Quinine causes cinchonism (nausea, vomiting and tinnitus) in overdose but also blindness which is delayed and sometimes not noticed until the morning after the acute toxicity has resolved. Think of it as aspirin (the salicylism) that causes blindness.
Acute digoxin poisoning manifests with vomiting, hyperkalaemia and brady-tachyarrhythmias potentially leading to death, whereas chronic digoxin toxicity is far more insidious, still with gastrointestinal symptoms but in addition bradycardia and automaticity on the ECG.
NSAIDs are generally benign in overdose unless a large amount is ingested which would take some effort. As 66% of NSAID overdoses are with ibuprofen we will use this as an example.
Hypoglycaemia can occur at therapeutic doses especially in those who develop renal impairment. In overdose these drugs cause a profound and prolonged hypoglycaemia, usually apparent within 8 hours post ingestion of a standard preparation.
Funtabulously Frivolous Friday Five 188 - Just when you thought your brain could unwind on a Friday, some medical trivia FFFF.
Define cachexia. List the factors that may predispose to cachexia AND the consequences of cachexia in a ventilated patient with sepsis and multi-organ dysfunction syndrome.
In patients suffering from major burns, outline the possible physiologic derangements and their underlying mechanisms that could contribute to problems of oxygenation and ventilation.
Outline the Intensive Care management of a 25-year-old male who has fulfilled brain death criteria and is awaiting surgery for organ donation.
We are all at risk of missing the giant man in the gorilla suit every day in ED.
Working in the ED environment is unlike most other areas of medicine. Stress levels can be high, maintaining patient flow in the face of access block and exit block can seem futile, and a chaotic environment
Days 2 and 3 of essentials 2010 have come and gone. It was no surprise to me, nor to other EMCrit fanatics, that Scott Weingart, MD stole the show with his talks on (p)re-oxygenation; delayed sequence intubation, and post-arrest care. More detailed information on these topics be found on EMCrit - go there now!
A decade after Wrenn and Slovis gave us the 'Ten Commandments of Emergency Medicine', Timothy Givens proposed the following 'Ten commandments of Pediatric Emergency Medicine' to supplement the originals.