Cyanide Poisoning Quiz

“Where there is
smoke, there may
be cyanide…..”
This quiz is designed to test your knowledge on the identification
and treatment of patient suffering cyanide poisoning. Please
complete by March 31 2008 and turn answer sheet into MaryJo.
If you have any questions, please contact Don Stroup or MaryJo
Koschel.
Thank you!
• References for quiz:

Bledsoe, BE and Benner, R. Critical Care

Paramedic, Prentice Hall, 2006, pp. 947-
948, 967-968.
Koschel, MJ. “Cyanide Poisoning: An Old
Enemy with New Risks” Journal of
Emergency Nursing Supplement, August
2006, Vol. 32, No. 4.
www.cyanidepoisoning.org
1. Cyanide acts as a poison through
which mechanism?
a. The toxic action of the cyanide destroys the
cell’s ability to excrete carbon dioxide.
b. The exogenous metabolic pathways for
cyanide excretion are overcome so cyanide
cannot be used.
c. There is inhibition of the oxidative function of
mitochondrial cytochrome oxidase.
d. The binding of cyanide to the ferric iron
portion of cytochrome oxidase increases
cellular oxidation.
2. Patient history that might trigger concern
about the possibility of cyanide poisoning
include all except:
a. The patient’s occupation as a lab scientist or
technician, metal worker, miner, aircraft
worker, firefighter or exterminator.
b. The patient’s mental status prior to poisoning.
c. Exposure to fire smoke, in particular of
fabrics or plastics in cars or automobiles.
d. Handling of common plants or organic
substances that break down into cyanide.
1. The physical findings of cyanide
poisoning include:
a. Tachypnea
b. Bitter-almond odor of patient’s urine.
c. Bright-red retinal veins secondary to
decreased venous oxygen
concentrations.
d. Bright-red retinal veins secondary to
increased venous oxygen
concentrations.
1. A key factor that should raise
suspicion that someone has cyanide
poisoning is when the patient
presents with
a. Immediate loss of consciousness,
collapse and seizures.
b. Decreased level plasma lactate (< 8
mosml/L)
c. Smoke inhalation with carbon
monoxide poisoning.
d. Exposure to plants releasing cyanide.
1. Acute cyanide poisoning is treated by:
a. Decreasing the exposure.
b. Increasing fluids.
c. Antidotal therapy.
d. Decontamination of workers.
6. The cyanide antidote kit (CAK) is composed
of:
a. Amyl nitrite, sodium nitrite, and sodium
thiosulfate
b. Methemoglobin
c. Amyl nitrate perles for inhalation
1. Administration of 100% oxygen is
essential for effective treatment in
cyanide poisoning because:
a. It treats concurrent carbon monoxide
poisoning.
b. It is necessary to decrease
respiratory alkalosis.
c. It works to boost mitochondrial
enzymes activated by cyanide.
d. It interferes with mitochondrial
cytochrome oxidase.
8. What are the side effects of CAK
administration and their antidote?

3. Hydroxocobalamin converts to what

compound when it binds with cyanide
molecules in the body?

5. What is the adult and pediatric dose

for Cyanokit (hydoxocobalamin)?