An 8-year-old is brought in by her parents with shortness of breath and wheezing. She’s been receiving her “rescue inhaler” at home and continues to have symptoms. You examine her and find that she has normal oxygen saturation, mild tachypnea and retractions, and diffuse wheezes. You think that she’s experiencing an acute asthma exacerbation. Given the current pandemic, and a recent report that administering nebulizer treatments to COVID-19 positive patients was correlated with transmission of COVID-19 to healthcare workers , what is the best way to treat the patient?
The abuse of which common office supply substance can result in syncope and the EKG findings shown?
- Dust Off (difluoroethane)
- Elmer’s glue (polyvinyl acetate)
- Hand sanitizer (ethyl alcohol)
- Rubber cement (heptane, isopropyl alcohol)
As the COVID-19 pandemic continues to unravel, the role of hydroxychloroquine (HCQ) in the treatment of patients with this disease has been a major focus of discussion on the news and social media. Despite the lack of good data supporting its use in the clinical setting, there have been numerous reports of individual consumption of HCQ resulting in accidental overdose and even death. It is therefore important to recognize and manage patients who may present with HCQ toxicity.
What life-threatening symptoms can result from the ingestion of this plant?
- Delayed onset bone marrow suppression
- Hepatic failure
- Mucosal swelling of the anterior airway
- Paralysis and respiratory failure
A 25-year-old woman is brought into the emergency department by friends due to “acting weird.” She was at a rave and is reported to have consumed alcohol, marijuana, and ecstasy. On exam, she is afebrile, tachycardic, normotensive, and breathing comfortably on room air. She is lethargic, mumbling incomprehensibly, and does not follow commands. Her glucose is 115 mg/dL, her pregnancy test is negative, her EKG reveals sinus tachycardia, her ethanol level is 30 mg/dL, and a stat CT head is negative. Her chemistry panel reveals a sodium level of 114 mEq/L. You order a 100 mL 3% sodium chloride bolus, but it may take 30 minutes to arrive from the central pharmacy. At this point, the nurse informs you that the patient is seizing.
Inadvertent contact with this aquatic species causes excruciating pain and an overwhelming sense of impending doom. What is this?
- Box Jellyfish (Chironex fleckeri)
- Irukandji Jellyfish (Carukia barnesi)
- Lion’s Mane Jellyfish (Cyanea capillata)
- Portuguese Man o’ War (Physalia physalis)
A child presents with tachypnea, tachycardia, and drooling after ingesting the sweet smelling contents of the pictured household item. What toxin could explain this presentation?
- Eucalyptus oil
- Methyl salicylate/Oil of Wintergreen