Question 1

A 32-year-old female is conscious and alert at a group home for recovering alcoholics and states, "I'm having rum fits." Counselors from the home tell you that she is a chronic alcoholic who entered their program three days ago and has not had a drink since. Physical examination reveals cool, diaphoretic skin; dilated pupils bilaterally that are responsive to light; and obvious anxiety. HR = 122, BP = 156/104, RR = 20, SaO₂ = 99%, blood glucose = 62 mg/dL. Based on the clinical exam findings, all of the following should be part of your patient management EXCEPT:

Accepted Answer

Metoprolol should not be given in this scenario as the patient's high heart rate may be compensatory for her low blood glucose and giving a beta blocker could mask this important symptom. The other options are appropriate interventions for an alcoholic in withdrawal, with D50W addressing the low blood glucose, normal saline helping to maintain hydration, and thiamine providing important nutrition for a person with chronic alcoholism.

Question 2

A 19-year-old male has ingested fifty 325 mg aspirin tablets 20 minutes before your arrival. He is alert and complaining of burning abdominal pain. Which of the following is appropriate in the prehospital management of this patient?

Accepted Answer

Activated charcoal is appropriate in the prehospital management of a patient who has ingested a potentially toxic amount of aspirin. It works by adsorbing the aspirin in the gastrointestinal tract, preventing its absorption into the bloodstream.

Question 3

Your patient is a 20-year-old female who is conscious and alert, though obviously hallucinating after ingesting LSD. Her friends state that she is having a "bad trip," and you note that she is vigorously scratching her arms to the point of drawing blood. Physical examination reveals warm, slightly diaphoretic skin and dilated pupils bilaterally. Which of the following medications should be considered to manage this patient?

Accepted Answer

Haloperidol is a dopamine antagonist that is often used to manage the symptoms of LSD-induced hallucinations and psychosis. It can also help to alleviate agitation and aggression. Thiamine is used to prevent or treat neurological symptoms associated with alcoholism but is not indicated for LSD intoxication. Narcan is an opioid antagonist and not indicated in this case. Avapro is a blood pressure medication and not indicated for this patient's symptoms.

Question 4

Which of the following is NOT associated with chronic alcohol ingestion?

Accepted Answer

Chronic alcohol ingestion is associated with various health issues, such as decreased sensation in hands and feet (A) due to peripheral neuropathy, thiamine deficiency (B) leading to Wernicke-Korsakoff syndrome, and esophageal varices (D) due to liver damage causing portal hypertension. However, hyperactivity (C) is not typically associated with chronic alcohol ingestion. In fact, chronic alcohol abuse can lead to depression, lethargy, and decreased motivation.

Question 5

Your patient was in the building when a fire started at a factory that manufactures plastics. He is complaining of a headache, palpitations, and a burning sensation in his throat. His airway, breathing, and circulation are intact. Heart rate = 128, respirations = 22, blood pressure = 148/84, SaO₂ = 93%. You should immediately:

Accepted Answer

The patient's symptoms indicate possible exposure to toxic fumes from the fire. Supportive measures, such as administering oxygen and monitoring vital signs, should be initiated immediately. Administration of amyl and sodium nitrite is not indicated for this presentation. Applying the cardiac monitor may be necessary to monitor the patient's heart rate and rhythm, but it is not the immediate priority. Intubation may be necessary if the patient's airway becomes compromised, but it is not indicated at this time.

Question 6

All of the following are examples of one of the three "principles of decontamination" that are specific to toxicological emergencies EXCEPT:

Accepted Answer

The administration of an NS fluid challenge is not a principle of decontamination; it is a supportive treatment. Decontamination principles include preventing absorption, enhancing elimination, and removing the patient from the toxic environment.

Question 7

"Rock" and "crack" are street names for:

Accepted Answer

"Rock" and "crack" are slang terms commonly used to refer to the drug cocaine.

Question 8

Which of the following statements concerning Africanized honeybees is accurate?

Accepted Answer

Africanized honeybees, often known as "killer bees," are more aggressive than other types of bees and tend to attack in larger numbers, which can result in a person receiving more stings compared to being stung by other types of bees. The venom itself is not more toxic, and there is no specific antivenin for their stings, nor does it specifically cause acute renal failure.

Question 9

Your patient is a 24-year-old, 176-pound male who is alert and oriented 12 hours after ingesting thirty 500 mg tablets of Tylenol. Which of the following are the most likely complaints or findings?

Accepted Answer

Tylenol (acetaminophen) overdose typically presents with nausea, vomiting, weakness, and fatigue in the initial 24 hours following ingestion.

Question 10

Your patient is a 56-year-old female who is alert and sitting in a chair. She states that she accidentally took too many of her Cardizem tablets. Which of the following signs or symptoms would you least expect to find?

Accepted Answer

Cardizem (diltiazem) is a calcium channel blocker used to treat hypertension and tachycardia. Overdose typically leads to hypotension and bradycardia, not tachycardia. Warm, dry skin and tachycardia would be least expected as symptoms of a Cardizem overdose.

Question 11

LSD and PCP are examples of:

Accepted Answer

LSD and PCP are both classified as hallucinogens, which are a class of drugs that alter perception, mood, and thought processes. They do not have the same effects as amphetamines, sedatives, or narcotics.

Question 12

Alcohol is classified as a(n):

Accepted Answer

Alcohol is classified as a depressant because it slows down the central nervous system and can cause drowsiness, relaxation, and a decrease in inhibitions.

Question 13

Your patient is a 19-year-old male who ingested thirty 500 mg tablets of Tylenol 25 minutes ago. Police officers on the scene are requesting that you "check him out" before they transport him for psychiatric evaluation. The patient denies ingesting other drugs or alcohol and has no complaints. HR = 94, BP = 116/74, RR = 12, SaO₂ = 98%. Which of the following would be most appropriate?

Accepted Answer

The answer of Your patient is a 19-year-old male who...

Question 14

The primary goal in the prehospital care of a patient who has been bitten by a pit viper is to:

Accepted Answer

The primary goal in the prehospital care of a patient who has been bitten by a pit viper is to slow the absorption of venom. This can be done by immobilizing the affected limb, keeping the patient calm and at rest, and administering antivenom if available. Other interventions, such as inducing diuresis or alkalinizing the urine, are not as important in the immediate care of the patient. Removing the venom from the surrounding tissue is also not recommended, as it can cause further tissue damage and may not be effective in removing all of the venom.

Question 15

The order Hymenoptera includes:

Accepted Answer

The order Hymenoptera includes wasps.

Question 16

Mushrooms from the class ________ are responsible for over 90 percent of deaths from mushroom toxicity.

Accepted Answer

Amanita mushrooms contain toxins that can cause liver failure and death. They are responsible for the majority of deaths from mushroom toxicity. Button, shiitake, and galerina mushrooms can also be toxic but are less commonly fatal.

Question 17

A 38-year-old male is conscious and alert after a black widow spider bite to his right hand. You note pain and swelling to the hand, and the patient states that he is dizzy and nauseous. HR = 117, BP = 128/78, RR = 20. During your physical examination, you note that he begins to experience severe, painful muscle spasms in his right arm. Which of the following is NOT appropriate?

Accepted Answer

Sodium bicarbonate is not appropriate for the treatment of black widow spider bites. The recommended treatments for black widow spider bites include administration of calcium gluconate to alleviate muscle spasms and diazepam or midazolam to relieve muscle spasticity and anxiety. Sodium bicarbonate is not a treatment for spider bites and has no benefit in this scenario.

Question 18

A couple has been experimenting with Ecstasy. They are both complaining of anxiety, nausea, and palpitations. You would also expect:

Accepted Answer

Ecstasy has been shown to increase heart rate and blood pressure, which can lead to a number of cardiovascular complications such as arrhythmias, myocardial infarctions, or strokes. Therefore, elevated blood pressure is a common occurrence in individuals taking Ecstasy. Dyspnea, seizures, and bradycardia are not common complications associated with Ecstasy use.

Question 19

The need to progressively increase the dose of a drug to reproduce the effect originally achieved at smaller doses is:

Accepted Answer

Tolerance is the need to increase the dose of a drug to reproduce the effect originally achieved at smaller doses. Addiction refers to a psychological and physiological dependence on a drug, substance abuse involves using a drug in a way that harms oneself or others, and habituation is a state of decreased responsiveness to a drug or stimulus over time.

Question 20

Which of the following cause(s) injury by inducing liquefaction necrosis?

Accepted Answer

Alkalis can cause injury by inducing liquefaction necrosis, which is the breakdown of tissue due to the alkaline pH. Caustics can also cause injury through similar mechanisms, but the term caustic is generally used to refer to strong acids or bases that can corrode or burn tissues. Emulsifiers are compounds used to mix oil and water and are unlikely to cause tissue injury on their own. Acids can cause injury by inducing coagulation necrosis, which is the denaturation of proteins and death of cells due to the acidic pH.

Quiz 8: Toxicology and Substance Abuse