Buy Toxicology and Drugs of Addiction

Buy Toxicology and Drugs of Addiction
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Buy Toxicology and Drugs of Addiction
1. The Rumack-Matthew nomogram is a risk stratification tool that should be employed when an
overdose of which of the following medications is confirmed.
A. Warfarin
B. Salicylic acid
C. Acetaminophen
D. Digoxin
2. Which of the following, if present upon initial presentation in a patient with acute digoxin
overdose, portends a poor prognosis?
A. Visual disturbance
B. An ECG showing a high-degree atrio-ventricular block
C. Serum digoxin levels greater than 1 ng/mL
D. A serum potassium concentration greater than 5.5 mEq
3. A patient is brought in to the emergency department after being found down by her mother. She
admits to the attending physician that she ingested a large dose of her prescribed amitriptyline
approximately seven hours prior. Which of the following pieces of information would be
MOST helpful in risk stratification of likelihood of having a major cardiac or neurologic event
due to her medication overdose?
A. Ingested dose
B. Peak serum amitriptyline concentration
C. Serum potassium level
D. QRS duration
4. A 29-year-old female is transferred to the intensive care unit (ICU) with a temperature of
104.5°F. Her only medical history includes herpes labialis and migraines, for which she
regularly takes sumatriptan combined with ondansetron or metoclopramide for the associated
severe nausea. She was initially admitted to the hospital for a cholecystectomy, which was
complicated by vancomycin-resistant enterococcus (VRE) bacteremia, and she was treated with
linezolid. She was started on appropriate empiric therapy and became acutely altered,
tremulous, and febrile. Blood cultures were obtained and showed no growth. Which of the
following would be the BEST initial therapy for this patient?
A. Cyproheptadine
B. Change antibiotic regimen
C. Dantrolene
D. Acetaminophen
5. A 58-year-old female is admitted to the ICU for a suspected infection. She is started on
moxifloxacin and fluconazole. She is intubated and sedated and subsequently treated for
gastroparesis with erythromycin. Which ECG finding is MOST likely associated with this
patient’s medication regimen?
A. Prolonged QRS
B. Widened QT interval
C. Prolonged PR
D. Presence of Osborn wave
6. A 55-year-old male who has a history of alcohol abuse disorder is brought to the emergency
department after experiencing a generalized tonic-clonic seizure in prison. He was incarcerated
24 hours prior to presentation. After 24 hours on intravenous midazolam therapy, he continues
to have delirium tremens. Which of the following strategies is the LEAST appropriate?
A. Add gabapentin to current regimen
B. Add phenobarbital to current regimen
C. Continue administering midazolam until Clinical Institute Withdrawal Assessment from
Alcohol—Revised (CIWA-Ar) score is less than 8 or until 50 mg midazolam is given
D. Perform endotracheal intubation and start a propofol infusion
7. A 56-year-old male is admitted to the ICU overnight after admitting to snorting large quantities
of cocaine. He is diaphoretic and agitated, with vital signs as follows: BP 223/150; rectal
temperature 103.3°F. He endorses substernal chest pain, and his ECG shows ST segments that
are depressed compared to his admission from one month ago. Which of the following is the
LEAST appropriate treatment for this patient?
A. Lorazepam
B. Phentolamine
C. Nitroglycerin
D. Labetalol
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