1. Isoniazid Seizure Glutamic acid decarboxylase Coenzyme pyridoxamine No GABA formed AG metabolic acidosis Blocks conversion of lactate to pyruvate Hyperglycemia

2. 22 y/o male asthmatic took some pills to kill himself and is comatose. BP 120/80 HR 110 RR 20 T 101 Wheezing 7.36/22/250

3. Primary Metabolic Acidosis Primary Metabolic Alkalosis ASA Post-ictal Ibuprofen Xanthines Asthma Liver disease

4. 24 y/o male intern on July 2 cannot handle the work and is found in the call room comatose. HR 75 BP 120/80 RR 16 T 98

5. Sedatives/Hypnotics Benzodiazepines Not Barbituates or opiates RR MeprobamateFluctuating MSE Cyclic estersPE ETOHSmell MethaqualoneAnti-ACH,EPS Hyperaccussis

6. 50 y/o male with nebulous complaints, asking for something to help him sleep. You noticed that he has blisters on legs and trunk.

7. Bullae BarbituatesConsider MeprobamatePemphigus Ethyl chlorovinylDrug rxn Diclofenac Not Skin poppers

8. I have blurry vision and cannot focus my eyes.

9. Mydriatics AnticholinergicsNicotinic Antidepressants Antihistamines Sympathomimetics Crack eye or nebulizer Red top drops Eye disease

10. Miotics Opiates Clonidine Cholinergics AnticholinergicsMuscarinic-rare Buspirone/olanzipine Neuroleptics Post-eye surgery Green/blue/yellow top drops Pontine hemorrhage

11. 3 y/o BIBA unresponsive after eating 3 of granny’s BP pills. HR 70 BP naRR 11 Child responsive to deep stimulus and has pinpoint pupils

12. 50 y/o hypertensive BIBA for syncope in church. HR 40 BP 90/60 RR 16

13. Bradycardia Clonidine* Calcium channel blockers Beta-blockers Cardiac glycosides Opiates Cholinergics Cushing reflex Inferior wall MI Health

14. On the first cold day of fall, a child BIBA comatose. Later, parents arrive with c/o HA and not feeling well, but are more concerned of child’s status and what they are going to tell him when he wakes up as his dog has mysteriously died on the same day.

15. Hypothermia CO Sulfonylureas Phenothiazines Sedative/hypnotics Opiates ETOH

16. 17 y/o female was just dumped by her boyfriend. Mother called EMS because she is breathing “too fast”. OE: upset, anxious female

17. AG Metabolic Acidosis Methanol Uremia DKA Paraldehyde Iron, INH, Ibuprofen Lactic acidosis Ethylene glycol Salicylates Also CN,CO,theophylline,hydrocarbons

18. Hyperventilation CholinergicsFever TheophyllineSepsis CocaineHypoxia AG metabolic acidosisAsthma PE Midbrain hemorrhage Anxiety

19. Police bring in a “crack head” wandering on the Grand Concourse on July 4, confused and agitated. BP 150/105 HR110 RR 22 T 104

20. Hyperthermia Sympathomimetics Anticholinergics NMS Serotonin syndrome Arsenic LSD Ecstasy Heat stroke/exhuastion Thyriod Storm

21. 22 y/o female found in a club’s bathroom comatose. Intubated on field without drugs.

22. Hypoventilation Opiates ETOH Isopropyl Clonidine Cholinergics (late) Botulism NMJ disorders Sedatives/hypnotics GHB

23. 38 y/o male BIBA at the gym c/o weakness and had a syncopal event. He takes an antiepileptic agent and a new medicine for his back pain. Unremarkable exam. EKG shows widened QRS with QT 530 ms

24. Class IA Antiarrhythmics Quinidine, procainamide TCA Propoxyphene Methacarbamol, cyclobenzoprene Cocaine Phenothiazines Carbamazepine 2nd generation antihistamines

25. 50 y/o female who just arrived from Mexico, c/o of being bitten by a scorpion which was in her coat pocket while she was reaching for her medication. She was also bitten 10 days ago by a skunk while running away from a snake after using IV drugs in her backyard. OE: agitated and salivating copiously.

26. Sialorrhea Rabies Clozaril Metal fume fever Mercury Scorpion stings Crotalids Cholinergics Ketamine

27. 20 y/o male returned from Dominican Republic c/o diarrhea. He has spent a month eating his grandmother’s cooking, whose hygiene is dubious. HR 50 BP 120/80 RR 20 T 104

28. Faget’s sign/Pel-Ebstien Fever Salmonella Yellow Fever Legionella Psittacosis Antineoplastic drugs Tumors Hepatomas/liver mets Myxoma Nephroma Lymphoma Sarcoma