Clinical Toxicology - Poisoned Patients Management
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What is a primary aim in the management of a poisoned patient?

  • Administer antidotes as the first step
  • Establish the cause of poisoning before treatment
  • Maintain respiration and circulation (correct)
  • Increase the concentration of poison in the system

    • In clinical toxicology, which of the following is considered a common source of poisoning?

  • Atmospheric pollutants
  • Occupational chemicals
  • Food preservatives
  • Household cleaning products (correct)

    • Which statement reflects an important strategy in treating poisonings?

  • Focusing solely on the substance involved
  • Restricting all oral intake regardless of the situation
  • Assessing the vital signs and reflexes (correct)
  • Administering activated charcoal immediately

    • What is the first goal in the treatment of acute poisoning?

    <p>Keep the concentration of the poison as low as possible</p> Signup and view all the answers

    What should clinicians do regardless of the type of toxin ingested?

    <p>Always assume a life-threatening intoxication</p> Signup and view all the answers

    Which of the following best describes the focus of clinical toxicology?

    <p>Effects of drugs and chemicals on humans</p> Signup and view all the answers

    What is the correct approach when managing a poisoned patient?

    <p>Manage as if all patients have life-threatening poisoning</p> Signup and view all the answers

    What is an essential component of supportive care in poisoning management?

    <p>Monitoring the patient's vital signs</p> Signup and view all the answers

    What is the primary purpose of risk assessment in the context of acute poisoning?

    <p>To predict the patient's likely clinical course and complications</p> Signup and view all the answers

    Which of the following aspects is NOT included in the physical examination of a patient suspected of acute poisoning?

    <p>Mood and emotional state</p> Signup and view all the answers

    What is the first step in a five-step risk assessment for managing acutely poisoned patients?

    <p>Identifying the ingested agent(s)</p> Signup and view all the answers

    Which method is recommended for preventing further absorption of poison through dermal exposure?

    <p>Removing all clothing and washing the skin gently for at least 30 minutes</p> Signup and view all the answers

    In the evaluation of acute poisoning cases, which feature is considered in conjunction with the dose and time since ingestion?

    <p>Clinical features and progress</p> Signup and view all the answers

    Which of the following clinical features should be examined during a neurological assessment?

    <p>Pupil size and reflexes</p> Signup and view all the answers

    Which option describes a key management goal in cases of poisoning?

    <p>Prevention of further poison absorption and enhancement of elimination</p> Signup and view all the answers

    What should be assessed to predict the likelihood of significant toxicity in an acutely poisoned patient?

    <p>Dose taken calculated in mg/kg body weight</p> Signup and view all the answers

    What is the main focus of management in cases of poisoning?

    <p>Supportive care and prevention of poison absorption</p> Signup and view all the answers

    What is the primary factor contributing to death from poisoning?

    <p>Loss of airway-protective reflexes</p> Signup and view all the answers

    Which fluid is preferred for intravenous infusion in hypotensive patients?

    <p>Normal saline or isotonic solution</p> Signup and view all the answers

    What is the first step in the Disability (Neurological) assessment for poisoning victims?

    <p>Checking the blood sugar level</p> Signup and view all the answers

    What should be considered when evaluating a poisoning victim's temperature?

    <p>Possible toxic syndromes associated with hyperthermia</p> Signup and view all the answers

    Which vital signs are critical to assess during the circulation evaluation in poison management?

    <p>Blood pressure and pulse rate</p> Signup and view all the answers

    When dealing with toxic seizures, what is the recommended initial treatment?

    <p>IV administration of benzodiazepines</p> Signup and view all the answers

    What is the significance of gathering information from sources other than the patient in poisoning cases?

    <p>To accurately identify the poison and ingestion details</p> Signup and view all the answers

    What is the primary method used to remove solid corrosives in emergency situations?

    <p>Removal with forceps</p> Signup and view all the answers

    What is the recommended time frame for administering ipecac syrup for inducing vomiting?

    <p>Within 30 minutes of ingestion</p> Signup and view all the answers

    Which of the following conditions is NOT a contraindication for induction of emesis?

    <p>Mild intoxication</p> Signup and view all the answers

    Under what circumstances is gastric lavage indicated?

    <p>When emesis has failed or is contraindicated</p> Signup and view all the answers

    Which of the following is an indication for using activated charcoal?

    <p>Ingestion within one hour with significant risk of toxicity</p> Signup and view all the answers

    What is the adult dosage of activated charcoal?

    <p>1 gm/kg</p> Signup and view all the answers

    Which agent is NOT bound to activated charcoal?

    <p>Opiates</p> Signup and view all the answers

    What type of cathartic acts by increasing motility in the gastrointestinal tract?

    <p>Irritant cathartics</p> Signup and view all the answers

    What is the purpose of using chelating agents in clinical toxicology?

    <p>To bind metallic poisons and form soluble compounds</p> Signup and view all the answers

    Which method of poison excretion enhancement is particularly beneficial when renal function is impaired?

    <p>Peritoneal dialysis</p> Signup and view all the answers

    In the context of pharmacological antidotes, what type of antagonism do competitive antagonists primarily involve?

    <p>Competing with the agonist for the same receptor site</p> Signup and view all the answers

    What is the main principle behind hemodialysis used in poison excretion enhancement?

    <p>Separation of toxins using a semipermeable membrane</p> Signup and view all the answers

    What type of substances are used in hemoperfusion to aid in toxin clearance?

    <p>Charcoal or resin as adsorbent materials</p> Signup and view all the answers

    What is the primary goal of Whole Bowel Irrigation (WBI)?

    <p>To clean GIT from non-absorbed ingested toxins</p> Signup and view all the answers

    Which of the following conditions is a contraindication for performing Whole Bowel Irrigation?

    <p>Recent bowel surgery</p> Signup and view all the answers

    Which antidote works by interacting with a poison to form a non-toxic complex?

    <p>Activated charcoal</p> Signup and view all the answers

    Which of the following antidotes competes with the poison for certain receptors?

    <p>Naloxone</p> Signup and view all the answers

    What type of antidote is N-acetylcysteine classified as?

    <p>Chemical antidote</p> Signup and view all the answers

    Which of the following is an example of a physical antidote?

    <p>Activated charcoal</p> Signup and view all the answers

    What is the mechanism of action for Fomepizole as an antidote?

    <p>Decreases the conversion of poison into toxic metabolites</p> Signup and view all the answers

    Which type of antidote is designed to bypass the effects of a poison?

    <p>Physiological antidotes</p> Signup and view all the answers

    Study Notes

    Clinical Toxicology - Initial Evaluation & Management of Poisoned Patients

    • Clinical toxicology focuses on the effects of drugs and chemicals on humans and other animals, specifically drug overdoses and poisonings. It involves determining the substance and its amount in the body.
    • Clinical toxicology overlaps with other fields like biochemistry, pharmacology, and pathology.
    • All poisoned patients should be managed as if they have a life-threatening intoxication, even if they appear normal.
    • The initial approach to a poisoned patient should be the same, regardless of the ingested toxin. This approach is termed routine poison management.
    • Common poisonings include exposures to household cleaning products, pesticides, and most importantly prescription and over-the-counter medications.
    • Crucial strategies include promptly treating the patient (not the poison), establishing supportive therapy for respiration and circulation, and meticulously tracking vital signs and reflexes to assess intoxication progress.

    Approach to the Poisoned Patient (ABCDEs)

    • Airway: Keep airways patent and remove any obstructions. Loss of airway reflexes is a major cause of death. Potential obstructions include flaccid tongue, or aspiration of gastric contents.
    • Breathing: Evaluate respiratory rate and oxygen saturation. If no monitor is available but the patient has a high respiratory rate, supplemental oxygen should be considered.
    • Circulation: Quickly assess vital signs (blood pressure, pulse rate, rhythm) and hydration status. Secure venous access. Draw blood for routine tests. Begin intravenous fluids, using normal saline or another isotonic solution if the patient is hypotensive.
    • Disability (Neurological): Evaluate level of consciousness. If the patient has seizures, check blood sugar. If the blood sugar is less than 72 mg/dL, administer 50 mL of 50% dextrose intravenously. Treat toxic seizures with IV benzodiazepines; refractory seizures may need barbiturates.
    • Exposure (temperature): Consider toxic syndromes associated with hyperthermia, as high drug levels can elevate body temperature significantly.

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    Description

    This quiz covers the essential aspects of clinical toxicology, focusing on the initial evaluation and management of poisoned patients. Learn about the crucial strategies employed in managing various poisonings, including support for vital functions and the routine approach to care.

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