Question Of The Day

This biochemical marker has been theorized to be a predictor of delayed neurologic sequalae after carbon monoxide poisoning.   Netrin-1. Netrin-1 has been previously investigated as a predictive biomarker of neurologic sequalae following both hemorrhagic and ischemic stroke. Kokulu K et al. sought to examine…

Aleurites Moluccana, often referred to as “Nuez de la India”, has been purported to be an effective weight loss supplement. Unfortunately, these non-toxic candlenuts have been mistaken for this which has resulted in toxicity?   Due to similar appearances, candlenuts have been inadvertently substituted with…

In a recent randomized study in patients with anticholinergic toxicity, fewer patients that received physostigmine compared to lorazepam had this effect?   Delirium. According to a recent paper by Wang et al., fewer patients receiving physostigmine had delirium compared to lorazepam. Wang GS et al….

Use of this drug, for its antioxidant effects, may decrease the toxicity secondary to aluminum phosphide?   N-Acetylcysteine. Tehrani et al. in a prospective, randomized, open-label trial evaluated the effects of NAC on patients with acute aluminum phosphide toxicity. In the NAC group, there was…

Unlike research suggestive of a ‘ceiling effect’ for respiratory depression after higher doses of buprenorphine in adults, pediatric exposures to buprenorphine result in respiratory depression not insignificantly. What is one proposed mechanism for this?   P-Glycoprotein (P-gp). P-gp plays an important role against toxicity by…

What are some potential causes of a false positive ethylene glycol result by enzymatic assay? 1. Diabetic Ketoacidosis 2. Elevated Lactate and LDH 3. Propylene glycol   Carlos Martinez, MD, Hanna Lubbos, MD, Leslie I. Rose, MD, Charles Swartz, MD, and Fredrick Kayne, PhD (1998)…

Two patients present to the hospital with nausea, vomiting and diarrhea that started 12 hours after ingestion of a meal they prepared with foraged mushrooms. What qualititative test can be done to determine if the mushrooms contain amatoxin?   Wieland-Meixner test. The Meixner test has…

Atractyloside and gummiferin (carboxyatractiloside) are the toxic components of the Mediterranean thistle, Atractylis gummifera L., also called the Addad plant in Morocco. A recent report described 3 fatalities in children accidentally ingesting this plant. What is the mechanism of action of these two toxins?  …

Serum creatinine may be elevated in the setting of normal renal function. Etiologies include decreased creatinine excretion, increased production creatinine, consumption of excess quantities of creatine and interference with laboratory assays. What drugs are implicated as a cause of reduced tubular secretion of creatinine?  …

In a patient receiving dantrolene, calcium channel blockers are contraindicated because of this potential life-threatening effect?   Hyperkalemia and cardiovascular collapse. In an older swine study done by Saltzman LS et al., dantrolene administration in swine pre-treated with verapamil resulted in decreased cardiac function and…