toxicologyflashcards.txt

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toxicologyflashcards.txt
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2011-02-28 01:35:11
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Toxicology
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EMS Toxicology
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  1. What does PHAILS stand for?
    • Pesticides
    • Hydrocarbons
    • Acids, Alkalis, Alcohol
    • Iron
    • Lithium
    • Solvents
  2. What is the acronym PHAILS used for?
    Recalling the substances poorly absorbed by activated charcoal
  3. What three drugs make up the antidote kit for cyanide poisoning?
    • Amyl nitrite (inhaled)
    • Sodium nitrite (IV)
    • Sodium thiosulfate (IV)
  4. What are the other names for the Cyanide Antidote Kit?
    • Taylor Kit
    • Lilly Kit
    • Pasadena Kit
  5. What is the pathophysiology behind cyanide poisoning?
    • Cyanide interrupts the electron transport chain in the mitochondria greatly reducing the number of ATP that can be manufactured.
    • Cyanide combines with enzyme cytochrome oxidase, which inhibits cellular oxygenation, leading to anaerobic metabolism, then to metabolic acidosis, then cellular death.
  6. How does the Cyanide Antidote Kit work?
    • Changes the chemical structure of hemoglobin by adding an iron molecule, making methemoglobin.
    • Methemoglobin is incapable of carrying oxygen, but it draws out the cyanide from the cytochrome oxidase.
    • The sodium thiosulfate that is given then detoxifies the cyanide in the blood, just like the body normally does.
  7. What is a major side effect that should be expected with the Cyanide Antidote Kit?
    • Hypotension
    • Patient should be lying down if possible
    • MCEP may order vasopressors
  8. How is cyanide poisoning sometimes treated in the field?
    Hydroxycobalamin (AKA Cyanokit)
  9. How does Hydroxycobalamin work?
    Binds to cyanide and forms cyanocobalamin instead of methemoglobin, which does not lower the oxygen carrying capacity of the blood
  10. What are the expected side effects of Hydroxycobalamin?
    • Transient hypertension
    • Reddish discoloration of the skin
  11. Activated charcoal removes toxins by the process of:
    Adsorption (binding)
  12. The drug of choice for carbamate poisonings is:
    Atropine
  13. The mnemonic device SLUDGE helps you to remember the:
    Signs of organophosphate poisoning
  14. You are called to a local park where several people attending a family reunion report stomach pain, nausea, and vomiting. Patients report that lunch was served 2 hours ago. This time frame would lead you to suspect that the cause of the food poisoning was:
    Bacterial toxin
  15. You are called to a local beach to treat a man who stepped on a starfish. He now has a painful wound in which a piece of the starfish is still intact. Treatment for this patient includes:
    Immerse the foot in very warm water
  16. Sedative-hypnotic drugs include:
    Benzodiazepines and barbiturates
  17. Most poisonings in the United States occur:
    In the home
  18. You are called to a local woodshop where a man was found seizing, immediately after working with a paint-removal product. The man was not wearing gloves. He is now confused and lethargic. He is tachypneic and complains of abdominal pain. After protecting his airway, treatment for this patient may include:
    Ethanol
  19. If the stinger is left in the wound after a sting by a honey bee, you should:
    Scrape the stinger from the wound
  20. Drug therapy for patients with organophosphate poisoning:
    Should be administered if the patient has two or more symptoms of respiratory distress
  21. The most commonly ingested NSAID in overdose is:
    Ibuprofen
  22. Acetaminophen overdose leads to toxicity of the:
    Liver
  23. The mnemonic device CHAMP helps you remember:
    Which hydrocarbons may benefit from gastric lavage
  24. You are called to treat a 2-year-old child who has just ingested lye. The child is conscious and cooperative. The poison control center may advise you to administer what oral solution?
    Milk
  25. What medication can you use to prevent exacerbation of Wernicke-Korsakoff syndrome?
    Thiamine
  26. Activated charcoal is most effective when the:
    Poison was ingested less than an hour before the administration of charcoal
  27. The most common route of mercury poisoning is:
    Inhalation
  28. The pharmacological management of choice for a symptomatic overdose of a tricyclic antidepressant is:
    Sodium bicarbonate
  29. Syrup of ipecac is :
    Not recommended for routine use in the prehospital setting
  30. Most poisoned patients require what type of therapy in the prehospital setting?
    Supportive care
  31. An employee in a pest-control business is found unconscious on a garage floor. You find him drooling and diaphoretic. The most appropriate medication for this patient is:
    Atropine
  32. A chemical that may be produced when nylon and polyurethane burn and is of particular concern in any fire environment is:
    Cyanide
  33. Disulfiram is a medication taken by alcoholics to prevent:
    Alcoholic intake
  34. Which of the following is an early sign of toxicity in reaction to a tricyclic antidepressant?
    Blurred vision
  35. A reasonable approach in an adult who has taken an overdose of pills would be:
    • 1. Lavage followed by two glasses of milk
    • 3. Charcoal followed by two glasses of water
    • 4. Lavage followed by charcoal
  36. The most common cardiovascular complications of poisoning by ingestion is:
    Rhythm disturbances
  37. The preferred method of keeping a poison from entering the small intestine is:
    Use of activated charcoal
  38. Organophosphates affect primarily which neurotransmitter?
    Acetylcholine
  39. You find your 22-year-old patient unconscious and breathing six times per minute. His pupils are equal and pinpoint. Your partner begins ventilation and oxygenation using a bag-mask. You are unable to establish vascular access by IV or IO. Which of the following interventions has the highest priority?
    Administer naloxone 2 mg IM
  40. Activated charcoal should be withheld if the ingestion occurred :
    Within 1 or more hours before EMS arrival
  41. Any substance that produces harmful physiological or psychological effects is called a(n):
    Poison
  42. Alcohol withdrawal can lead to hallucinations in _____ hours.
    24 to 36
  43. The most commonly ingested NSAID in overdose is:
    Ibuprofen
  44. Among a patient�s prescription medications, you find a bottle of lithium, leading you to suspect that the patient has:
    Bipolar disorder
  45. What finding would lead you to eliminate a spider bite as the cause of an injected poison?
    Multiple bites
  46. Management of a patient bitten by a pit viper should include:
    Immobilizing the limb
  47. Minor symptoms of alcohol withdrawal usually:
    Peak within 24 to 36 hours
  48. Medical direction may advise you to promote gastric emptying in a patient who has ingested lead or mercury because:
    The risk for systemic toxicity outweighs the risk for aspiration
  49. The absorption of toxins takes place primarily in the:
    Small intestine
  50. How should the envenomation site of a jellyfish sting be treated?
    Apply isopropanol and baking soda
  51. Most accidental poisonings in children from 1 to 3 years of age occur by means of:
    Ingestion
  52. The antidote for benzodiazepine overdose is:
    Flumazenil
  53. You are called to a local woodshop where a man was found seizing, immediately after working with a paint-removal product. The man was not wearing gloves. He is now confused and lethargic. He is tachypneic and complains of abdominal pain. You suspect this patient has been poisoned by:
    Methanol
  54. Which drug is found in the Pasadena cyanide antidote kit?
    Amyl nitrite
  55. You find your 22-year-old patient unconscious and breathing six times per minute. His pupils are equal and pinpoint. Your partner begins ventilation and oxygenation using a bag-mask. You are unable to establish vascular access by IV or IO. Which of the following interventions has the highest priority?
    Administer naloxone 2 mg IM
  56. Cocaine is a(n):
    CNS stimulant
  57. You respond to a call for an overdose. When you arrive, you find a teenage girl who is drowsy and snoring, but arouses to sternal pressure. Her friends think she took some Vicodin and Valium 40 minutes ago and drank some vodka. Her vital signs are BP 98/70 mmHg, P. 116 bpm, R 16/min., SaO2 97%. Which of the following interventions would be appropriate?
    Insert a nasal airway and administer naloxone 0.4 mg IV
  58. The drug of choice to treat an overdose of opiates is:
    Naloxone
  59. Which of the following organs is most likely to show the effects of poisoning first?
    Heart
  60. Most pediatric lead poisonings occur as a result of:
    Ingestion of paint chips
  61. What are the four routes through which poisons may enter the body?
    • Inhalation
    • Absorption
    • Ingestion
    • Injection
  62. What percentage of all accidental ingestion of poisons occurs in children 1 to 3 years of age?
    80%
  63. What is the first priority in managing a poisoned patient after scene safety?
    Securing a patent airway
  64. What are the specific questions that should be asked as part of the history of a poisoned patient?
    • What?
    • When?
    • How much?
    • Antidote been given?
    • Psychiatric history/suicide attempts?
  65. What is a cathartic?
    An agent that causes bowel evacuation
  66. What are the main goals (2) in managing a poisoned patient?
    • Managing symptoms
    • Preventing absorption
  67. What does CHAMP stand for?
    • Camphor
    • Halogenated
    • Aromatic
    • Metal-containing
    • Pesticide-containing
  68. How quickly do symptoms appear in cases of chemical food poisoning?
    Within 30 minutes
  69. How quickly do symptoms appear in cases of food poisoning caused by bacterial toxins?
    1 to 12 hours
  70. How quickly do symptoms develop in cases of food poisoning caused by viral or bacterial infections?
    12 to 48 hours
  71. What is a direct-acting chemical?
    Chemical capable of producing injury without first being transformed or changed i.e. hydrofluoric acid
  72. A cyanide antidote kit should not be given to a patient who is suspected to be suffering from cyanide poisoning due to what circumstance?
    • Smoke inhalation
    • Carbon monoxide poisoning already limits oxygen carrying capability
    • Patient could die from anoxious brain injury
  73. What is the only hymenopteran species with venom that results in necrotic activity?
    The imported fire ant

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