NEET 24 - Poisoning - Case studies (4) 15/04/24
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1) A 45-year-old man presented to the ED complaining of vomiting, watery diarrhea, lightheadedness, and headache. He had arrived in town the previous night to present at a conference and was staying at a local hotel. His roommate experienced similar, but less severe, symptoms. The patient received IV fluids, ondansetron, and ketorolac, and he was discharged a few hours later after feeling much better. The next morning, the patient failed to show up for his conference presentation. He was found in bed without a pulse and could not be resuscitated. His skin appeared pink and blotchy in places (shown). Which of the following tests could have made the diagnosis on his initial presentation to the ED? *
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2) A 57-year-old man presents via ambulance from a house fire. The fire department was called by a neighbour who noticed clouds of smoke and large flames towering over his home. Vital signs are blood pressure 139/87 mm Hg, heart rate 109 bpm, respiratory rate 18 breaths/min, and SpO2 91% on room air. On physical examination, he is somnolent, and soot is noted on his clothing, primarily on the left side. Which of the following clinical features is the most accurate predictor of severe toxicity?
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3)  A 35-year-old male presents to the emergency department with complaints of headache, dizziness, and nausea. He reports that he was using a petrol-powered generator in his garage for several hours due to a power outage. Vital signs reveal a blood pressure of 130/80 mmHg, heart rate of 90 bpm, respiratory rate of 18 breaths per minute, temperature of 37.2°C (98.9°F), and oxygen saturation of 98% on room air. Physical examination is notable for confusion and mild lethargy. Arterial blood gas analysis shows a pH of 7.38, PaCO2 of 42 mmHg, PaO2 of 100 mmHg, and carboxyhemoglobin level of 20%. Which of the following is the most appropriate next step in management? *
1 point
4)  A factory worker was found unresponsive in his workplace. He is afebrile anicteric, tachypneic and drowsy. There is a pale discoloration with clear lung field and hyperdynamic cardiovascular findings. His ABG with 100% oxygen after intubation is given below.  What is the most likely diagnosis?

Ph = 7·30 

PO2 = 80 mmHg 

PCO2 = 30 mmHg 

SaO2 = 95% 

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