Question of the Day – Tuesday October 6, 2020
A 47 year old male presents to the Emergency Department with altered mental status. Initial labs reveal: VBG: 6.91/17/50; BMP: 140/7.1/105/<5/20/1.0; gluc 130; ALT 42; AST 56; Ammonia 327. What is the likely culprit? Methanol. Hyperammonemia has been associated with methanol and ethylene glycol…
Question of the Day – Monday October 5, 2020
This drug may produce a false positive immunoassay for this illicit substance? What is the drug and what is the illicit substance? Dextromethorphan has been significantly associated with false positive results for PCP on urine drug screen tests in multiple case reports and a…
Question of the Day – Friday October 2, 2020
Envenomation from which animal leads to a collection of hypercatecholaminergic symptoms known as Irukandji syndrome? Irukandji syndrome develops from envenomation from the small box jellyfishCarukia barnesi in the coastal waters of tropical Australia that is thought to produce a massive catecholamine release. Criteria needed…
Question of the Day – Thursday October 1, 2020
What is the culprit toxin causing the effects seen from ingestion of “mad honey”? Grayanotoxin. Honey produced from Rhododendrons (Ericaceae family) is known to contain grayanotoxins, the main isomer being grayanotoxin III. These neurotoxins block sodium channels, thereby interfering with the action potential in cell…
Question of the Day – Wednesday September 30, 2020
What is the direct translation of “Konzo”? Konzo means “tied legs” in the Yaka language of SW DR Kongo https://en.wikipedia.org/wiki/Konzo
Question of the Day – Tuesday September 29, 2020
In addition to CYP 2E1 inhibititoin, what additional mechanism of fomepizole has been implicated in its utility in APAP toxicity? – JNK inhibition Akakpo JY et al. Delayed Treatment with 4-methylpyrazole protects against acetaminophen hepatotoxicity in mice by inhibition of c-Jun n-Terminal Kinase. Toxicologic…
AACT Position Statement on the Benadryl® Challenge
Recently there have been reports of severe adverse outcomes after social media popularized “Benadryl® Challenge.” Diphenhydramine, often sold under the brand name Benadryl®, is a powerful antihistamine that is available over the counter. Individuals have intentionally ingested large amounts of diphenhydramine while recording the effects…
Question of the Day – Monday September 28, 2020
What is the most common cause of idiosyncratic drug induced liver injury in the US Drug Induced Liver Injury Network registry? Amoxicillin-Clavulanate deLemos AS, Ghabril M, Rockey DC, et al. Amoxicillin-Clavulanate-Induced Liver Injury. Dig Dis Sci. 2016;61(8):2406-2416. doi:10.1007/s10620-016-4121-6
Question of the Day – Friday September 25, 2020
Available as an over-the-counter diuretic, what product can result in the following urine discoloration? Magnesium salicylate, available as “diurex” Viswanathan, Stalin. “Urine Bag as a Modern Day Matula.” ISRN Nephrology, vol. 2013, 2013, pp. 1–8., doi:10.5402/2013/215690.
Question of the Day – Thursday September 24, 2020
Name 3 xenobiotics associated with black urine. According to the cited referecene, the following xenobiotics have been associated with black urine: Alpha-methyldopa, cresol, iron, cascara, senna, L-dopa, methocarbamol, metronidazole, nitrofurantoin, sorbitol. Aycock RD, Kass DA. Abnormal urine color. South Med J. 2012;105(1):43-47. doi:10.1097/SMJ.0b013e31823c413e