Often confuse methanol and ethylene glycol poisoing? Need a refresher on how they present? Read on below for a quick review that could come in useful one day either at the bedside or while taking an exam.
A 25 year old female presents with plaquenil overdose. She is hypotensive with a systolic blood pressure of 70. She complains of dizziness. EKG shows QRS widening. You initiate 2L of normal saline but her systolic blood pressure persists in the 70s. What is your vasopressor of choice?
Answer: B - Epinephrine
A 30 year-old female presents altered and minimally responsive. She was found next to an empty bottle of Valproic Acid. Her blood pressure is 130/80, heart rate is 90, afebrile and without tachypnea or hypoxia. You stabilize her. Depakote level is 550. What is the treatment of the choice?
Answer: A, L-carnitine
This post was inspired by a recent clinical case in our department. A 7 week full term infant s/p spontaneous vaginal delivery with a normal maternal prenatal screen and course presents to your ED for not eating x 12 hours. On exam, you note decreased spontaneous movements, a weak suck and a weak cry noted. Vitals are normal. What's the diagnosis?
A 74 year old male presents to the Emergency Department with altered mental status. Family reports decreased intake over the past few days. She takes Digoxin for CHF. Her bllood pressure is 78/42 and her HR is 48. Her creatinine is 3.7, K 6.0, serum digoxin level is pending. What is the most appropriate initial therapy for this patient?