ABP Med Toxicology study guide
ABP Med Toxicology · Work through your exam, one topic at a time.
Medical Toxicology is one of the pediatric subspecialty certificates the American Board of Pediatrics lists alongside adolescent medicine, pediatric emergency medicine, and other subspecialties. The credential is intended for physicians who have completed accredited subspecialty training in medical toxicology and who seek board certification in that field, typically in addition to primary certification in pediatrics or another specialty. The ABP Med Toxicology study guide has 10 sections and about 2,767 words.
01General Principles of Toxicology and Risk Assessment
Hazard is the intrinsic capacity of an agent to cause harm; risk is the probability that harm occurs under a defined exposure. Questions frequently blur the two.
297 words, about 1 min02Toxicokinetics, Toxicodynamics, and Laboratory Testing
Absorption determines the decontamination window; activated charcoal is most useful within one to two hours. Volume of distribution (Vd) predicts extracorporeal removal: a large Vd ( 1 L/kg, lipophilic drugs such as tricyclics, digoxin, chloroquine) means dialysis will not help.
308 words, about 2 min03Analgesics, Sedative-Hypnotics, and Cardiovascular Drugs
Acetaminophen overdose is diagnosed by the Rumack-Matthew nomogram applied to a level drawn at least four hours after a single acute ingestion. The treatment line begins at 150 µg/mL at 4 hours.
276 words, about 1 min04Drugs of Abuse, Withdrawal Syndromes, and Addiction
Sympathomimetics (cocaine, methamphetamine) produce hypertension, tachycardia, diaphoresis, agitation, and seizures; treatment is benzodiazepines, cooling, and sodium bicarbonate for wide-complex rhythms. MDMA adds serotonergic features and, critically, hyponatremia from free-water intake plus SIADH, which can cause seizures and cerebral edema - treat symptomatic hyponatremia with hypertonic saline, not fluid restriction alone.
263 words, about 1 min05Household, Industrial, and Occupational Exposures
Carbon monoxide binds hemoglobin with roughly 200-fold greater affinity than oxygen, shifting the dissociation curve left and impairing mitochondrial cytochrome oxidase. Symptoms are nonspecific; pulse oximetry and calculated saturation are normal, so co-oximetry is required.
286 words, about 1 min06Pesticides, Metals, and Environmental Toxicology
Organophosphates and carbamates produce a cholinergic syndrome (SLUDGE/DUMBELS): salivation, lacrimation, urination, diarrhea, bronchorrhea, broncho/pradycardia, miosis, and muscle fasciculations. Atropine is titrated until secretions dry - the pupil and heart rate are unreliable endpoints.
249 words, about 1 min07Plants, Mushrooms, Marine Toxins, and Envenomations
Cardiac glycoside plants (foxglove, oleander, lily of the valley) cause vomiting, bradycardia, and hyperkalemia; digoxin Fab may bind some but cross-reactivity varies. Anticholinergic plants (Datura, jimsonweed, deadly nightshade) cause dry skin, mydriasis, delirium, and urinary retention - treat with benzodiazepines and, in severe cases, physostigmine only when there is no sodium-channel blockade.
268 words, about 1 min08Antidotes, Decontamination, and Enhanced Elimination
Activated charcoal (1 g/kg) adsorbs most drugs if given within 1–2 hours, but is contraindicated in caustic ingestion, unprotected airway, ileus, and hydrocarbon aspiration risk; it is not useful for iron, lithium, alcohols, or most metals. Gastric lavage is reserved for very early, life-threatening ingestions.
257 words, about 1 min09Pediatric-Specific Poisoning, Ingestions, and Prevention
Children explore by mouth, have higher minute ventilation and surface-area-to-mass ratios, and lower glycogen reserves, so hypoglycemia and hypothermia appear early. Their smaller mass makes a tiny absolute dose clinically significant.
292 words, about 1 min10Toxicologic Emergencies and Critical Care Management
Approach every poisoned patient with ABCDE, remembering that toxins kill through hypoventilation, hypotension, arrhythmia, seizures, and hyperthermia. Airway management may require rapid sequence intubation with hemodynamic awareness; many toxins ( opioids, benzodiazepines, alcohols ) cause hypoventilation that responds to simple support or a titrated antidote.
271 words, about 1 min