Chapter 21 Toxicology Flashcards

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1
Q

How do poisons typically act to harm the body?

A

By changing the normal metabolism of cells or by destroying them

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2
Q

If the victim of a toxicologic emergency vomits, an EMT should _____.

A

Use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care

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3
Q

Of the four avenues of poisoning, generally _____ is the most worrisome in terms of treatment to the EMS provider.

A

Injection

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4
Q

Victims of inhaled poisoning will require what?

A

Immediate transport to an emergency department for evaluation

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5
Q

The recommended treatment for absorbed or contact poisons includes _____.

A

Safely removing or diluting the poisonous substance

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6
Q

Most poisoning occur via the _____ route.

A

Ingestion

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7
Q

Heroin is an example of a(n):

A

Opiod

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8
Q

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:

A

Oxycodone (Percocet)

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9
Q

Activated charcoal is given to patients who have ingested certain substances because it:

A

Binds to the substance and prevents absorption

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10
Q

As you enter the residence of a patient who has possibly overdosed, you should:

A

Be alert for personal hazards

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11
Q

You receive a call to a residence where a man found his wife unresponsive on the couch. The patient’s respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should:

A

Ventilate her with a BVM

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12
Q

When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:

A

Internal bleeding may be profuse because prolonged alcohol consumption weakens the structure of the bones

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13
Q

Which of the following statements regarding the Salmonella bacterium is correct?
A) Refrigeration of food will prevent salmonellosis
B) Symptoms of salmonellosis appear within 12 hours
C) The Salmonella bacterium produces toxins that cause food poisoning
D) The Salmonella bacterium itself causes food poisoning

A

D) The Salmonella bacterium itself causes food poisoning

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14
Q

Which of the following sets of vital signs would the EMT most likely encounter in a patient with acute cocaine overdose?
A) BP, 60/40 mmHg; pulse, 140 beats/min
B) BP, 190/90 mmHg; pulse, 40 beats/min
C) BP, 200/100 mmHg; pulse, 150 beats/min
D) BP, 180/100 mmHg; pulse, 50 beats/min

A

C) BP, 200/100 mmHg; pulse, 150 beats/min

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15
Q

An overdose of acetaminophen, the active ingredient in Tylenol, will most likely cause:

A

Liver failure

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16
Q

In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mmHg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be most alert for:

A

Seizures and cardiac arrhythmias

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17
Q

A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patients wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is most likely experiencing:

A

Delirium tremens

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18
Q

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing:

A

Tolerance

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19
Q

The most important consideration in caring for a patient who has been exposed to an organophosphate insecticide or some other cholinergic agent is to:

A

Avoid exposure yourself

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20
Q

“Nerve gases” overstimulate normal body functions that are controlled by parasympathetic nerves, causing:

A

Increased salivation

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21
Q

You responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her sleeping in her chair, and several empty alcohol containers are present. She is breathing heavily. You are able to arouse her consciousness for a short period of time. What course of action takes priority?

A

Have her take activated charcoal while she is conscious

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22
Q

The presence of burning or blistering of the mucous membranes suggests ingestion of _____.

A

Poison

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23
Q

If the patient has a chemical agent in the eyes, you should irrigate the eyes quickly and thoroughly for at least _____ to _____ minutes for acid substances

A

5; 10

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24
Q

If the patient has a chemical agent in the eyes, you should irrigate the eyes quickly and thoroughly for at least _____ to _____ minutes for alkali substances

A

15; 20

25
Q

It is important to remember that some chemicals _____ when they come into contact with water.

A

Explode

26
Q

What is a stimulant?

A

An agent that produces an excited state

27
Q

What is an opioid?

A

A drug or agent with actions similar to morphine

28
Q

What is the name for an agent that blocks the parasympathetic nerves?

A

Anticholinergic

29
Q

What is the name for an agent that overstimulates the body functions controlled by the parasympathetic nerves?

A

Cholinergic

30
Q

Define poison

A

Any substance that can damage body structure or impair body function

31
Q

Define toxin

A

Substance produced by bacteria, animals, plants that changes normal metabolism

32
Q

Define delerim tremens (DTs)

A

A severe withdrawal syndrome seen in alcoholics who are deprived of alcohol

33
Q

What are some characteristics of DTs

A
Restlessness and agitation
Fever
Diaphoresis
Disorientation and/or confusion
Delusions and/or hallucinations
Seizures
34
Q

What is the usual dose of activated charcoal for a patient?

A

1g per kg of body weight

35
Q

Define opioid

A

A type of narcotic medication used to relieve pain

36
Q

Define opiate

A

A subset of opioids, referring to natural, non-synthetic opioids (no chemicals)

37
Q

What is the most commonly accepted sign of opioid abuse?

A

Pinpoint pupils

38
Q

What are some common opioids and opiates?

A
Codeine
Fentanyl (Sublimaze)
Heroin
Hydrocodone (Vicodin)
Morphine
Oxycodone hydrochloride (OxyContin)
39
Q

What are some abused inhalants?

A
Cleaning compounds
Glues
Paint thinners
Lacquers
Aerosol sprays
40
Q

What do abused inhalants do to the brain?

A

Temporarily displace oxygen causing a rush of euphoria

41
Q

What is hydrogen sulfide?

A

Highly toxic, colorless, and flammable gas with a distinctive rotten-egg odor

42
Q

Where does hydrogen sulfide occur naturally?

A

Sewers
Volcanoes
Swamps
Crude petroleum

43
Q

What do sympathomimetics mimic in the body?

A

The effects of the sympathetic (fight or flight) nervous system

44
Q

What signs/symptoms do sympathomimetic frequently cause?

A

Hypertension
Tachycardia
Dilated pupils

45
Q

What are some of the most addictive substances?

A
Cocaine
Heroin
Methamphetamine
Alcohol
Nicotine
46
Q

What is an acute cocaine overdose patient at high risk for?

A

Seizures
Cardiac dysrhythmias
Stroke

47
Q

How long can the effects of synthetic cathinones (bath salts) reportedly last?

A

As long as 48 hours

48
Q

What does synthetic marijuana or “spice” refer to?

A

A variety of herbal incense or smoking blends that resemble THC and produce a similar high
(No medical benefit, high potential for abuse)

49
Q

What do hallucinogens do to a person?

A

Alter their sensory perceptions

50
Q

What signs/symptoms would a patient experiencing a “bad trip” on hallucinogens likely have?

A

Tachycardia
Hypertension
Anxiety
Paranoia

51
Q

What do anticholinergics do to the body?

A

Block the parasympathetic nerves

52
Q

What phrase can help paint a picture of an anticholinergic overdose?

A

“Hot as a hare” (hyperthermia)
“Blind as a bat” (dilated pupils)
“Dry as a bone” (dry skin and mucous membranes)
“Red as a beet” (reddened skin)
“Mad as a hatter” (agitation or delirium)

53
Q

What do Cholinergic agents do to the body?

A

Overstimulate normal body functions caused by the parasympathetic nervous system

54
Q

What might a patient exhibit if poisoned by a cholinergic agent?

A

Excess salivation
Mucous membrane oversecretion
Uncontrolled diarrhea
Excessive tearing of the eyes

55
Q

What is the mnemonic SLUDGEM used for?

A

Remembering cholinergic poisoning signs and symptoms

56
Q

What does SLUDGEM stand for?

A
Salvation, sweating
Lacrimation (teary eyes)
Urination
Defecation, drooling, diarrhea
Gastric upset and cramps 
Emesis
Muscle twitching, miosis (pinpoint pupils)
57
Q

What signs and symptoms would a patient with aspirin poisoning frequently exhibit?

A

Anxiety
Confusion
Tachypnea
Hyperthermia

58
Q

What is staphylococcus?

A

A bacterium that is quick to grow and produce toxins in foods that have been prepared in advance and kept too long, even in the refrigerator