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  #1  
Old 07-18-2010
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Poison swallowed two gallons of a battery cleaning agent

A patient with dysphagia admits to having swallowed two gallons of a battery cleaning agent. Treatment will involve all of the following except?
A. Ipecac
B. Correct acid/base disorders
C. NPO
D. Water
E. Milk
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Old 07-18-2010
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is it milk bec ca+2 ---chelator

not too sure
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Old 07-18-2010
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what's NPO?

i think ill go for milk.
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Old 07-18-2010
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Does NPO mean not per os (IV nutrition)? Whats in battery cleaning agent? Any ideas? Is it just heavy metals so we need heavy metal chelators?
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Old 07-19-2010
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emm guys battery cleaning agent is alkali... and NPO is nil per oral....
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Old 07-19-2010
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Quote:
Originally Posted by doctorF View Post
emm guys battery cleaning agent is alkali... and NPO is nil per oral....
oh

in that case can i answer ipecac? what is the answer anyways? u're killing us with the suspense.
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Old 07-19-2010
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yep the correct answer is A.

Ingestion of alkali agents found in battery/drain cleaners/detergents causes corrosive actions on the GI mucosa due to the alkali nature of these solutions. The treatment is to maintain airway control, correct metabolic disarrangements and prevent the patient from having further mucosa damage. Ipecac is a syrup that induces vomiting and can be used to remove poison from the stomach. It should not be used in treatment of corrosives, such as alkaline bases, strong acids or petroleum distillates as it may cause additional injury to the throat or aspiration when these solutions are vomited out. Similarly, gastric lavage would not be indicated to treat these types of poisonings.
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Old 07-19-2010
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Quote:
Originally Posted by doctorF View Post
yep the correct answer is A.

Ingestion of alkali agents found in battery/drain cleaners/detergents causes corrosive actions on the GI mucosa due to the alkali nature of these solutions. The treatment is to maintain airway control, correct metabolic disarrangements and prevent the patient from having further mucosa damage. Ipecac is a syrup that induces vomiting and can be used to remove poison from the stomach. It should not be used in treatment of corrosives, such as alkaline bases, strong acids or petroleum distillates as it may cause additional injury to the throat or aspiration when these solutions are vomited out. Similarly, gastric lavage would not be indicated to treat these types of poisonings.
damn... all i needed to know was what was in battery cleaning agent. i tot it was mercury because batteries have mercury but thinking of it now, they mentioned battery cleaning agent! (still, i wouldnt have known it was alkali).

thx for this question.
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Old 07-19-2010
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oops thanks for the question
thinking batteries was acidia ehhehe was wrong
thanks once again
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Old 07-19-2010
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Quote:
Originally Posted by ecgram View Post
oops thanks for the question
thinking batteries was acidia ehhehe was wrong
thanks once again
welcome welcome my pleasure lollzzz
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Old 07-20-2010
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good question.
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Old 07-20-2010
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Quote:
Originally Posted by Seetal View Post
damn... all i needed to know was what was in battery cleaning agent. i tot it was mercury because batteries have mercury but thinking of it now, they mentioned battery cleaning agent! (still, i wouldnt have known it was alkali).

thx for this question.
Well I guess you can think of it this way.. cleaning agents are normally corrosives anyways, so you need something to protect the mucosal surface. That means not inducing the chemical to come out of the esophagus - mouth once its already gone inside and also protecting the gastric mucosa. I believe it was called a Demulscent.. that's any agent that protects the mucosa in case of ingestion of a harmful chemical.
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Old 07-21-2010
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Originally Posted by patelMD View Post
Well I guess you can think of it this way.. cleaning agents are normally corrosives anyways, so you need something to protect the mucosal surface. That means not inducing the chemical to come out of the esophagus - mouth once its already gone inside and also protecting the gastric mucosa. I believe it was called a Demulscent.. that's any agent that protects the mucosa in case of ingestion of a harmful chemical.
yeah! totally. thanks!
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Old 07-23-2010
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i chose A
becoz it an alkalin may ipecac worse the situation
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Old 08-16-2010
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Quote:
Originally Posted by doctorF View Post
yep the correct answer is A.

Ingestion of alkali agents found in battery/drain cleaners/detergents causes corrosive actions on the GI mucosa due to the alkali nature of these solutions. The treatment is to maintain airway control, correct metabolic disarrangements and prevent the patient from having further mucosa damage. Ipecac is a syrup that induces vomiting and can be used to remove poison from the stomach. It should not be used in treatment of corrosives, such as alkaline bases, strong acids or petroleum distillates as it may cause additional injury to the throat or aspiration when these solutions are vomited out. Similarly, gastric lavage would not be indicated to treat these types of poisonings.


Dear DoctorF, you said the answer is A (ipecac) and in the explanation you said that ipecac SHOULD NOT be used in treatment of corrosives (the battery cleaning agent in this case)????
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Old 08-16-2010
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Quote:
Originally Posted by cuteguy View Post
Dear DoctorF, you said the answer is A (ipecac) and in the explanation you said that ipecac SHOULD NOT be used in treatment of corrosives (the battery cleaning agent in this case)????
my dear. the question was asking for the wrong answer. and ipecac is the wrong answer.
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  #17  
Old 08-17-2010
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Correct Answer

Well i think this question can be approached in another easy way.

The pt swallowed 2 gallons of battery cleaning agent. So if we dont know for sure wats the actual compound. We can assume it can either be
  1. Acid
  2. Basic
  3. Organic solvent like petrol, acetone, gasoline (also used for cleaning purposes)
In a case of ingestion of all of these three substances, its not recommended to induce vomiting. Because of fear of esophageal rupture in case of the first two and risk of inhalational injury for the later, as organic solvents are volatile.

As Ipecac is solely used to induce vomiting, so treatment will involve all of the given substances except Ipecac.
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Old 08-17-2010
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Good points Does anyone know why we would ever use Ipecac on the USMLE? Would we ever want to induce vomiting?
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Old 08-17-2010
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Quote:
Originally Posted by ashishkabir View Post
Good points Does anyone know why we would ever use Ipecac on the USMLE? Would we ever want to induce vomiting?

hmm.. i think we can induce vomiting for some substances (drugs) that were ingested provided it hasnt been longer than 4 hours since the ingestion. if it has been more than 4 hours, some drugs have their antidotes while for others gastric lavage can be used (but i think gastric lavage is quite invasive)..

anyone beg to differ?
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Old 08-17-2010
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when corrosive poisons are ingested then we dont use emetics since it cozes more damage to the tissue..its strictly c/i....in other cases use of gastric lavage or activated charcoal or emetics are governed primarily by time factor...
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