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Toxicological Emergencies Flashcards

7 cards from real ENPC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A child presents with bradycardia, hypotension, and altered mental status after suspected beta-blocker overdose. Which treatment is MOST appropriate?

    Answer: High-dose insulin therapy

    High-dose insulin (1 unit/kg bolus followed by infusion) improves myocardial energy metabolism and cardiac output in beta-blocker toxicity.

  2. Which presentation characterizes the second phase (6-24 hours) of iron toxicity in a pediatric patient?

    Answer: Apparent improvement or symptom-free latent period

    Phase II of iron toxicity (6-24 hours) is a deceptive latent period of apparent improvement before systemic toxicity develops.

  3. A 3-year-old ingests a button battery confirmed by X-ray to be lodged in the esophagus. What is the PRIORITY intervention?

    Answer: Urgent endoscopic removal within 2 hours

    Esophageal button batteries require emergency endoscopic removal within 2 hours due to rapid liquefactive necrosis and perforation risk.

  4. Flumazenil reverses benzodiazepine overdose but should be used cautiously because it can:

    Answer: Precipitate seizures in benzodiazepine-dependent patients

    Flumazenil can precipitate acute benzodiazepine withdrawal seizures in patients with physical dependence on benzodiazepines.

  5. A child with carbon monoxide poisoning has a carboxyhemoglobin level of 35%. What is the MOST appropriate oxygen therapy?

    Answer: 100% oxygen via non-rebreather mask

    100% oxygen via non-rebreather mask reduces the carboxyhemoglobin half-life from ~5 hours on room air to ~60-90 minutes.

  6. Which substance is MOST likely to cause a delayed cardiovascular toxicity presentation 6-12 hours after ingestion?

    Answer: Extended-release calcium channel blockers

    Extended-release formulations absorb slowly, causing delayed-onset cardiovascular toxicity requiring prolonged cardiac monitoring.

  7. A child presents with dry mouth, urinary retention, hyperthermia, tachycardia, flushed skin, and hallucinations. Which substance is MOST likely responsible?

    Answer: Diphenhydramine (Benadryl)

    Diphenhydramine causes classic anticholinergic toxidrome: 'hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.'

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