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Rapid onset of coma, bradycardia, and myoclonic jerking are common effects in overdose of which of the following illicit drug.
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Which set of symptoms would indicate that a nerve agent might have been used in an attack?
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CSPI Exam study ques
| Question | Answer |
|---|---|
| Rapid onset of coma, bradycardia, and myoclonic jerking are common effects in overdose of which of the following illicit drug. | Gamma-hydroxybutyrate (GHB) |
| Which set of symptoms would indicate that a nerve agent might have been used in an attack? | Vomiting, Rhinorrhea, muscle weakness, and faciculations. |
| Gastrointestinal upset, slow heart rate, excessive salivation, muscle faciculations and pinpoint pupils are all effects consistent wout what type of pesticide exposure? | Organophosphates |
| First degree heart block, hypotension, and bradycardia are the most common consequences of overdose from which of the following classes of antihypertensives? | Beta=Adrenergic Blockers |
| A pt is on Warfarin, levothyroxine, and digoxin and starts to bruise and have nose bleeds Which OTC med could contribute to these symptoms? | Analgesics (Aspirin, ibuprofen) |
| A female ingests 3 oz fo liquid 6 hrs ago and labs are: Na 147 mmol/L, K+ 6.0, cloride 108 mmol/L, CO2 11 mmol/L, BUN 17 mg/dL, creat 2.0 mg/dL, gluc 166 mg/dL, Ca 10.3 mg/dL,Osmolaity 348 Osm/kg H20, Ethanol <10 mg/dL | Based on the labs - radiator antifreeze. |
| Food borne illness outbreak that can cause vomiting, bloody diarrhea, severe abdominal crampig with a duration 24 hrs. | E-coli 0157:H7 |
| Exposure to a wheel cleaner product without gloves all day. 7 hours later severe pain to the fingertips but not blistered, red or broken. He washed his hands right after. What would this exposure be and what would be the treatment | Hydrodfluoric acid; topical administration of calcium gluconate gel |
| A man dusted his home with Sevin (Carbaryl) powder. He complains of SOB, and pain with inspiration. He is anxious appearing, diaphoretic, lacrimation, salivatio, with no central or nicotinic effect. What treatment would you recommend | Atropine only |
| An adult in ER 1 hr after bite from an eastern diamondback rattlesnack (Crtalus Adamanteus). 2 punture wnds on left ankle. Edema to mid-calf and extensive ecchymosis. VS: 125/92, HR 120, RR 20, T 98.2. What is the treatment? | Begin administration of polyvalent Crotalidae immun fab (Crofab)with starting dose of 4-6 vials. |
| Man in ER found lethargic & vomiting. an empty bottle orultra-rapid acting insulin. B/P 140/80, HR 72, RR 30, T 98.6 BS 102, no gluc given in field, no mental staus change with Naloxone 2 mf IV. Pt in metabolic acidosis and anion gap what med caused this | Metformin (Glucophage) |
| A 2 yo pt presents to ER with known G6PD deficiency. Which antidote would be contraindicated for the child | out of Flumazonil (Romazicon), Pyridoxine (Nestrex), Octrotide (Sandostatin), you would give methylene blue (Uroleen Blue) |
| A child got 4 tabs of Glipizide 10 mg. Parents cannot wake him after 3 hr nap, found bottle, called EMS, BG 37mg/dL. Child given D25W. pt awakened BG monitored Q30 min. 2 hrs later in ED became confused and drowsy, BG 45 mg/dL, ? recmmedation? | Octreotide (Sandostatin) |
| A woman brought to ED with status epilepticus after ingesting 90 tablets of an unk med attempting suicide. Med Hx tuberculosis, friends said that pills ingested were prescibed to her. Valium and ativan did not help seizures, what should be given. | A. Fosphenytoin (cerebryx) B. Phenobarbital, (Luminal) C. Propofol (dipravan) D. Pyridoxine (Vitamin B-6) The right answer |
| Which of the following herbal products is associated with hepatic injury? | A. Kava "right answer" B. Milk thistle C. St. Johns Wort D. Ginseng |
| LK presented approximately 1 hr after ingesting an unk amount of his anitriptyline in a suicide attempt. Which of the following is consistent with TCA OC? | A. Dry mouth, hypotension, urinary retention, tachycardia, seizure. B. Polyuria, polydyipsia, hypernatremia, seizures. C. Salivation, lacrimation, excessive pulm secreation, seizures. D. T of 104 degrees, alt mental stat, ocular clonus, brisk relfexes |
| A man in ED with hs of receiving IM inj of Prolixin deconate (fluphenazine deconate 25mg/mL) and oral Haloperidol for 5 days. He had a T 108, muscle regidity, dysphagia, altered mental status. What is the most likley cause of his presentation. | A. Malignant Hyperthermia B. Cocaine Abuse C. "Neuroleptic Malignant syndrome" D. Serotonin Syndrome |
| Which of the following statements about vitamins is true? | A. There are no legitimate uses for megavit tx B. Severe flused sensation, pruritus, nausea, HA, are caused by B6 OD C. "Fat soluble vit are A,D, E, and K" D. A large acute ingestion of MVI without iron by a healthy 2 yo chils should be sent to ED |
| Male pt in ED is agitated & hallucinating, VS: B/P 196/102, HR 113, RR 18, T 38.4, HEENT pupils 5 MM pealra, moist mucous membranes, normal bowel sounds, diaphoretic | A. Marijuana B. Hydrocodone C. Jimson Weed D. "MDMA" |
| Which of the following statements concerning mercury is true. | A. ingestion of inorganic mercury, most pts are asymptomatic B. maternal exposure to mercury does not cross blood brain barrier to affect fetus C. "Methyl mercury cross the blood brain barrier" D. Element mercury does volatilize into inahalable toxin |
| Which of the following delayed clinical effect is most consistent with significant inhalation of chloramine gas? | A. "pulmonary edema" B. Renal failure C. Methemaglobinemia D. Hemolysis |
| Healthy man in ED with N/V, and sore throat. 8 hrs after ingestin home-made fish and rice pot pies, Nausea 2 hrs post ingestion. Neuro effect, blurred vision, drooping eyelids, and difficulty swallowing and speaking. What food borne toxin is responsible. | A. Domoic Acid B. Scombrotoxin C."Botullinin toxin" D. Shiga Toxin |
| Pt on Lithium for 2 yrs ad has ingested 120 lithium 450 mg tabs, after 4 hrs had seizure and vomited. She was unresponsive and had be intubated, lavaged. No pill fragments found. IV bolus 125/hr. Lithium level 4.0 B/P 90/60, HR 105, RR 14, T. 100.3. | you recommend: A. Increase fluid volume, monitoring urine output hourly. B. Preform whole bowel irrigation C. Give multidose Charcoal, giving cathartic with initial dose and every other dose after that. D."Consult Nephrologist for hemodyalisis ASAP" |
| A mother calls and states her 11 kg child came to her with an open empty bottle of bayer low dose ASA 81 mg. How many tablets would the child have to ingest to be toxic for ASA? | A. 16 tablets B. 56 tablets C. 88 tablets D. "21 tablets" |
| A mother calls the Poison center stating that 1 hr earlier her toddler took an unk amount of cough and cold syrup. What is the first questions you should ask? | A. The age of the patient B. the weight of the patient C."Are there any symptoms" D. How much medication is missing |
| JM had cyanotic lipes but otherwise asymptomatic, no HX, but is being treated for cystitis with antibiotic, also taking meds for decreased urinary burning. The pt repairs cars for a living but hasnt been to work for 48 hrs. The pt has what poisoning. | A. CO poisoning B. Hydrogen sulfide poisoning C. "Methemoglobinemia" D. Metal Fume fever |
| A 3 yr old male has ingested an unk quantity of Orajel Max strength. Benzocaine 20%. VS are HR 161, RR 34, T. 36.8 He is lethargic vomiting, cyanotic in lips and nail beds. Methgb 53%, what is treatment | A. Methoxtrexate B. "methylene blue" C. Metaraminol D. methinonine |
| A man in ED with chief complaint of N/V. During hx he seized, initial labs showed Bld Gluc 34 mg/dL. Which plant can cause toxic effects. | A. Pokeweed (phytolacca Americana) B. Castor Bean (Ricinus communi) C. Cassava (Manihot Esculenta) D. "Ackee fruit (Blighia sapida)" |
| A mother calls the poison center becasue her child chewed just a piece of an unk plant that has big leaves. The child immediately cried and while on the phone the childs mouth started to swell. What plant was most likely ingested? | A. Dieffenbachia (Dieffenbacia amoena) B. Fox glove (Digitalis Purpurea) C. Jade plant (Crassula argentea) D. Yew (Taxus canadensis) |
| What clinical effects are commonly assiciated with 3,4-methylendioxymethamo=phetamine (MDMA) toxicity? | A. Hypotension, tacycardia, hypothermia, hypernatremia. B."HTN, Tachy, hyponatremia, hyperthermia" C. Hypotension, brady, hypothermia, hypernatremia D. HTN, Brady, hyperthermia, Hypernatremia |
| BR may have ingested an unk quantity of his grandmothers Zolpidem. Which of the following would be expected in this exposure. | A. Hypertension B. "Sedation" C. Seizures D. QRS prolongation C. |
| A 2 yo was inadvertently given an overdose of lorazepam while in the ER for a leg fx. Which of the following would be an indication for giving flumazenil? | A. Hypertension B. "Respiratory distress" C. Seizures D. QRS prolongation |
| A 13 yo female took an unk amount of BP meds. 2 hrs after ingestion she was feeling dizzy and was brought into an ED. She was hypotensive and bradycardic. Which medication most likely caused this? | A. Triamterene and hydrochlorthiazide B. Nitroglycerin C. Lisinopril D."Carvedilol" |
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