Toxicologic Emergencies

Question 1

It occurs as a result of an extreme decrease in venous return from the vasodilation and lowered intravascular volume, which results in severe cardiorespiratory compromise.

Answer 1

Anaphylactic Shock

Question 2

An example of a poisonous gas

Answer 2

Carbon Monoxide

Question 3

A purgative/osmotic laxative that acts as a detoxifying antidote.

Answer 3

Sodium Sulfate

Question 4

Small, brightly colored with short fangs and teeth behind them.

Answer 4

Coral Snakes

Question 5

Both are disperse throughout the body and will wait for the next allergen exposure.

Answer 5

Mast cells and Basophils

Question 6

A systemic reaction in insect stings which manifests anaphylactic or anaphylactoid reaction.

Answer 6

Cardiovascular collapse

Question 7

Initial ____ followed by drowsiness.

Answer 7

Euphoria

Question 8

It is the aspiration of the stomach contents and the washing out of the stomach by means of a gastric tube.

Answer 8

Gastric Lavage

Question 9

If the patient is unconscious, he/she is intubated with a _____.

Answer 9

cuffed ET tube

Question 10

Amount of return is ___ in the amount placed in the stomach.

Answer 10

greater than or equal (≥)

Question 11

These are injected poisons that can produce either local or systemic reactions by an insect.

Answer 11

Insect Stings

Question 12

Why should we not squeeze venom sac?

Answer 12

Because this may cause additional venom to be injected.

Question 13

It contains large amount of histamine where antibodies attach themselves to its membrane.

Answer 13

Mast Cells

Question 14

Pediatric dose for Ipecac Syrup

Answer 14

15mL followed by 8-16 oz of water

Question 15

Box jellyfish is locally known as

Answer 15

Kwatro Kantos

Question 16

May apply steroidal creams like

Answer 16

Hydrocortisone

Question 17

They are associated with acute medical emergencies that ultimately involve compromise cardiovascular and respiratory systems.

Answer 17

Anaphylaxis and Anaphylactoid reactions

Question 18

Samples for toxicology screening:

Answer 18

Blood
Urine
Gastric contents

Question 19

Adult dose for Ipecac Syrup

Answer 19

30mL PO followed by 2 glasses of water

Question 20

Most important cause of symptoms of anaphylaxis.

Answer 20

Histamine

Question 21

Identify the poison:

Answer 21

what, where, when, why, how much, who witnessed, and what time since ingestion

Question 22

Treatment of choice for carbon monoxide poisoning.

Answer 22

Hyperbaric Chamber Oxygenation

Question 23

Purposes of Gastric Lavage:

Answer 23

1. To remove unabsorbed poison after poison ingestion.
2. To diagnose and treat gastric hemorrhage and to arrest hemorrhage.
3. To clean the stomach before endoscopic procedures.
4. To remove liquid or small particles of material in the stomach.

Question 24

Positioning to prevent aspiration of gastric contents.

Answer 24

on side with head down

Question 25

Abnormal levels of carboxyhemoglobin

Answer 25

30-40%

Question 26

Ask patient to avoid:

Answer 26

Exposure (camps picnic sites) Going barefoot outdoors Perfumes, scented soaps Wearing bright colors

Question 27

Series of bands in coral snakes.

Answer 27

Yellow, Red, Yellow, Black

Question 28

Drugs for jellyfish sting

Answer 28

Epinephrine (SQ or IV) Diphenhydramine or Chlorphenamine (IM or IV) Bronchodilator for bronchospasms (hydrocortisone) Antihypertensives and Antidysrhythmics.

Question 29

Save the sample of the first ___ washings.

Answer 29

two (2)

Question 30

A painful, potentially lethal condition caused by sting and envenomation from multiple jellyfish species.

Answer 30

Irukandji Syndrome

Question 31

Most popular coral snake in the Philippines, blue/silver and black strands.

Answer 31

Walo-walo

Question 32

It absorbs the poison on the surface of its particles and allows to pass with the stool.

Answer 32

Oral Activated Charcoal

Question 33

____ per lavage, let it stay for ____ before draining

Answer 33

150-200 mL, 1 minute

Question 34

These are injected poisons caused by jellyfish.

Answer 34

Jellyfish sting

Question 35

Snakes with triangular heads, vertical pupils, indentations between the eyes and nostrils, and long fangs.

Answer 35

Pit Vipers

Question 36

It is the rupture of mast cells.

Answer 36

Degranulation

Question 37

[Gastric Lavage] Place the unconscious patient in a left lateral position with the head lowered (approx. ___ downward).

Answer 37

15⁰

Question 38

It can produce immediate or delayed effects. It can be accidental or intentional.

Answer 38

Ingested Poison

Question 39

These severe reactions can be either ___ mediated or ___ mediated in nature.

Answer 39

immune, chemically

Question 40

Keep the patient calm and rest in a _____ position.

Answer 40

Recumbent

Question 41

Goosebumps; arrector pili muscles contract and lift the hair follicles upright.

Answer 41

Piloerection

Question 42

Tachycardia and hypertension due to the _____nature of the toxin.

Answer 42

hyperadrenergic

Question 43

A toxicologic emergency because of envenomation from snakebites.

Answer 43

Snakebites

Question 44

The initial exposure to the allergy-inducing agent (allergen) results in the formation of antibody called IgE or Immunoglobulin E, where the final exposure is called ____.

Answer 44

primary immune response

Question 45

It can be because the patient is attempting suicide and locked himself inside a car with no ventilation and under the basement of a parking lot.

Answer 45

Carbon Monoxide Poisoning

Question 46

After the procedure, the stomach may be left empty or be instilled with a _____.

Answer 46

saline cathartic

Question 47

_____ is caused when the poison is caustic to the body (strong acid or strong alkali).

Answer 47

Immediate injury

Question 48

Normal levels of carboxyhemoglobin

Answer 48

<12%

Question 49

If mild, soak the skin in hot water.

Answer 49

43-45⁰C

Question 50

[CO Poisoning] Observe patient closely for ___, ___, ___, and ___.

Answer 50

Psychosis Spastic paralysis Visual disturbances Deterioration of personality

Question 51

Lavage may be completed after how many liters?

Answer 51

2-5 liters

Question 52

Severe envenomation leads to neurotoxicity with:

Answer 52

Respiratory paralysis Shock Coma Death

Question 53

It should feel _____, to be immersed until pain eases approximately ______.

Answer 53

hot, not scalding; 20-30 minutes

Question 54

A life-threatening hypersensitivity or pseudoallergic reactions to exogenous agent.

Answer 54

Anaphylaxis

Question 55

These are gas or chemicals that may produce variety of health problems.

Answer 55

Toxin and Poison Exposure

Question 56

Most common insect sting

Answer 56

Bee sting

Question 57

Severe pain, muscle cramping, hypertension, and potentially life-threatening cardiac complications resembles a

Answer 57

Catecholamine surge

Question 58

ECG may reveal ____ and ____ ectopy.

Answer 58

atrial; ventricular

Question 59

It is the process of passing blood through an extracorporeal circuit and cartridge containing an absorbent, after which the detoxifies blood is returned to the patient.

Answer 59

Hemoperfusion

Question 60

What type of mask is used to provide 100% oxygen in managing CO Poisoning?

Answer 60

Tight Fitting Mask