Final Exam Review

Mario took a whole Costco sized bottle of aspirin to help with his pain after fighting Bowser. He’s generally healthy and has no issues/disease states. He ends up in the hospital feeling terrible. His salicylate levels are: 90 mg/dL. What are the best treatments for him?

• Hemodialysis until the SA conc. is <19 mg/dL

• 3 ampules of sodium bicarb in 1 L D5W

• 3 ampules of sodium bicarb in 1 L D5W + Potassium in a separate IV

• Fluid/electrolyte and hyperthermia management

Luigi spends his days drinking liquid courage before helping Mario on his adventures. After so many years, he’s developed ESRD and liver failure. On his most recent adventure, Mario recommended he take an entire Costco sized bottle of aspirin to help with pain after their fight with Bowser. Luigi ends up in the hospital. His salicylate level is 95 mg/dL. Is he a candidate for hemodialysis?

• Yes, his SA level makes him a candidate for hemodialysis.

• No, his SA level needs to be at least 100 mg/dL.

• Yes, all patients who have salicylate toxicity need hemodialysis.

• No, he needs to fail supportive therapy 1^st.

Mario has been advertising that Costco sized bottles of aspirin are the best for relieving aches and pains. Peach decided to take an entire bottle after her most recent kidnapping. She ends up in the hospital. Her SA levels are 130 mg/dL. Is she a candidate for hemodialysis? What’s her goal?

• Yes, her SA level is >100 mg/dL. Continue until SA conc. Is <19 mg/dL.

• Yes, her SA level is >90 mg/dL. Continue until SA conc. Is 0 mg/dL.

• No, her SA level needs to be at least 120 mg/dL. Clear clinical improvement.

• No, she needs to fail supportive therapy first. Clear clinical improvement.

Adults have an initial respiratory alkalosis, later followed by metabolic acidosis. Children present with metabolic acidosis not respiratory alkalosis.

a.     True

• True

• False

Which of the following are abnormalities associated with salicylate toxicity

• Metabolic acidosis

• Pulmonary edema

• Elevated lactic acid

• Tinnitus

Match the toxic alcohol to its metabolite

• Formic Acid

• Ethanol

• Oxalic Acid

• Methanol

• acetone

• Ethylene Glycol

• Acetaldehyde

• Isopropanol

Methanol --> ​ (a)   --> ​ (b)  

Ethanol --> ​ (c)  

Ethylene glycol --> ​ glycol aldehyde --> ​ (d)   --> ​ (e)   --> calcium oxalate

• Formaldehyde
• Formic Acid
• acetaldehyde
• Glycolic acid
• Oxalic Acid

Wario gave Waluigi a glass of some unknown liquid. Waluigi drank it hoping to meet God. Instead, he went blind. What was inside the liquid?

• Methanol

• Isopropyl

• Tito’s Vodka

• Ciroc

Reorder the following steps for toxicology

• Breathing

• Assess CNS (Glucose)

• Airway

• Alter toxin pharmacokinetics

• Circulation & Perfusion

Match the following toxindrome to its manifestation

• Normal to depressed mental status, salivation, lacrimation, urination, fasciculation

• Ethanol or sedative – hypnotics

• depressed, hyporeflexia

• Cholinergics

• Normal to agitated delirium, clonus, tremor, seizures

• Anticholinergics

• depressed, agitated, hyporeflexia, ataxia

• Serotonin toxicity

• delirium, dry mucous membranes, flush, urinary retention

• Opioids