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Aquifer Internal Medicine Case 26
Questions And Answers 100% Correct
benzo/alcohol intoxication - ✔✔lethargy, confusion, slurred speech, blurred speech,
dizziness, lack of coordination
benzo/alcohol withdrawal - ✔✔anxiety, agitation, seizures
stimulant intoxication - ✔✔hyperalert, restless, elevated temp, anorexia, nausea, dilated
pupils, sweating, seizures, dizziness, tremor, hyperreflexia, labile affect, insomnia,
aggression, euphoria, arrhythmia, htn, tachycardia
simulant overdose - ✔✔dry mouth, dilated pupils, sweating, tachycardia, respiratory
failure, seizures, paresthesias, tremor, coma, psychosis, paranoid, delirium,
hallucinations, arrhythmia, chest pain, HTN
opioids intoxication - ✔✔euphoria, flushing, pinpoint pupils, skin picking, sleepiness,
constipation
opioid overdose - ✔✔pinpoint pupils, shallow respirations, stupor, hypotonia, coma,
delirium, circulatory collapse and hypotension
barbiturates intoxication - ✔✔muscle aches, floating feeling, sleepiness, ataxia, diplopia,
dysmetria, hypotonia, lateral nystagmus, slurred speech, violent behavior, euphoria
Katelyn Whitman© 2025, All Rights Reserved.
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barbiturates overdose - ✔✔pinprick analgesia, ataxia, delirium, orthostatic hypotension,
lateral nystagmus, shallow breathing, bradycardia
calculate osmolality - ✔✔Na x 2 + Glu/18 + BUN/2.8
osmolar gap calculation - ✔✔measured Serum Osmolality - calculated Osmolality
Osmolar Gap in Anion Gap Metabolic Acidosis - ✔✔if osmolar gap present: likely
organic alcohol toxicity
signs hypernatremia - ✔✔lethargy, weakness, irritability, delirium, encephalopathy,
seizures
hypernatremia: pure water loss - ✔✔decreased water intake, DI
hypernatremia: hypotonic fluid loss - ✔✔diuretics, osmotic diuresis, GI losses, burns,
sweating
hypernatremia: hypertonic sodium gain - ✔✔iatrogenic sodium bicarb infusion,
ingestion of sodium solutions, seawater ingestion
treatment ethylene glycol poisoning - ✔✔fomepizole (inhibits alcohol dehydrogenase)
hypotonic solutions - ✔✔D5W = 0 mEq Na/L (0 mmol Na/L)
0.2% NS in D5W = 34 mEq Na/L (34 mmol Na/L)
0.45% NS in water = 77 mEq Na/L (77 mmol Na/L)
management hypernatremia - ✔✔a. stabilize with NS until clinically euvolemic
Katelyn Whitman© 2025, All Rights Reserved.
Aquifer Internal Medicine Case 26
Questions And Answers 100% Correct
benzo/alcohol intoxication - ✔✔lethargy, confusion, slurred speech, blurred speech,
dizziness, lack of coordination
benzo/alcohol withdrawal - ✔✔anxiety, agitation, seizures
stimulant intoxication - ✔✔hyperalert, restless, elevated temp, anorexia, nausea, dilated
pupils, sweating, seizures, dizziness, tremor, hyperreflexia, labile affect, insomnia,
aggression, euphoria, arrhythmia, htn, tachycardia
simulant overdose - ✔✔dry mouth, dilated pupils, sweating, tachycardia, respiratory
failure, seizures, paresthesias, tremor, coma, psychosis, paranoid, delirium,
hallucinations, arrhythmia, chest pain, HTN
opioids intoxication - ✔✔euphoria, flushing, pinpoint pupils, skin picking, sleepiness,
constipation
opioid overdose - ✔✔pinpoint pupils, shallow respirations, stupor, hypotonia, coma,
delirium, circulatory collapse and hypotension
barbiturates intoxication - ✔✔muscle aches, floating feeling, sleepiness, ataxia, diplopia,
dysmetria, hypotonia, lateral nystagmus, slurred speech, violent behavior, euphoria
Katelyn Whitman© 2025, All Rights Reserved.
, 2|Page
barbiturates overdose - ✔✔pinprick analgesia, ataxia, delirium, orthostatic hypotension,
lateral nystagmus, shallow breathing, bradycardia
calculate osmolality - ✔✔Na x 2 + Glu/18 + BUN/2.8
osmolar gap calculation - ✔✔measured Serum Osmolality - calculated Osmolality
Osmolar Gap in Anion Gap Metabolic Acidosis - ✔✔if osmolar gap present: likely
organic alcohol toxicity
signs hypernatremia - ✔✔lethargy, weakness, irritability, delirium, encephalopathy,
seizures
hypernatremia: pure water loss - ✔✔decreased water intake, DI
hypernatremia: hypotonic fluid loss - ✔✔diuretics, osmotic diuresis, GI losses, burns,
sweating
hypernatremia: hypertonic sodium gain - ✔✔iatrogenic sodium bicarb infusion,
ingestion of sodium solutions, seawater ingestion
treatment ethylene glycol poisoning - ✔✔fomepizole (inhibits alcohol dehydrogenase)
hypotonic solutions - ✔✔D5W = 0 mEq Na/L (0 mmol Na/L)
0.2% NS in D5W = 34 mEq Na/L (34 mmol Na/L)
0.45% NS in water = 77 mEq Na/L (77 mmol Na/L)
management hypernatremia - ✔✔a. stabilize with NS until clinically euvolemic
Katelyn Whitman© 2025, All Rights Reserved.
