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Beta Blocker and Calcium Channel Blocker Toxicity — Written Clinical Reasoning
DCE-style written reasoning for Beta Blocker and Calcium Channel Blocker Toxicity.
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Target exams
SAQ 1 — Integrated plan (12 marks)
Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]
Model Answer
1. Frame and red flags (3 marks) [1]
State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]
2. Discriminating assessment (3 marks) [2]
List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]
3. Treatment sequence (4 marks) [1] [3]
Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]
4. Follow-up and communication (2 marks) [2]
Disposition, safety-net advice, and who owns follow-up. [1] [2]
References6ShowHide
- [1]Meamar R, Samsamshariat S, Dorvashi G, Feizi A, et al. Intravenous Lipid Emulsion in Beta-Blocker With or Without Calcium Channel Blocker Toxicity: A Systematic Review of Human Case Reports and Series J Appl Toxicol, 2026.PMID 42365995
- [2]St-Onge M, Anseeuw K, Cantrell FL, et al. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults Crit Care Med, 2017.PMID 27749343
- [3]Suarez F, Koyfman A, Long B Pearls and Pitfalls for the Emergency Clinician: Beta Blocker and Calcium Channel Blocker Toxicity J Emerg Med, 2026.PMID 41833262
- [4]Lavonas EJ, Akpunonu PD, Arens AM, Babu KM, et al. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Circulation, 2023.PMID 37721023
- [5]Lindeman E, Baer Eriksson L, Thorsson M, Nordmark Grass J [High dose insulin euglycemia therapy – an important addition to the treatment arsenal in severe toxic myocardial depression] Lakartidningen, 2017.PMID 28994852
- [6]Darracq MA, Thornton SL, Do HM, Bok D, et al. Utilization of hyperinsulinemia euglycemia and intravenous fat emulsion following poison center recommendations J Med Toxicol, 2013.PMID 23412936