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TOXICOLOGY (SET C)

Total questions: 100

Worksheet time: 53mins

Name
Class
Date
1.

Medications which have been implicated in nitrate/nitrite toxicity include:

a)

nitroglycerin

b)

nitroglycerin

c)

silver nitrate burn cream

d)

all of these

2.

A drop of blood with methemoglobin appears what color in filter paper?

a)

chocolate-brown

b)

red

c)

violet

d)

clear yellow

3.

Solanine is a toxic substance present in:

a)

kamote

b)

patatas

c)

ube

d)

papaya

4.

Which of the following symptoms is NOT a characteristic symptom of benzodiazepine overdose?

a)

Drowsiness

b)

NONE

c)

somnolence

d)

Ataxia

e)

confusion

5.

Aspirin believes to inhibit clotting by its action on which of the following endogenous subtances?

a)

xanthin oxidase

b)

cyclooxygenase

c)

endorphin A

d)

fibrinogen

6.

Haloperidol differs from chlorpromazine in that haloperidol:

a)

is not an antipsychotic agent

b)

does not cause sedation

c)

does not produce extrapyramidal effects

d)

is not a phenothiazine

7.

What is the compound present in cuticle remover?

a)

aromatic ammonia compound

b)

titanium dioxide

c)

potassium hydroxide

d)

thioglycolate

8.

What is the color of the vomitus and stool of patient with boric acid toxicity?

a)

blue-green

b)

chocolate-brown

c)

gray

d)

black

9.

Which of the following is NOT an industrial hazard?

a)

formalin

b)

ethanol

c)

disulfiram

d)

chloroform

10.

Methylene blue is used in the treatment of ___________ poisoning.

a)

ASA

b)

nitrates

c)

acetaminophen

d)

phenol

11.

What is the active ingredient of Racumin?

a)

0.75% coumatetralyl

b)

0.75% atropine

c)

0.75% naphthalene

d)

vit. K

12.

Which of the following patients in whom poisoning or drug overdose should be suspected?

a)

patient with altered LOC

b)

trauma patient

c)

patient with bizarre clinical presentation

d)

all of these

13.

An antileprosy drug that acts by causing sulfation of hemoglobin.

a)

isoniazid

b)

digoxin

c)

dapsone

d)

benzodiazepine

14.

The mechanism of action involved in the use of EDTA as an antidote for heavy metal poisoning:

a)

adsorption

b)

oxidation

c)

chelation

d)

precipitation

15.

Dermatological manifestation of ethanol intoxication:

a)

icterus

b)

ecchymosis

c)

erythema

d)

cyanosis

16.

Plant substance Rotenone is found in:

a)

singkamas

b)

balinghoy

c)

adelfa

d)

mustasa

e)

tubang-bakod

17.

Plant substance Isothiocyanate is found in:

a)

singkamas

b)

balinghoy

c)

adelfa

d)

mustasa

e)

tubang-bakod

18.

Plant substance Curcin is found in:

a)

singkamas

b)

balinghoy

c)

adelfa

d)

mustasa

e)

tubang-bakod

19.

Plant substance manihotoxin is found in:

a)

singkamas

b)

balinghoy

c)

adelfa

d)

mustasa

e)

tubang-bakod

20.

Plant substance oleandrin is found in:

a)

singkamas

b)

balinghoy

c)

adelfa

d)

mustasa

e)

tubang-bakod

21.

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?

a)

The drug’s serum levels will likely need to be carefully monitored.

b)

The drug is likely to cross the blood-brain barrier.

c)

The drug is likely to have extensive drug-drug interactions.

d)

The drug is unlikely to have any serious adverse effects.

22.

Which of the following is an example of an immunologic drug reaction?

a)

hepatotoxicity from methotrexate

b)

contact dermatitis from topical antihistamine

c)

tinnitus after a single small dose of aspirin

d)

thrush while taking antibiotics

23.

The following drugs are confirmed teratogens in humans: (Multiple answer)

a)

ethanol

b)

warfarin

c)

isotretinoin

d)

paracetamol

24.

The following are appropriate in the first-line management of acute severe asthma in a 5-year old child. (Multiple answer)

a)

nebulized beta2 agonists

b)

systemic corticosteroids

c)

rectal diazepam

d)

systemic ipratropium

25.

Many toxins must be biotransformed into a more _________ form before they can be excreted from the body.

a)

water-soluble

b)

lipid-soluble

26.

Removal of toxins before entrance into the systemic circulation is known as: (Multiple Answer)

a)

presystemic elimination

b)

post-systemic elimination

c)

first-pass

d)

distribution

27.

Which of the following is an important mechanism of removing particulate matter from the alveoli?

a)

sneezing

b)

coughing

c)

swallowing

d)

blowing one’s nose

28.

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:

a)

cannabis

b)

amphetamine

c)

cocaine

d)

LSD

29.

The salt concentration of seawater is about:

a)

0.5%

b)

0.2%

c)

1.0%

d)

3.0%

30.

In freshwater drowning there is:

a)

hypernatremia

b)

hyperkalemia

c)

hyermagnesemia

d)

hypercalcemia

31.

Which of the following is NOT commonly associated with methyl mercury vapor poisoning?

a)

acute, corrosive bronchitis

b)

interstitial pneumonitis

c)

increased excitability

d)

vomiting and bloody diarrhea

32.

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?

a)

arsenic

b)

carbon monoxide

c)

lead

d)

methyl salicylate

33.

For the management of intraoperative myocardial ischemia, which of the following is not advised?

a)

heparin

b)

intravenous nitroglycerin

c)

calcium channel blocker

d)

atropine

34.

Which of the following is the most common presenting symptom of noncirrhotic portal hypertension?

a)

chronic liver failure

b)

ascites

c)

upper gastroinstestinal bleeding

d)

encephalopathy

35.

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?

a)

paracetamol poisoning

b)

diethyl glycol poisoning

c)

malaria

d)

hanta virus infection

36.

Identify the toxic substance exhibited by the indicated odor:

fruit-like

a)

ethanol

b)

marijuana

c)

nitrobenzene

d)

hydrogen sulfide

e)

etchlorvynol

37.

Identify the toxic substance exhibited by the indicated odor:

burnt rope

a)

ethanol

b)

marijuana

c)

nitrobenzene

d)

hydrogen sulfide

e)

etchlorvynol

38.

Identify the toxic substance exhibited by the indicated odor:

rotten egg

a)

ethanol

b)

marijuana

c)

nitrobenzene

d)

hydrogen sulfide

e)

etchlorvynol

39.

Identify the toxic substance exhibited by the indicated odor:

shoe polish

a)

ethanol

b)

marijuana

c)

nitrobenzene

d)

hydrogen sulfide

e)

etchlorvynol

40.

Identify the toxic substance exhibited by the indicated odor:

vinyl shower curtain

a)

ethanol

b)

marijuana

c)

nitrobenzene

d)

hydrogen sulfide

e)

etchlorvynol

41.

Sorbitol and other sugar alcohols have been associated with:

a)

respiratory distress syndrome

b)

osmotic diarrhea

c)

hepatotoxicity

d)

immediate hypersensitivity reaction

42.

Chloracne is associated with:

a)

prominent hyperkeratosis of the follicular canal

b)

production of excessive sebum

c)

exposure to halogenated aliphatic hydrocarbons

d)

exposure to chlorine gas

43.

Which of the following is the most significant contributor to air pollution by mass in suburban areas?

a)

manufacturing

b)

transportation

c)

space heaters

d)

electric power generation

44.

The grayanotoxins found in many species of Rhododendron produce effects similar to:

a)

cyanogenic glycosides

b)

veratrum alkaloids

c)

lycopenes

d)

disulfiram

45.

What are the most commonly associated dose-related side effects of carbamazepine?

a)

diplopia, nausea, ataxia

b)

renal failure, rash, decreased WBC

c)

pulmonary toxicity, liver failure

d)

angina, urticarial, vomiting

46.

Which of the following is NOT a sign of alcohol withdrawal?

a)

diaphoresis

b)

increased blood pressure

c)

sedation

d)

tremor

47.

Which of the following drugs is associated with the “gray-baby syndrome” infants?

a)

demeclocycline

b)

chloramphenicol

c)

amphotericin B

d)

kanamycin

48.

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:

a)

naloxone

b)

flumazenil

c)

lorazepam

d)

physostigmine

49.

The use of olsalazine is contraindicated in patients with a history of hypersensitivity to:

a)

salicylates

b)

sulfonamides

c)

imidazolines

d)

phenothiazines

50.

Paraquat and diquat differ substantially in their:

a)

metabolism to a free radical

b)

ability to initiate lipid peroxidation in vivo

c)

uptake by the lung

d)

generation of superoxide anion in vivo

51.

Toxic injury to the cell body, axon and surrounding Schwann cells of peripheral nerves are referred to, respectively, as

a)

neuropathy, axonopathy and myelopathy

b)

neuronopathy, axonopathy and myelinopathy

c)

neuropathy, axonopathy and gliosis

d)

neuronopathy, dying-back neuropathy and myelopathy

52.

Which one of the following is least likely to develop paracetamol-induced hepatotoxicity following overdose?

a)

45 y old male alcoholic

b)

20 y female on antiTB medication.

c)

18 y male with AIDS

d)

7 y old female with diabetes mellitus

53.

The mainstay of treatment for a patient suffering from symptomatic dengue infection is:

a)

Acyclovir

b)

Decadron

c)

Third generation cephalosporin

d)

Supportive therapy

54.

Which of the following may cause cancer of the urinary bladder?

a)

cadmium

b)

aniline dyes

c)

mercury

d)

lead

55.

All of the following are caused by sulfur dioxide EXCEPT:

a)

bronchospasm

b)

mucosal irritation

c)

conjunctival irritation

d)

vagal paralysis

56.

Extensive pleural thickening and calcification especially involving the diaphragmatic pleura are classical features of:

a)

Coal worker’s pneumoconiosis

b)

Asbestosis

c)

Silicosis

d)

Siderosis

57.

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:

a)

atropine

b)

flumazenil

c)

vitamin K

d)

protamine

58.

The preferred treatment for chronic lead poisoning is:

a)

anti-anxiety agents

b)

environmental decontamination and chelating agents

c)

fluoride ions

d)

emesis and alkalinization of urine

59.

A factor which significantly contributes to the toxic risk of DDT-like pesticides is:

a)

high vapor pressure

b)

affinity for androgen receptors

c)

mutagenicity

d)

chemical stability and high lipophilicity

60.

Which one of the following inhibitor-enzyme combinations is NOT an example of competitive reversible inhibition?

a)

paracetamol : cyclooxygenase

b)

ibuprofen : cyclooxygenase

c)

trimethoprim : bacterial dihydrofolate reductase

d)

captopril : acetylcholine esterase

61.

Which of the following physical findings/lab values is indicative of dehydration?

a)

low sodium level

b)

elevated creatinine clearance

c)

poor skin turgor

d)

weight loss of 10% from usual weight

62.

Which of the following adverse events is NOT associated with chloramphenicol ear drops?

a)

overgrowth of resistant organism

b)

ototoxicity

c)

bone marrow suppression

d)

hypoalbuminemia

63.

Lead toxicity is largely due to its ability to mimic and interfere with normal functioning of which of the following ions?

a)

Sodium ion

b)

Potassium ion

c)

Chloride ion

d)

Calcium ion

64.

Local anesthetics interfere with the movement of which ion as a fundamental basis for their action?

a)

calcium

b)

sodium

c)

potassium

d)

magnesium

65.

Which of the following is NOT an agricultural poison?

a)

pyrethrum

b)

mothball

c)

naloxone

d)

coumatetralyl

66.

This thiazine dye is used in the treatment of methemoglobinemia:

a)

ethylene blue

b)

amaranth

c)

methylene blue

d)

tartrazine

67.

The chelator of choice in symptomatic iron poisoning.

a)

dimercaprol

b)

deferoxamine mesylate

c)

EDTA

d)

all of these

68.

Continuous monitoring in the ED patient should routinely include:

a)

vital signs

b)

cardiac

c)

SaO2

d)

all of these

69.

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

a)

I only

b)

II and III only

c)

III only

d)

I and II only

70.

The thiazide diuretics decrease the excretion of:

a)

uric acid

b)

urea

c)

sodium

d)

bicarbonate

71.

it produces GI bleeding from gastritis, ulcers, hepatitis and cirrhosis

a)

ethanol

b)

formaldehyde

c)

phenol

d)

boric acid

e)

nitrates

72.

topical exposure to the skin may produce a deep white patch that turns red, then stains the skin brown

a)

ethanol

b)

formaldehyde

c)

phenol

d)

boric acid

e)

nitrates

73.

it is widely used to treat psychosis and agitated depression

a)

nitrites

b)

salicylates

c)

local anesthetics

d)

acetaminophen

e)

phenothiazine

74.

they alter platelet function and may prolong prothrombin time

a)

nitrites

b)

salicylates

c)

local anesthetics

d)

acetaminophen

e)

phenothiazine

75.

it causes precipitation of proteins and will cause coagulation necrosis of exposed tissue

a)

ethanol

b)

formaldehyde

c)

phenol

d)

boric acid

e)

nitrates

76.

it has been used as an antiseptic and fungistatic in talcum powder

a)

ethanol

b)

formaldehyde

c)

phenol

d)

boric acid

e)

nitrates

77.

it relaxes veins at lower doses and arteries at higher doses

a)

nitrites

b)

salicylates

c)

local anesthetics

d)

acetaminophen

e)

phenothiazine

78.

it is a widely used drug found in many OTC and prescription analgesics and cold remedies

a)

nitrites

b)

salicylates

c)

local anesthetics

d)

acetaminophen

e)

phenothiazine

79.

these are potent oxidizing agents

a)

ethanol

b)

formaldehyde

c)

phenol

d)

boric acid

e)

nitrates

80.

it binds to sodium channels in nerve fibers, blocking the sodium current responsible for nerve conduction

a)

nitrites

b)

salicylates

c)

local anesthetics

d)

acetaminophen

e)

phenothiazine

81.

Evidence gathered from the result of autopsy.

a)

chemical

b)

symptomatic

c)

post-mortem

d)

experimental

82.

It is also known as wood spirit.

a)

ethanol

b)

methanol

c)

isopropanol

d)

butanol

83.

Contraindicated in heart failure because a strong negative inotrope:

a)

ibuprofen

b)

verapamil

c)

digoxin

d)

furosemide

84.

Which of the following drugs cause constipation?

a)

metformin

b)

misoprostol

c)

amoxicillin

d)

amiodarone

85.

In the management of uterine haemorrhage the following are used: (Multiple Answer)

a)

IV fibrinogen

b)

IV ergometrine

c)

aortic compression

d)

uterine packing

86.

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?

a)

butter

b)

cotton gauze

c)

absorbent pad

d)

petrolatum gauze

87.

When a patient is allergic to penicillin, he may develop cross-hypersensitivity reactions when he uses which one of the following drugs?

a)

erythromycin

b)

cephalexin

c)

streptomycin

d)

tetracycline

88.

All of the following agents are pesticides EXCEPT:

a)

insecticides

b)

herbicides

c)

vertebrate poisons

d)

cytotoxic agents

89.

The organophosphates commonly found in insecticides are thought to act by which of the following mechanisms?

a)

combining with acetylcholine

b)

potentiating the action of acetylcholinesterase

c)

reacting at the cholinergic receptor

d)

forming a very stable complex with acetylcholinesterase

90.

Which category of drugs administered to the mother is usually contraindicated during breastfeeding?

a)

antihypertensive

b)

antineoplastic

c)

antidepressant

d)

antimicrobial

91.

identify the poisonous substance exhibited by the indicated animal

honeybee

a)

dendrotoxin

b)

apitoxin

c)

tetrodotoxin

d)

venom

e)

maculotoxin

92.

identify the poisonous substance exhibited by the indicated animal

dart frog

a)

dendrotoxin

b)

apitoxin

c)

tetrodotoxin

d)

venom

e)

maculotoxin

93.

identify the poisonous substance exhibited by the indicated animal

puffer fish

a)

dendrotoxin

b)

apitoxin

c)

tetrodotoxin

d)

venom

e)

maculotoxin

94.

identify the poisonous substance exhibited by the indicated animal

coral snake

a)

dendrotoxin

b)

apitoxin

c)

tetrodotoxin

d)

venom

e)

maculotoxin

95.

identify the poisonous substance exhibited by the indicated animal

blue-ringed octopus

a)

dendrotoxin

b)

apitoxin

c)

tetrodotoxin

d)

venom

e)

maculotoxin

96.

In patient with benzodiazepine poisoning, which of the following is an indication for flumazenil use?

a)

accidental pediatric ingestion

b)

co-ingestion of tricyclic antidepressants

c)

chronic benzodiazepine user

d)

alcoholic patient

97.

The quantity of medicine that can kill an organism.

a)

fatal dose

b)

LD50

c)

teratology

d)

threshold limit value

98.

When reporting cases of poisoning like eating in public restaurant, the cases should be reported to the:

a)

nurse

b)

pharmacist

c)

public health officer

d)

family doctor

99.

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?

a)

Down syndrome

b)

scurvy

c)

child abuse

d)

meningococcemia

100.

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?

a)

cyanide

b)

mercuric chloride

c)

organophosphate

d)

methanol