Monday, May 7, 2007

VizD Challenge Week of 5/7/2007

A 52-year-old man who is regularly on lisinopril for hypertension became progressively ill a few days after ingesting cough syrup. He presented to a hospital in Panama with abdominal pain, nausea, and vomiting and subsequently developed acute renal failure and paralysis.

Questions:
1. What is the cause of this patient's presentation?
2. Name the federally mandated Act that arose from the mass poisoning that occurred from this toxin in 1937?
3. Name two potential treatments for this patient?


Winner receives $10.
To submit your answer please click on "comments" below.
For more information about the contest, click here.

VizD
is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.

10 comments:

Helen said...

1. Diethylene glycol poisoning from tainted cough syrup.

2. Federal Food, Drug, and Cosmetic Act of 1938.

3. Dialysis.

Kev said...

1.Diethylene glycol poisoning as found in the "cough syrup" he ingested
2.Federal Food, Drug, and Cosmetic Act of 1938
3. Either ethanol infusion or fomepizole as it is a diol in the same family as ethylene glycol

Kev said...

1. Diethylene glycol poisoning from the ingestion of the "Cough Syrup"
2. Federal Food, Drug, and Cosmetic Act of 1938
3. Treated with either ethanol infusion or fomepizole as diethylene glycol is in the same diol family of ethylene glycol

Bryan Darger said...

1.) Diethylene glycol poisoning
2.) Federal Food, Drug, and Cosmetic Act
3.) I'm an undergrad, so I'm a bit out of my depth here... can you treat it with ethanol, because EtOH dehydrogenase binds preferentially to that? Also fomepizole is used to inhibit that same enzyme (perhaps a better choice than EtOH), and you can use hemodialysis to treat the kidney failure. Activated charcoal might be indicated at first to slow absorbtion of the toxin, but again, I dunno. I just remember reading about the use of ethanol to treat the poisoning in my mom's EM little red reference book.

The blog is good stuff. Very motivating!

Anonymous said...

ethylene glycol poisoning...haitian diethylene glycol tragedy...ethanol, and fomepizole

Marilyn said...

The chemical that caused the illness was diethylene glycol.

The act was the 1938 Food, Drug, and Cosmetic Act.

(I found those answers at http://www.fda.gov/oc/history/elixir.html )

The patient can be treated with ethanol in the early stages and haemodialysis later on.

(I found this answer here http://emj.bmj.com/cgi/content/abstract/19/3/267 )

Am I right?
my email is marilyntox@netzero.net

Felicia said...

diethylene glycol poisoning

the hatian diethylene glycol tragedy

ethanol and fomepizole

Anonymous said...

1)Diethylene glycol poisoning?

2) The Federal Food, Drug and Cosmetic Act

3) Ethanol and Antizol

Juliamd

Anonymous said...

i assume you saw:

http://www.nytimes.com/2007/05/06/world/americas/06poison.html

Jonathan said...

1. What is the cause of this patient's presentation?
Diethylene Glycol poisoning
2. Name the federally mandated Act that arose from the mass poisoning that occurred from this toxin in 1937?
Federal, Food Drug and Cosmetic Act of 1938
3. Name two potential treatments for this patient?
Fomepizole and Hemodialysis