Pediatric Poisoning Exam
Name:__________________
1.
2.
3.
Date:__________
It is a crisp fall morning and you are called to the nurse’s office of a local middle school at
8:30am. The nurse explains that a 14 year old male student was brought in by the bus driver after
he noticed the child didn’t look well. The patient appears a bit lethargic and although he answers
your questions, he seems confused by simple facts, like the day of the week. His vital signs are
within the low range of what is considered normal, his skin color appears normal, but his ECG
shows some occasional dysrhythmias. Based on your initial findings, what might you suspect is
causing the patient’s symptoms?
a.
Carbon monoxide poisoning
b.
The “huffing” of methylene chloride
c.
The “huffing” of carbon tetrachloride
d.
An undiagnosed cardiac defect
Within what timeframe following the ingestion of a poison is activate charcoal most effective?
a.
Within 1-2 hours following ingestion
b.
Within 2-12 hours following ingestion
c.
Within 12-24 hours following ingestion
d.
Activated charcoal is never indicated for the treatment of ingested poisons.
You are called to a home where you find a hysterical mother and a screaming 3 year old girl. The
mother explains that she was cleaning the bathroom and turned her back for a minute, which is
when her daughter grabbed the toilet bowl cleaner and drank some. You note there are burns
around the child’s mouth and lips. What is the toxic substance that caused the burns to the child’s
mouth and lips?
a.
A Methanol
b.
An Acid or an Alkali
c.
A Hydrocarbon
d.
An Ammonia
4.
5.
6.
You are called to the parking lot behind a convenience store by the local police. A police officer
explains that the youths were caught “huffing” an aerosol can that they had stolen from the
convenience store and he directs you to a 15 year old boy who is lying on the pavement. What
type of signs and symptoms might the boy exhibit after having “huffed” from an aerosol can?
a.
Burns around his mouth and nose
b.
Dry, hot skin and the appearance of “hives”
c.
Tachypnea
d.
Strong urge to urinate
You are called to a home for a medical emergency. Upon arrival, you find a 5 year old boy who is
very lethargic. As you try to ascertain his level of consciousness, you find that he attempts to talk,
but his speech is slurred and he is talking about an elephant he was riding. His worried mother
explains that he started “talking funny” and acting as though he were drunk during dinner. You
note that the boy’s clothes are greasy and stained with something blue. His father explains that the
boy was “helping” him all day as he did yard work and tuned up the family car. Based on the
patient’s symptoms, your observations, and the history given by the parents, what do you suspect
is the source of the child’s problem?
a.
The ingestion of hydrocarbons
b.
The ingestion of methanol
c.
The ingestion of ethanol
d.
The ingestion of ethylene glycol
You are called to a home where a family is having a barbeque. You are directed to a 4 year old
boy whose uncle explains that he drank some lighter fluid while he was trying to light the grill.
The boy is sputtering and coughing and you note he is cyanotic. His respiratory effort is becoming
progressively labored. What toxin did the child ingest?
a.
Ethylene glycol
b.
Alkali
c.
Hydrocarbons
d.
Carbamate
7.
8.
9.
You respond an “allergic reaction” call at a farm located about ten miles in the county. Upon
arrival you find a 10 year old boy that appears alert but confused, he is profusely sweating, his
pupils are rapidly changing size, he has excessive nasal drainage and is salivating. The boy also
states that he has stomach cramps. His father states that he was riding with him on the tractor
while they were spraying the field and must have been stung by a bee or something. What do you
suspect the child is suffering from?
a.
Allergic reaction to bee sting
b.
Hydrocarbon inhalation
c.
Organophosphate poisoning
d.
Ammonia poisoning
Because children’s electrolytes are susceptible to imbalance, only ____________ is to be used for
gastric lavage.
a.
Sugar water
b.
D5-W
c.
Normal Saline
d.
Plain tap water
What is the first priority in treating the poisoning patient?
a.
Managing the airway
b.
Finding out the type of poison ingested
c.
Gathering a complete medical history
d.
Obtaining a baseline neurological exam
10. You are called to a home where you find an elderly woman who directs you to the backyard.
There you find a 12 year old boy who the woman explains is a neighbor who she hired to clean out
her garage. The boy is lying on the ground and you note that he is diaphoretic and it is obvious
that the patient had vomited. A head-to-toe exam reveals he is semi-conscious, having difficulty
breathing, his pupils are constricted, and there is watery discharge from both his eyes and nose.
You further note that the muscles in his arms and legs are “quivering,” which can be seen through
his skin. He has also lost control of his urine and bowels. Based on your findings, from what do
you think the boy is suffering?
a.
An asthma attack
b.
Exposure to organophosphates
c.
Exposure to hydrocarbons
d.
Exposure to ammonia