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Old 05-17-2011
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Poison Patient Attempts Suiside By Ingesting Multivitamin Pills

A 64 year old man is brought into the ER in frail state by his wife after he tried committing suicide by ingesting a whole bottle of multivitamin pills, after the Lakers were knocked out of the playoffs. Vitals reveal BP 90/80, RR 22, Temp 101, Pulse 120. P/E reveals small hemorrhages on his forearms. When asked to raise either of his arms, he is unable to. Further history reveals he is on Warfarin therapy for an MI that occurred 8 years ago. Which of the following Vitamins is responsible for the physical symptoms?

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D
E) Vitamin E
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  #2  
Old 05-17-2011
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Default Up To Date Question


This is really an up to date question, the Lakers just got knocked out last week
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Old 05-17-2011
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Vitamin E toxicity?
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Old 05-17-2011
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i think its vitamin E toxicity,cz vit E has warfarin like activity.
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Old 05-17-2011
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tough question ????
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Old 05-18-2011
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yep vitamin E it is, remember this from goljan audio
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Old 05-18-2011
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can anyone explain it for us please
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vit e toxicity
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Old 05-18-2011
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Quote:
Originally Posted by samran.haider View Post
yep vitamin E it is, remember this from goljan audio
me too, haha
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Old 05-18-2011
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Vitamin E for sure...and i dont remember it from goljan audios I saw a patient
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Old 05-18-2011
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Does Vit E toxicity cause increased body temperature? Why?
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Old 05-18-2011
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Correct Answer The Answer is E) Vitamin E

Yes guys,

It is infact Vitamin E. Goljan or Kaplan does not go into concepts other than stating patients on Warfarin patients who take Vitamin E are at a risk of Haemorrhage.

The symptoms and vitals are of haemorrhage.

Ex. BP of 90/80
HR of 120
Unable to raise arms
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  #13  
Old 05-18-2011
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Correct Answer Correct Answer: Vit E

Vit E Toxicity, Goljan Rocks...
Hahaha, I just know the answer by Goljan Audio, and he does explain...

Vit E toxicity Inhibit synthesis of vit k dependent coagulation factors ( 2-7-9-10- protein C and S ) in other words, you are ANTI coagulated.... and he does explain the exact scenario.

Therefore, Vit E toxicity is synergistic with Warfarin.

=)
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  #14  
Old 05-18-2011
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Quote:
Originally Posted by rulz View Post
Vit E Toxicity, Goljan Rocks...
Hahaha, I just know the answer by Goljan Audio, and he does explain...

Vit E toxicity Inhibit synthesis of vit k dependent coagulation factors ( 2-7-9-10- protein C and S ) in other words, you are ANTI coagulated.... and he does explain the exact scenario.

Therefore, Vit E toxicity is synergistic with Warfarin.

=)

Yes, he does explain that, but he does not explain the exact mechanism behind spontaneous hemorrhaging.
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Old 05-18-2011
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Can anybody explain why his temperature is higher than normal?
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Quote:
Originally Posted by usluipek View Post
Can anybody explain why his temperature is higher than normal?
Im just speculating here, but multivitamin contains iron, so possibly due to Iron poisoning
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Old 05-18-2011
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I think it has to be with the Oxidation process that its involve the Vit E which prevent Free radical to damage the membrane, i thnk it generate H+ or any other sustance which lead to Increase the Temperature ....

...

Last edited by rulz; 05-18-2011 at 06:32 PM.
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Quote:
Originally Posted by rulz View Post
I think it has to be with the Oxidation process that its involve the Vit E which prevent Free radical to damage the membrane, i thnk it generate H+ or any other sustance which lead to Increase the Temperature ....

...
I think what you are talking about is uncoupling agents such as aspirin and 2,4 DNP. They will cause increase in heat, while depleting ATP.

As far as I know, looking at Vitamin E toxicities, most common is excessive bleeding due to depletion of Vit K dependent factors. Fever was not one of the symptoms.
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Old 05-18-2011
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Quote:
Originally Posted by patelMD View Post
I think what you are talking about is uncoupling agents such as aspirin and 2,4 DNP. They will cause increase in heat, while depleting ATP.

As far as I know, looking at Vitamin E toxicities, most common is excessive bleeding due to depletion of Vit K dependent factors. Fever was not one of the symptoms.
No, if you look over goljan note when he stated mechanism of vit e, prevent lipid oxidation over free radical damage, thats what im guessing. Dont get misleaded.

I checked over fa also, same thing, so thats what i was saying.
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Quote:
Originally Posted by rulz View Post
No, if you look over goljan note when he stated mechanism of vit e, prevent lipid oxidation BY free radical damage, thats what im guessing. Dont get misleaded.

I checked over fa also, same thing, so thats what i was saying.
Yes, I agree.. it is an anti-oxidant (it takes up free electron to neutralize it). Im not sure that exact mechanism (in a hyper state) will lead to increased temperature.

Anyway, I think that's beyond the scope of what we're studying, as long as we know the most important properties we're good!
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Quote:
Originally Posted by patelMD View Post
Yes guys,

It is infact Vitamin E. Goljan or Kaplan does not go into concepts other than stating patients on Warfarin patients who take Vitamin E are at a risk of Haemorrhage.

The symptoms and vitals are of haemorrhage.

Ex. BP of 90/80
HR of 120
Unable to raise arms
Can you explain why the patient is unable to raise his arms? I understand the hemorrhage part because of what you have already explained but the inability to raise his arms really threw me off track.

Wouldnt that be caused by a Vit E deficiency? (Symptoms from UptoDate include ataxia, hyporeflexia, loss of proprioception and vibration, and/or skeletal myopathy)
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Old 05-18-2011
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Quote:
Originally Posted by apx85 View Post
Can you explain why the patient is unable to raise his arms? I understand the hemorrhage part because of what you have already explained but the inability to raise his arms really threw me off track.

Wouldnt that be caused by a Vit E deficiency? (Symptoms from UptoDate include ataxia, hyporeflexia, loss of proprioception and vibration, and/or skeletal myopathy)
Well, by unable to raise the arms, I suspected hypotension so muscle weakness is the most common thing that will lead to that..
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Old 05-19-2011
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good question ... thanks a lot ...

can someone post more questions like dis .....
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Biochemistry-, Pharmacology-, Step-1-Questions, Toxicology-

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