Paramedics Exam Toxicology and Poisoning 3

Question 1

A patient on digoxin presents with nausea, yellow-green visual halos, and AV block. What is the definitive treatment?

Accepted Answer

Digoxin-specific antibody fragments (Digibind/DigiFab)

Answer

Activated charcoal 1 g/kg orally

Answer

Atropine 1 mg IV

Answer

Calcium chloride 1 g IV

Question 2

A patient overdosed on verapamil presents with bradycardia, hypotension, and hyperglycemia. What is the most appropriate first-line antidote?

Accepted Answer

Calcium chloride 1 g IV

Answer

Glucagon 5 mg IV

Answer

Sodium bicarbonate 1 mEq/kg IV

Answer

Atropine 1 mg IV

Question 3

A child ingested iron tablets and presents with vomiting, bloody diarrhea, and abdominal pain. Which chelating agent is indicated?

Accepted Answer

Deferoxamine

Answer

Dimercaprol (BAL)

Answer

N-acetylcysteine

Answer

Calcium disodium EDTA

Question 4

Multiple patients are exposed to a nerve agent (VX) during a chemical attack. Which medication combination is most appropriate?

Accepted Answer

Atropine and pralidoxime (2-PAM)

Answer

Naloxone and thiamine

Answer

Sodium bicarbonate and calcium gluconate

Answer

Flumazenil and activated charcoal

Question 5

A 19-year-old presents with hallucinations, agitation, and tachycardia after ingesting psilocybin mushrooms. Which intervention is most appropriate?

Accepted Answer

Provide a calm environment and consider benzodiazepines for severe agitation

Answer

Administer naloxone 0.4 mg IV immediately

Answer

Administer flumazenil 0.2 mg IV

Answer

Apply physical restraints immediately and give haloperidol

Question 6

A patient presents with hyperthermia (104°F), agitation, diaphoresis, and chest pain after cocaine use. Which life-threatening complications should you prioritize?

Accepted Answer

Acute coronary syndrome and rhabdomyolysis

Answer

Hypoglycemia and coagulopathy

Answer

Hypothermia and respiratory depression

Answer

Bradycardia and hypotension

Question 7

You arrive at a scene where multiple patients have been exposed to an unknown chemical. What is the FIRST action you should take?

Accepted Answer

Ensure scene safety and don appropriate PPE before any patient contact

Answer

Administer atropine to all patients with salivation

Answer

Establish IV access on all symptomatic patients

Answer

Call for additional EMS units and wait for their arrival