Toxicology

Question 1

A 2 year old, Marcus, is brought to the emergency department after mother found him in the pantry with an empty bottle of paracetamol liquid, 120 mg/5 ml. Mother thinks the 100 ml bottle was previously at least three quarters full. Syrup was observed on the child’s lips and chin, and on the clothes and floor. It is 4 hours since Marcus was found with the bottle. He looks happy and playful and there are no specific signs found on examination.

How should Marcus be managed?

Question 1Select one:

a.
Obtain serum paracetamol level

b.
Give gastric lavage via ng tube

c.
Give emetic to induce vomiting

d.
Administer IV N-acetyl cysteine

Answer 1

Obtain serum paracetamol level

at 4 hours - then can decide NAC

Question 2

A child of 3 years old is brought to your care after swallowing some fuchsia berries.

What plan of management is advisable?

Question 2Select one:

a.
Reassurance

b.
ICU admission

c.
ED admission

d.
GP observation

Answer 2

Reassurance

Question 3

You are asked to see Tom, a 3-year-old boy, whose mother is concerned that he has swallowed 15 ml of petrol less than an hour ago. In the emergency department, What is the appropriate management?

Question 3Select one:

a.
Activated charcoal via nasogastric tube

b.
Observation and supportive management

c.
Gastric lavage via nasogastric tube

d.
Syrup of Ipecac to induce emesis

Answer 3

Observation and supportive management

risk of aspiration with others

Question 4

A 3 year old boy presents after several weeks of abdominal pain, vomiting and anorexia. He has been behaving more lethargic.

He lives with his family in a recently refurbished old house. There are no exposures of concern at preschool. The family are concerned that he may be reacting to the recent unexpected death of their 4-year old family Labrador.

What provisional diagnosis would you consider?

Question 4Select one:

a.
Preschool grieving reaction

b.
Subacute lead poisoning

c.
Grumbling appendicitis

d.
Giardia lambdia infection

Answer 4

Subacute lead poisoning

renovation

Question 5

All EXCEPT ONE of the following drugs is associated with teratogenic effects. WHICH ONE is NOT teratogenic?

Question 5Select one:

a.
heparin

b.
phenytoin

c.
alcohol

d.
warfarin

Answer 5

heparin

doesn’t cross placenta