A poison center receives a call about a 2-year-old who ingested an unknown amount of acetaminophen approximately 30 minutes ago. The child weighs 12 kg and appears well. What is the MOST important initial step?
Pediatric Poisoning
Question · Easy
Two exes, two antidotes
Short
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Which toxidrome is characterized by miosis, bradycardia, bronchorrhea, salivation, lacrimation, urination, defecation, and emesis?
Toxicology Assessment
Chapter 1: Pharmacology & Toxicology Principles
1.1 Toxicokinetics: Absorption, Distribution, Metabolism, and Elimination Alterations in Overdose
Study guide
What is the antidote for acetaminophen overdose?
Antidote Protocols
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A parent calls about their 3-year-old who swallowed a button battery 20 minutes ago. The child is asymptomatic. What is the MOST appropriate recommendation?
Common Poisonings
Which of the following is the appropriate first-line antidote for opioid overdose presenting with respiratory depression?
A caller reports exposure to household bleach (sodium hypochlorite 3-6%). The patient splashed it in their eyes 5 minutes ago. What is the MOST important immediate recommendation?
Exposure Management
1.2 Toxicodynamics, Receptor Pharmacology, and Dose-Response Relationships
The Rumack-Matthew nomogram is used to guide treatment decisions for which type of poisoning?
Question · Medium
Which of the following substances has the potential to cause toxicity or death in a toddler from ingestion of a single tablet or small volume ('one pill can kill')?
A poison center specialist receives a call about a patient who ingested a caustic alkali substance. Which of the following interventions is CONTRAINDICATED?
Decontamination Decisions
What is the mechanism of carbon monoxide (CO) toxicity?
1.3 Cellular and Biochemical Mechanisms of Toxicity
A 4-year-old ingests several iron-containing prenatal vitamins. At what dose of elemental iron (mg/kg) should the child be referred to the emergency department?
Which antidote is used to treat cyanide poisoning?
When is activated charcoal MOST effective for GI decontamination?
A caller reports that their child ate several berries from a holly plant (Ilex species). What is the expected toxicity?
1.4 Hepatic Biotransformation, Phase I/II Reactions, and CYP450 Interactions
What clinical finding is MOST characteristic of the anticholinergic toxidrome?
Which snake genus is responsible for the majority of venomous snakebites in the United States?
Envenomations Natural Toxins
A poison center specialist is documenting a case in the National Poison Data System (NPDS). Which of the following is a required data element for every human exposure case?
Documentation Requirements
A patient presents with tinnitus, hyperventilation, and an elevated anion gap metabolic acidosis with respiratory alkalosis. Which substance is MOST likely responsible?
Chapter 2: Poison Center Case Assessment Fundamentals
2.1 Exposure History: The Questions That Change Management
What is the appropriate initial dose of atropine for an adult patient with symptomatic organophosphate poisoning?
Question · Hard
Which of the following is the MOST appropriate follow-up interval for a poison center case involving an asymptomatic unintentional pediatric ingestion managed at home?
Follow Up Protocols
Which of the following substances is NOT effectively adsorbed by activated charcoal?
A patient has ingested ethylene glycol. Which of the following antidotes should be administered?
2.2 Toxicologic Calculations: Doses, Concentrations, and Conversions
What is the expected time course for the development of hepatotoxicity following acute acetaminophen overdose?
A brown recluse spider (Loxosceles reclusa) bite typically causes which type of local reaction?
When communicating with a panicked caller who found their child with an open medication bottle, what is the MOST effective initial communication strategy?
Communication Skills
Which mushroom genus contains amatoxins and is responsible for the majority of fatal mushroom poisonings worldwide?
Chapter 3: Analgesics, Opioids & Over-the-Counter Medications
3.1 Acetaminophen Overdose: Pathophysiology, Rumack-Matthew Nomogram, and NAC Protocols
Which of the following is an indication for whole bowel irrigation (WBI) as a decontamination method?
A patient is found unresponsive with pinpoint pupils and a respiratory rate of 6 breaths per minute. Which toxidrome is this presentation MOST consistent with?
What is the recommended treatment for a black widow spider (Latrodectus) envenomation with severe muscle cramping and pain?
A poison center specialist receives a call from a nurse in an emergency department asking about the toxic dose of aspirin in a pediatric patient. What is the generally accepted potentially toxic single acute dose of aspirin?
3.2 Salicylates: Pathophysiology, Acid-Base Derangements, and Urinary Alkalinization
What is the primary mechanism of toxicity for laundry detergent pods in young children?
A patient who ingested a calcium channel blocker presents with hypotension and bradycardia refractory to calcium, atropine, and vasopressors. Which additional therapy should be considered?
What is the purpose of the severity coding system used in NPDS documentation?
A 35-year-old patient presents after intentional ingestion of an unknown quantity of a tricyclic antidepressant (TCA). The ECG shows a QRS duration of 120 ms. What is the MOST appropriate initial treatment?
3.3 Nonsteroidal Anti-inflammatory Drugs (NSAIDs) and Miscellaneous OTC Analgesics
Which of the following plants contains cardiac glycosides that can cause life-threatening dysrhythmias?
What is the most common route of exposure reported to US poison control centers?
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