Diagnosis of poisoning.

Diagnosis of poisoning involves a thorough medical history, physical examination, and laboratory tests. The healthcare provider will ask about the patient's symptoms, any recent exposure to toxic substances, and any medications or supplements they may have taken.

Physical examination may reveal signs of poisoning such as abnormal vital signs, altered mental status, skin discoloration, and abnormal breath sounds.

Laboratory tests may include blood tests to check for levels of toxic substances in the blood, urine tests to check for metabolites of toxic substances, and imaging studies such as X-rays or CT scans to look for signs of organ damage.

In some cases, specific tests may be needed to identify the exact toxin involved in the poisoning, such as toxicology screening or analysis of samples from the patient's environment.

Once a diagnosis of poisoning is confirmed, treatment will depend on the specific toxin involved and may include supportive care, antidotes, and decontamination procedures. Prompt and accurate diagnosis is crucial in order to provide appropriate treatment and prevent complications.

Diagnosis of poisoning

History:

- Patient history: Onset of symptoms, medications taken, exposure to toxic substances, previous poisoning episodes
- Family and friends: Information about patient's habits, access to substances
- Workplace and school: Potential exposure to hazardous materials
- Environmental factors: Household cleaning products, pesticides, carbon monoxide detectors, smoke alarms

Physical examination:

- General: Respiratory distress, hypotension, altered mental status, seizures
- Head and neck: Eyelid edema, miosis, mydriasis, nystagmus
- Chest: Auscultation for wheezing, rales, or diminished breath sounds
- Cardiovascular: Arrhythmias, hypotension, tachycardia
- Skin: Redness, papules, blisters, burns
- Neurological: Tremor, weakness, seizures, altered mental status

Laboratory tests:

- Serum toxicant levels:
- Quantitative analysis to determine substance concentration
- Interpretation based on therapeutic and toxic levels
- Urine drug screen:
- Qualitative analysis to detect presence of illicit drugs or prescription medications
- Blood gas analysis:
- pH, pCO2, pO2, bicarbonate
- Electrolytes and renal function:
- Sodium, potassium, chloride, bicarbonate, creatinine
- Liver function tests:
- AST, ALT, alkaline phosphatase, bilirubin
- Hematologic tests:
- Hemoglobin, hematocrit, white blood cell count

Imaging studies:

- Chest X-ray: Pulmonary edema, aspiration pneumonia
- Computed tomography (CT) scan: Head injury, cerebrovascular accident
- Magnetic resonance imaging (MRI) scan: Brain injury, spinal cord injury

Additional diagnostic procedures:

- Gastric lavage: Removal of ingested toxins via nasogastric tube
- Activated charcoal administration: To adsorb toxins in the gastrointestinal tract
- Hemodialysis or peritoneal dialysis: Removal of toxins from the bloodstream
- Specific antidotes: For specific poisons, such as naloxone for opioid overdose

Differential diagnosis:

- Infectious diseases (e.g., meningitis, encephalitis)
- Metabolic disorders (e.g., diabetic ketoacidosis, hypoglycemia)
- Psychiatric disorders (e.g., psychosis, delirium)
- Trauma (e.g., head injury, spinal cord injury)