Paramedics Exam Toxicology and Poisoning

Question 1

A patient presents with miosis, excessive salivation, bronchospasm, and bradycardia after exposure to pesticides. What is the most appropriate initial treatment?

Accepted Answer

Atropine and pralidoxime

Answer

Naloxone 0.4 mg IV

Answer

Activated charcoal and gastric lavage

Answer

Sodium bicarbonate 1 mEq/kg IV

Question 2

A 25-year-old is unresponsive with pinpoint pupils and a respiratory rate of 4 breaths/min. What is the priority intervention?

Accepted Answer

Administer naloxone and support ventilation

Answer

Administer flumazenil 0.2 mg IV

Answer

Administer activated charcoal via NG tube

Answer

Apply supplemental oxygen via nasal cannula only

Question 3

Which of the following is a contraindication to administering activated charcoal?

Accepted Answer

Ingestion of a caustic acid or alkali

Answer

Aspirin ingestion within 2 hours

Answer

Acetaminophen ingestion within 1 hour

Answer

Tricyclic antidepressant overdose

Question 4

A worker found unconscious in an enclosed space with a running generator has cherry-red skin. What is the most likely diagnosis?

Accepted Answer

Carbon monoxide poisoning

Answer

Cyanide poisoning

Answer

Methemoglobinemia

Answer

Organophosphate toxicity

Question 5

A depressed patient presents with wide complex tachycardia, seizures, and hypotension. Her ECG shows a prolonged QRS. Which treatment is indicated?

Accepted Answer

Sodium bicarbonate 1–2 mEq/kg IV

Answer

Lidocaine 1 mg/kg IV

Answer

Amiodarone 150 mg IV

Answer

Magnesium sulfate 2 g IV

Question 6

A 35-year-old female ingested an entire bottle of acetaminophen 8 hours ago and now has nausea, vomiting, and right upper quadrant pain. What is the treatment of choice?

Accepted Answer

N-acetylcysteine (NAC)

Answer

Activated charcoal 1 g/kg orally

Answer

Naloxone 2 mg IV

Answer

Flumazenil 0.2 mg IV

Question 7

Which finding would you NOT expect in a patient with cyanide poisoning?

Accepted Answer

Bradycardia and pinpoint pupils

Answer

Altered mental status and agitation

Answer

Severe metabolic acidosis with high anion gap

Answer

Bitter almond odor on the breath