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Toxicology Chapter 27
Terms in this set (100)
A 100-pound violent young woman who requires four large paramedics to subdue and contain her is most likely under the influence of:
A 22-year-old man experienced an acid chemical burn to his left forearm. He complains of intense pain and tingling in his fingers. He is conscious and alert, and denies any other symptoms. You should:
begin immediate irrigation with water.
A 29-year-old woman was found unresponsive by her husband. When you arrive at the scene and begin your assessment, you note that the patient's respirations are slow and shallow, her pulse is slow and weak, and her pupils are markedly dilated. Your partner begins assisting the patient's ventilations as you assess her blood pressure, which is 70/48 mm Hg. The patient's husband hands you an empty bottle of phenobarbital, which was filled the day before, and tells you that his wife takes the medication for seizures. After establishing vascular access, you should:
administer crystalloid fluid boluses to improve her blood pressure.
A 45-year-old man is found unresponsive in an alley. During your assessment, you note that he is tachycardic and breathing rapidly. He has an obvious odor of alcohol on his breath. Your MOST immediate concern should be to:
take actions to prevent aspiration.
A 69-year-old man presents with confusion, a headache, dyspnea, and palpitations after he rescued his two grandchildren from their burning house. During your assessment, you note that he has an odd odor on his breath; however, he denies being diabetic. You should:
have him inhale amyl nitrate for 20 seconds and then 100% oxygen for 40 seconds out of each minute.
A metallic taste in the mouth, explosive diarrhea, and a skin rash are most indicative of:
A middle-aged woman who has been taking 2 mg of clonazepam each day for 6 months finds that she now requires 4 mg each day to achieve the same effect. This is an example of:
A patient who ingested a significant amount of ethylene glycol 6 hours ago would most likely present with:
slurred speech and ataxia
A patient who ingested a significant quantity of acetaminophen less than 24 hours ago would most likely present with
malaise, nausea, and a loss of appetite.
A person who compulsively uses a drug, despite the fact that he or she knows the drug will cause physical or psychological harm, is:
A person who is "speedballing" is:
using cocaine in combination with heroin, by injecting them either underneath the skin or directly into a vein, in order to regulate the high.
A therapeutic dose of Valium simply relaxes one person, but causes severe central nervous system depression in another patient. This is an example of:
A woman drives her husband to your EMS station after he was exposed to a large amount of pesticide. Your assessment reveals that he is responsive to pain only, is hypoventilating, is markedly bradycardic, and is incontinent of urine and feces. The cardiac monitor reveals marked sinus bradycardia. As your partner assists the patient's ventilations, you should:
establish vascular access and begin administering atropine sulfate.
A young man is found unresponsive by his girlfriend. Your assessment reveals marked respiratory depression; a slow, weak pulse; and pinpoint pupils. There are numerous medication bottles found in his home. Of these, he has MOST likely ingested:
Alcohol potentiates Valium. This means that:
alcohol enhances the effects of Valium
Any sympathomimetic drug will cause:
Cardiac arrest following a narcotic overdose is usually the result of:
Clinical signs and symptoms following exposure to a toxin will manifest most rapidly if the patient:
is exposed by the injection route
Common signs and symptoms of a tricyclic antidepressant overdose include:
altered mental status and tachycardia.
Crack is a combination of:
cocaine, baking soda, and water.
Cyanide blocks the utilization of oxygen at the cellular level by:
combining with cytochrome oxidase.
Death from acetaminophen overdose is most often caused by:
progressive liver failure.
During your assessment of a 33-year-old woman who you suspect is under the influence of a drug, the patient tells you that she was "listening to the painting on the wall" before you arrived. Her pulse rate and blood pressure are both elevated. This clinical presentation is MOST consistent with the use of:
Early signs of MAOI overdose include all of the following, except:
Exposure to sarin or tabun would result in:
Fluid-refractory hypotension following a barbiturate overdose is treated most effectively with:
From an anatomic and physiologic perspective, inhaled toxins:
quickly reach the alveoli and rapidly gain access to the circulatory system
Gamma-hydroxybutyrate is most commonly used to:
facilitate sexual assault
Hematologic manifestations of lead poisoning include
If administered in conjunction with nitrates, sildenafil would most likely cause:
If you are treating a patient with a suspected benzodiazepine overdose and find that the patient is hypotensive, bradycardic, and comatose:
you should consider concomitant overdose with another CNS depressant.
Inadvertent lithium toxicity would most likely occur in a patient who is taking:
Lithium is most commonly used to treat patients with:
LSD is classified as a:
Management for an ingested poison focuses mainly on
neutralizing the poison in the stomach.
Most ingested poisons will cause:
nausea and vomiting.
Once in the body, approximately 90% of inorganic lead accumulates in
Organophosphates exert their effect by:
stimulating the cholinergic nervous system.
Patients with alcoholism are prone to subdural hematomas and gastrointestinal bleeding because:
their blood-clotting mechanisms are impaired.
Patients with delirium tremens often experience:
Poisoning with ________________ is most often the result of improper food storage or canning.
Prehospital treatment for a patient who overdosed on aspirin may include:
Priority care for an unresponsive patient who has overdosed on phenobarbital includes:
securing the airway and preventing aspiration.
Severe salicylate toxicity produces:
Signs and symptoms of marijuana use include all of the following, except:
Signs and symptoms of organophosphate poisoning include:
Spray paints and lacquer thinner contain __________, and typically cause __________________ when they are inhaled recreationally.
toluene, hallucinations and mania
The bioavailability and excretion rate of a toxin are influenced by the
amount of toxin and the relative speed at which it is metabolized.
The dieffenbachia plant is also referred to as "dumb cane" because:
ingestion can result in the patient being unable to speak.
The emotional state of craving a drug to maintain a feeling of well-being is called:
The foxglove plant contains ______________ and can result in ______________ when it is ingested.
cardiac glycosides, dysrhythmias
The hyperpnea and tachypnea associated with methyl alcohol intoxication is secondary to:
The least common sign or symptom of carbon monoxide toxicity is:
cherry red skin color.
The most common cause of death following a tricyclic antidepressant overdose is:
a cardiac dysrhythmia.
The most important prehospital treatment intervention for a patient with carbon monoxide poisoning is
The odor of bitter almonds on a patient's breath should make you suspicious for exposure to:
The poisonous part of the apricot plant is/are the _______, which contain(s) _______.
The recommended dose and method for administering naloxone to a patient who overdosed on a narcotic and is unresponsive and hypoventilating is:
2 mg injected slowly until the patient's respirations improve.
The toxic chemical in castor beans is:
The toxicity of carbon monoxide arises primarily from:
its affinity for hemoglobin in red blood cells.
Toxic effects of alcohol on the liver include all of the following, except:
Treatment for cyanide poisoning may include all of the following, except:
Tricyclic antidepressant medications:
may produce toxic effects with even minimal dosing errors.
Unlike an opioid, an opiate:
is a natural product derived from opium.
Unlike dermal exposure to a strong acid, dermal exposure to a strong alkali:
requires longer irrigation with water because alkalis are less water soluble.
Upon arriving at the scene of an incident involving a chlorine gas spill, you should:
park the ambulance upwind.
What is a lethal dose of ethylene glycol in a 190-pound man?
When caring for an unresponsive patient with a toxicologic emergency, you should:
protect the airway, perform a rapid assessment, obtain vital signs, try to gather a medical history from the family, and transport promptly.
When chlorine gas comes in contact with the body's mucous membranes, it forms:
When heroin passes through the liver:
it is metabolized into acetyl-morphine, which continues to exert narcotic effects that may outlast the effects of naloxone.
Which of the following antidepressant medications has the highest safety margin?
Which of the following cardiac medications has a small therapeutic window and the greatest propensity to reach toxic levels?
Which of the following cardiac rhythm disturbances most commonly results from inadvertent overdose of a prescribed cardiac medication?
Which of the following drugs is a narcotic?
Which of the following drugs is classified as an anticholinergic?
Which of the following ECG abnormalities is most suggestive of cocaine toxicity?
Prolongation of the QT interval
Which of the following is a sign of severe barbiturate withdrawal?
Which of the following is atypical of an alcoholic?
Chronically pale face and palms
Which of the following is not a common sign of lead poisoning?
Which of the following is the most immediate danger to an unresponsive patient with acute alcohol intoxication?
Aspiration of vomitus
Which of the following medications is not a tricyclic antidepressant?
Which of the following questions often yields the LEAST reliable answer when questioning a patient who intentionally exposed himself or herself to a toxic substance?
Why did you take the substance?
Which of the following statements regarding alcoholism is correct?
A person who consumes alcohol is considered to be physically dependent if abrupt cessation of drinking causes withdrawal symptoms.
Which of the following statements regarding methyl alcohol is correct?
Methyl alcohol is also known as wood alcohol, and is present in paints, paint removers, windshield washer fluid, and varnishes.
Which of the following statements regarding SSRIs is correct?
SSRIs have fewer anticholinergic and cardiac effects than tricyclics.
Which of the following toxins causes the most serious consequences when absorbed through the skin?
Which of the following types of medications does NOT contain amphetamine?
Drugs used to treat insomnia
With hyperbaric oxygen therapy, carbon monoxide is typically eliminated from the body within:
15 to 20 minutes
You are caring for an alcoholic patient who has been abstinent for about 2 days. The patient is confused, restless, and tells you that he sees snakes crawling on the walls. His blood pressure is 76/52 mm Hg, pulse rate is 140 beats/min and weak, and respirations are 24 breaths/min with adequate depth. In addition to administering oxygen, you should:
treat his hypotension with crystalloid fluid boluses.
You are dispatched to a residence for a 61-year-old woman with flu-like symptoms. Upon your arrival, the patient greets you at the door. She complains of a headache and nausea, and tells you that she has vomited twice. Her husband, who is lying on the couch in the living room, began experiencing the same symptoms at about the same time. You should:
remove both patients from the residence at once.
You are dispatched to an apartment complex for a suicide attempt. While you are en route, an on-scene law enforcement officer advises you that the patient, who is unresponsive, ingested an unknown quantity of an unknown drug. Upon arriving at the scene, you should
safely gain access to the patient while looking for an egress route.
You are transporting a patient who is under the influence of methamphetamine. The patient, who is clearly anxious, has a blood pressure of 160/90 mm Hg, a pulse rate of 140 beats/min, and a respiratory rate of 24 breaths/min. The patient suddenly becomes violent and begins thrashing around, trying to get off the stretcher. After asking your partner to stop the ambulance to assist you with the patient, you should:
administer IM haloperidol.
You are transporting a young female who intentionally ingested a large quantity of her prescribed Pamelor. She is conscious, but drowsy, and complains of a dry mouth and blurred vision. The cardiac monitor reveals sinus tachycardia at 120 beats/min. You are administering high-flow oxygen and have established a patent IV line. With regard to her ECG rhythm, you should be especially alert for:
You arrive at the scene of an unknown drug-related emergency. Law enforcement is present and has ensured scene security. The patient, a young male, is found sitting at the kitchen table. He is laughing uncontrollably and tells you, "Life sure is good!" Your partner finds a basin of water and an empty box of baking soda on the counter. You should be MOST suspicious that this patient:
has smoked crack cocaine.
You have administered a total of 10 mg of Narcan to an unresponsive 30-year-old man whom you believe has overdosed on a narcotic. However, the patient remains unresponsive, is hypoventilating, and is bradycardic. Your transport time to the closest appropriate hospital is 40 minutes. You should:
continue assisted ventilation for 2 to 3 minutes, insert an advanced airway device, and transport immediately.
You respond to a local motel for a young woman who was sexually assaulted. Upon your arrival, you find the patient sitting on the bed talking to a police officer. The last thing she remembers is meeting "some guy" at a nightclub the evening before and then having a few drinks with him. She is conscious, but sleepy. Her respirations are 12 breaths/min and regular, pulse rate is 56 beats/min and strong, and blood pressure is 102/58 mm Hg. The cardiac monitor reveals sinus bradycardia at 50 to 60 beats/min. You should:
administer high-flow oxygen, monitor her oxygen saturation, begin transport, and start an IV line en route to the hospital.
You should be most suspicious that a patient has systemic iron toxicity if he or she presents with:
You would expect a person to be hypertensive and tachycardic following exposure to all of the following, EXCEPT:
You would NOT expect a person using methamphetamine to present with:
Your FIRST priority when dealing with a patient who may have overdosed is to:
request law enforcement.
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