Review questions Flashcards
THE STINGER SHOULD BE REMOVED IMMEDIATELY BY WHATEVER MEANS IS AVAILABLE. T/F
FALSE
WHICH OF THE FOLLOWING TYPES OF MUSHROOMS WOULD CAUSE A DISULFRAM LIKE RXN? • AMANTIA PHALLOIDES • AMANITA MUSCARINAE • CORTINARIUS SP. • COPRINUS SP.
COPRINUS SP.
APPLY ICE PACKS AS NEEDED. T/F
TRUE
IF ANAPHYLAXIS OCCURS, IT WILLB E WITHIN 30 MIN. T/F
TRUE
HOW LONG SHOULD YOU OBS A PATIENT WITH 50 BEE STINGS OR MORE? • YOU DON’T. YOU FOLLOW IT AT HOME. • 2 HOURS AND HAVE NORMAL LABS • 4 HOURS AND HAVE NORMAL LABS • 6-8 HOURS AND HAVE NORMAL LABS
6-8 HOURS AND HAVE NORMAL LABS
WHICH THERAPY MAY BE HELPFUL TREATING AN INGESTION OF MUSHROOMS CONTAINING MONOMETHYLHYDRAZINE? • N-ACETYLCYSETEINE • PRUSSION BLUE • PYRIDOXINE • THIAMINE
PYRIDOXINE
WHICH LABS ARE MOST PREDICTIVE OF SEVERE OUTCOME IN A AGKISTRODON (COTTONMOUTH) ENVENOMATION? • PT/INR • D DIMER • CK AND MYOGLOBIN • PLATELETS AND FIBRINOGEN
PLATELETS AND FIBRINOGEN
CALLER ASKS ABOUT USING TOBACCO ON A BEE STING. YOUR RESPONSE SHOULD INCLUDE:
•APPLY TOBACCO FOR INCREASED BLOOD FLOW TO THE AREA
•DO NOT USE TOBACCO, INSTEAD WASH THE AREA THOROUGHLY
•TOBACCO MAY DECREASE THE LOCAL REACTION
•WE DO NOT REC TOBACCO AS NOT EVERYONE HAS ACCESS TO IT
DO NOT USE TOBACCO, INSTEAD WASH THE AREA THOROUGHLY
WHICH OF THE FOLLOWING ABOUT LOXOCELES SPIDER (BROWN RECLUSE) ENVENOMATIONS IS TRUE?
•CAUSES INTENSE PAIN AT THE BITE SITE IMMEDIATELY
•PROPHYLACTIC ANTIBIOTICS SHOULD NOT BE USED FOR ALL BITES
•THE VENOM CONTAINS POTENT ANTICOAGULANTS AND NEUROTOXINS
•THE BITE LESION WILL HEAL RAPIDLY AND RARELY LEAVE ANY SCARS
PROPHYLACTIC ANTIBIOTICS SHOULD NOT BE USED FOR ALL BITES
MAN IS BITTEN BY AN INSECT. HE FEELS A PINPRICK SENSATION FOLLOWED BY STOMACH PAIN. WHAT BIT HIM? • SCORPION STING • CENTEPEDE STING • MOSQUITO WITH WEST NILE • BLACK WIDOW SPIDER BITE
BLACK WIDOW SPIDER BITE
WHICH IS THE BEST DESCRIPTION OF A BLACK WIDOW SPIDER?
•BLACK, HAIRY WITH ORANGE HOURGLASS MARKINGS ON STOMACH
•BLACK, HAIRLESS WITH HOURGLASS MARKINGS ON ABDOMEN
•BLACK, HAIRLESS WITH ORANGE HOURGLASS MARKINGS ON THE BACK
•BLACK, HAIRY WITH WHITE SPOTS ON THE BACK AND JUMPS
BLACK, HAIRLESS WITH HOURGLASS MARKINGS ON ABDOMEN
ER 1 HOUR POST SNAKE BITE. 2 PUNCTURE ON ANKLE. EDEMA TO MID-CALF/EXTENSIVE ECCHYMOSIS.
•ICE TO AREA FOR 5 MIN INTERVALS UNTIL EDEMA SUBSIDES
•BEGIN ADMIN OF CROFAB W/ 4-6 VIALS
•CONT TO OBS. CROFAB IF IT CROSSES A 2ND JOINT
•OBS MIN 8 HOURS, DC HOME IF NO WORSENING SYM
BEGIN ADMIN OF CROFAB W/ 4-6 VIALS
PT VOMITING AFTER EATING FISH/RICE. BLURRED VISION, DROOPING EYELIDS, DIFFICULTY SWALLOWING. • DOMOIC ACID • SCOMBROTOXIN • BOTULININ TOXIN • SHIGA TOXIN
BOTULININ TOXIN
RASH ON FACE C/O N/V. DURING ASSESSMENT, DISCOVER LUNCH AT A SEAFOOD RESTAURANT. • BREVETOXIN • DOMOIC ACID • CIGUATOXIN • SCOMBROTOXIN
SCOMBROTOXIN
PT HAS BEEN HAVING ITCHY RED EYES, AND DIFFICULTY GETTING A DEEP BREATH SINCE THEIR ARRIVAL. • BREVETOXIN • TETRODOTOXIN • CIGUATOXIN • SAXITOXIN
BREVETOXIN
WHAT WOULD YOUR RECOMMENDATIONS BE?
•SEEK MD ATTENTION AND NOTIFY THE FLORIDA PCC
•CREATE A STEAM ROOM IN BATHROOM AND INHALE WATER VAPORS
•TAKE AN ANTIHISTAMINE
•LEAVE THE AREA IMMEDIATELY
TAKE AN ANTIHISTAMINE
WHICH MUSHROOM IS ASSOCIATED WITH CHOLINERGIC SYM? • CHILTOCYBE DEALBATA • AMANITA MUSCRIA • PSILOCYBE CUBENSIS • GYROMITRA ESCULENTA
CHILTOCYBE DEALBATA
WHAT SUBSTANCE WHEN INGESTED WITH MUSHROOMS IN THE COPRINE CATEGORY WILL CAUSE SYM? • FISH • ALCOHOL • MAOIS • SSRI
ALCOHOL
RUQ PAIN, VOMITING STARTED 24HOURS AFTER INGESTING MUSHROOMS TO HALLUCINATE • AMATOXIN • ORELLANINE • PSILOCYBE • LYCOPERDON
AMATOXIN
PT BITTEN BY AN IDENTIFIED RACER SNAKE 20 MIN AGO. BITE SITE: LITTLE ERYTHEMA, NO BLEEDING
•OBTAIN CBC, COAGS, PLTS AND BEGIN ANTIVENOM
•PROVIDE WOUND CARE, TETANUS, AND DC HOME
•OBSERVE THE PT IN THE ED FOR 8-12 HOURS
•OBAIN LABS, OBS 8-12 HOURS, GIVE WOUND CARE AND TETANUS
PROVIDE WOUND CARE, TETANUS, AND DC HOME
ISOPROPYL ALCOHOL IS METABOLIZED TO: • ACETONE • ETHANOL • FORMALDEHYDE • METHANOL
ACETONE
THE CORROSIVE EFFECTS SEEN WITH INGESTION OF AN IODINE TINCTURE, MAY BE MINIMIZED BY? • LAVAGE WITH POTASSIUM PERMANGANATE • ADMINISTER MAALOX • INGESTING COLD FLUIDS • HAVING THE PATIENT EAT STARCHY FOODS
HAVING THE PATIENT EAT STARCHY FOODS
THE COMBINATION OF HH SODIUM HYPOCHLORITE AND HH AMMONIA WILL PRODUCE? • CARBON DIOXIDE • CHLORAMINE GAS • HYDROGEN CHLORIDE • CHLORINE GAS
CHLORAMINE GAS
2YO 2HRS AFTER INGESTING A MUSHROOM MOM DID NOT BRING IN. THE CHILD IS VOMITING
• CHECK CK
• GIVE ANTI-EMETICS
• TREND LFTS TO DETERMINE IF TREATMENT IS NEEDED
• START NAC
GIVE ANTI-EMETICS
PT WAS BIT BY A CORAL SNAKE 2 HRS AGO. LABS AND P.E. ARE BENIGN. WHAT IS YOUR RECOMMENDATION?
•ADMIT TO ICU FOR 24 HOURS AS SYM CAN BE DELAYED
•MONITOR IN THE ER FOR 6HRS D/C IF PT ASX
•D/C HOME SINCE SYM SHOULD BE IMMEDIATE
•DISCHARGE, CORAL SNAKES NEVER REQUIRE HOSPITALIZATION
ADMIT TO ICU FOR 24 HOURS AS SYM CAN BE DELAYED
A CHILD INGESTED 1 TAB OF AZO. WHAT DO YOU INSTRUCT THE PARENTS TO WATCH FOR? • BRIGHT RED CHEEKS • CONFUSION • CYANOSIS • TREMORS
CYANOSIS
2 Y/O INGESTED BUBBLE LIGHTS 30 MIN AGO. YOUR RECOMMENDATION TO HCF SHOULD INCLUDE: • CARBOXYHEMOGLOBIN • NO LABS NEEDED, JUST AN IRRITANT • EKG • GI CONSULT
CARBOXYHEMOGLOBIN
CALLER STATES PT WAS BITTEN BY MULTPLE FIRE ANTS. C/O GENERALIZED URTICARTIA, SOB. YOU RECOMMEND: • CALLING 911 • APPLY DPH TO BITES • TAKE AN ANTIHISTAMINE • APPLY ICE TO THE BITES
CALLING 911
THROAT PAIN, DIFFICULTY SWALLOWING, HYPERSALIVATION AFTER INGESTING LIQUID IN GUN BLUING. WHAT SUBSTANCE? • SELENIOUS ACID • CLEANING OIL • ACETONE • METHANOL
SELENIOUS ACID
ALL OF THE FOLLOWING MEDICATIONS CAN CAUSE HYPERGLYCEMIA IN AN OD EXCEPT: • APAP • CA CHANNEL BLOCKERS • BETA BLOCKERS • IRON
BETA BLOCKERS
AC WILL ABSORB ALL OF THE FOLLOWING MEDS EXCEPT: • APAP • THEOPHYLINE • PROPRANOLOL • FERROUS SULFATE
FERROUS SULFATE
IN AN APAP OD, WHICH OF THE FOLLOWING LABS IS MOST HELPFUL TO MONITOR THE PATIENT’S PROGRESS? • CREATININE • ALKALINE PHOPHATASE • PROTHROMBIN TIME • BILIRUBIN
PROTHROMBIN TIME
THE MOST COMMON SYM OCCURING IN THE FIRST 6 HOURS AFTER APAP OD ARE: • N/V • HYPERGLYCEMIA • TACHPNEA • TINNITIS
N/V
3YO INGESTED 3OZ OF APAP ELIXIR (160MG/5CC) APPROX 30 MIN AGO. PT WEIGHS 33LBS. • 192MG/KG • 98MG/KG • 90MG/KG • 36MG/KG
192MG/KG
WHICH OF THE FOLLOWING ANTIHISTAMINES IS LEAST LIKELY TO CAUSE CNS DEP WHEN TAKEN IN OD? • HYDROXYZINE • DPH • PROMETHAZINE • LORATADINE
LORATADINE
AN ED CALLS 3YO/15KG ATE 15X81MG W.IN HR. PT IS ASX. MD IS SURE OF #. YOUR ADVISE?
•GIVE AC, THEN OBS THE CHILD FOR SEVERAL HOURS
•GIVE AC, GET 4HR APAP/ASA IF WNL, DC PT.
•THIS IS SUBTOXIC DOSE AND NO TX IS REQUIRED
•GIVE AC, THEN DC HOME
THIS IS SUBTOXIC DOSE AND NO TX IS REQUIRED
WHICH OF THE FOLLOWING IS AN INDICATION FOR DIALYSIS IN AN ASA OD? • COAGULOPATHIES • ACUTE SALICYLATE LEVEL OF 60MG/DL • HYPOGLYCEMIA • PERSISTENT CNS DISTURBANCE
PERSISTENT CNS DISTURBANCE
WHICH OF THE FOLLOWING STATEMENTS ABOUT ASA OD IS FALSE?
•IN AN OD, PEAK LEVELS MAY BE DELAYED AT LEAST 6 HRS
•AMS IS CONSIDERED A SIGN OF SEVERE TOXIN ACUTE OD
•SX OF RESP ALKALOSIS THEN META ACID IN ACUTE OD
•IN CHRONIC OD, HIGHER BLOOD CORRELATE WELL WITH SX
IN CHRONIC OD, HIGHER BLOOD CORRELATE WELL WITH SX
WHICH OF THE FOLLOWING STATEMENTS IS TRUE REGARDING THE NORMOGRAM?
•APAP LEVELS >150 NO NEED FOR NORMAGRAM REGARDLESS OF TIME
•CHRONIC ING PLOTTED WHEN LEVEL IS DRAWN 4HRS POST LAST DOSE
•APAP LEVELS AFTR CHRONIC INGESTION CANNOT BE PLOTTED
•CANT PLOT AN APAP LEVEL IF APAP PM WAS TAKEN
APAP LEVELS AFTR CHRONIC INGESTION CANNOT BE PLOTTED
WHICH OF THE FOLLOWING ESSENTIAL OILS CAN CAUSE ASA TOX? • CAMPHOR • OIL OF WINTERGREEN • EUCALPTUS OIL • TEA TREA OIL
OIL OF WINTERGREEN
WHEN SHOULD ASA LEVELS BE OBTAINED? •2 HOURS POST INGESTION •Q2HR UNTIL PEAK AND DECLINE IN ANHY POT TOXIC PT •4 HRS POST INGESION •UPON ARRIVAL AND 4 HOURS
Q2HR UNTIL PEAK AND DECLINE IN ANHY POT TOXIC PT
WHICH OF THE FOLLOWING SX CAN BE SEEN IN A DPH OD?
•AGITATION, HALLUCINATIONS, MYDRIASIS, WARM SKIN, TACHY
•MIOSIS, AGITATION, NYSTAGMUS, HTN, DELUSIONS
•]DROWSINESS, ATAXIA, SLURRED SPEECH, TACHY, COMA
•ATAXIA, PROTRUDING TONGUE, HTON
AGITATION, HALLUCINATIONS, MYDRIASIS, WARM SKIN, TACHY
WHICH OF THE FOLLOWING SX CAN BE SEEN IN DEXTROMETHORPHAN OD?
•MIOSIS, DYSTONIA, NYSTAGMUS, HTN, DELUSIONS
•AGITATION, HALLUCINATIONS, MYDRIASIS, WARM SKIN, HTN
•DROWSINESS, ATAXIA, SLURRED SPEECH, TACHY
•ATAXIA, PROTRUDING TONGUE, HTON
MIOSIS, DYSTONIA, NYSTAGMUS, HTN, DELUSIONS
CALLER STATES 5YO, 50 LBS INGESTED 4X30MG PSEUDOPHEDRINE TABS. PT IS DROWSY, DOES HE NEED ED? • SUBTOXIC AMT, OBS AT HOME • OBS AT HOME WITH A FU • HAVE PARENTS CALL 911 • REFER TO ED FOR EKG/LABS/AC
HAVE PARENTS CALL 911
ER 3YO DROWSY, MIOSIS, 1 SEIZ AFTER UNKNOWN INGESTION. UDS + PCP. SHOULD CPS BE CALLED?
•YES. SCHEDULE 1 DRUG WAS INGESTED
•NO. PARENTS ARE ALLOWED ONE INCIDENT BEFORE CALLING CPS
•DEXTROMETHORPHAN MAY CAUSE FALSE POSITIVE FOR PCP
•ADVISE TO FOLLOW THEIR PROTOCOL
DEXTROMETHORPHAN MAY CAUSE FALSE POSITIVE FOR PCP
ER 22KG KID INGESTED 10ML OF A 98%MS. (ACF=1.4). HOW MUCH ASA WAS INGESTED? • 220MG/KG • 623.6MG/KG • 445MG • 13720MG
623.6MG/KG
11KG M FOUND WITH AN OPEN AND EMPTY BOTTLE OF ASA 81MG. HOW MANY TABS WOULD BE TOXIC? • 16 • 56 • 88 • 21
21
15YO F FOUND RESP TO PAINFUL STIMULATION. 1 SEIZ. DILATED/NONREACTIVE PUPILS. 100.1 80/55 140 14. • PHENLEPHRINE • TRIAZOLAM • DPH • SPICE
DPH
THE MYDRIASIS CAUSED BY A SYMPATHOMIMMETIC AGENT SUCH AS COCAINE IS • REEACTIVE TO LIGHT • IS PERMANENT • NOT REACTIVE TO LIGHT • SUBSIDES 1-2 DAYS POST EXPOSURE
REEACTIVE TO LIGHT
A UDS + FOR TCA MAY BE A FALSE POS WHEN WHICH OF TH FOLLOWING MEDS IN INGESTED? • +TCA MEANS A TCA WAS TAKEN • LOMOTIL • DEXTROMETHORPHAN • DPH
DPH
WHAT ARE THE SIGNS AND SYM OF PSEDUOPHEDRINE AND PHENYLEPHRINE TOXICITY?
•ATAXIA, HYPOREFLEXIA, AND SENSORY NEUROPATHIES
•BRADYCARDIA, SA AND AV BLOCK, ASYSTOLE
•SALIVATION, LACRIMATION, URINATION, DEFECATION, EMESIS
•MYDRIASIS, AGITATION, VISUAL/AUDIT, HALLUCINATIONS, SEIZ
MYDRIASIS, AGITATION, VISUAL/AUDIT, HALLUCINATIONS, SEIZ
AN NSAID THAT HAS A PREDOMINANT FINDING OF SEIZ AND MUSCLE TWICHING IS: • IBUPROFEN (MOTRIN) • INDOMETHACIN (INDOCIN) • MEFENAMIC ACID (PONSTEL) • KETOROLAC (ACULAR PF SOLUTION)
MEFENAMIC ACID (PONSTEL)
FLUSHED, MYDRIASIS, DRY, 140/90 140 18 101F. LITTLE URINE OUTPUT. WHICH WOULD NOT CAUSE THESE SX? • PSEUDOPHEDRINE • DPH • AMITRIPTYLINE • CHLORPROMAZINE
PSEUDOPHEDRINE
A PATIENT IS FOUND UNRESPONSIVE/INTUBATED, APAP LEVEL IS 16. WHAT IS YOUR NEXT REC?
•REPEAT THE APAP LEVEL IN 2 HRS TO SEE IF IT IS CLIMBING
•THE LEVEL IS TOO LOW TO BE CLINICALLY SIGNIFICANT
•START NAC
•TREND THE LFTS
START NAC
THE FOLLOWING LABS ARE USEFUL IN PTS WHO PRESENT EARLY FOLLOWING AN ACUTE APAP INGESTION? • APAP LEVEL • APAP, LFT, ELECTROLYTES, INR • LFT, APAP, COAGS • APAP, ASA, LYTES, EKG, UDS\
APAP LEVEL
PATIENTS WHO PRESENT WITH AN UNKNOWN TOI OR >8HRS POST APAP INGESTION REQUIRE WHICH LABS? • APAP LEVEL • APAP, LYTES, RFT, LFT, INR • APAP, LFT, COAGS • LFT, INR, RFT
APAP, LYTES, RFT, LFT, INR
ALL OF THE FOLLOWING ARE TRUE ABOUT NAPTHALENE EXCEPT?
•NO LONGER USED IN MOTHBALLS THEREFORE NOT A RISK
•FOUND IN MOTHBALLS, COAL TAR, DYES, RESINS, FUELS, SOLVENTS
•MAY CAUSE HEMOLYTIC ANEMIA, METHEMOGLOBINEMIA, RENAL FAIL
•MAY CAUSE DELAYED HEMOLYSIS
NO LONGER USED IN MOTHBALLS THEREFORE NOT A RISK
HOW WOULD YOU TX METHEMOGLOBINEMIA DUE TO A MOTHBALL INGESTION? • LIPIDS • TRANSFUSION • METHYLENE BLUE • WBI
METHYLENE BLUE
RAPID ONSET OF COMA, BRADYCARDIA, MYOCLONIC JERKING ARE EFFECTS WITH WHICH OF THE FOLLOWING? • GAMMA-HYDROXYBUTYRATE (GHB) • MDMA • HEROIN • MARIJUANA
GAMMA-HYDROXYBUTYRATE (GHB)
1ST DEGREE HEART BLOCK, HTON, BRADYCARDIA ARE MOST COMMON WITH WHICH OF THE FOLLOWING?
• NITRATES
• ANGIOTENSION-CONVERTING-ENZYME INHIBITORS
• THIAZIDE DIURETICS
• BETA-ADRENGIC BLOCKERS
BETA-ADRENGIC BLOCKERS
67YO F WITH BRUISING, NOSEBLEEDS. MEDS: WARFARIN/LEVOTHYROXINE/DIGOXIN. PT’S SYM D/T: • ANTACIDS • OTC HEAD MEDICINE • BULK FORMING LAXATIVES • COUGH SUPPRESSANTS
OTC HEAD MEDICINE
M LETHARGIC/VOMITING. EMPTY BOTTLE ULTRA-RAPID ACTING INSULIN WAS FOUND. BSI 102/LACTIC ACID • ROSGLITAZONE (AVANDIA) • SITAGLIPTIN (JANUVIA) • METFORMIN (GLUCOPHAGE) • GLYBURIDE (DIABETA)
METFORMIN (GLUCOPHAGE)
UNRESPONSIVE CHILD/4X GLIPIZIDE 10MG. SUGAR 37. D5W/PT AWAKE/THEN CONFUSED/SUGAR 45/REC? • OCTREOTIDE (SANDOSTATIN) • NALOXONE (NARCAN) • PHYTONADIONE (AQUAMEPHYTON) • GLUCAGON (GLUCAGON)
OCTREOTIDE (SANDOSTATIN)
WHICH OF THE FOLLOWING HERBAL PRODUCTS IS ASSOCIATED WITH HEPATIC INJURY? • KAVA • MILK THISTLE • ST JOHNS WORT • GINSENG
KAVA
FLUPHENAZINE DECONOATE AND ORAL HALPERIDOL FOR 5 DAYS. MUSCLE RIGIDITY/108F/DYSPHAGIA • MALIGNANT SYNDROME • NEUROLYPTIC MALIGNANT SYNDROME • COCAINE ABUSE • SEROTONIN SYNDROME
NEUROLYPTIC MALIGNANT SYNDROME
AGITATED/HALLUCINATING/TACHY/HTN/NORMAL BOWEL SOUNDS/DIAPHORETIC • MARIJUANA • JIMSON WEED • HYDROCODONE • MDMA
MDMA
WHICH DELAYED CLINICAL EFFECT IS MOST CONSISTENT WITH SIGNIFICANT INHALATION OF CHLORAMINE GAS? • PULMONARY EDEMA • RENAL FAILURE • METHHEMOGLOBINEMIA • HEMOLYSIS
PULMONARY EDEMA
MOM CALLS: 1 HR AGO KID TOOK UNK AMT OF COUGH/COLD SYRUP. WHAT IS THE FIRST QUESTION YOU ASK? • THE AGE OF PATIENT • ARE THERE ANY SYM? • THE WEIGHT OF PT • HOW MUCH MEDICATION IS MISSING?
ARE THERE ANY SYM?
CYANOTIC LIPS/ON ANTIBIOTIC. TAKING MED FOR URINARY BURNING. WHAT IS OUR CONCERN? • CO POISONING • HYDROGEN SULFICE POISONING • METHEMOGLOBINEMIA • METAL FUME FEVER
METHEMOGLOBINEMIA
PERSISTENT N/V. SEIZ. GLUCOSE OF 34 MG/DL. WHICH PLANT CAN CAUSE THESE TOXIC EFFECTS? • POKEWEED (PHYTOLACCA AMERICANA) • CASSAVA (MANIHOT ESCULENTA) • CASTOR BEAN (RICINUS COMMUNI) • ACKEE FRUIT (BLIGHIA SAPIDA)
ACKEE FRUIT
WHAT EFFECTS ARE COMMONLY ASSOCIATED WITH 3,4 METHYLENEDIOXYMETHAPHETAMINE (MDMA) TOX?
• HTON, TACHY, HYPOTHERMIA, HYPERNATREMIA
• HTON, BRADY, HYPOTHERMIA, HYPERNATREMIA
• HTN, TACHY, HYPONATREMIA, HYPERTHERMIA
• HTN, BRADY, HYPERTHERMIA, HYPERNATREMIA
HTN, TACHY, HYPONATREMIA, HYPERTHERMIA
WHICH OF THE FOLLOWING HEAVY METALS IS ASSOCIATED WITH MEE’S LINES? • ARSENIC • LEAD • MERCURY • IRON
ARSENIC
WHICH OF THE FOLLOWING WILL CAUSE BLUE VOMIT? • BORIC ACID • BLUE LISTERINE • ANTIFREEZE • IODINE
BORIC ACID
WHICH OF THE FOLLOWING DRUGS IS ASSOICIATED WITH JAW CLENCHING, HYPONATREMIA, EUPHORIA? • KETAMINE • COCAINE • MDMA • METHAMPHETAMINE
MDMA
WHICH OF THE FOLLOWING IS MOST ASSOCIATED WITH METAL FUME FEVER? • ZINC, COPPER • CADMIUM, ALUMINUM • STEEL, CADMIUM • IRON, COBALT
ZINC, COPPER
2YO IRRITABLE, HTN, THIRSTY, VOMITING. WHICH IS MOST LIKELY RESPONSIBLE FOR THE SYM? • SALT • GINGER • PARSLEY • CINNAMON
SALT
ALL OF THE FOLLOWING ARE TRUE REGARDING COCAINE EXCEPT?
•SYM INCLUDE EUPHORIA, AGITATION, HYPERTHERMIA, HTN
•BETA BLOCKERS ARE USED TO TREAT THE TACHYCARDIA
•MAIN CONCERNS INCLUDE DYSTHYTHMIAS, RHABDOMYLYSIS
•NITRATES, CCB, ALPHA BLOCKERS ARE USED FOR HTN IF NEEDED
BETA BLOCKERS ARE USED TO TREAT THE TACHYCARDIA
UNRESP GIVEN NARCAN WITH REPONSE. MD ASKS HOW MUCH NARCAN IS NEEDED FOR THE DRIP. YOUR ANSWER
•RATE IS 2/3 DOSE EFFECTIVE FOR INITIAL REVERSAL; TITRATE
•RATE IS 1/3 OF DOSE EFFECTIVE FOR INITIAL REVERSAL, TITRATE
•WE NEVER REC A NARCAN DRIP
•OBS FOR NOW/START AGAIN WITH 0.2MG NARCAN IF RESP DEP
RATE IS 2/3 DOSE EFFECTIVE FOR INITIAL REVERSAL; TITRATE
WHICH OF THE FOLLOWING IS ASSOCIATED WITH HTON, BRADY, SEIZ? • PROPANOLOL • METOPROLOL • NALDOLOL • SOTALOL
PROPANOLOL
ALL OF THE FOLLOWING B BLOCKERS CAN BE DIALYZED EXCEPT • LABETOLOL • ATENOLOL • SOTALOL • ACEBUTALOL
LABETOLOL
B BLOCKER TOXICITY IS NOT ASSOCIATED WITH WHICH ONE OF THE FOLLOWING? • BRADYCARDIA • HYPERGLYCEMIA • AV BLOCK • HTON
HYPERGLYCEMIA
WHICH CALCIUM SALT IS THE PREFERRED DRUG FOR IV THERAPY DURING A CCB OD? • CA CHLORIDE • CA GLUCONATE • CA CARBONATE • CALCIUM PHOSPHATE
CA GLUCONATE
WHICH OF THE FOLLOWING TX IS NOT USEFUL IN TREATING A CCB OD? • GLUCAGON • DIALYSIS • INSULIN • INTRA-AORTIC BALLOON PUMP
DIALYSIS
WHICH OF THE FOLLOWING WOULD BE EXPECTED TO RESULT IN THE MOST NEGATIVE EFFECTS AFTER OD? • AMLODIPINE • DILTIAZEM • VERAPAMIL • NEFEDIPINE
VERAPAMIL
WHICH OF THE FOLLOWING IS THE ANTIDOTE FOR DIGITALIS OD?
DIGIBIND
B BLOCKERS CAN INCREASE BRONCHIOLAR SMOOTH MUSCLE TONE RESULTING IN BRONCOSPAM. T/F
T
PROPANOLOL MAY CAUSE QRS WIDENING DUE TO SODIUM CHANNEL BLOCKADE. T/F
T
B BLOCKERS SX USUALLY OCCUR W/IN 6HRS BUT CAN BE SEEN AS EARLY AS 20 MIN. T/F
T
SCOOPED ST SEGMENTS ARE ASSOCIATED WITH WHICH OD? • B BLOCKER OD • DIGITALIS OD • CA CHANNEL BLOCKER OD • TRICYCLIC ANTIDEPRESSANT OD
DIGITALIS OD
ANY DYSRHYTHMIAS IS POSS WITH A DIGOXIN OD EXCEPT? • PVCS • BIDIRECTIONAL VENTRICULAR TACHYCARDIA • SVT • AV BLOCK
SVT
WHICH CA SALT IS CONTRAINDICATED IN KIDS DUE TO CAUSING SCLEROSIS OF THE VESSELS? • CA CHLORIDE • CA CARBONATE • CA GLUCONATE • CA PHOSPHATE
CA CHLORIDE
1YO OLD INGESTED 1/3 OF A 10Z 2% DPH. PT WEIGHS 18 POUNDS HOW MUCH DID THE PT EAT? • 25MG/KG • 13.8MG/KG • 37.8MG/KG • 7.5MG/KG
25MG/KG
6YOF WAS GIVEN HALDOL FOR IMAGING AND IS NOW AGITATED, NECK IS STIFF. WHAT DO YOU RECOMMEND? • ATIVAN • DIPHENHYDRAMINE • PROPOFOL • VALIUM
DPH
DEFEROXAMINE IS THE CHELATOR OF CHOICE FOR AN OD OF WHICH OF THE FOLLOWING AGENTS? • ARSENIC • IRON • LEAD • MERCURY
IRON
CAFFEINE IS PHARMACOLOGICALLY AND TOXICOLOGICALLY SIMILAR TO WHAT MEDICATION? • AMITRIPTYLLINE • CARBAMAZEPINE • PHENCYCLIDINE • THEOPHYLLINE
THEOPHYLLINE
WHICH TOXIN GENERATES CARBON MONOXIDE ENDOGENOUSLY?
• CARBON MONOXIDE RELEASED FROM CAR EXHAUST
• METHYLENE CHLORIDE
• METHANE
• PROPANE
METHYLENE CHLORIDE
WHICH OF THE FOLLOWING SYMPTOMS IS MOST LIKELY TO OCCUR IN CHRONIC MERCURY INHALATION? • CNS MANIFESTATIONS • AMS • SOB • NO SYMPTOMS
CNS
PATIENT ARRIVES TO ER WITH HR145, 145/91, FLUSHED, HALLUCINATING. WHAT DID MOST LIKELY INGEST? • WATER HEMLOCK • POINSETTA • JIMSON WEED • FOX GLOVE
JIMSON WEED
WHICH OF THE FOLLOWING IS RELATED WITH OTOTOXICITY? • GENTAMYCIN • PENICILLIN • LEVAQUIN • CIPRODEX
GENTAMYCIN
WHICH OF THE FOLLOWING IS REALTED TO NEPHROTOXICITY? • AMINOGLYCOSIDES • CEPHALOSPORINS • MACROLIDES • PENICILLINS
AMINOGLYCOSIDES
4YO CHILD, UNKNOWN DRUG. HE IS OBS FOR 4HRS IS ASX, 10HRS LATER HE DEVS CNS DEP • DIPHENOXYLATE • WELLBUTRIN XR • DOXEPIN • FLEXERIL
DIPHENOXYLATE
WHICH OF THE FOLLOWING IS RELATED WITH ANION GAP ACIDOSIS, OSMOLAR GAP, SNOWFIELD VISION. • ISOPROPYL ALCOHOL INGESTION • METHANOL INGESTION • ETHYLENE GLYCOL INGESTION • ETHANOL
METHANOL INGESTION
WHICH SYM CAN YOU EXPECT TO SEE IN A TRAMADOL OD?
• BRADYCARDIA, HTON, SEIZ
• CYCLICAL COMA, BRADYCARDIA, SEIZ
• N/V/D, CNS DEPRESSION, REFLEX TACHYCARDIA
• QRS WIDENING, TACHYCARDIA, SEIZ
BRADYCARDIA, HTON, SEIZ
ALL OF THE FOLLOWING ARE TRUE REGARDING PRODUCTS WITH A PH<7 EXCEPT:
• CAUSE COAGULATION NECROSIS
• LIFE THREATENING UPPER AIRWAY EDEMA
• CAUSE LIQUEFACTIVE NECROSIS
• PT MAY BE DC IF ASX 12 HOURS/GRADE 1 BURN AND TOLERATING PO
CAUSE LIQUEFACTIVE NECROSIS
NERVE AGENTS SUCH AS SARIN ARE ORGANOPHOSPHATE CHEMICAL COMPOUNDS. T/F
T
ALL OF THE FOLLOWING STATEMENTS REGARDING PHOSGENE ARE TRUE EXPECT?
• CAUSES A CORROSIVE TYPE OF SKIN AND TISSUE LESION
• SKIN LESIONS ARE PAINLESS
• RESP EFFECTS INCLUDE PULM EDEMA/DEATH DUE TO RESP ARREST
• CAN CAUSE BLINDNESS IN HIGH CONCENTRATIONS
SKIN LESIONS ARE PAINLESS
WHICH OF THE FOLLOWING ANTIDOTES IS CONTRADICTED IN A PATIENT WITH A PEANUT ALLERGY? • DEFEROXAMINE • CYANOKIT • METHYLENE BLUE • BAL
BAL
BAL OR DMSA ARE THE ANTIDOTES USED TO TREAT WHICH OF THE FOLLOWING? • MUSTARD GAS • LEWISITE • CHLORPHENOXY COMPOUNDS • VX
LEWISITE
CALL STATING 69YO F ACCIDENTALLY INGESTED 2-3 MOUTHFULS OF PEROXIDE 10%. YOUR ADVICE? • DILUTE. NO SX SHOULD DEVELOP • REFER TO ED • OBS AT HOME. .ER IF SEVERE SX. • DILUTE. N/V ARE POSSIBLE
ED
HCF CALL STATING 7YO F ARRIVED SEIZING, WITH BACK ARCHED, UNKNOWN INGESTION. WHICH? • ALDICARB • DEET • BROMETHALIN • STRYCHNINE
STRYCHNINE
WHICH OF THE FOLLOWING RODENTICIDES IS ASSOCIATED WITH ALOPECIA, AND PAINFUL NEUROPATHIES? • THALLIUM • NORBORMIDE • WARFARIN • RED SQUILL
THALLIUM
ALL OF THE FOLLOWING ARE TRUE ABOUT ARSENIC EXCEPT:
•HAS A GARLIC LIKE ODOR
•CAUSES HTON THAT MAY BE RESISTANT TO FLUIDS
•CAN BE CHEALATED WITH BAL/DMSA
•DIAGNOSIS IS CONFIRMED VIA SPOT URINE TESTING
DIAGNOSIS IS CONFIRMED VIA SPOT URINE TESTING
WHICH OF THE FOLLOWING IS ASSOCIATED WITH BASOPHILIC STIPPLING • LEAD • THALLIUM • ARSENIC • MERCURY
LEAD
WHICH OF THE FOLLOWING WOULD WE MOST LIKELY SEE IN A PT WITH ACUTE MERCURY VAPOR INHALATION? • HEMOLYSIS • NEUROLOGICAL SYMPTOMS • AIRWAY IRRITATION • NO SYM. WE DO NOT WORRY ABOUT THIS
AIRWAY IRRITATION
WHAT IS OUR CONCERN WITH NITRATES AND NITRITES?
• PATIENT DEVELOPING AMS
• HTON, SEIZ
• PT DEVEVLOPING RESP SYM
• PT DEVELOPING METHEMOGLOBINEMIA AND HEMOLYSIS
PT DEVELOPING METHEMOGLOBINEMIA AND HEMOLYSIS
WHICH OF THE FOLLOWING MUSCLE RELAXERS CAN CAUSE ANTICHOLINGERGIC EFFECTS? • CARISOPRODOL (SOMA) • CYCLOBENZAPRINE (FLEXERIL) • METHOCARBAMOL (ROBAXIN) • ALL OF THE ABOVE
ALL
ALL OF THE FOLLOWING REGARDING SOMA ARE TRUE EXCEPT? • MAY CAUSE TRANSIENT QUADRIPLEGIA • CAN CAUSE SEROTONIN SYNDROME • MAY CAUSE TRANSIENT VISION LOSS • MOST PATIENTS DEVELOP RESP DEPRESSION
MOST PATIENTS DEVELOP RESP DEPRESSION
ALL ANTICHOLINGERIC DRUGS CAUSE QRS WIDENING? T/F
F
7YO IN ER WITH SEVERE BLEEDING/NOT RESP TO K/ING RAT POISON 1 WEEK AGO. WHAT DO YOU REC? • INCREASE VIT K • START PT ON RIVAROBAXIN • PCC • ECCMO
PCC
HOW DO YOU TREAT SEIZ CAUSED BY AN ISONIAZID OD? • BARBITUATES • PYRIDOXINE (B6) • BACLOFEN • BENZODIAZEPINES
B6