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Tox Review Flashcards | StudBud
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Tox Review
Tox Review
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Answers
1
Which of the following symptoms should be anticipated?
Hallucinations
Hypotension
Seizure
GI Hemorrhage
2
What type of acid-base disorder is caused by salicylate overdose?
Metabolic acidosis and respiratory alkalosis
Metabolic alkalosis and respiratory alkalosis
Metabolic acidosis and respiratory acidosis
Metabolic alkalosis and respiratory acidosis
3
Which of the following distinguish anticholinergic syndrome from the other syndromes listed?
Dry skin
Altered movements
Altered mental status
Fever
4
Antidotes: Aspirin
Vitamin K
BAL
Sodium Bicarb
NAC
5
Which of the following treatments has the strongest evidence for this OD?
High-Dose Insulin
Gastric Lavage
Intralipid Emulsion
Hemodialysis
6
Which would be abnormal?
Calcium
Lead
Iron
Magnesium
7
A glass etcher = hydrofluoric acid on himself. What's the treatment?
Calcium Chloride
Sodium Bicarb
Magnesium Chloride
Potassium Chloride
8
What are the features of Wernicke encephalopathy and what is the treatment?
Ophthalmoplegia, Ataxia, Encephalopathy, Thiamine
Ataxia, Diplopia, Dysmetria, Glucose
Coma, pretibial edema, hypothermia, Glucose
Ophthalmoplegia, Confabulation, Sensory deficits, Thiamine
9
Which of the following statements regarding acetaminophen ingestion in pregnant patients is TRUE?
Pregnant pt. should be treated with NAC if ingest >75 mg/kg PO in < 8hrs
All pregnant pt. should be treated with NAC after any ingestion of Tylenol
Pregnant pt. should be treated with NAC if level is above the Treat Line
Treat Line on the nomogram should be lowered 100 µg/mL at 4 hours
10
Which etiology is likely with the finding of calcium oxalate crystals in the urine and high anion gap?
Eszopiclone
Chloral Hydrate
Buspirone
Ethylene Glycol
11
Intoxication with these drugs of abuse may cause life threatening hyperthermia. Except?
Cocaine
Methamphetamine
Cannabis
Ecstasy
12
5 yo p/w abd pain, n/v, and bloody diarrhea. Took grandmas meds Hypotensive/Tachycardic. + AG acidosis, hyperglycemia?
Diltiazem
Iron
Digoxin
Metformin
13
Which of the following medications can also cause these symptoms?
Amiodarone
Diphenhydramine
Lidocaine
Clonidine
14
Which is not a feature of Korsakoff’s psychosis (aka alcohol-induced persisting amnestic disorder)?
Memory impairment
Expressive Aphasia
Inability to learn new information
Confabulation
15
Which of the following antidepressants is most likely to produce seizures without other symptoms of severe toxicity?
Fluoxetine
Bupropion
Trazodone
Amitriptyline
16
Apparent overdose of diltiazem. Which of the following findings would lead you to suspect a co-ingestant?
Metabolic acidosis
Hyperglycemia
AV Block
Prolonged QRS complex
17
Jail Clearance. Pt smoked crack cocaine. ℅ Headache. GCS 15 BP 195/00 HR 102. PE is normal. Next step?
Acetaminophen administration, discharge if headache resolves
Head computed tomography (CT) scan, discharge if normal
Head CT scan, lumbar puncture if normal, discharge if both are normal
Blood pressure reduction, discharge if headache resolves
18
What would appropriate to do next?
Administer IV Atropine
Perform RSI
Administer oral activated charcoal
Remove the child’s clothing and wash the skin
19
Which of the following additional treatments are most appropriate to administer at this time?
Cyproheptadine and phentolamine
Haldol and metoprolol
Chlorpromazine and norepinephrine
Bromocriptine and labetalol
20
What is the best initial treatment of hyperthermia in patients with anticholinergic syndrome?
Evaporative cooling
Cooling blankets
Acetaminophen
Dantrolene
21
Antidotes: Tylenol
Fomepizole
Hydroxocobalamin
NAC
BAL
22
5yo took grandma’s heart meds. She has sinus bradycardia and low BP. Blood sugar high. Calcium given w/ no change. Next?
Intravenous fat emulsion
Glucagon
Epinephrine
High-dose insulin
23
Which of the following medications crosses the blood-brain barrier and treats anticholinergic syndrome?
Pyridostigmine
Edrophonium
Neostigmine
Physostigmine
24
What treatment is indicated?
Phenobarbital
Phenytoin
Pyridoxine
Propofol
25
You suspect a patient has a cholinergic syndrome.Which of the following would make you question your diagnosis?
Fasciculations
Diarrhea
Mydriasis
Confusion
26
A 41 yo p/w ibuprofen overdose. C/O epigastric pain, n/v. ~ 2 hours ago took four 800mg ibuprofen. What's next?
Oral activated charcoal
Urinary alkalinization
Observation for resolution of symptoms
Check electrocardiogram (ECG) to determine further treatment
27
In pt.’s with propranolol overdose, which drug may produce dramatic improvement in heart rate and blood pressure?
Administer oral activated charcoal
Administer IV Glucagon
Administer IV Atropine
Administer naloxone
28
Which type of necrosis is found in a Alkali caustic ingestion?
Caseous
Liquefactive
Coagulative
Fibrinoid
29
Which of the following is the most consistent with this presentation?
Serotonin syndrome
Neuroleptic malignant syndrome
Cocaine intoxication
Anticholinergic syndrome
30
What the toxin?
Arsenic
Malathion
Strychnine
Lead
31
Which of the following sedative hypnotics is most likely to cause fatal cardiac dysrhythmias in overdose?
Buspirone
Flunitrazepam
Zolpidem
Chloral Hydrate
32
Most lethal OD's demonstrate clinical symptoms w/in several hours of ingestion. Some are more acute like:
Buspirone
Acetaminophen
Verapamil
Mushrooms
33
Which of the following substance is adsorbed by activated charcoal ?
Gasoline
Iron
Metoprolol
Hydrofluoric acid
34
Why are you not concerned about their ingestion?
No Hematemesis
Early onset GI Symptoms
Normal Mental Status
Normal Vital Signs
35
Glass guy, chemical spill on hand. Intense pain/pallor. +perioral/extrem paresthesias and hypotension. What's next?
Latex gloves w/ Tyvek suit treat with calcium gluc gel and IV calcium gluc
Standard universal precautions treat with subQ calcium carbonate injection
N95 Mask w/ 4 mil nitrile gloves treat w/ intra-art infusion calcium gluc
Powered air-purifying respirator treat with IV mag sulf
36
Drain cleaner ingestion containing hydrochloric acid. Airway open, vital signs normal. Next Step?
Dilution with alkali
Activated charcoal
Gastric lavage
Upper endoscopy
37
Pt. ingests 8 mg of dig. He has VT on his ECG. BP is 93/54 mm Hg. Labs not available. How many vials of dig need?
2 Vials
4 Vials
8 Vials
16 Vials
38
21 yo M p/w vertical nystagmus and extremely bizarre aggressive behavior. What’s diagnosis?
PCP
GBH
Steroids
Cocaine
39
How long does a typical urine drug screen result remain positive after use of cocaine?
3 days
1 week
2 weeks
1 day
40
Antidotes: Isoniazid
Deferoxamine
Pyridoxine
Vitamin B12
Pyruvate
41
Dystonia, Parkinsonism, Seizures, VT, Pinpoint Pupils. Whats the overdose?
Diphenhydramine
Hydrocodone
Alprazolam
Phenegran
42
What is the elimination half-life naloxone?
1 hr
4 hr
30 min
2 hr
43
Which of the following is the most appropriate therapy?
Observation only
Hemodialysis
Forced diuresis
Urinary alkalinization
44
For which patient is it most reasonable to consider the use of flumazenil?
43-year-old man with depression and anxiety
5-year-old boy with no known medical problems who took his mother’s meds
22-year-old woman with no known medical problems
30-year-old man who is known to abuse cocaine
45
Which of the following is the most accurate statement regarding additional management?
Sedation with benzodiazepines and ICU monitoring is rarely required
Treatment with dantrolene or bromocriptine supported by large-scale trial
Aggressive fluid resus not recommended s/t risk of fluid overload
Discontinuing antipsychotics and temperature management are most important
46
Antidotes: Cyanide
Hyboxocobalamin
Deferoxamine
Calcium Disodium
Sodium Bicarb
47
Which of the following treatments is the most appropriate?
Urine Alkalization
Whole Bowel Irrigation
Dialysis
Activated charcoal
48
If the patient smells like Garlic you should be concerned about?
Toluene
Cyanide
Organophosphates
Methyl Salicylate
49
Which of the following is a contraindication to physostigmine use in a patient with anticholinergic syndrome?
Tricyclic antidepressant overdose
Coexisting myasthenia gravis
Altered mental status
Seizure
50
For what drug ingestion would you alkalinize the urine?
Iron
Aspirin
Gasoline
Metoprolol
51
Which of the following is the next most appropriate step in management?
NAC per R-M Nomogram
Transfer to Liver Transfer Center
Multi-dose Activated Charcoal
Hemodialysis
52
Pt p/w confusion. Vitals BP 105/77 HR 69 RR 10 Temp 37 SaO2 96% 2 L. GCS 10, PE normal. IV in, Monitor on. What's next?
Give Narcan
Give D50 1 amp
ECG
Bedside Glucose
