CPEN LATEST EXAM ACTUAL QUESTIONS AND
ANSWERS RATED A+
✔✔Opioids - ✔✔Clonidine: slows HR, hypotension
Treat with Narcan
✔✔Methemoglobinemia - ✔✔Blue baby, can be congenital or caused by the nitrates in
well water
treated with Methylene blue
✔✔Caustic Substances - ✔✔Ph of <2 or >12 greater injury
Similar to a burn
Ocular lesions:irrigate, pH before and after
✔✔Organophosphates - ✔✔Insecticides
MTWtHF syndrome: mydriasis, muscle twitching, muscle cramps, inc HR, weakness,
HTN
SLUDGE: muscarinic- salivation, urination, defecation, gastric cramping, emesis
Bronchial secretions- give atropine
✔✔Anticholinergic/Antihistimines - ✔✔Benadryl: hot,dry, flushed, agitated, sx, tachy,
CNS depression
✔✔Sympathomimetic/Decongestants/cocaine/amphetamines - ✔✔Flushed, diaphoretic,
agitated, enlarged pupils, inc BP, inc HR, sx, inc Temp,A ,B,C,D
✔✔Dextromethorpan - ✔✔intox, hallucinations, euphoria
treat with narcan
✔✔Magnets - ✔✔may pass if single
multiples can entrap tissues
✔✔Hydrocarbons - ✔✔Fuel, oil, waxes, polish
No GI decontam- can cause V and aspiration
Lipid pna
Obs for 6 hrs
✔✔Inhaled hydrocarbons - ✔✔Huffing/sniffing: myocardial irritability(butane, propane,
air fresheners)
Refrigerants: may freeze mouth and airway
Toulene sniffing: glue and nail polish
✔✔Iron ingestion - ✔✔60mg/kg toxic
St. 1: 30m-2hr N/V/D c abd discomfort
St. 2: 2-12 hr latent, toxic
, St. 3: Cardivas. collapse, hepatic injury, dec LOC
St. 4: Damage to GI if survived
Antidote: Deferoxamine- bonds with free iron, rose colored urine. Urine clear with all
iron excreted
✔✔Lead - ✔✔High levels cause leth and seizures
✔✔Methadone - ✔✔Opioid used as a detox, 1/2 life as long as 40 hr
CNS depression, resp depression, constricted pupils
Narcan will reverse symptoms
✔✔Hypoglycemics - ✔✔1 tab fatal
Can cause delayed hypogly
Sandostatin: suppresses insulin release
✔✔Glasgow: Eye opening - ✔✔4: spontaneously
3: to speech
2: to pain
1: no response
✔✔Glasgow: Best verbal response - ✔✔5: oriented/coos
4: irritable and cries/ confused
3: inappropriate words/ cries to pain
2: Incomprehensible/ moans or grunts
1: no response
✔✔Glasgow: Best Motor Response - ✔✔6:Obeys command/ spontaneous
5:localizes pain
4:withdraw from pain
3: flexion
2: extension
1: no response
✔✔Seizure - ✔✔Med:
Ativan(lorazepam) drug of choice
Valium(diazepam) IV or rectal
Versed(midazolam) IM or IN
✔✔Types of seizures - ✔✔Febrile
Simple <15 min, no focal onset, 1st 24 hr
Complex >15 min, focal onset, more than 1 in 24hr
✔✔Types of seizures partial - ✔✔Simple Partial: no impairment in LOC, 10-20sec, w/o
postictal
Complex Partial: impairment in LOC, more than 30 sec., postictal
ANSWERS RATED A+
✔✔Opioids - ✔✔Clonidine: slows HR, hypotension
Treat with Narcan
✔✔Methemoglobinemia - ✔✔Blue baby, can be congenital or caused by the nitrates in
well water
treated with Methylene blue
✔✔Caustic Substances - ✔✔Ph of <2 or >12 greater injury
Similar to a burn
Ocular lesions:irrigate, pH before and after
✔✔Organophosphates - ✔✔Insecticides
MTWtHF syndrome: mydriasis, muscle twitching, muscle cramps, inc HR, weakness,
HTN
SLUDGE: muscarinic- salivation, urination, defecation, gastric cramping, emesis
Bronchial secretions- give atropine
✔✔Anticholinergic/Antihistimines - ✔✔Benadryl: hot,dry, flushed, agitated, sx, tachy,
CNS depression
✔✔Sympathomimetic/Decongestants/cocaine/amphetamines - ✔✔Flushed, diaphoretic,
agitated, enlarged pupils, inc BP, inc HR, sx, inc Temp,A ,B,C,D
✔✔Dextromethorpan - ✔✔intox, hallucinations, euphoria
treat with narcan
✔✔Magnets - ✔✔may pass if single
multiples can entrap tissues
✔✔Hydrocarbons - ✔✔Fuel, oil, waxes, polish
No GI decontam- can cause V and aspiration
Lipid pna
Obs for 6 hrs
✔✔Inhaled hydrocarbons - ✔✔Huffing/sniffing: myocardial irritability(butane, propane,
air fresheners)
Refrigerants: may freeze mouth and airway
Toulene sniffing: glue and nail polish
✔✔Iron ingestion - ✔✔60mg/kg toxic
St. 1: 30m-2hr N/V/D c abd discomfort
St. 2: 2-12 hr latent, toxic
, St. 3: Cardivas. collapse, hepatic injury, dec LOC
St. 4: Damage to GI if survived
Antidote: Deferoxamine- bonds with free iron, rose colored urine. Urine clear with all
iron excreted
✔✔Lead - ✔✔High levels cause leth and seizures
✔✔Methadone - ✔✔Opioid used as a detox, 1/2 life as long as 40 hr
CNS depression, resp depression, constricted pupils
Narcan will reverse symptoms
✔✔Hypoglycemics - ✔✔1 tab fatal
Can cause delayed hypogly
Sandostatin: suppresses insulin release
✔✔Glasgow: Eye opening - ✔✔4: spontaneously
3: to speech
2: to pain
1: no response
✔✔Glasgow: Best verbal response - ✔✔5: oriented/coos
4: irritable and cries/ confused
3: inappropriate words/ cries to pain
2: Incomprehensible/ moans or grunts
1: no response
✔✔Glasgow: Best Motor Response - ✔✔6:Obeys command/ spontaneous
5:localizes pain
4:withdraw from pain
3: flexion
2: extension
1: no response
✔✔Seizure - ✔✔Med:
Ativan(lorazepam) drug of choice
Valium(diazepam) IV or rectal
Versed(midazolam) IM or IN
✔✔Types of seizures - ✔✔Febrile
Simple <15 min, no focal onset, 1st 24 hr
Complex >15 min, focal onset, more than 1 in 24hr
✔✔Types of seizures partial - ✔✔Simple Partial: no impairment in LOC, 10-20sec, w/o
postictal
Complex Partial: impairment in LOC, more than 30 sec., postictal
