CPEN CPEN Toxicology and Poisoning Emergencies 1 — Questions and Answers
Question 1: A 3-year-old presents after ingesting acetaminophen. Which antidote is indicated for acetaminophen toxicity?
- N-acetylcysteine (NAC) (Correct answer)
- Naloxone
- Flumazenil
- Atropine
Correct answer: N-acetylcysteine (NAC)
N-acetylcysteine (NAC) is the antidote for acetaminophen toxicity as it replenishes hepatic glutathione and prevents liver injury.
Question 2: Which finding is most consistent with organophosphate poisoning in a pediatric patient?
- Mydriasis and dry skin
- Miosis, bradycardia, and excessive secretions (Correct answer)
- Tachycardia and hyperthermia
- Hypertension and diaphoresis
Correct answer: Miosis, bradycardia, and excessive secretions
Organophosphate poisoning causes a cholinergic toxidrome characterized by miosis, bradycardia, bronchospasm, and excessive secretions (SLUDGE).
Question 3: A toddler ingests iron tablets. Which early sign indicates iron toxicity?
- Hematemesis and diarrhea (Correct answer)
- Pinpoint pupils
- Urticaria and angioedema
- Hyperglycemia
Correct answer: Hematemesis and diarrhea
The early gastrointestinal phase of iron toxicity presents with vomiting, hematemesis, and diarrhea due to direct mucosal injury.
Question 4: Which medication is the antidote for benzodiazepine overdose in a pediatric patient?
- Naloxone
- Physostigmine
- Flumazenil (Correct answer)
- Pyridoxine
Correct answer: Flumazenil
Flumazenil competitively antagonizes benzodiazepine receptors and reverses CNS and respiratory depression caused by benzodiazepine overdose.
Question 5: A 5-year-old ingested a button battery. What is the most serious immediate risk?
- Lead poisoning
- Esophageal perforation from electrical current and alkali burns (Correct answer)
- Choking hazard only
- Intestinal obstruction
Correct answer: Esophageal perforation from electrical current and alkali burns
Button batteries lodged in the esophagus generate an electrical current and hydroxide ions that cause rapid, severe alkali burns and esophageal perforation.
Question 6: Which intervention is the priority for a child presenting with suspected carbon monoxide poisoning?
- Administer sodium bicarbonate IV
- Apply 100% oxygen via non-rebreather mask (Correct answer)
- Perform gastric lavage
- Administer activated charcoal
Correct answer: Apply 100% oxygen via non-rebreather mask
High-flow 100% oxygen via non-rebreather mask displaces CO from hemoglobin and is the first-line treatment for carbon monoxide poisoning.
CPEN CPEN Toxicology and Poisoning Emergencies 1
A 3-year-old presents after ingesting acetaminophen.
Which antidote is indicated for acetaminophen toxicity?