CPEN Toxicology and Poisoning Emergencies Flashcards

A teenager ingests a large amount of acetaminophen 8 hours ago. Which lab value is the priority assessment?

Answer: Serum acetaminophen level and liver function tests

Serum acetaminophen level plotted on the Rumack-Matthew nomogram and LFTs are essential to determine toxicity risk and need for NAC treatment.

Which symptom cluster represents a sympathomimetic toxidrome in a pediatric patient?

Answer: Tachycardia, hypertension, mydriasis, diaphoresis

Sympathomimetic toxidrome (e.g., cocaine, amphetamines) presents with tachycardia, hypertension, hyperthermia, mydriasis, and diaphoresis due to catecholamine excess.

A child is brought in after a suspected clonidine ingestion. What clinical presentation is expected?

Answer: Bradycardia, hypotension, and CNS depression mimicking opioid toxidrome

Clonidine stimulates central alpha-2 receptors, producing bradycardia, hypotension, miosis, and sedation that closely mimics opioid toxicity.

What is the correct dose range of naloxone for opioid reversal in a pediatric patient under 20 kg?

Answer: 0.1 mg/kg IV up to 2 mg

The standard naloxone dose for pediatric opioid reversal is 0.1 mg/kg IV/IM (up to 2 mg maximum) and may be repeated every 2–3 minutes.

Which ingestion requires whole bowel irrigation as a decontamination method?

Answer: Iron tablets or sustained-release medications

Whole bowel irrigation with polyethylene glycol is indicated for iron tablets and sustained-release drug ingestions not adsorbed by activated charcoal.

A child presents with methemoglobinemia after topical benzocaine use. Which treatment reverses this condition?

Answer: Methylene blue IV

Methylene blue reduces methemoglobin back to functional hemoglobin by acting as an electron donor in the NADPH-dependent pathway.