FISDAP Toxicology and Substance Abuse

Question 1

A patient is found unresponsive with pinpoint pupils, slow respirations (4/min), and cyanosis. Bystanders report heroin use. What is the priority intervention?

Accepted Answer

Support ventilation and administer naloxone

Answer

Administer activated charcoal

Answer

Establish IV access and administer dextrose

Answer

Place the patient in the recovery position and monitor

Question 2

A patient presents with salivation, lacrimation, urination, defecation, GI distress, and emesis (SLUDGE). The patient was spraying insecticide. What class of toxin is responsible?

Accepted Answer

Organophosphates (cholinergic agents)

Answer

Opioids

Answer

Sympathomimetics

Answer

Benzodiazepines

Question 3

An EMT responds to a patient found in a closed garage with a running vehicle. The patient is confused and has a headache. Skin color appears flushed and cherry-red. What is the most appropriate initial treatment?

Accepted Answer

Remove the patient from the environment and administer 100% high-flow oxygen

Answer

Administer naloxone and transport

Answer

Provide rescue breathing only and monitor SpO2

Answer

Administer aspirin and transport for cardiac evaluation

Question 4

A patient who takes tricyclic antidepressants (TCAs) is found unresponsive with a wide QRS complex on the monitor. Which treatment is most appropriate for this toxicity?

Accepted Answer

Administer sodium bicarbonate to alkalinize the blood

Answer

Administer naloxone 2 mg IV

Answer

Give activated charcoal and induce vomiting

Answer

Perform immediate synchronized cardioversion

Question 5

A patient presents with hyperthermia, tachycardia, hypertension, dilated pupils, and agitation after cocaine use. Which toxidrome does this represent?

Accepted Answer

Sympathomimetic toxidrome

Answer

Cholinergic toxidrome

Answer

Opioid toxidrome

Answer

Sedative-hypnotic toxidrome

Question 6

A patient with a history of chronic alcohol use is now having a seizure. He reports his last drink was 48 hours ago. What is the most likely cause?

Accepted Answer

Alcohol withdrawal seizure

Answer

Acute alcohol intoxication causing CNS depression

Answer

Wernicke's encephalopathy from thiamine deficiency

Answer

Hypercalcemia from liver disease