CEN 2026/2027 EXAM
QUESTIONS AND ANSWERS |
100% PASS
What is the classic triad of an opioid toxidrome? - ANSWER
✔✔Pinpoint pupils (miosis), respiratory depression, and depressed
mental status (coma).
What is the definitive antidote for an opioid overdose? - ANSWER
✔✔Naloxone (Narcan).
Describe the classic presentation of an anticholinergic toxidrome. -
ANSWER ✔✔Mad as a hatter, blind as a bat, red as a beet, hot as a
hare, dry as a bone (delirium, mydriasis, flushed skin, hyperthermia, dry
mucous membranes).
,What is the specific antidote for severe, life-threatening anticholinergic
toxicity? - ANSWER ✔✔Physostigmine.
What acronym describes the cholinergic toxidrome (organophosphates)?
- ANSWER ✔✔SLUDGE (Salivation, Lacrimation, Urination,
Defecation, Gastrointestinal distress, Emesis) or DUMBELS.
What are the two primary antidotes for organophosphate (cholinergic)
poisoning? - ANSWER ✔✔Atropine (for muscarinic effects like
bronchorrhea) and Pralidoxime/2-PAM (for nicotinic effects like
fasciculations).
What is the definitive clinical endpoint for Atropine administration in
organophosphate poisoning? - ANSWER ✔✔The drying of thick
bronchial secretions (resolution of bronchorrhea).
What is the primary presentation of a sympathomimetic toxidrome (e.g.,
cocaine, meth)? - ANSWER ✔✔Tachycardia, hypertension,
hyperthermia, mydriasis (dilated pupils), diaphoresis, and severe
agitation.
Which class of medications is strictly contraindicated in cocaine-induced
chest pain? - ANSWER ✔✔Pure beta-blockers (e.g., propranolol) due
to the risk of unopposed alpha-adrenergic stimulation.
,What is the first-line pharmacological treatment for cocaine-induced
agitation and tachycardia? - ANSWER ✔✔Benzodiazepines (e.g.,
lorazepam, diazepam).
What is the antidote for a benzodiazepine overdose? - ANSWER
✔✔Flumazenil (use with caution in chronic users due to seizure risk).
What is the hallmark ECG finding in a Tricyclic Antidepressant (TCA)
overdose? - ANSWER ✔✔Widened QRS complex (>100 ms) and a
prominent terminal R wave in lead aVR.
What is the definitive antidote for TCA-induced cardiotoxicity (widened
QRS)? - ANSWER ✔✔Intravenous Sodium Bicarbonate.
What is the primary mechanism of Sodium Bicarbonate in TCA toxicity? -
ANSWER ✔✔It increases the extracellular sodium load to overcome
the fast sodium channel blockade and alkalizes the blood.
What are the early, phase 1 symptoms of acetaminophen toxicity? -
ANSWER ✔✔Usually asymptomatic, or mild nausea, vomiting, and
malaise.
What tool is used to determine the need for treatment in an acute
acetaminophen overdose? - ANSWER ✔✔The Rumack-Matthew
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, Nomogram (requires a serum level drawn at least 4 hours post-
ingestion).
What is the definitive antidote for acetaminophen toxicity? - ANSWER
✔✔N-acetylcysteine (NAC).
What is the classic early symptom of salicylate (aspirin) toxicity? -
ANSWER ✔✔Tinnitus (ringing in the ears).
What unique acid-base imbalance is caused by salicylate toxicity? -
ANSWER ✔✔Combined primary respiratory alkalosis (medullary
stimulation) and primary metabolic acidosis (uncoupled oxidative
phosphorylation).
What is the targeted treatment for severe salicylate toxicity? -
ANSWER ✔✔Urinary alkalinization with a continuous Sodium
Bicarbonate infusion.
What is the most critical electrolyte abnormality seen in acute digoxin
toxicity? - ANSWER ✔✔Hyperkalemia (serum potassium > 5.5 mEq/L
is highly predictive of mortality).
What is the definitive antidote for severe digoxin toxicity? - ANSWER
✔✔Digoxin Immune Fab (Digibind).
QUESTIONS AND ANSWERS |
100% PASS
What is the classic triad of an opioid toxidrome? - ANSWER
✔✔Pinpoint pupils (miosis), respiratory depression, and depressed
mental status (coma).
What is the definitive antidote for an opioid overdose? - ANSWER
✔✔Naloxone (Narcan).
Describe the classic presentation of an anticholinergic toxidrome. -
ANSWER ✔✔Mad as a hatter, blind as a bat, red as a beet, hot as a
hare, dry as a bone (delirium, mydriasis, flushed skin, hyperthermia, dry
mucous membranes).
,What is the specific antidote for severe, life-threatening anticholinergic
toxicity? - ANSWER ✔✔Physostigmine.
What acronym describes the cholinergic toxidrome (organophosphates)?
- ANSWER ✔✔SLUDGE (Salivation, Lacrimation, Urination,
Defecation, Gastrointestinal distress, Emesis) or DUMBELS.
What are the two primary antidotes for organophosphate (cholinergic)
poisoning? - ANSWER ✔✔Atropine (for muscarinic effects like
bronchorrhea) and Pralidoxime/2-PAM (for nicotinic effects like
fasciculations).
What is the definitive clinical endpoint for Atropine administration in
organophosphate poisoning? - ANSWER ✔✔The drying of thick
bronchial secretions (resolution of bronchorrhea).
What is the primary presentation of a sympathomimetic toxidrome (e.g.,
cocaine, meth)? - ANSWER ✔✔Tachycardia, hypertension,
hyperthermia, mydriasis (dilated pupils), diaphoresis, and severe
agitation.
Which class of medications is strictly contraindicated in cocaine-induced
chest pain? - ANSWER ✔✔Pure beta-blockers (e.g., propranolol) due
to the risk of unopposed alpha-adrenergic stimulation.
,What is the first-line pharmacological treatment for cocaine-induced
agitation and tachycardia? - ANSWER ✔✔Benzodiazepines (e.g.,
lorazepam, diazepam).
What is the antidote for a benzodiazepine overdose? - ANSWER
✔✔Flumazenil (use with caution in chronic users due to seizure risk).
What is the hallmark ECG finding in a Tricyclic Antidepressant (TCA)
overdose? - ANSWER ✔✔Widened QRS complex (>100 ms) and a
prominent terminal R wave in lead aVR.
What is the definitive antidote for TCA-induced cardiotoxicity (widened
QRS)? - ANSWER ✔✔Intravenous Sodium Bicarbonate.
What is the primary mechanism of Sodium Bicarbonate in TCA toxicity? -
ANSWER ✔✔It increases the extracellular sodium load to overcome
the fast sodium channel blockade and alkalizes the blood.
What are the early, phase 1 symptoms of acetaminophen toxicity? -
ANSWER ✔✔Usually asymptomatic, or mild nausea, vomiting, and
malaise.
What tool is used to determine the need for treatment in an acute
acetaminophen overdose? - ANSWER ✔✔The Rumack-Matthew
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, Nomogram (requires a serum level drawn at least 4 hours post-
ingestion).
What is the definitive antidote for acetaminophen toxicity? - ANSWER
✔✔N-acetylcysteine (NAC).
What is the classic early symptom of salicylate (aspirin) toxicity? -
ANSWER ✔✔Tinnitus (ringing in the ears).
What unique acid-base imbalance is caused by salicylate toxicity? -
ANSWER ✔✔Combined primary respiratory alkalosis (medullary
stimulation) and primary metabolic acidosis (uncoupled oxidative
phosphorylation).
What is the targeted treatment for severe salicylate toxicity? -
ANSWER ✔✔Urinary alkalinization with a continuous Sodium
Bicarbonate infusion.
What is the most critical electrolyte abnormality seen in acute digoxin
toxicity? - ANSWER ✔✔Hyperkalemia (serum potassium > 5.5 mEq/L
is highly predictive of mortality).
What is the definitive antidote for severe digoxin toxicity? - ANSWER
✔✔Digoxin Immune Fab (Digibind).
