ENPC Toxicological Emergencies 2

Question 1

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

Accepted Answer

High-dose insulin therapy

Answer

Epinephrine bolus alone

Answer

Calcium chloride 10%

Answer

Sodium bicarbonate

Question 2

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

Accepted Answer

Apparent improvement or symptom-free latent period

Answer

GI hemorrhage and persistent vomiting

Answer

Circulatory shock and severe metabolic acidosis

Answer

Hepatic failure with coagulopathy

Question 3

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

Accepted Answer

Urgent endoscopic removal within 2 hours

Answer

Induce vomiting immediately

Answer

Administer activated charcoal

Answer

Monitor and allow spontaneous passage

Question 4

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

Accepted Answer

Precipitate seizures in benzodiazepine-dependent patients

Answer

Cause prolonged sedation in children

Answer

Worsen respiratory depression

Answer

Induce tachyarrhythmias

Question 5

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

Accepted Answer

100% oxygen via non-rebreather mask

Answer

Nasal cannula at 2 L/min

Answer

Simple face mask at 6 L/min

Answer

Room air with close monitoring

Question 6

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

Accepted Answer

Extended-release calcium channel blockers

Answer

Immediate-release acetaminophen

Answer

Aspirin

Answer

Benzodiazepines

Question 7

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

Accepted Answer

Diphenhydramine (Benadryl)

Answer

Heroin

Answer

Cocaine

Answer

Organophosphate