Question Of The Day

In 1981, in Spain, the ingestion of an oil fraudulently sold as olive oil caused an outbreak of a previously unrecorded condition, later known as toxic oil syndrome (TOS). What were the acute clinical characteristics of this syndrome? Intense incapacitating myalgias, morbilliform skin eruption, marked…

Injection of xylazine and xylazine-containing illicit drug mixtures has been associated with what chronic condition? Skin ulcerations. According to the cited cross-sectional survey study, the prevalence of skin lesions was 35%. Reyes JC, Negrón JL, Colón HM, et al. The emerging of xylazine as a…

What are some risk factors for wooden chest syndrome? Lipophilic opioids (fentanyl, remifentanil, sufentanil), rapid injection, higher doses, age over 60 years, conditions or medications that cause a deficiency of dopamine levels (Parkinson’s disease), medications that increase norepinephrine and serotonin levels. Buxton JA, et al….

What is the proposed mechanism of wooden chest syndrome? The proposed mechanism of WCS is activation of µ-opioid receptors in the central nervous system (CNS) via a dopaminergic pathway resulting in skeletal muscle rigidity Rosal NR, Thelmo FL Jr, Tzarnas S, DiCalvo L, Tariq S,…

Long-term methotrexate therapy has been associated with what hepatic effects? Long term therapy with frequent but mild elevations in serum liver enzymes. More importantly, methotrexate has been associated with development of fatty liver and hepatic fibrosis and, in rare instances, portal hypertension and symptomatic cirrhosis….

A deficiency of which vitamin can cause degeneration of optic nerve fibers? Vitamin B12. Vitamin B12 deficiency optic neuropathy is a rare complication of this deficiency that results in progressive, bilateral, painless vision loss that is often associated with reduced color vision and central or…

What are deterministic versus stochastic health effects of radiation exposure? Deterministic health effects, such as acute radiation syndrome, are those occurring above a dose threshold and increase in severity with an increasing radiation dose. In other words, deterministic health effects are directly related to the…

In a review of the literature of the serotonin toxidrome, the authors elegantly critiqued the diagnostic criteria and reviewed the mechanism and pathophysiology of toxicity. Of the seven serotonin receptors, which two receptors does excess serotonin act on to cause toxicity? It is likely no…

In a recent review of snake envenomation, the authors discussed venom-induced consumption coagulopathy, which causes a depletion of clotting cascade factors and spontaneous or uncontrolled bleeding. What is the most relevant procoagulant toxin? Metalloproteinases activate prothrombin, factor V, factor X and fibrinogenase. Seifert S, Armitage…

What are the MRI findings associated with Wernicke’s Encephalopathy? According to the cited reference: “MRI findings are represented by symmetric hyperintensity on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images and corresponding hypointensity or no abnormalities on T1-weighted images within the medial thalami. The thalamic lesions…