CEN Toxicology and Environmental Emergencies

Question 1

A patient presents with bradycardia, miosis, excessive salivation, urination, and muscle fasciculations after working in an agricultural field. Which toxidrome is this?

Accepted Answer

Cholinergic toxidrome (organophosphate poisoning)

Answer

Sympathomimetic toxidrome

Answer

Anticholinergic toxidrome

Answer

Opioid toxidrome

Question 2

What is the antidote for organophosphate/cholinergic poisoning?

Accepted Answer

Atropine and pralidoxime (2-PAM)

Answer

N-acetylcysteine

Answer

Physostigmine

Answer

Flumazenil

Question 3

A patient presents after acetaminophen overdose 4 hours ago. The Rumack-Matthew nomogram is used to determine treatment. Which antidote is indicated?

Accepted Answer

N-acetylcysteine (NAC)

Answer

Flumazenil IV

Answer

Sodium bicarbonate infusion

Answer

Activated charcoal only

Question 4

A patient presents with hypertension, tachycardia, hyperthermia, mydriasis, and agitation. Which toxidrome is this presentation consistent with?

Accepted Answer

Sympathomimetic toxidrome

Answer

Cholinergic toxidrome

Answer

Opioid toxidrome

Answer

Sedative-hypnotic withdrawal

Question 5

A patient with a tricyclic antidepressant (TCA) overdose presents with a wide QRS complex and hypotension. Which treatment is most appropriate?

Accepted Answer

Sodium bicarbonate 1–2 mEq/kg IV bolus

Answer

Magnesium sulfate IV

Answer

Physostigmine IV

Answer

Activated charcoal via NG tube

Question 6

Which antidote is used for methanol or ethylene glycol poisoning to competitively inhibit alcohol dehydrogenase?

Accepted Answer

Fomepizole (4-MP)

Answer

Ethanol

Answer

N-acetylcysteine

Answer

Hydroxocobalamin

A patient presents with bradycardia, miosis, excessive salivation, urination, and muscle fasciculations after working in an agricultural field.Which toxidrome is this?

A patient presents with bradycardia, miosis, excessive salivation, urination, and muscle fasciculations after working in an agricultural field.
Which toxidrome is this?