Chapter 28 Flashcards
Exposure to sarin or tabun would result in:
excessive lacrimation.
What is a lethal dose of ethylene glycol in a 190-pound man?
175 ml
The toxicity of carbon monoxide arises primarily from its:
affinity for hemoglobin in red blood cells.
Which of the following is a sign or symptom of organophosphate poisoning?
Vomiting
You would expect a person to be hypertensive and tachycardic following exposure to:
Bath salts
Which of the following is a sign of marijuana use?
Drowsiness
In general, symptoms of arsenic poisoning appear within which timeframe after arsenic ingestion?
30 minutes to several hours
Common signs and symptoms of a tricyclic antidepressant overdose include:
altered mental status and tachycardia.
Drug misuse is defined as:
any use of a drug that causes physical, psychological, or legal harm to the user.
The toxic chemical in castor beans is:
Ricin
Metabolic acidosis, hyperkalemia, and rhabdomyolysis that occurs with MAOI toxicity are usually the result of:
persistent seizures.
Appropriate prehospital treatment for a patient who has overdosed on a stimulant and is excessively tachycardic and violent includes:
benzodiazepines.
An acetone breath odor is common following exposure to:
Aspirin
A common sign or symptom of carbon monoxide toxicity is:
pallor or cyanosis.
Gamma-hydroxybutyrate is most commonly used to:
facilitate sexual assault.
From an anatomic and physiologic perspective, inhaled toxins:
quickly reach the alveoli and rapidly gain access to the circulatory system.
Which of the following is an ECG change that would most likely be observed in a patient with tricyclic antidepressant toxicity?
Terminal R wave in aVR
Immediate treatment for a patient who overdosed on a narcotic and is hypercarbic includes:
ventilation with a bag-mask device.
Upon arriving at the scene of an incident involving a chlorine gas spill, you should:
park the ambulance upwind.
Which of the following medications is a tricyclic antidepressant?
Clomipramine
A 45-year-old woman is found unresponsive in an alley. During your assessment, you note that she is tachycardic and breathing rapidly. She has an obvious odor of alcohol on her breath. Your most immediate concern should be to:
take actions to prevent aspiration.
Severe salicylate toxicity produces:
metabolic acidosis.
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:
Tolerance
Which of the following types of medications contain amphetamine?
Nasal decongestants
Organophosphates exert their effect by:
stimulating the cholinergic nervous system.
Ingestion of the foxglove plant can result in which of the following symptoms?
Dysrhythmias
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 150 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.
Patients with alcoholism are prone to subdural hematomas and gastrointestinal bleeding because:
their blood-clotting mechanisms are impaired.
Treatment for cyanide poisoning may include:
amyl nitrite.
Management for an ingested poison focuses mainly on:
neutralizing the poison in the stomach.
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 person who compulsively uses a drug, despite the fact that they know the drug will cause physical or psychological harm, is:
Addicted
When chlorine gas comes in contact with the body’s mucous membranes, it forms:
hydrochloric acid.
The recommended dose and method for administering naloxone to a patient who overdosed on a narcotic and is unresponsive and hypoventilating is:
0.4 to 2 mg slowly until the patient’s respirations improve.
Which of the following is a sign of severe MAOI toxicity?
Hyperthermia
A known alcoholic man is found unresponsive by a law enforcement officer. An empty container of antifreeze was found near him. Your assessment reveals that his respirations are deep and rapid, his pulse rate is rapid and weak, and his pupils are dilated and sluggishly reactive. As your partner administers high-flow oxygen to the patient, you should:
assess his blood glucose level and apply a cardiac monitor.
What is the poisonous part of the apricot plant?
Seed
Your first priority when dealing with a patient who may have overdosed is to:
request law enforcement.
Which of the following antidepressant medications has the highest safety margin?
Paroxetine
The hyperpnea and tachypnea associated with methyl alcohol intoxication is secondary to:
metabolic acidosis.
Lithium is most commonly used to treat patients with:
Bipolar disorder
Symptoms of delirium tremens usually begin within how many hours after the last alcohol intake?
48 to 72
Prehospital treatment for a patient who overdosed on aspirin may include:
sodium bicarbonate.
Which of the following drugs is classified as an anticholinergic?
Atropine
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:
LSD
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 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 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.
Pulse oximetry will not provide a true assessment of arterial oxygenation in patients with carbon monoxide toxicity because:
the device cannot determine whether carbon monoxide or oxygen is bound to the hemoglobin.
In adult patients, oral ingestion of a caustic substance:
is usually intentional.
Crack is a combination of:
cocaine, baking soda, and water.
Alcohol potentiates Valium. This means that:
alcohol enhances the effects of Valium.
The most important prehospital treatment intervention for a patient with carbon monoxide poisoning is:
providing high-flow oxygen.
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.
Spray paints and lacquer thinner contain which of the following substances?
Toluene
Which of the following cardiac rhythm disturbances most commonly results from inadvertent overdose of a prescribed cardiac medication?
Bradycardia
Which of the following is a sign of severe barbiturate withdrawal?
Hallucinations
A 100-pound violent young woman who requires four large paramedics to subdue and contain her is most likely under the influence of:
PCP
Which of the following interventions is influenced strongly by the amount of time that has elapsed since a patient ingested a toxic substance?
Gastric lavage
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:
QRS widening.
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.
You are dispatched to a residence for a 61-year-old woman with flulike 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.
A patient in the later stages of iron poisoning would be expected to present with:
Liver failure
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.
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 beats/min. You should:
monitor her oxygen saturation, start an IV line at a keep-vein-open rate, transport, and monitor her en route to the hospital.
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.
Death from acetaminophen overdose is most often caused by:
progressive liver failure.
A 22-year-old woman experienced an acid chemical burn to her left forearm. She complains of intense pain and tingling in her fingers. She is conscious and alert, and denies any other symptoms. You should:
begin immediate irrigation with water.
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. Which of the following has he most likely ingested?
Oxycodone
You should be most suspicious that a patient has systemic iron toxicity if they present with:
hematemesis
Mild to moderate iron toxicity should be expected with ingestion of how much iron?
20 to 60 mg/kg
Inadvertent lithium toxicity would most likely occur in a patient who is taking:
NSAIDs
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.
The clinical presentation of a stimulant abuser includes:
excitement, hypertension, tachycardia, and dilated pupils.
Poisoning with which of the following is most often the result of improper food storage or canning?
Clostridium botulinum
If administered in conjunction with nitrates, sildenafil would most likely cause:
Severe hypotension
