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Phys Vivaspharmacological

Phys Vivas · pharmacological

Beta Blocker and Calcium Channel Blocker Toxicity — Viva Defence

DCE viva defence for Beta Blocker and Calcium Channel Blocker Toxicity.

1 min readVerification in progress

Target exams

FRACP DCEMRCP PACES
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Study tools

Target exams

FRACP DCEMRCP PACES
Prompt
DCE viva defence for Beta Blocker and Calcium Channel Blocker Toxicity.

Beta Blocker and Calcium Channel Blocker Toxicity Viva

Long Case Viva Defence

Opening statement

"This patient presents with a problem best framed as Beta Blocker and Calcium Channel Blocker Toxicity. My priorities are to identify red flags, confirm the mechanism with purposeful investigations, start a sequenced management plan, and integrate multimorbidity and follow-up." [1] [2]

Examiner questions

Q1: "What makes this urgent?" [1]

"I look for threats to airway, perfusion, neurology, metabolism, infection or bleeding, and I escalate those before elective work-up." [1] [2]

Q2: "What is your first investigation package?" [2]

"I order tests that change management now, not a scattergun panel." [1] [2]

Q3: "Walk me through treatment." [1]

"Stabilise, treat the mechanism, prevent complications, and plan monitoring." [1] [2] [3]

Q4: "What is the classic trap?" [2]

"Treating a label without confirming the discriminating mechanism, or delaying escalation." [1] [2]

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References6ShowHide
  1. [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. [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. [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. [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. [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. [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
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