Another TCA overdose!
A classic overdose for you to ponder in classic Q&A style, which incidentally marks the 50th toxicology conundrum on LITFL!
Category Medical Specialty
Alprazoslammed
An ingestion of 100mg of alprazolam... Boring benzodiazepine or badness brewing? Find out in this case-based series of questions-and-answers.
Portal vein thrombosis
Portal vein thrombosis: thrombus formation in the portal vein +/- tributaries (superior mesenteric vein, IMV and splenic vein)
Spontaneous Bacterial Peritonitis
Spontaneous Bacterial Peritonitis: often occurs in patients with severe hepatic dysfunction -> should lead to transplantation consideration if appropriate
Portal Hypertension
Portal Hypertension = increased resistance to flow through liver -> shunted around the other collateral vascular beds; the most common complication of cirrhotic liver disease
Hypokalaemic Periodic Paralysis
Hypokalaemic Periodic Paralysis; rare channelopathy; muscle weakness/paralysis with a matching fall in K+ levels; starts in adolescence; weakness may be mild -> full body paralysis
Leptospirosis
Leptospirosis is an infection caused by the spirochaete genus of Leptospira. Severe forms may result in critical illness, including Weil disease and severe pulmonary haemorrhage
Spinal Injury Patient Hot Case
GENERAL APPROACH Phase of injury— Acute: ileus, cardiovascular, ventilation— Sub-acute: recurrent atelectasis and segmental collapse— Chronic: pain, psychological issues, infection (uro, resp, pressure areas), autonomic dysreflexia, spasm. Stability of spine Tracheostomy Other injuries INTRODUCTION CUBICLE Edgerton spinal bed until spine…
Obstetric Patient Hot Case
GENERAL APPROACH Illness requiring ICU admission Pregnancy + Baby Delivery – when or already done INTRODUCTION CUBICLE CTG presence of midwives INFUSIONS PET: MgSO4, phenytoin, hydralazine, GTN pre-term labour: tocolytics, steroids thromboembolism: heparin bleeding: blood products, fluid boluses, TXA cardiogenic…
Hepatic veno-occlusive disease
Hepatic veno-occlusive disease aka sinusoidal obstruction syndrome (SOS) important complication of stem cell transplantation (SCT) mortality >30%
Haemophagocytic lymphohistiocytosis
Haemophagocytic lymphohistiocytosis (HLH) may be inherited (AR; 5 subtypes, aka familial HLH) or acquired; may mimic severe sepsis, consider in apparent sepsis without source
Cryoprecipitate
Cryoprecipitate is prepared by thawing fresh frozen plasma (FFP) between 1°C and 6°C and recovering the precipitate
The cold-insoluble precipitate is refrozen.