation, coma - Dry, pale |
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Cholinergics (organophosphates, carbamate insecticides, nerve agents, nicotine)
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- (VARIABLE) Bradycardia, HTN or hypotension, tachypnea or bradypnea
- (NARROW) Miosis (pinpoint) - Confusion, delirium, coma, *seizures - SLUDGE - Diaphoresis, *salivation, *lacrimation, *urination, *defecation, *GE |
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Sedative/hypnotics (benzodiazepines, barbiturates, alcohols)
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- (DOWN) Hypothermia, bradycardia, hypotension, bradypnea
- Miosis or variable - Sedation, stupor, coma - Dry, pale |
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Serotonin syndrome (MAOIs, SSRIs)
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- (UP) Hyperthermia, tachycardia, HTN, tachypnea
- (WIDE) Mydriasis - (HYPER) Confusion, agitation, coma, *rigidity - Diaphoresis, *flushed |
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Unknown ingestion
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- Always measure salicylate/tylenol levels - treatable condition
- Abdominal XR may identify radioopaque compounds |
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Radioopaque toxins
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C - chloral hydrate, carbon tet, calcium salts, crack vials, drug packets
H - Heavy metals (arsenic, iron, lead, mercury, thallium) I - Iodinated compounds (thyroxine) P - Psychotropics (phenothiazine, lithium, TCAs) E - Enteric-coated tablets S - Salicylates, sustained-release preparations |
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Dishwasher detergent ingestion
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- Oropharyngeal, upper airway, esophageal injury to caustic alkali
- Sx: drooling, dysphagia, emesis - Rx: No lavage, emetics, etc - refer for urgent endoscopy to evaluate esophagus (oral lesions do not correlate w/degree of injury) if ingestion is conclusive |
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Organophosphate poisoning
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SLUDGE - Salivation, lacrimation, urination, defecation, gastric emesis plus bronchospasm/bronchorrhea
- Nicotinic sx include weakness, twitching, paralysis - Cholinergic poisoning (ex: fertilizer) - Systemic (activated charcoal) and dermal (washing) decontamination - Rx: atropine (competes for ACh at muscarinic receptors) and pralidoxime (competes at nicotinic receptors) |
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CO poisoning
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- Sx: HA, nausea, vomiting, tachypnea, tachycardia, +/- cherry red mucous membranes
- Rx: remove from envt, give high-flow oxygen, measure COHb level (>3-5% in nonsmoker = diagnostic) |
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Ingestion sx: gagging, coughing, drooling profusely, white eschars on tongue/soft palate, vomiting
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Corrosive alkali (eg, drain cleaner) - systemic/CV sx rare, but may have vomiting +/- hematemesis, resp distress, stridor, wheezing, face/hands/chest burns
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Ingestion: altered mental status (lethargy to coma), tachypnea, relative bradycardia, relative hypotension, late-onset crystalluria?
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Ethylene glycol (antifreeze) - toxidrome common to all alcohols
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Ingestion sx: respiratory distress, coughing, gagging, choking, fever, tachypnea, cyanosis, abnormal lung findings, CNS depression, seizures or coma
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Gasoline/hydrocarbon ingestion (think resp sx)
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Ingestion sx: salivation, lacrimation, urinary incontinence, diarrhea, abd cramping, bronchorrhea, bronchospasm, muscle weakness, tachypnea, bradycardia, miosis
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Organophosphates (acetylcholine toxidrome)
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Ingestion sx: eye redness, cough (with inhalation), vomiting
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Glyphosphate-containing weed killers
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Exposure: incubation 1-12 days, pruritic papule resembling a spider bite, progressing to central vesicular/bullous lesion that becomes necroti/hemorrhagic with central black, painless eschar
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Cutaneous anthrax (B. anthracis)
- Often a/w surrounding edema, induration, erythema but NO TENDERNESS, regional LAD, fever, malaise, HA; total resolution in 6 wks |
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Rx for anticholinergic toxicity?
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Physostigmine
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Rx for cholinergic toxicity?
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Atropine +/- pralidoxime
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