Examination for Organophosphate Intoxication

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1. Organophosphate compounds can be found in which of the following products ?
Veterinary medicine
Agricultural pesticides
Home lawn and garden insecticides
Chemical weapons
All of the above


2. Organophosphate poisonings cause which of the following type of crisis ?
Adrenergic
Cholinergic
Addisonian
Sympathetic
Serotonegic


3. Which of the following is NOT a common symptom of organophosphate poisoning ?
Miosis
Dry mouth
Muscle fasciculations/weakness
Bradycardia
Productive Cough


4. Which of the following is more common in children than in adults with organophosphate poisoning ?
Seizures
Bradycardia
Diaphoresis
Lacrimation


5. Atropine counters mainly the nicotinic effects of organophosphate poisoning ?
True
False


6. Which of the following is true about the Intermediate Syndrome ?
Atropine works well to alleviate the symptoms.
It frequently causes proximal limb muscle weakness.
The symptoms are secondary to muscarinic effects.
The symptoms are secondary to nicotinic effects.


7. Which is true of lab testing and 2-PAM ?
2-PAM can help to normalize RBC AChE.
2-PAM can help to normalize pseudocholinesterase
RBC AChE levels don’t correlate as well as pseudocholinesterase levels do to the severity of the poisoning.
All of the above


8. Which of the following is true for health care workers caring for organophosphate exposure ?
Protect yourself from vomitus and contaminated clothing.
Wear rubber gloves.
Wear vinyl gloves.
A and B
All of the above


9. What is true of dosing of atropine ?
The initial dose is 2-4 mg.
Double the dose every 10 minutes until symptom relief.
Don’t give atropine if the patient has dilated pupils.
Tachycardia is a contraindication to atropine use in organophosphate poisoning.


10. Which of the following is INCORRECT when discussing 2-PAM ?
It works by releasing AChE from the organophosphate.
It is most effective within 24-48 hours of exposure.
It helps slow the aging process of phosphorylated AChE.
It should be given prophylactically to workers exposed to organophosphates.


11. If intubation is necessary, it is OK to use succinylcholine as the paralytic agent ?
True
False


12. How long do you need to monitor patients after severe poisoning treated with atropine ?
12 hours
24 hours
48 hours
72 hours


13. Side effects of 2-PAM include: ?
bradycardia
seizures
hypertension
tachypnea


14. Which of the following is true for organophosphate poisoned patients ?
Dilantin should be used for treatment of seizures.
2-PAM should be withheld until you see if atropine alone relieves the symptoms.
Furosemide should be used in cases of refractory pulmonary edema.
A and C
All of the above.