CPR Toxicological Emergencies and Overdose Management 3

Question 1

Which ECG finding is most characteristic and specific for severe digoxin toxicity?

Accepted Answer

Bidirectional ventricular tachycardia

Answer

Prolonged QT interval

Answer

Right bundle branch block

Answer

Delta waves with short PR interval

Question 2

A patient presents with severe agitation, hypertension, and hyperthermia after cocaine intoxication. Which is the most appropriate initial treatment?

Accepted Answer

IV benzodiazepines for CNS and cardiovascular stabilization

Answer

IV propranolol for heart rate control

Answer

Oral calcium channel blocker as first-line

Answer

Epinephrine to stabilize blood pressure

Question 3

What is the Rumack-Matthew nomogram used for in the emergency management of overdose?

Accepted Answer

Determining hepatotoxicity risk in acetaminophen overdose based on serum level and time since ingestion

Answer

Predicting TCA overdose severity from ECG findings

Answer

Calculating naloxone dosing for opioid overdose

Answer

Grading organophosphate toxicity severity

Question 4

A worker exposed to hydrofluoric (HF) acid has severe burns, hypocalcemia, and life-threatening cardiac dysrhythmias. What specific treatment is required?

Accepted Answer

Calcium gluconate gel topically and IV calcium replacement

Answer

Standard burn care with silver sulfadiazine dressings

Answer

Copious irrigation with sodium bicarbonate solution

Answer

Magnesium sulfate infusion alone

Question 5

A patient with severe lithium toxicity presents with tremor, confusion, ataxia, and seizures. Which intervention is the highest priority?

Accepted Answer

Supportive care and urgent hemodialysis consultation

Answer

IV sodium bicarbonate to alkalinize urine and enhance excretion

Answer

Activated charcoal to reduce GI absorption

Answer

Flumazenil for concurrent sedation reversal

Question 6

Which drug class is absolutely contraindicated in cocaine-induced coronary vasospasm and chest pain?

Accepted Answer

Non-selective beta-blockers (e.g., propranolol)

Answer

Aspirin

Answer

Sublingual nitroglycerin

Answer

Benzodiazepines

Question 7

What is the first-line pharmacologic treatment for severe symptomatic methemoglobinemia (MetHb >30%)?

Accepted Answer

Methylene blue IV (1–2 mg/kg)

Answer

Hyperbaric oxygen therapy

Answer

Exchange transfusion

Answer

Ascorbic acid IV infusion