Practise 103 single best answer questions on toxicology for the MRCEM SBA exam. Every question comes with a detailed explanation, so you learn why the right answer is right and why the others are wrong.
Poisoning is a daily ED presentation, and exam questions reward precise knowledge: treatment thresholds, timing of levels, and which antidote to give and when.
A 27-year-old woman presents 3 hours after taking 6 g of aspirin (about 90 mg/kg). She has tinnitus and nausea, RR 28 and HR 110. VBG: pH 7.48, HCO₃ 18 mmol/L, lactate 1.3 mmol/L. Her 3-hour salicylate level is 285 mg/L.
What is the most appropriate next step?
A. Discharge after 6 hours if symptoms resolve
B. Start IV sodium bicarbonate for urinary alkalinisation
C. Give 50 g oral activated charcoal now
D. Refer to ICU for haemodialysis
E. Repeat the salicylate level in 2 hours
Answer: E. Absorption of salicylate in overdose can be delayed, so levels may keep rising. A single early level is not enough to decide treatment, and the level must be repeated.
Try 20 free sample questions to see the style and explanations, then choose the plan that suits you.