Question of the Day – Friday, October 28, 2022
In the descriptive retrospective survey conducted by Ciganda and Laborde, what was the most commonly used herbal as an abortifacient? Ruda Carmen Ciganda M.D. & Amalia Laborde M.D. (2003) Herbal Infusions Used for Induced Abortion, Journal of Toxicology: Clinical Toxicology, 41:3, 235-239, DOI: 10.1081/ CLT-120021104…
Question of the Day – Thursday, October 27, 2022
According to a recent prospective study, how effective is a single, large dose of intramuscular naloxone in reversing opioid toxicity in adult patients in the outpatient setting? In the cited reference, a single 1.6 mg IM dose of naloxone was effective in initially reversing respiratory…
Question of the Day – Wednesday, October 26, 2022
In the out-of-hospital setting, larger intramuscular doses of naloxone may be used because the IM route is more rapid and reliable. What is the frequency of severe agitation following administration of a single 1.6 mg IM naloxone dose in patients with opioid toxicity in the…
Question of the Day – Tuesday, October 25, 2022
According to a recent systematic review of ethylene glycol poisoning, mortality was unlikely to occur if the glycolate concentration was under what value? Various studies have demonstrated that the anion gap is a good correlate for the glycolate concentration in the setting of ethylene glycol…
Question of the Day – Monday, October 24, 2022
In the out-of-hospital setting, larger intramuscular doses of naloxone may be used because the IM route is more rapid and reliable. What is the frequency of severe agitation following administration of a single 1.6 mg IM naloxone dose in patients with opioid toxicity in the…
Question of the Day – Friday, October 21, 2022
In a recent multicenter prospective study of children who presented to the emergency department with opioid intoxication, what characteristics predicted severe outcome (ICU admission or in-hospital death)? Fentanyl exposure and age > 10 years. Cohen N, Mathew M, Davis A, et al. Predictors of severe…
Question of the Day – Thursday, October 20, 2022
What is the most common laboratory interference in patients with thiocyanate toxicity? Pseudohyperchloremia, especially as measured by ion selective electrodes. In the cited reference, chloride values were repeatedly elevated (113–148 mmol/L) or not reported due to instrument error flags, including “above measurement range” (reported in…
Question of the Day – Wednesday, October 19, 2022
At what time of year do gyromitrin containing mushrooms typically grow? Spring. Mushrooms are commonly found under conifer trees. Goldfrank LR. Mushrooms. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019. Accessed August…
Question of the Day – Tuesday, October 18, 2022
What is the mechanism of toxicity of gyromitrin? Gyromitrin undergoes a series of hydrolysis reactions to form monomethylhydrazine which prevents the activation of pyridoxine to pyridoxal 5’ phosphate, a required cofactor for glutamic acid conversion to GABA. Symptoms typically consist of a variety of neurologic…
Question of the Day – Monday, October 17, 2022
Which Gyromitra species of mushrooms contain gyromitrin? Gyromitra esculenta, Gyromitra ambigua, and Gyromitra infula. Goldfrank LR. Mushrooms. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019. Accessed August 29, 2022. https://accessemergencymedicine.mhmedical.com/content.aspx?bookid=2569§ionid=210276854