Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome

Overview Definition Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic disorder associated with the use of antipsychotics that presents as a classic tetrad: Epidemiology Etiology Pathophysiology and Clinical Presentation Pathophysiology Clinical presentation Cardinal features of the neuroleptic malignant syndrome include: Other signs and symptoms are as follows: Diagnosis and Management Laboratory findings in NMS The […]

Metal Poisoning (Lead, Arsenic, Iron)

Lead line in gingiva - metal poisoning

Lead Poisoning Etiology Lead poisoning, also known as plumbism, may result from inhalation or ingestion of lead from: Pathophysiology Clinical presentation Children: Adults: Diagnosis Management Arsenic Poisoning Etiology Pathophysiology Clinical presentation Acute: Chronic: Diagnosis Management Iron Poisoning Etiology Epidemiology Iron toxicity is one of the leading causes of deaths by poisoning in children < 6 […]

Toxicology of Plants

Lily of the valley

Amanita phalloides Etiology A. phalloides is the most toxic of the world’s cyclopeptide-containing mushrooms. Pathophysiology The toxicity of A. phalloides is caused by amatoxins and phallotoxins.  Amatoxins: Phalloidin: Clinical presentation Toxicity occurs over several days and usually develops in 3 characteristic stages: Stage I:  Stage II: Stage III: Diagnosis The diagnosis typically relies on the […]

Esophageal Perforation

Chest x-ray of pneumomediastinum and left-sided pleural effusion

Overview Definition Esophageal perforation, also called esophageal rupture, is a transmural defect of the esophageal wall that exposes the mediastinum to GI content. Epidemiology Etiology Pathophysiology The pathogenesis of esophageal perforation depends on the cause. Clinical Presentation Clinical features History: Manifestations: Exam findings: Complications Diagnosis Management Stabilization Initial approach: Obtain surgical (including cardiothoracic) consult, as […]

Pericardial Effusion and Cardiac Tamponade

Subxiphoid approach for pericardiocentesis

Epidemiology and Etiology Definition Pericardial effusion is the accumulation of fluid in the pericardial space. Cardiac tamponade is the accumulation of pericardial fluid sufficient to impair cardiac filling and cause hemodynamic compromise. The rate of fluid accumulation, and not necessarily the amount, is most important. Epidemiology Pericardial effusion: Cardiac tamponade:  Etiology Many conditions are associated […]

Respiratory Failure

Hypoxemia

Definition and Classification Definition Respiratory failure is a syndrome that develops when the respiratory system is unable to maintain oxygenation and/or ventilation. Classification Respiratory failure may be classified based on:  The time course: The underlying issue: Etiology Etiology of hypoxemic respiratory failure Etiology of hypercapnic respiratory failure Pathophysiology Right-to-left shunt Ventilation-to-perfusion inequality A mismatch between […]

Cyanide Poisoning

Acute cyanide poisoning

Overview Definition Cyanide is a highly lethal mitochondrial toxin causing death within minutes to hours of exposure. Epidemiology Etiology Pathophysiology and Clinical Presentation Pathophysiology Clinical presentation Symptoms develop within seconds to minutes. Diagnosis and Management Diagnosis History and physical exam: Laboratory tests: Management General considerations: Decontamination: Resuscitation: Antidotes: Differential Diagnosis References

Dog and Cat Bites

Dog bite

Overview Epidemiology International data are lacking, but statistics in the United States include: Table: Demographics based on animal Dog bites Cat bites Approximately 90% of all animal bites Approximately 10% of all animal bites Men > women Women > men Children > adults Adults > children Less often result from provocation More often result from […]

Insect and Scorpion Stings

Vespula sp. Wasp sting

Epidemiology and Species Epidemiology Insect stings: Scorpion stings: Clinically relevant species The Hymenoptera order includes the following stinging insects: Venomous scorpions in the United States include: Pathophysiology General Hymenoptera venom characteristics Apids Vespids Formicids Bark scorpions Clinical Presentation Presentation of insect stings Local signs and symptoms: Systemic signs and symptoms (anaphylaxis): Presentation of scorpion stings […]

Spider Bites

Female black widow spider

Epidemiology and Species Epidemiology Clinically relevant species In the United States, the following spider bites can result in serious systemic symptoms:  Brown recluse spider: Black widow spider: Pathophysiology Brown recluse spider Black widow spider Clinical Presentation Brown recluse spider Black widow spider Diagnosis Diagnosis Spider bites are a clinical diagnosis. Mnemonic “NOT RECLUSE” can help […]

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