Chapter 30 Toxicology

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What is the most common route of entry?
A) A. Absorption
B) B. Ingestion
C) C. Inhalation
D) D. Injection

B

What drug would you use to treat an overdose of mescaline?
A) A. Dextrose
B) B. Diazepam
C) C. Narcan
D) D. Sodium bicarbonate

B

You arrive on the scene of an overdose. Your patient is a 34-year-old male. He is supine and unconscious on the floor with an empty bottle of amitriptyline that was filled yesterday. What drug can you consider administering to this patient?
A) A. Magnesium sulfate
B) B. Midazolam hydrochloride
C) C. Nalmefene hydrochloride
D) D. Sodium bicarbonate

D

At what rate does carbon monoxide bind to hemoglobin over oxygen?
A) A. 10´
B) B. 20´
C) C. 100´
D) D. 200´

D

You are on scene with a patient who is experiencing a severe bought of delirium tremens. What drug can you consider administering to assist this patient?
A) A. Cardizem
B) B. Etomidate
C) C. Narcan
D) D. Valium

D

The majority of poisonings occur in what age group?
A) A.

B

Your patient has overdosed on meperidine and is experiencing visual illusions. After establishing ABC's, what can you consider administering to this patient?
A) A. Dextrose
B) B. Diazepam
C) C. Narcan
D) D. Sodium bicarbonate

C

What type of viscosity solvents is prone to aspiration?
A) A. Low
B) B. Medium
C) C. High
D) D. Charged

A

Your patient has taken a lethal dose of labetalol. What drug do you carry that could be used with online medical direction to counteract the effects of this drug?
A) A. Amiodarone
B) B. Epinephrine
C) C. Glucagon
D) D. Procainamide

C

What type of injury would produce liquefaction necrosis?
A) A. Acids
B) B. Alkalines
C) C. Hydrocarbons
D) D. Methanol

B

Minor symptoms of alcohol withdrawal usually:
A) d. Persist for up to 3 months
B) a. Are delayed for up to 3 days with the administration of thiamine
C) c. Peak within 24 to 36 hours
D) b. Begin about 2 days after the last drink

C

If the stinger is left in the wound after a sting by a honeybee, you should:
A) c. Remove the stinger from the wound
B) a. Leave the stinger in place
C) d. Use forceps to remove the stinger
D) b. Pull the wound out with fingers only

A

An employee in a pest-control business is found unconscious on a garage floor. You find him drooling and diaphoretic. The most appropriate medication for this patient is:
A) b. Diphenhydramine
B) c. Methylprednisolone
C) a. Atropine
D) d. Naloxone

C

Syrup of ipecac is:
A) b. Recommended for children who cannot tolerate activated charcoal
B) a. Not recommended for routine use in the prehospital setting
C) c. Recommended for pregnant patients who cannot receive activated charcoal
D) d. Routinely used following ingested poison

B

Why might medical direction advise you to promote gastric emptying in a patient who has ingested lead or mercury?
A) c. The viscosity of these materials does not allow them to exit the stomach.
B) b. The risk for systemic toxicity outweighs the risk for aspiration.
C) a. Small amounts of these metals will lead to cancer.
D) d. These heavy metals generally lead to bowel obstruction.

B

Most poisoned patients require what type of therapy in the prehospital setting?
A) c. Gastric lavage
B) d. Supportive care
C) a. Antidote therapy
D) b. Control of dysrhythmias

B

You are called to a local beach to treat a man who stepped on a starfish. He now has a painful wound in which a piece of the starfish is still intact. Treatment for this patient includes:
A) b. Applying baking soda
B) a. Administering small localized injections of lidocaine
C) c. Immersing the foot in warm, fresh water
D) d. Rinsing the foot in fresh water

C

A 'wet' patient presentation that includes tearing, emesis, and salivation would lead you to suspect what kind of toxicologic syndrome?
A) a. Anticholinergic
B) c. Hallucinogenic
C) d. Opiate
D) b. Cholinergic

D

A 'wet' patient presentation that includes tearing, emesis, and salivation would lead you to suspect what kind of toxicologic syndrome?
A) a. Anticholinergic
B) c. Hallucinogenic
C) d. Opiate
D) b. Cholinergic

A

The most common route of entry for poisons in children is:
A) b. Ingestion
B) c. Inhalation
C) d. Injection
D) a. Absorption

A

What is the definition of the RAIN mnemonic?
A) d. Respond, Assess, Intervene, Notify
B) c. Recognize, Avoid, Isolate, Notify
C) a. Respond, Access, Intervene, Notify
D) b. Recognize, Access, Isolate, Notify

B

You are called to treat a 2-year-old child who has just ingested lye. The child is conscious and cooperative. The poison control center might advise you to administer what oral solution?
A) a. A weak solution of sulfuric acid
B) d. Vinegar
C) c. Water
D) b. Fruit juice

C

A contraindication for gastric lavage is:
A) b. An uncooperative patient
B) c. Endotracheal intubation
C) a. A patient younger than 5 years of age
D) d. Ingestion of low-viscosity hydrocarbons and corrosives

D

You are called to a local woodshop where a man was found seizing, immediately after working with a paint-removal product. The man was not wearing gloves. He is now confused and lethargic. He is tachypneic and complains of abdominal pain. After protecting his airway, treatment for this patient may include:
A) d. Ethanol
B) c. Calcium carbonate
C) a. A cathartic
D) b. A weak base

A

A contraindication for gastric lavage is:
A) b. An uncooperative patient
B) c. Endotracheal intubation
C) a. A patient younger than 5 years of age
D) d. Ingestion of low-viscosity hydrocarbons and corrosives

D

The most efficient absorption of toxins takes place primarily in the:
A) b. Mouth
B) d. Stomach
C) a. Large intestine
D) c. Small intestine

D

Most poisonings in the United States occur:
A) c. In men between the ages of 14 and 25
B) a. As a result of alcohol overdose
C) d. In the home
D) b. As a result of inhaling toxic substances

C

Activated charcoal should be withheld if the ingestion occurred:
A) c. Within 30 minutes before EMS arrival
B) d. Within 45 minutes before EMS arrival
C) a. More than 1 hour before EMS arrival
D) b. Within 20 minutes before EMS arrival

C

Why might an EMS provider contact a poison control center?
A) d. To determine whether the exposure was accidental or intentional
B) c. To determine the most current treatment regimen of the poison
C) a. To determine whether a patient is experiencing anaphylaxis
D) b. To determine whether intubation is necessary

B

Acetaminophen overdose leads to toxicity of the:
A) a. Brain
B) c. Kidneys
C) b. Intestines
D) d. Liver

D

Any substance that produces harmful effects on the human body is called a(n):
A) b. Chemical
B) c. Poison
C) a. Allergen
D) d. Medication

B

Which of the following is an early sign of toxicity in reaction to a tricyclic antidepressant?
A) b. Bradypnea
B) a. Blurred vision
C) d. Hyperthermia
D) c. Hypertension

B

Cocaine is a(n):
A) b. CNS stimulant
B) d. Phencyclidine
C) c. Opiate
D) a. Benzodiazepine

A

Organophosphates affect primarily which neurotransmitter?
A) d. Norepinephrine
B) c. Epinephrine
C) a. Acetylcholine
D) b. Dopamine

C

The drug of choice to treat an overdose of opiates is:
A) d. Naloxone
B) b. Diphenhydramine
C) c. Methylprednisolone
D) a. Diazepam

A

The most common age group for accidental toxic plant exposure is:
A) d. Young adults
B) a. Children
C) c. Teenagers
D) b. Infants

B

The mnemonic device CHAMP helps you remember:
A) b. Specific antidotes for alkali ingestion
B) a. Pertinent historical findings for a poisoned patient
C) d. Which hydrocarbons may benefit from gastric lavage
D) c. The sequence of actions to take for poisoned patients

C

You are called to a local woodshop where a man was found having a seizure immediately after working with a paint-removal product. The man was not wearing gloves. He is now confused and lethargic. He is tachypneic and complains of abdominal pain. You suspect this patient has been poisoned by:
A) c. A hydrocarbon
B) d. Methanol
C) a. A strong acid
D) b. Ethylene glycol

B

To identify potential chemicals at accident scenes, every ambulance should carry on board:
A) d. An MSDS forms pocketbook
B) a. A computer with internet access
C) b. A National Institute of Occupational Safety and Health (NIOSH) guidebook
D) c. A set of binoculars

C

What is a function of a poison control center?
A) c. To identify which medications parents have that a child is likely to steal
B) a. To serve as a resource of education for the public and medical providers
C) b. To control the scene of large chemical spills in order to limit exposure
D) d. To provide incident command at hazardous material incidents

B

What is the most universally accepted decontamination solution?
A) d. Soap and water
B) c. A slightly basic chemical wash
C) b. A slightly acidic chemical wash
D) a. A 10% iodine solution

A

Failure to adequately assess the scene of a possible toxin exposure may:
A) b. Lessen the chances of a patient getting a weapon
B) a. Allow the patient to be removed more quickly
C) c. Put the EMS providers in danger
D) d. Shorten your exposure time, thus eliminating symptoms

C

What finding would lead you to eliminate a spider bite as the cause of an injected poison?
A) d. Two fang marks at the site of the injection
B) a. A bull's-eye appearance around the wound
C) c. Swelling around the injection site
D) b. Multiple bites

D

Most pediatric lead poisonings occur as a result of:
A) c. Ingestion of small batteries
B) d. Inhaling fumes from industries
C) a. Contaminated soil
D) b. Ingestion of paint chips

D

The mnemonic device SLUDGEM helps you to remember the:
A) d. Treatment steps for absorbed toxins
B) c. Signs of organophosphate poisoning
C) a. Causes of death after poisoning
D) b. Classifications of antidotes for inhaled toxins

B

How should the envenomation site of a jellyfish sting be treated?
A) d. Rinse the wound in fresh, warm water.
B) b. Cover the wound with wet sand.
C) c. Leave visible tentacles in place.
D) a. Apply isopropanol and baking soda

A

The pharmacologic management of choice for a symptomatic overdose of a tricyclic antidepressant is:
A) c. Naloxone
B) a. Atropine sulfate
C) d. Sodium bicarbonate
D) b. Epinephrine

C

The preferred method of keeping a poison from absorbing into the GI tract is:
A) b. Gastric lavage
B) c. Use of activated charcoal
C) a. Administration of ipecac
D) d. Use of medications to induce diarrhea

B

Sedative-hypnotic drugs include:
A) b. Hallucinogens and MAO inhibitors
B) c. Opioids and methamphetamines
C) a. Benzodiazepines and barbiturates
D) d. PCP and ketamine

C

The antidote for benzodiazepine overdose is:
A) d. Pralidoxime
B) b. Flumazenil
C) a. Calcium
D) c. Naloxone

B

Alcohol withdrawal can lead to hallucinations in _____ hours.
A) c. 36 to 48
B) d. 48 to 72
C) b. 24 to 36
D) a. 10 to 24

C

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