Question of the Day – Friday February 26, 2021

The street term “tranq” refers to what? In a recent report, there is increasing presence of xylazine in heroin and/or fentanyl deaths in Philadelphia, Pennsylvania. In Philadelphia, xylazine is referred to as “tranq” on the street and “tranq dope” refers to heroin and fentanyl cut…

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Question of the Day – Thursday February 25, 2021

During a chemotherapy treatment, a patient inadvertently received a 10 fold dosing error of IV methotrexate. Glucarpidase was given shortly after the dosing error was identified. 48 hours later, the serum methotrexate concentration was still markedly elevated. What is the likely culprit? False elevation of…

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Question of the Day – Wednesday February 24, 2021

A patient presents with nausea, vomiting, flushing and altered mental status after participating in a cleanse the day prior. You note this on her ankle. What is the exposure? Kambo. Kambo or sapo is the dried skin scrapings from the giant leaf frog (Phyllomedusa bicolor)….

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Question of the Day – Tuesday February 23, 2021

What can be used as a predictor for mortality in patients poisoned by cardiotoxic drugs? ECG and Troponin while CK-MB was not predictive. Hilal, M. A., Mahmoud, S. E., Shokry, M. M., & Said, A. M. (2020). Predictive Role of Cardiac Troponin I, Creatine Kinase-Mb…

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Question of the Day – Monday February 22, 2021

What preceding signs or symptoms are strongly associated with hemolysis in patients’ envenomated by Loxosceles reclusa? One study found that the odds ratio for hemolysis was highest for malaise (OR 40.7) and myalgia (OR 10.2). Others included exanthema (OR 9.0), fever/ chills (OR 8.5), nausea…

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Question of the Day – Friday February 19, 2021

Retinal pigment epithelium (RPE) changes have recently been described in a small subset of patients with poisoning from what? Organophosphates. In a recent study of 16 patients with organophosphate poisoning, RPE changes were the most commonly observed changes. The RPE is known to have α7…

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Question of the Day – Thursday February 18, 2021

What is a potentially life threatening effect of fetal salicylate poisoning? Intracerebral hemorrhage. Salicylate metabolites accumulate in the fetal brain and because of this, there have been cases of fatal intracerebral hemorrhage. Farid H et al. A 19 year old at 37 weeks gestation with…

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Question of the Day – Wednesday February 17, 2021

A 35 year old woman at 35 weeks gestation intentionally overdoses on aspirin 325 mg tablets. Maternal aspirin level is 60 mg/dL. How are fetal versus maternal salicylate levels different? Though limited case reports, there are a few case reports of acute salicylate poisoning in…

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Question of the Day – Tuesday February 16, 2021

What percentage of postpartum deaths are due to suicide? Lindahl V et al. reported that while suicide deaths and attempts are lower during pregnancy and in the postpartum period than in the general population of women, when deaths do occur, suicides account for 20% of…

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Question of the Day – Monday February 15, 2021

According to a 2019 retrospective study, what is the most common emergency department presentation of methamphetamine intoxication? In a study of 378 emergency department presentations, acute behavioral disturbance was the manifestation of methamphetamine toxicity in 78% of cases. As part of usual clinical care, the…

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