Intensive Care of Acute Poisoning - A. V. Hovenko 2010

Self-assessment tests

1. Forced diuresis as a detoxification method is indicated for poisoning by:

A. Phenobarbital

Б. Ethanol

B. Carbofos

Г. All Answers are correct

Д. B and C are correct

2. Contraindications for forced diuresis include:

A. Exotoxic Shock

Б. Hemolysis

B. Comatose state

Г. No contraindications

Д. B and C are correct

3. Hemodialysis is contraindicated in poisoning by:

A. Amitriptyline, aminazine Б. Phenobarbital

B. Ethylene glycol

Г. Mercury and heavy metal compounds

Д. Methyl alcohol

4. Peritoneal dialysis is contraindicated in poisoning by:

A. Amitriptyline

Б. Dichloroethane, carbofos

B. Methyl alcohol

Г. Ethaminal-sodium

Д. Ethylene glycol

5. Detoxification hemadsorption is not indicated for poisoning by:

A. Amitriptyline

B. Sodium aminal, phenobarbital

B. Dichloroethane, carbophos

G. Methyl alcohol

6. Blood exchange transfusion is advisable in poisoning with which of the following substances:

A. Aniline

B. Arsine

B. Acetic essence causing severe hemolysis

G. Only A and B are correct

D. Only B and V are correct

7. In case of poisoning with an unknown poison, the following antidote should be administered:

A. Do not administer anything

Б. Unithiol

B. Atropine

G. Unithiol, chromosmon, atropine

8. Atropine is used as an antidote in poisoning with:

A. Insulin

Б. Amitriptyline

B. OP

G. Ethylene glycol, methyl alcohol

Д. Heavy metals

9. Ethyl alcohol is used as an antidote in poisoning with:

A. Insulin

Б. Amitriptyline

B. OP

G. Ethylene glycol, methyl alcohol

E. Heavy metals

10. Proserine is used as an antidote for poisoning by:

A. Insulin

B. Amitriptyline

C. OP Compounds

D. Ethylene glycol, methyl alcohol

E. Heavy metals

11. Unitiol is used as an antidote for poisoning by:

A. Insulin

B. Amitriptyline

C. OP Compounds

D. Ethylene glycol, methyl alcohol

E. Heavy metals

12. Dipiroxim is used as an antidote for poisoning by:

A. Insulin

B. Amitriptyline

C. OP Compounds

D. Ethylene glycol, methyl alcohol

E. Heavy metals

13. Methylene blue is used as an antidote for poisoning by:

A. Insulin

B. Amitriptyline

C. OP compounds, heavy metals

D. Ethylene glycol, methyl alcohol

E. Aniline

14. Glucagon is used as an antidote in poisoning with:

A. Insulin

B. Amitriptyline

C. OPF

D. Ethylene glycol, methyl alcohol

E. Heavy metals, aniline

15. The duration of the resorption phase in inorganic acid poisoning is:

A. 1-3 h

B. 3-6 h

C. 6-12 h

D. 12-24 h

16. The duration of the resorption phase in organic acid poisoning is:

A. 1-3 h

B. 3-6 h

C. 6-12 h

D. 12-24 h

17. Hemodynamic disturbances in exotoxic shock caused by acetic acid poisoning are characterized by:

A. Decreased stroke volume

B. High total peripheral vascular resistance

C. Low total peripheral vascular resistance

D. Both A and B are correct

E. Both A and C are correct

18. In poisoning with corrosive poisons, gastric lavage via a tube is performed within:

A. Up to 12 h

B. From 13 to 24 h

B. On the 2nd day

Г. On the 3rd day

Д. During the first 5 days

19. Gastric lavage via a tube in cases of poisoning with corrosive agents involves The Use of:

A. Water or a weak alkaline solution in acid poisoning

Б. Water or a weak alkaline solution in alkali poisoning

B. Water or a magnesium solution in acid poisoning

20. In poisoning with vinegar essence, the most appropriate method for removing free Hemoglobin is:

A. Blood exchange transfusion

Б. Forced diuresis

B. Hemadsorption

Г. Drainage of the thoracic lymphatic duct

21. Characteristic Clinical symptoms of acute oral mercury poisoning include:

A. Gastroenterocolitis, Kidney and Liver damage

Б. Hemodynamic disorders, exotoxic shock

B. Blood damage (hemolysis)

Г. All answers are correct

Д. Only A and B are correct

22. Characteristic clinical symptoms of acute oral copper sulfate poisoning include:

A. Gastroenterocolitis, toxic hepatopathy

Б. Hemodynamic disorders (exotoxic shock), hemolysis

B. Blindness

Г. All answers are correct

Д. Only A and B are correct

23. A Diagnosis of alcohol intoxication can be established based on the following complex of symptoms:

A. Loss of consciousness, anisocoria, myofibrillations, hypersalivation, flexor hypertonia, tachycardia, involuntary urination and defecation

B. Loss of consciousness, anisocoria, bradycardia, unilateral areflexia, and flexor atonia

C. Loss of consciousness, miosis, myofibrillations, bradycardia, hypersalivation, bronchorrhea, flexor hypertonia

D. Loss of consciousness, facial hyperemia, dry mucous membranes and Skin, mydriasis, tachycardia

24. The lowest blood alcohol concentration at which a comatose state may develop is:

A. 1 g/L

B. 3 g/L

C. 5-6 g/L

D. 8-10 g/L

E. More than 10 g/L

25. The duration of the toxicogenic phase in methanol and ethylene glycol poisoning is:

A. 6-12 hours

B. 12-24 hours

C. 24-48 hours

D. 48-72 hours

E. More than 3 days

26. The Treatment of ethylene glycol poisoning involves the use of:

A. Gastric lavage via a tube

B. Plasma alkalinization, forced diuresis, hemodialysis, administration of ethyl alcohol

C. Administration of unithiol, detoxification hemosorption

D. Both A and B are correct

E. Both A and C are correct

27. The duration of detoxification therapy in methanol and ethylene glycol poisoning is:

A. 6 hours

B. 12 hours

B. 24 h

C. 2-3 days

D. More than 3 days

28. Clinical manifestations of formalin poisoning include all of the following, except:

A. Burns of the digestive tract

B. Lacrimation, cough, dyspnea

C. Erythrocyte hemolysis

D. Toxic nephropathy, toxic hepatopathy

E. Psychomotor agitation

29. Clinical manifestations of aniline poisoning are characterized by:

A. Cyanosis, methemoglobinemia, hemolysis, motor agitation, clonic-tonic convulsions, coma

B. Respiratory depression, hypotension or collapse, toxic nephropathy and hepatopathy

C. Pronounced hypervolemia

D. Both A and B are correct

E. Both B and C are correct

30. In oral aniline poisoning, there are no contraindications to:

A. Gastric lavage via a tube, administration of activated charcoal, liquid petrolatum, or castor oil into The Stomach

B. Exchange transfusion, hemodialysis, forced diuresis

C. Intravenous administration of 1% methylene blue solution (1-2 ml/kg) or chromosmon

D. Intravenous administration of sodium thiosulfate (30% solution up to 100 ml)

E. Cleansing enema

31. Clinical manifestations of Carbon monoxide poisoning include The Development of:

A. Motor agitation, visual and auditory hallucinations, loss of consciousness, amnesia after emerging from coma

B. Respiratory depression, tachycardia, Hypertension, methemoglobinemia

C. Hemolysis, toxic nephropathy

G. All answers are correct

D. Only A and B are correct

32. At what carboxyhemoglobin blood level does a patient develop a coma:

A. Upon admission to the hospital with HbCO at 50% and above

B. Upon admission to the hospital with HbCO at 30%

C. At the scene of the incident with HbCO at 50% and above

D. At the scene of the incident with HbCO at 30%

33. Carbon monoxide poisoning requires the Structure/175.html">Implementation of (against the Background of syndromic infusion therapy):

A. Blood exchange transfusion and HBO therapy in case of coma development and HbCO concentration above 50%

B. HBO therapy in the presence of a soporific state and HbCO concentration above 30%

C. I.v. administration of methylene blue

D. A and C are correct

E. B and C are correct

34. Clinical manifestations of trichloroethylene poisoning include the development of:

A. Impaired consciousness, drowsiness, lethargy, coma

B. Exotoxic shock, hemolysis, toxic hepatopathy, nephropathy

C. Gastroenteritis

D. A and B are correct

E. A and C are correct

35. Detoxification Methods for dichloroethane and carbon tetrachloride poisoning include:

A. Gastric lavage via a tube, bowel cleansing (use of laxatives, pharmacological stimulation of the intestine, whole gut lavage)

B. Blood exchange transfusion

C. Hemisorption, hemodialysis, peritoneal dialysis, forced diuresis

D. A and B are correct

E. A and C are correct

36. Detoxification methods for trichloroethylene poisoning include:

A. Gastric lavage via tube, bowel cleansing (laxatives, pharmacological stimulation), forced diuresis, hemodialysis

Б. Blood exchange transfusion

B. Hemosorption

Г. Peritoneal dialysis

З7. The diagnosis of chlorophos poisoning can be established based on the following clinical signs:

A. Agitation, dry skin, choreiform hyperkinesia, tachycardia, mydriasis

Б. Agitation, diaphoresis, myofibrillation, bronchorrhea, bradycardia, nausea, miosis

B. Epileptiform seizures, tachycardia, mydriasis

Г. Agitation, nausea, salivation, abdominal pain, hemoglobinuria

38. Organophosphate poisoning is characterized by:

A. High free hemoglobin levels

Б. Presence of methemoglobin

B. Decreased activity of the enzyme cholinesterase

Г. High carboxyhemoglobin levels

З9. Specific therapy for moderate (grade II) organophosphate poisoning should be considered:

A. Atropine intravenously during the first day, then subcutaneously for 5–6 days under Heart rate monitoring

Б. Atropine until blood cholinesterase activity increases

B. Dipiroxim or dietixim during the first day

Г. Both A and B are correct

Д. Both Б and B are correct

40. A patient with organophosphate poisoning shows a blood cholinesterase level at 30% of normal on the 4th day. In this case, it is necessary to:

A. Increase the dose of atropine

Б. Administer dipiroxim

B. Perform blood exchange transfusion

G. Fresh donor blood transfusion, ultraviolet blood irradiation

41. Typical clinical manifestations of barbiturate poisoning:

A. Loss of consciousness (coma), respiratory depression

Б. Miosis

B. Mydriasis

Г. A and B are correct

Д. A and C are correct

42. Management of severe Amitriptyline poisoning includes:

A. Gastric lavage via a tube, whole bowel irrigation, forced diuresis, hemadsorption

Б. Hemodialysis, intravenous administration of neostigmine

B. Peritoneal dialysis

Г. Intravenous administration of bemegride

43. Clinical symptoms of belladonna poisoning include:

A. Psychomotor agitation

Б. Dry mucous membranes and skin, tachycardia

B. Bronchorrhea, salivation, miosis

Д. A and B are correct

Г. A and C are correct

44. Emergency measures for poisoning with belladonna and its derivatives involve:

A. Gastric lavage, administration of activated charcoal, forced diuresis

Б. Administration of seduxen, thioridazine, physostigmine

B. Hemodialysis, administration of diphenhydramine

Г. A and B are correct

Д. A and C are correct

45. Death cap (Amanita phalloides) poisoning is characterized by the following symptoms:

A. After a latent period lasting more than 6–24 hours, nausea, vomiting, and diarrhea develop

Б. Delusions, hallucinations, psychomotor agitation, development of hemolysis

B. Toxic nephropathy and hepatopathy

Г. A and B are correct

Д. A and C are correct

46. Poisoning by fly agaric (Amanita muscaria) is characterized by:

A. Latent period of 6–24 hours, development of hemolysis

Б. Nausea, vomiting, delusions, hallucinations, psychomotor agitation

B. Mydriasis

Г. A and C are correct

Д. B and C are correct

47. Poisoning by false morels / true morels is characterized by:

A. Latent period of 6–24 hours, erythrocyte hemolysis

Б. Latent period of 1–2 hours, diarrhea, delusions, hallucinations, psychomotor agitation

B. Mydriasis

Г. B and C are correct

Д. A and C are correct

48. In case of poisoning by death cap (Amanita phalloides), it is necessary to:

A. Perform gastric lavage via a tube, administer activated charcoal, induce forced diuresis, and correct the water-electrolyte balance

Б. Perform hemoperfusion and provide liver-protective therapy

B. Hemodialysis, peritoneal dialysis

Г. A and B are correct

Д. B and C are correct

49. Clinical symptoms of whitehellebore (Veratrum) poisoning:

A. Loss of consciousness

B. Delirium, hallucinations

C. Nausea, vomiting, bradycardia, decreased BP

D. Tachycardia

E. ECG shows slowed intraventricular conduction, atrioventricular block

50. Treatment for hellebore poisoning involves:

A. Intravenous or subcutaneous administration of atropine, gastric lavage via tube, forced diuresis

B. Hemodialysis, intravenous cardiac Glycosides

C. Intravenous administration of alupent, novodrin

D. A and C are correct

E. B and C are correct

51. Bites from elapid snakes (such as cobras) lead to:

A. Severe tissue edema, lymphangitis, lymphadenitis

B. Hemolysis, thrombohemorrhagic syndrome

C. Muscle paralysis, respiratory failure

D. A and B are correct

E. All of the above are correct

52. Bites from viperid snakes (such as vipers, blunt-nosed vipers) lead to:

A. Severe tissue edema, lymphadenitis, lymphangitis

B. Hemolysis, thrombohemorrhagic syndrome

C. Muscle paralysis, respiratory failure

D. A and B are correct

E. B and C are correct

53. First aid for a snakebite includes:

A. Applying a tourniquet (if possible), incising the skin at the bite site

B. Squeezing or suctioning venom from the wound, administering antihistamines and corticosteroids, performing a circular novocaine block with adrenaline

B. Administer polyvalent or specific antivenom intravenously or intramuscularly within the first 10 hours.

Г. All answers are correct

Д. B and C are correct

54. Acute paracetamol poisoning leads to:

A. Increased plasma alkaline phosphatase

Б. Coma, hyperventilation

B. Thrombocytopenia

Г. All answers are correct

Д. A and B are correct

55. Management of acute benzodiazepine poisoning includes:

A. Naloxone

Б. Oral activated charcoal, intravenous flumazenil

B. Alkaline diuresis

Г. Intravenous doxapram administration

56. Salicylate overdose causes:

A. Coma and acidosis

Б. Hemolysis

B. Hypofibrinogenemia

Г. All of the above

Д. A and C are correct

57. Laser therapy is indicated for:

A. Hypoxia

Б. Hemolysis

B. Pathological pulmonary conditions (Pneumonia, edema)

Г. A and B are correct

D. Both A and B are correct

58. The use of ultraviolet blood irradiation (UVBI) is indicated in:

A. Hemolysis

B. Decreased cholinesterase activity

C. Pathological processes in the Lungs (pneumonia, pulmonary edema)

D. Both A and B are correct

E. Both B and C are correct

59. Specific treatment for opiate poisoning involves the administration of:

A. Cordiamin

B. Caffeine

C. Naloxone

D. Sodium bicarbonate

60. Treatment for acute Chemical Poisoning begins:

A. After qualitative identification of the substance

B. After Quantitative determination of the toxicant in biological fluids

C. After identifying the source of poisoning

D. With the immediate restoration of vital body Functions

61. Several days after barbiturate poisoning, the most frequent cause of death is:

A. Respiratory center depression

B. Hypostatic pneumonia

C. ACUTE RENAL FAILURE

D. Pulmonary edema

62. To accelerate The excretion of barbiturates in the urine, it is necessary to:

A. Use alkaline solutions to alkalinize the urine

B. Decrease urinary pH

B. To normalize plasma oncotic pressure

Г. To administer morphine

63. The Toxic Effect of barbiturates is enhanced by:

A. Hypoproteinemia

Б. Hypoglycemia

B. Acidosis

Г. All of the above

64. The toxic effect of ethylene glycol is caused by the following factors, except:

A. The Effect of ethylene glycol itself

Б. The action of ethylene glycol metabolites

B. Metabolic acidosis

Г. Hypocalcemia

Д. Hypomagnesemia

65. Following poisoning with methemoglobin-forming agents resulting in The conversion of 30% of hemoglobin to methemoglobin, the patient exhibits the following symptoms, except:

A. Cyanosis

Б. Chocolate-colored skin

B. Dyspnea

Г. Stupor

Д. Headache

66. In the early period of the toxicogenic phase of Acute Poisoning with heavy metal compounds and arsenic, the use of the following measures is indicated, except:

A. Gastric lavage with administration of 50–100 ml of a 5% Unithiol solution via a tube at the end of the Procedure

Б. Administration of castor oil or liquid petrolatum after gastric lavage

B. Intravenous administration of physostigmine (eserine)

Г. Administration of specific antidotes

Д. Early hemodialysis

67. Antidote therapy for poisoning with inorganic mercury compounds is performed with:

A. Unithiol at a single dose of 1 ml of a 5% solution per 10 kg of body weight

Б. Naloxone at a dose of 0.01 mg/kg

B. Calcium tetacin (75 mg/kg/day)

Г. Desferal (80 mg/kg/day)

68. In sulfuric acid poisoning, the most effective gastric lavage is carried out:

A. Via a tube

Б. By inducing vomiting

B. With a weak alkali solution

Г. With a weak potassium permanganate solution

69. A patient with acute cocaine poisoning develops:

A. Agitation (euphoria)

Б. Arterial hypertension

B. Irritation of the sympathetic Nervous system

Г. Correct answers A and Б

Д. Correct answers A and B

70. Which of the following drugs has a specific antidote:

A. D-tubocurarine

Б. Succinylcholine

B. Morphine

Г. Thiopental

71. Novocaine poisoning presents with the following clinical signs:

A. Chills, fever, pallor, drowsiness

Б. Convulsions, arterial hypertension, tachycardia

B. Convulsions, arterial hypertension, Acute Respiratory Failure

G. Skin flushing, arterial hypertension, dyspnea

72. The initial measures for a toxic reaction to local anesthetics include the following:

A. Intravenous administration of barbiturates

B. Oxygen therapy

C. Use of respiratory stimulants

D. Correct answers A and B

E. Correct answers A and C

73. Depending on the clinical course following a snakebite, the victim should receive all of the following interventions, except:

A. Hemodialysis

B. Mechanical ventilation

C. Restoration of hemostasis

D. Administration of tetanus antitoxin

74. The myocardial effects of digitalis overdose are mitigated by the use of the following drugs, except:

A. Calcium chloride

B. Potassium chloride

C. Phenytoin

D. Ornid

E. Lidocaine

75. Signs of cardiac glycoside overdose:

A. Skin rash

B. Ventricular extrasystoles

C. Tachycardia

76. The Clinical presentation of toadstool poisoning is caused by the effects of:

A. Muscarine

B. Atropine-like Alkaloids

B. Phallotoxins

Г. Correct answers A and B

Д. Correct answers A and C

77. Liver damage in death cap (Amanita phalloides) poisoning occurs due to the effect on hepatocytes of:

A. Phallotoxins, amanitins

Б. Amanitins, nicotine

B. Muscarine, amanitin

Г. Nicotine, muscarine

78. Oral boric acid poisoning is characterized by the following, EXCEPT:

A. The lethal dose for adults is 15-30 g

Б. Boron accumulates in the nervous and skeletal systems

B. Boric acid is excreted mainly via urine by the Kidneys

Г. Epithelial desquamation with a maculopapular rash develops

Д. Naloxone is used as an antidote

79. Potassium permanganate poisoning is characterized by the following, EXCEPT:

A. Mucous membranes turn brown

Б. MAIN CLINICAL MANIFESTATIONS are associated with its corrosive effect

B. Liver and kidney damage is characteristic of a later period

Г. Heparin therapy is recommended

Д. Milk consumption is recommended

80. Specific antagonists of narcotic analgesics (other than naloxone) must be used with caution in drug addicts due to the risk of:

A. Potentiating the action of analgesics

Б. Developing cardiovascular collapse

B. Developing Liver failure

Г. Developing renal failure