Emergency Medicine/Toxicology

Question 1

Acute mental status change of unclear etiology, first treatment should be

Answer 1

Naloxone, Dextrose, and Thiamine

Question 2

Gastric emptying is ONLY useful when?

Answer 2

First hour after overdose (NEVER in case of acids or alkalines)

Question 3

Ipecac is always wrong in

Answer 3

children

Question 4

In a toxicology case where you don’t know what to do, give

Answer 4

charcoal

Question 5

Antidote for acetaminophen OD

Answer 5

N-acetylcysteine

Question 6

Antidote for aspirin OD

Answer 6

bicarbonate to alkalinize the urine, charcoal to block absorption, and dialysis in severe cases

Question 7

Antidote for carbon monoxide poisoning

Answer 7

100% oxygen, hyperbaric in some cases

Question 8

Antidote for digoxin poisoning

Answer 8

digoxin binding antibodies

Question 9

Antidote for ethylene glycol and methanol poisoning

Answer 9

fomepizole or ethanol

Question 10

Antidote for methemoglobinemia

Answer 10

Methylene blue

Question 11

Antidote for Neuroleptic malignant syndrome

Answer 11

bromocriptine, dantrolene

Question 12

Antidote for organophosphates

Answer 12

atropine, pralidoxime

Question 13

Antidote for TCA OD

Answer 13

bicarbonate to protect the heart!

Question 14

Hepatic failure in setting of acetaminophen OD will take place ___ hours later

Answer 14

48-72

Question 15

NAC is only useful to prevent liver toxicity ___ hours after ingestion of acetaminophen

Answer 15

24

Question 16

Aspirin acts as a direct stimulant to the ___ causing ___

Answer 16

brainstem; hyperventilation

Question 17

Aspirin can cause what disease of the lungs?

Answer 17

Acute respiratory distress syndrome

Question 18

In aspirin OD, respiratory alkalosis always precedes

Answer 18

metabolic acidosis

Question 19

In addition to CBC and CMP, order which three tests in aspirin/salicylate overdose

Answer 19

ABG, PT/INR/PTT, and salicylate level

Question 20

Benzo overdose is not fatal!

Answer 20

Let the patient sleep

Question 21

On all OD patients, order which three levels?

Answer 21

aspirin, acetaminophen, and alcohol levels due to high frequency of co-ingestion!

Question 22

The most common cause of death in fires is

Answer 22

CO poisoning!

Question 23

CO poisoning presents with what symptoms?

Answer 23

shortness of breath
lightheadedness/headaches
disorientation
metabolic acidosis in severe disease

Question 24

Cyanosis + Normal pO2 =

Answer 24

methemoglobinemia

Question 25

The most urgent step in TCA overdose is

Answer 25

EKG to check for widening of the QRS

Question 26

The most urgent step in hypothermia patients is to perform an

Answer 26

EKG: look for J waves of Osborn, which look like ST segment elevation

Question 27

Red eye + fixed midpoint dilated pupil =

Answer 27

Acute angle closure glaucoma

Question 28

Initial therapy for acute angle closure glaucoma is

Answer 28

pilocarpine drops to constrict the pupil
Mannitol can also be used to open the angle
Acetazolamide decreases production of aqueous humor

Question 29

Sudden loss of vision like “a curtain coming down” =

Answer 29

retinal detachment, consult optho!

Question 30

Diagnose uveitis with

Answer 30

slit-lamp examination