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WorksheetsTOXICOLOGY (SET C)
Total questions: 100
Worksheet time: 53mins
Medications which have been implicated in nitrate/nitrite toxicity include:
nitroglycerin
nitroglycerin
silver nitrate burn cream
all of these
A drop of blood with methemoglobin appears what color in filter paper?
chocolate-brown
red
violet
clear yellow
Solanine is a toxic substance present in:
kamote
patatas
ube
papaya
Which of the following symptoms is NOT a characteristic symptom of benzodiazepine overdose?
Drowsiness
NONE
somnolence
Ataxia
confusion
Aspirin believes to inhibit clotting by its action on which of the following endogenous subtances?
xanthin oxidase
cyclooxygenase
endorphin A
fibrinogen
Haloperidol differs from chlorpromazine in that haloperidol:
is not an antipsychotic agent
does not cause sedation
does not produce extrapyramidal effects
is not a phenothiazine
What is the compound present in cuticle remover?
aromatic ammonia compound
titanium dioxide
potassium hydroxide
thioglycolate
What is the color of the vomitus and stool of patient with boric acid toxicity?
blue-green
chocolate-brown
gray
black
Which of the following is NOT an industrial hazard?
formalin
ethanol
disulfiram
chloroform
Methylene blue is used in the treatment of ___________ poisoning.
ASA
nitrates
acetaminophen
phenol
What is the active ingredient of Racumin?
0.75% coumatetralyl
0.75% atropine
0.75% naphthalene
vit. K
Which of the following patients in whom poisoning or drug overdose should be suspected?
patient with altered LOC
trauma patient
patient with bizarre clinical presentation
all of these
An antileprosy drug that acts by causing sulfation of hemoglobin.
isoniazid
digoxin
dapsone
benzodiazepine
The mechanism of action involved in the use of EDTA as an antidote for heavy metal poisoning:
adsorption
oxidation
chelation
precipitation
Dermatological manifestation of ethanol intoxication:
icterus
ecchymosis
erythema
cyanosis
Plant substance Rotenone is found in:
singkamas
balinghoy
adelfa
mustasa
tubang-bakod
Plant substance Isothiocyanate is found in:
singkamas
balinghoy
adelfa
mustasa
tubang-bakod
Plant substance Curcin is found in:
singkamas
balinghoy
adelfa
mustasa
tubang-bakod
Plant substance manihotoxin is found in:
singkamas
balinghoy
adelfa
mustasa
tubang-bakod
Plant substance oleandrin is found in:
singkamas
balinghoy
adelfa
mustasa
tubang-bakod
A 25-year-old medical student is given a prescription for asthma, which the physician states has a very high therapeutic index. Which of the statements best characterizes the drug as it relates to the therapeutic index?
The drug’s serum levels will likely need to be carefully monitored.
The drug is likely to cross the blood-brain barrier.
The drug is likely to have extensive drug-drug interactions.
The drug is unlikely to have any serious adverse effects.
Which of the following is an example of an immunologic drug reaction?
hepatotoxicity from methotrexate
contact dermatitis from topical antihistamine
tinnitus after a single small dose of aspirin
thrush while taking antibiotics
The following drugs are confirmed teratogens in humans: (Multiple answer)
ethanol
warfarin
isotretinoin
paracetamol
The following are appropriate in the first-line management of acute severe asthma in a 5-year old child. (Multiple answer)
nebulized beta2 agonists
systemic corticosteroids
rectal diazepam
systemic ipratropium
Many toxins must be biotransformed into a more _________ form before they can be excreted from the body.
water-soluble
lipid-soluble
Removal of toxins before entrance into the systemic circulation is known as: (Multiple Answer)
presystemic elimination
post-systemic elimination
first-pass
distribution
Which of the following is an important mechanism of removing particulate matter from the alveoli?
sneezing
coughing
swallowing
blowing one’s nose
The drug which is used to reduce appetite and fatigue, is commonly used as aphrodisiac. Addicts used it as a snuff and feel as if insects are creeping on the skin:
cannabis
amphetamine
cocaine
LSD
The salt concentration of seawater is about:
0.5%
0.2%
1.0%
3.0%
In freshwater drowning there is:
hypernatremia
hyperkalemia
hyermagnesemia
hypercalcemia
Which of the following is NOT commonly associated with methyl mercury vapor poisoning?
acute, corrosive bronchitis
interstitial pneumonitis
increased excitability
vomiting and bloody diarrhea
A 66-year-old man dies suddenly and unexpectedly. He is found in his home by a neighbor after the man was not seen for over a day. Police find no evidence of foul play. At autopsy, there are no signs of physical injury. The skin of his hands displays cherry red lividity. Which of the following toxins is most likely to be found in this man?
arsenic
carbon monoxide
lead
methyl salicylate
For the management of intraoperative myocardial ischemia, which of the following is not advised?
heparin
intravenous nitroglycerin
calcium channel blocker
atropine
Which of the following is the most common presenting symptom of noncirrhotic portal hypertension?
chronic liver failure
ascites
upper gastroinstestinal bleeding
encephalopathy
A 2-year-old boy was treated with paracetamol for fever, but after three days the child developed acute renal failure, marked acidosis and and encephalopathy. On urine examination, oxalate crystals are seen. The blood anion gap and osmolal gap has increased value? What is the most probable cause?
paracetamol poisoning
diethyl glycol poisoning
malaria
hanta virus infection
Identify the toxic substance exhibited by the indicated odor:
fruit-like
ethanol
marijuana
nitrobenzene
hydrogen sulfide
etchlorvynol
Identify the toxic substance exhibited by the indicated odor:
burnt rope
ethanol
marijuana
nitrobenzene
hydrogen sulfide
etchlorvynol
Identify the toxic substance exhibited by the indicated odor:
rotten egg
ethanol
marijuana
nitrobenzene
hydrogen sulfide
etchlorvynol
Identify the toxic substance exhibited by the indicated odor:
shoe polish
ethanol
marijuana
nitrobenzene
hydrogen sulfide
etchlorvynol
Identify the toxic substance exhibited by the indicated odor:
vinyl shower curtain
ethanol
marijuana
nitrobenzene
hydrogen sulfide
etchlorvynol
Sorbitol and other sugar alcohols have been associated with:
respiratory distress syndrome
osmotic diarrhea
hepatotoxicity
immediate hypersensitivity reaction
Chloracne is associated with:
prominent hyperkeratosis of the follicular canal
production of excessive sebum
exposure to halogenated aliphatic hydrocarbons
exposure to chlorine gas
Which of the following is the most significant contributor to air pollution by mass in suburban areas?
manufacturing
transportation
space heaters
electric power generation
The grayanotoxins found in many species of Rhododendron produce effects similar to:
cyanogenic glycosides
veratrum alkaloids
lycopenes
disulfiram
What are the most commonly associated dose-related side effects of carbamazepine?
diplopia, nausea, ataxia
renal failure, rash, decreased WBC
pulmonary toxicity, liver failure
angina, urticarial, vomiting
Which of the following is NOT a sign of alcohol withdrawal?
diaphoresis
increased blood pressure
sedation
tremor
Which of the following drugs is associated with the “gray-baby syndrome” infants?
demeclocycline
chloramphenicol
amphotericin B
kanamycin
A patient is experiencing signs of acute chlordiazepoxide (“Librium”) toxicity after having consumed approximately 15 doses in suicide attempt. An appropriate agent to administer is:
naloxone
flumazenil
lorazepam
physostigmine
The use of olsalazine is contraindicated in patients with a history of hypersensitivity to:
salicylates
sulfonamides
imidazolines
phenothiazines
Paraquat and diquat differ substantially in their:
metabolism to a free radical
ability to initiate lipid peroxidation in vivo
uptake by the lung
generation of superoxide anion in vivo
Toxic injury to the cell body, axon and surrounding Schwann cells of peripheral nerves are referred to, respectively, as
neuropathy, axonopathy and myelopathy
neuronopathy, axonopathy and myelinopathy
neuropathy, axonopathy and gliosis
neuronopathy, dying-back neuropathy and myelopathy
Which one of the following is least likely to develop paracetamol-induced hepatotoxicity following overdose?
45 y old male alcoholic
20 y female on antiTB medication.
18 y male with AIDS
7 y old female with diabetes mellitus
The mainstay of treatment for a patient suffering from symptomatic dengue infection is:
Acyclovir
Decadron
Third generation cephalosporin
Supportive therapy
Which of the following may cause cancer of the urinary bladder?
cadmium
aniline dyes
mercury
lead
All of the following are caused by sulfur dioxide EXCEPT:
bronchospasm
mucosal irritation
conjunctival irritation
vagal paralysis
Extensive pleural thickening and calcification especially involving the diaphragmatic pleura are classical features of:
Coal worker’s pneumoconiosis
Asbestosis
Silicosis
Siderosis
A 5-year-old male with no previous medical history is brought to the ER by his mother because he accidentally ingested a large dose of rat poison. He is conscious but appears quite agitated. On physical exam, he is found to have a blood pressure of 110/70 and a heart rate of 90. Labs are significant for an elevated PT but a normal PTT. The patient should be immediately treated with:
atropine
flumazenil
vitamin K
protamine
The preferred treatment for chronic lead poisoning is:
anti-anxiety agents
environmental decontamination and chelating agents
fluoride ions
emesis and alkalinization of urine
A factor which significantly contributes to the toxic risk of DDT-like pesticides is:
high vapor pressure
affinity for androgen receptors
mutagenicity
chemical stability and high lipophilicity
Which one of the following inhibitor-enzyme combinations is NOT an example of competitive reversible inhibition?
paracetamol : cyclooxygenase
ibuprofen : cyclooxygenase
trimethoprim : bacterial dihydrofolate reductase
captopril : acetylcholine esterase
Which of the following physical findings/lab values is indicative of dehydration?
low sodium level
elevated creatinine clearance
poor skin turgor
weight loss of 10% from usual weight
Which of the following adverse events is NOT associated with chloramphenicol ear drops?
overgrowth of resistant organism
ototoxicity
bone marrow suppression
hypoalbuminemia
Lead toxicity is largely due to its ability to mimic and interfere with normal functioning of which of the following ions?
Sodium ion
Potassium ion
Chloride ion
Calcium ion
Local anesthetics interfere with the movement of which ion as a fundamental basis for their action?
calcium
sodium
potassium
magnesium
Which of the following is NOT an agricultural poison?
pyrethrum
mothball
naloxone
coumatetralyl
This thiazine dye is used in the treatment of methemoglobinemia:
ethylene blue
amaranth
methylene blue
tartrazine
The chelator of choice in symptomatic iron poisoning.
dimercaprol
deferoxamine mesylate
EDTA
all of these
Continuous monitoring in the ED patient should routinely include:
vital signs
cardiac
SaO2
all of these
Effects expected as a result of inhaling the smoke of cannabis include:
I. vascular congestion of the eye
II. perceptual changes
III. decreased pulse rate
I only
II and III only
III only
I and II only
The thiazide diuretics decrease the excretion of:
uric acid
urea
sodium
bicarbonate
it produces GI bleeding from gastritis, ulcers, hepatitis and cirrhosis
ethanol
formaldehyde
phenol
boric acid
nitrates
topical exposure to the skin may produce a deep white patch that turns red, then stains the skin brown
ethanol
formaldehyde
phenol
boric acid
nitrates
it is widely used to treat psychosis and agitated depression
nitrites
salicylates
local anesthetics
acetaminophen
phenothiazine
they alter platelet function and may prolong prothrombin time
nitrites
salicylates
local anesthetics
acetaminophen
phenothiazine
it causes precipitation of proteins and will cause coagulation necrosis of exposed tissue
ethanol
formaldehyde
phenol
boric acid
nitrates
it has been used as an antiseptic and fungistatic in talcum powder
ethanol
formaldehyde
phenol
boric acid
nitrates
it relaxes veins at lower doses and arteries at higher doses
nitrites
salicylates
local anesthetics
acetaminophen
phenothiazine
it is a widely used drug found in many OTC and prescription analgesics and cold remedies
nitrites
salicylates
local anesthetics
acetaminophen
phenothiazine
these are potent oxidizing agents
ethanol
formaldehyde
phenol
boric acid
nitrates
it binds to sodium channels in nerve fibers, blocking the sodium current responsible for nerve conduction
nitrites
salicylates
local anesthetics
acetaminophen
phenothiazine
Evidence gathered from the result of autopsy.
chemical
symptomatic
post-mortem
experimental
It is also known as wood spirit.
ethanol
methanol
isopropanol
butanol
Contraindicated in heart failure because a strong negative inotrope:
ibuprofen
verapamil
digoxin
furosemide
Which of the following drugs cause constipation?
metformin
misoprostol
amoxicillin
amiodarone
In the management of uterine haemorrhage the following are used: (Multiple Answer)
IV fibrinogen
IV ergometrine
aortic compression
uterine packing
Which one of the following is most appropriate as a primary covering over a small area (2 in. X 2 in.) in a second-degree burn?
butter
cotton gauze
absorbent pad
petrolatum gauze
When a patient is allergic to penicillin, he may develop cross-hypersensitivity reactions when he uses which one of the following drugs?
erythromycin
cephalexin
streptomycin
tetracycline
All of the following agents are pesticides EXCEPT:
insecticides
herbicides
vertebrate poisons
cytotoxic agents
The organophosphates commonly found in insecticides are thought to act by which of the following mechanisms?
combining with acetylcholine
potentiating the action of acetylcholinesterase
reacting at the cholinergic receptor
forming a very stable complex with acetylcholinesterase
Which category of drugs administered to the mother is usually contraindicated during breastfeeding?
antihypertensive
antineoplastic
antidepressant
antimicrobial
identify the poisonous substance exhibited by the indicated animal
honeybee
dendrotoxin
apitoxin
tetrodotoxin
venom
maculotoxin
identify the poisonous substance exhibited by the indicated animal
dart frog
dendrotoxin
apitoxin
tetrodotoxin
venom
maculotoxin
identify the poisonous substance exhibited by the indicated animal
puffer fish
dendrotoxin
apitoxin
tetrodotoxin
venom
maculotoxin
identify the poisonous substance exhibited by the indicated animal
coral snake
dendrotoxin
apitoxin
tetrodotoxin
venom
maculotoxin
identify the poisonous substance exhibited by the indicated animal
blue-ringed octopus
dendrotoxin
apitoxin
tetrodotoxin
venom
maculotoxin
In patient with benzodiazepine poisoning, which of the following is an indication for flumazenil use?
accidental pediatric ingestion
co-ingestion of tricyclic antidepressants
chronic benzodiazepine user
alcoholic patient
The quantity of medicine that can kill an organism.
fatal dose
LD50
teratology
threshold limit value
When reporting cases of poisoning like eating in public restaurant, the cases should be reported to the:
nurse
pharmacist
public health officer
family doctor
A 9-year-old girl is brought to the emergency department by her aunt. On physical examination there are multiple contusions of varying ages on the head, torso, arms, and thighs. A chest radiograph reveals a healing 6th rib fracture on the left. Her weight is slightly under that expected for age. The child appears listless. Which of the following conditions is the most likely diagnosis?
Down syndrome
scurvy
child abuse
meningococcemia
A 4-year-old previously healthy child ingests a 100 ml bottle containing a clear liquid he found under the kitchen sink at home. The child is observed to develop central nervous system depression over the next 6 hours. Acidosis is documented on admission to the hospital. Three weeks later, it is noted that the child's visual acuity is markedly decreased. Which of the following chemical substances was most likely present in the liquid ingested by this child?
cyanide
mercuric chloride
organophosphate
methanol
