Foreign Bodies and Poison Quiz 2023 Graded A+
Where do you start when a patient presents with a suspected poisoning/foreign
body?
thorough history, advise patient to bring ingested substance to ED if possible, inventory
of medications at home, PE
What poisons would lead to a garlic odor of the breath?
arsenic and organophosphates
How would anticholinergic poisoning affect the skin?
it would make the skin warm and dry
What cholinergic symptoms would results from organic phosphate poisoning?
salivation and urination
What other PE findings might point you to the source of the poisoning?
pupil size, tearing, neurological sx such as ataxia, tremors, agitation, convulsions, or
coma
What might a TCA overdose present with?
dysrhythmias such as prolonged QRS
What should you think about when treating a poisoning?
ABCs, potential antidotes, if you should make the patient vomit or not
What all are considered foreign bodies?
food, coins, batteries, toys, etc.
What are some of the symptoms of an esophageal foreign body?
asymptomatic, drooling, refusing to eat, chest discomfort
What are some potential complications of an esophageal foreign body?
cyanosis, laceration/perforation of the esophagus, injury to the local tissues from
corrosive objects
What is the work-up for an esophageal foreign body diagnosis?
plain chest and abdominal x-rays
What is the treatment for esophageal foreign body?
endoscopy to remove the body
What are the s/sx of a foreign body in the ear?
ear pain, drainage, hearing loss
What are the s/sx of a foreign body in the nose?
unilateral purulent rhinitis, persistent sinusitis, blocked nasal passage
What are the s/sx of a foreign body in the lungs?
cough, cyanosis, wheezing
What should you perform when there is a poisoning in an older child?
a suicide risk assessment; mostly accidental in toddlers
What are the s/sx of hydrocarbon poisoning?
mucosal irritation, vomiting, bloody diarrhea, cyanosis, respiratory distress, tachycardia,
fever, CNS depression
What are some examples of hydrocarbons?
benzene, gasoline, petroleum distillates
What special tests are used to diagnose hydrocarbon poisoning?
chest x-ray, urinalysis, ECG
, How is hydrocarbon poisoning managed?
avoid emetics and lavage, oxygen with mist, antibiotics if pneumonia develops
What are the s/sx of caustics poisoning?
skin/mucosal burns, hematemesis, abdominal pain, respiratory distress, convulsions,
coma
What is an example of a caustic?
toilet bowl cleaner
What special tests are used to diagnose caustic poisoning?
EGD, ECG
How is caustic poisoning managed?
small amounts of water or milk, avoid vomiting, supportive care
What are the s/sx of base poisoning?
irritated mucous membranes, respiratory distress secondary to edematous epiglottis,
perforation of stomach or esophagus
What special test is used to diagnose base poisoning?
EGD
What are some examples of bases?
clorox, drano
How is base poisoning managed?
small amounts of water as dilutant, avoid vomiting, supportive care
What physical finding might be seen with acetaminophen poisoning?
hepatotoxicity
What special tests are used to diagnose acetaminophen poisoning?
monitor Tylenol plasma concentration
What is the antidote for acetaminophen poisoning?
acetylcysteine
What are the s/sx of aspirin/salicylate poisoning?
vomiting, hyperapnea, fever, encephalopathy, convulsions, coma, renal failure,
pulmonary edema
What special tests are used to diagnose aspirin/salicylate poisoning?
check serum salicylate level, watch for metabolic acidosis and decreased K+, elevated
or reduced serum glucose
How is aspirin/salicylate poisoning managed?
induce emesis, charcoal to bind the drug, correct dehydration, hemodialysis
What are the s/sx of antihistamine poisoning?
agitation, hallucinations, miosis, red eye, dry skin, fever, respiratory failure, CV collapse
What special tests are used to diagnose antihistamine poisoning?
EC6 ligase chains and pulse oximetry
How is antihistamine poisoning managed?
activated charcoal, whole-bowel irrigation, Physostigmine
What are the s/sx of organophosphate poisoning?
salivation, lacrimation, diaphoresis, urination, diarrhea, miosis, pulmonary congestion,
twitching, convulsions, coma
What are some examples of organophosphates?
chlorthion, diazinon
What special test is used to diagnose organophosphate poisoning?
Where do you start when a patient presents with a suspected poisoning/foreign
body?
thorough history, advise patient to bring ingested substance to ED if possible, inventory
of medications at home, PE
What poisons would lead to a garlic odor of the breath?
arsenic and organophosphates
How would anticholinergic poisoning affect the skin?
it would make the skin warm and dry
What cholinergic symptoms would results from organic phosphate poisoning?
salivation and urination
What other PE findings might point you to the source of the poisoning?
pupil size, tearing, neurological sx such as ataxia, tremors, agitation, convulsions, or
coma
What might a TCA overdose present with?
dysrhythmias such as prolonged QRS
What should you think about when treating a poisoning?
ABCs, potential antidotes, if you should make the patient vomit or not
What all are considered foreign bodies?
food, coins, batteries, toys, etc.
What are some of the symptoms of an esophageal foreign body?
asymptomatic, drooling, refusing to eat, chest discomfort
What are some potential complications of an esophageal foreign body?
cyanosis, laceration/perforation of the esophagus, injury to the local tissues from
corrosive objects
What is the work-up for an esophageal foreign body diagnosis?
plain chest and abdominal x-rays
What is the treatment for esophageal foreign body?
endoscopy to remove the body
What are the s/sx of a foreign body in the ear?
ear pain, drainage, hearing loss
What are the s/sx of a foreign body in the nose?
unilateral purulent rhinitis, persistent sinusitis, blocked nasal passage
What are the s/sx of a foreign body in the lungs?
cough, cyanosis, wheezing
What should you perform when there is a poisoning in an older child?
a suicide risk assessment; mostly accidental in toddlers
What are the s/sx of hydrocarbon poisoning?
mucosal irritation, vomiting, bloody diarrhea, cyanosis, respiratory distress, tachycardia,
fever, CNS depression
What are some examples of hydrocarbons?
benzene, gasoline, petroleum distillates
What special tests are used to diagnose hydrocarbon poisoning?
chest x-ray, urinalysis, ECG
, How is hydrocarbon poisoning managed?
avoid emetics and lavage, oxygen with mist, antibiotics if pneumonia develops
What are the s/sx of caustics poisoning?
skin/mucosal burns, hematemesis, abdominal pain, respiratory distress, convulsions,
coma
What is an example of a caustic?
toilet bowl cleaner
What special tests are used to diagnose caustic poisoning?
EGD, ECG
How is caustic poisoning managed?
small amounts of water or milk, avoid vomiting, supportive care
What are the s/sx of base poisoning?
irritated mucous membranes, respiratory distress secondary to edematous epiglottis,
perforation of stomach or esophagus
What special test is used to diagnose base poisoning?
EGD
What are some examples of bases?
clorox, drano
How is base poisoning managed?
small amounts of water as dilutant, avoid vomiting, supportive care
What physical finding might be seen with acetaminophen poisoning?
hepatotoxicity
What special tests are used to diagnose acetaminophen poisoning?
monitor Tylenol plasma concentration
What is the antidote for acetaminophen poisoning?
acetylcysteine
What are the s/sx of aspirin/salicylate poisoning?
vomiting, hyperapnea, fever, encephalopathy, convulsions, coma, renal failure,
pulmonary edema
What special tests are used to diagnose aspirin/salicylate poisoning?
check serum salicylate level, watch for metabolic acidosis and decreased K+, elevated
or reduced serum glucose
How is aspirin/salicylate poisoning managed?
induce emesis, charcoal to bind the drug, correct dehydration, hemodialysis
What are the s/sx of antihistamine poisoning?
agitation, hallucinations, miosis, red eye, dry skin, fever, respiratory failure, CV collapse
What special tests are used to diagnose antihistamine poisoning?
EC6 ligase chains and pulse oximetry
How is antihistamine poisoning managed?
activated charcoal, whole-bowel irrigation, Physostigmine
What are the s/sx of organophosphate poisoning?
salivation, lacrimation, diaphoresis, urination, diarrhea, miosis, pulmonary congestion,
twitching, convulsions, coma
What are some examples of organophosphates?
chlorthion, diazinon
What special test is used to diagnose organophosphate poisoning?
