Poisoning

Question 1

of poisonings are accidental.
The majority of poisonings occur at home
when the child’s caregiver is distracted.

Answer 1

Ninety percent

Answer 2

ingested

Question 3

Mortality is

Question 4

2. Etiology. The most common toxic exposures

involve commonly used

Answer 4

household products.

Question 5

(most common toxic exposure).

Answer 5

Cosmetics and personal-care products

Question 6

e. Analgesics (e.g.,

Answer 6

acetaminophen, non-

steroidal anti-inflammatory drugs [NSAIDs], aspirin)

Question 7

Miosis

Answer 7

OPOP

Question 8

Mydriasis

Answer 8

ACTA

Question 9

Nystagmus

Answer 9

Dilantin

Penicillin

Question 10

Retinal hemorrhage

Answer 10

Carbon monoxide

Methanol

Question 11

a. Screening laboratory tests include

Answer 11

serum glucose,
serum and urine toxicology screens,
and electrolytes.

Question 12

Causes of an increased anion gap (>16)

Answer 12

AMUDPILES

Question 13

b. Radiographic imaging of the abdomen may reveal

radiopague substances. These may be recalled

Answer 13

CHIPE

Question 14

2. If the patient has altered mental status,
   administer _________ for hypoglycemia and
   ___________ for possible opiate overdose.

Answer 14

Dextrose

naloxone

Question 15

a. rapidly induces emesis by direct

gastric irritation and CNS chemoreceptor

Answer 15

Syrup of ipecac

Question 16

Ipecac
(2) It is contraindicated in victims with decreased
level of consciousness, caustic or hydrocarbon
ingestions, and in children younger than

Answer 16

6 months

Question 17

b. is performed with a large bore oro-

gastric tube placed into the stomach to evacuate

Answer 17

Gastric lavage

Question 18

(1) Indications include life-threatening ingestions
presenting within 1-hour after ingestion and
ingestion of toxins that delay gastric emptying

Answer 18

Eg salicylates

Question 19

c. has a very large absorptive

surface area that binds toxins and minimize their absorption

Answer 19

Activated charcoal

Question 20

Charcoal improves clinical outcome, especially if given
within

Answer 20

1 hour after ingestion

Question 21

d. ) is rapid, complete
emptying of the intestinal tract accomplished
using polyethylene glycol (an osmotic agent) and
an electrolyte solution (to prevent electrolyte imbalance

Answer 21

Whole-bowel irrigation (WBI

Question 22

Preliminary studies show that WBI may be

effective for ingestions of

Answer 22

iron and other heavy metal

Question 23

Most common medications ingested by children and

adolescents.

Answer 23

Acetaminophen

Question 24

(2) Toxic intermediates produced when glutathione
is depleted bind directly to hepatocytes,
causing hepatocellular necrosis

Answer 24

Acetaminophen

Question 25

Acetaminophen poisoning antidote

Answer 25

NAC
(a) NAC is given orally as a 140 mg/kg loading
dose and is followed with 70 mg/kg every
4 hours for 17 doses. Intravenous NAC may

4 hours for 17 doses. Intravenous NAC may
also be used.

Question 26

(b) is hepatoprotective if given within
8 hours of ingestion. It may still be helpful
up to 72 hours after ingestion.

Answer 26

NAC

Question 27

2. has decreased as
   acetaminophen’s usage has increased; however,
   salicylates remain an ingredient in many compounds,
   such as Pepto-Bismol, Ben-Gay, and oil of wintergreen.

Answer 27

Salicylate poisoning

Question 28

is the most common
acid-base disturbance.
In salicylate poisoning

Answer 28

Respiratory alkalosis with an anion gapmetabolic acidosis

Question 29

Salicylate poisoning management

Answer 29

Gastric lavage
Activated charcoal every 4 hours
Obtain serum salicylate level
Alkali inaction of urine
Dialysis

Question 30

one of the most common and potentially fatal childhood poisonings. As little as 20 mg

Answer 30

Iron poisoning

Question 31

IRon poisoning

Management

Answer 31

(1) Gastric lavage should be performed.
(2) Activated charcoal does not bind to iron.
(3) Hypovolemia, blood loss, and shock should be
anticipated and treated.

Question 32

(5) Serum iron level should be obtained

Answer 32

2-6 hours

after ingestion.

Question 33

Iron poisoning treatment

Answer 33

Deferoxamine

Question 34

Deferoxamine should be given if

Answer 34

a) Serum iron levels > 500 µg/dL, or if >300 µg/dL
and acidosis, hyperglycemia, or leukocytosis are
present
b) Severe gastrointestinal symptoms are present
c) More than 100 mg/kg of iron is ingested

Question 35

of all poisonings occur in

children younger than 6 years of age.

Answer 35

Sixty percent