Question Of The Day

Terrestrial Flatworms, an invasive species to the United States, have been shown to secrete which toxin to subdue their prey? Tetrodotoxin Stokes, Amber N et al. “Confirmation and distribution of tetrodotoxin for the first time in terrestrial invertebrates: two terrestrial flatworm species (Bipalium adventitium and…

This hydrocarbon has been implicated in “degreaser’s flush”, where a disulfiram like reaction with concomitant ethanol consumption has occurred. Trichloroethylene is used as an industrial solvent, cleanser and degreaser. It competitively inhibits aldehyde dehydrogenase and when alcohol consumption occurs, it can result in a disulfiram…

What substances have been associated with hepatic angiosarcoma? Hepatic angiosarcoma is strongly associated with exposure to vinyl chloride, arsenic, thorium dioxide and androgenic hormones Huang N-C, et al. Arsenic, vinyl chloride, viral hepatitis, and hepatic angiosarcoma: a hospital-based study and review of literature in Taiwan….

What is the recommended observation time to watch body stuffers in the emergency department if they are asymptomatic? A retrospective review of 106 patients after cocaine body stuffing found no life threatening complications after a 6 hour observation period. In another case series, body stuffers…

The researchers of a small trial of 33 patients with cannabinoid hyperemesis syndrome compared treatment of abdominal pain and nausea two hours after randomization to either two different doses of haloperidol vs ondansetron. When the results of the 0.05 mg/kg and the 0.1 mg/kg doses…

What are the symptoms/adverse effects that prompt most emergency room department visits after using herbal dietary weight loss or energy products. Over 23,005 emergency department visits per year are attributed to adverse events from dietary supplements. Palpitation, chest pain, and tachycardia accounted for 71.8% of…

What is the most common cause of methemoglobinemia in the hospital setting? In a review of 132 cases, the most common product causing methemoglobinemia was a single benzocaine spray of unspecified duration. Moore TJ, Walsh CS, Cohen MR. Reported adverse event cases of methemoglobinemia associated…

In the early 2000s, there was an outbreak of a Parkinsonian syndrome in 23 Latvian IV methcathinone users. MRI brain imaging demonstrated increased bilateral T-1 signal intensity in the globus pallidus. What toxin was found to be responsible? Manganese. Potassium permanganate was used in the…

Methoxyflurane in an inhaled anesthetic that has been studied as an analgesic in acute traumatic pain. What end-organ toxicity has been associated with prolonged and high-dose methoxyflurane use? Nephrotoxicity. Methoxyflurane is an inhaled fluorinated anesthetic that is associated with polyuric renal failure secondary to the…

What is the most common immune-related adverse event (irAE) from immune checkpoint inhibitors to result in discontinuation of therapy or death? Dermatologic manifestations are the most common irAE’s however, pneumonitis is the most common adverse event to result in drug discontinuation or death. Lipe DN,…