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Set A

Total questions: 100

Worksheet time: 53mins

Name
Class
Date
1.

For a toxin to be absorbed through the skin, it must past through multiple layers in order to reach the systemic circulation. Which of the following layers is the most important in slowing the rate of toxin absorption through the skin?

a)

Stratum granulosum

b)

Stratum spinosum

c)

Stratum corneum

d)

Stratum basale

2.

Whole bowel irrigation is performed using:

a)

polyethylene glycol

b)

sodium phosphate enema

c)

magnesium citrate

d)

sodium sulphate

3.

Which of the following drugs does serum NOT used during toxicology testing?

a)

ibuprofen

b)

benzodiazepine

c)

cocaine

d)

Phenobarbital

4.

In carbon monoxide poisoning the following is seen EXCEPT:

a)

arrhythmias

b)

hypotension

c)

cyanosis

d)

hyperventilation

5.

. A 4-year-old child with a 4-day history of wheeze unresponsive to nebulized salbutamol and to adrenaline who is cyanosed and restless (PaO2 5kPa, PaCO2 10kPa) should be initially treated with:

a)

intravenous bicarbonate

b)

intravenous aminophylline

c)

immediate intubation and ventilation

d)

intravenous diazepam

6.

Which of the following is NOT characteristic of IgE-mediated food allergies?

a)

asthma

b)

diarrhea

c)

hypertension

d)

shock

7.

Toxic chemicals are most likely to be biotransformed in which of the following organs?

a)

CNS

b)

Heart

c)

Lung

d)

Liver

8.

An elderly man given atropine becomes excited and confused; appropriate treatment includes:

a)

intubation and ventilation

b)

morphine

c)

physostigmine

d)

chlorpromazine

9.

Neutralizing antibodies required in production of antivenoms:

a)

IgG

b)

IgA

c)

IgM

d)

IgE

10.

What is the primary goal in taking a history in a poisoned patient?

a)

Determining drug allergies

b)

Determining susceptibility to drug overdose

c)

Determining likelihood of an attempted suicide

d)

Determining the ingested substance

11.

An 8-year-old child is rescued 20 minutes after drowning and has a core temperature of 30°C and fixed dilated pupils. Further appropriate treatment includes:

a)

phenobarbitone

b)

rapid rewarming

c)

hypoventilation

d)

steroids

12.

Improperly canned foods can be contaminated with what bacteria causing respiratory paralysis?

a)

Clostridium perfringens

b)

Clostridium botulinum

c)

Bacillus cereus

d)

Clostridium difficile

13.

Which of the following is NOT a common mechanism of vascular toxicity?

a)

membrane disruption

b)

oxidative stress

c)

bioactivation of protoxicants

d)

reduction of accumulation of LDL in endothelium

14.

The following are reliable indications of air embolism: (Multiple Answer)

a)

a change in respiratory rate

b)

arrhythmias

c)

hypertension

d)

delta waves on EEG & a mill wheel murmur

15.

For bacterial mutagenicity testing developed by Bruce Ames and associates in 1973, which of the following would be used?

a)

Salmonella typhimurium

b)

Borrelia vincentii

c)

Streptococcus pneumonia

d)

Aerobacter aerogenes

16.

Moderate intoxications of salicylates are usually treated with urine akalinization through:

a)

potassium chloride

b)

sodium bicarbonate

c)

sodium chloride

d)

calcium carbonate

17.

Concerning analgesic drugs: (Multiple Answer)

a)

paracetamol is an anti-inflammatory drug

b)

indomethacin lowers a raised body temperature

c)

toxic doses of aspirin increase the rate and depth of respirations

d)

aspirin displaces other drugs from plasma proteins

18.

A chronic alcoholic came to ED with altered sensorium. His blood sugar level was normal. Treatment of this patient should be started with:

a)

Injection of vitamin B1

b)

IV dextrose 5%

c)

IV dextrose 50%

d)

IV normal saline

19.

The specific antidote for the treatment of poisoning due to oral ingestion of silver nitrate would be the oral administration of:

a)

acetic acid solution

b)

Na bicarbonate solution

c)

NSS

d)

lemon juice

20.

The study of the medico-legal aspects of the harmful effects of chemicals on human beings:

a)

clinical

b)

mechanistic

c)

environmental

d)

forensic

21.

The following are important air pollutants except:

a)

carbon monoxide

b)

ozone

c)

malathion

d)

sulfur dioxide

22.

Fatal dose of aspirin:

a)

5 grains

b)

5 grams

c)

5 milligrams

d)

none of these

23.

Which of the following is not a cause of acute lung injury?

a)

aspiration

b)

toxic gas inhalation

c)

cardiopulmonary bypass with heart lung machine

d)

lung contusion

24.

Local effects of poison except:

a)

erythema

b)

convulsion

c)

inflammation

d)

corrosion

25.

The ________ is the amount of chemical that enters and reacts with body systems to cause harm:

a)

TLV

b)

PEL

c)

Exposure

d)

Dose

26.

Rotten egg odor is a characteristic of poisoning with:

a)

heroin

b)

hydrogen sulfide

c)

ethylene glycol

d)

lead

27.

Prussian blue is the antidote for:

a)

lithium

b)

nitrite

c)

thallium

d)

cyanide

28.

This substance causes the famous “boiled-lobster” appearance

a)

bromates

b)

boric acid

c)

detergents

d)

chlorines

29.

Signs of bleeding include all of the following EXCEPT:

a)

rust-colored urine

b)

black, tarry stool

c)

unusual pain

d)

hypophonia

30.

A child who swallows an overdose of fluoride-containing product should be treated with a gastric lavage containing:

a)

neostigmine bromide

b)

calcium hydroxide solution

c)

sodium chloride

d)

EDTA

31.

Iron poisoning gives a_________ coloration of stool and urine.

a)

brown

b)

black

c)

blue

d)

red

32.

Early symptoms of theophylline toxicity include nausea, anorexia, and:

a)

bradycardia

b)

bleeding gums

c)

hypotension

d)

tachycardia

33.

Which of the following is NOT an initiating event in carcinogenesis?

a)

DNA adduct formation

b)

DNA strand breakage

c)

mutation of proto-oncogenes

d)

oxidative damage of DNA

e)

E. (No correct ans)

34.

Hemorrhage secondary to heparin administration can be best corrected by administration of:

a)

Vitamin K

b)

Whole blood

c)

Protamine

d)

Ascorbic acid

35.

In acute pulmonary edema the following are usually appropriate:

a)

sublingual nifedipine

b)

lie the patient supine

c)

oxygen

d)

I.V. loop diuretic

36.

Naloxone is indicated in a patient:

a)

having hallucinations

b)

with RR <15 per minute

c)

who is unarousable

d)

sleeping all day

37.

Which of the following is a common symptom of nickel exposure?

a)

renal failure

b)

diarrhea

c)

hepatic cirrhosis

d)

contact dermatitis

38.

A species of which of the following animals produces a venom that contains 60 percent formic acid?

a)

Snakes

b)

Lizards

c)

Ants

d)

Spiders

39.

All of the following symptoms would be expected following anticholinesterase insecticide poisoning EXCEPT:

a)

bronchodilation

b)

tachycardia

c)

diarrhea

d)

increased BP

40.

Which of the following clinical features does not characterize a sympathomimetic toxic syndrome?

a)

Hyperalertness

b)

altered mental status

c)

increased BP

d)

Hyperalertness

41.

Which of the following would NOT be used to enhance poison elimination?

a)

oral activated charcoal

b)

acidification of urine

c)

plasma exchange

d)

hemodialysis

42.

All of the following are common effects of toxicants on target molecules EXCEPT:

a)

blockage of neurotransmitter receptors

b)

Interference with DNA replication due to adduct formation

c)

Cross-linking of endogenous molecules

d)

Opening of ion channels

43.

Which of the following might increase the toxicity of a toxin administered orally?

a)

Increased intestinal motility

b)

Increased biotransformation of the toxin by gastrointestinal cells

c)

Increased excretion of the toxin by the liver into bile.

d)

Increased dilution of the toxin dose

44.

Tetrodotoxin is a selective inhibitor of the:

a)

Ca2+ channel

b)

Na+ channel

c)

K+ channel

d)

Cl- channel

45.

Allergic contact dermatitis is:

a)

a non-immune response caused by a direct action of an agent on the skin

b)

an immediate type I hypersensitivity reaction

c)

a delayed type IV hypersensitivity reaction

d)

characterized by the intensity of reaction being proportional to the elicitation dose

46.

Situations that predispose a digitalis-treated patient to toxicity include:

a)

hypercalcemia

b)

hyperkalemia

c)

hypermagnesemia

d)

hyperthyroidism

47.

The toxicity of nitrates is enhanced by in vivo conversion to:

a)

urea

b)

carbon dioxide

c)

nitrogen

d)

nitrites

48.

Which of the following toxins is suggested by the smell of garlic?

a)

cyanide

b)

toluene

c)

zinc

d)

organophosphate

49.

Nail polish remover contains:

a)

aniline

b)

ammonium hydroxide

c)

acetone

d)

phosphoric acid

50.

Which of the following agents has been associated with hemorrhagic stroke?

a)

Phenylpropanolamine

b)

terfenadine

c)

quinidine

d)

fenfluramine

51.

Halothane hepatotoxicity is linked to:

a)

history of cholecystitis

b)

prolonged anesthesia

c)

obesity

d)

age

52.

A peanut lodged in a child’s bronchus commonly presents with:

a)

hemoptysis

b)

interstitial emphysema

c)

chronic cough

d)

empysema

53.

An adult breathing 100% oxygen at sea level may suffer from:

a)

retrosternal chest pain

b)

permanent visual damage

c)

dizziness

d)

convulsions

54.

Pulmonary oxygen toxicity during oxygen therapy is associated with:

a)

prolonged exposure

b)

increased muscle activity

c)

high altitude

d)

increased carbon dioxide tension

55.

Isopropanol is not hepatotoxic but given in addition to carbon tetrachloride will enhance the hepatotoxicity of CCl4. This is an example of what chemical interaction?

a)

additive

b)

synergistic

c)

potentiation

d)

antagonistic

56.

The evidence of carcinogenicity of dietary intake is sufficient to include one’s diet as associated with neoplasms of all of the following except:

a)

gallbladder

b)

pancreas

c)

colon

d)

breast

57.

Contraindications to the administration of syrup of ipecac include which of the following?

a)

an unconscious patient

b)

a patient who is experiencing a generalized tonic-clonic seizure

c)

a patient who has ingested a caustic substance

d)

all of the above

58.

What type of medication is given to individuals as a form of supportive care to help them to reduce their dependence on ketamine?

a)

benzodiazepines

b)

antiparkinsonian medications

c)

antiepileptics

d)

narcotic analgesics

59.

Which of the following diseases is strongly associated with both cigarette smoking and excessive alcohol consumption?

a)

respiratory disease

b)

mental deterioration

c)

heart disease

d)

lung cancer

60.

Which form of cocaine is the most suitable for injection?

a)

crack

b)

rock

c)

the hydrochloride

d)

freebase

61.

Alcohol is best described as:

a)

depressant

b)

stimulant

c)

hallucinogen

d)

narcotic

62.

Which of the following antidotes are specific competitive antagonists used in clinical drug overdose?

a)

pralidoxime iodide

b)

acetylcysteine

c)

flumazenil

d)

protamine sulfate

63.

The treatment for someone bitten or stung by a venomous creature involves:

a)

applying a tourniquet to the affected part

b)

sucking out the venom from the wound

c)

facilitating systemic absorption of the venom

d)

neutralizing the toxins

64.

In acute cases of poisoning, activated charcoal acts to reduce absorption of the substance by:

a)

stimulating the chemoreceptor trigger zone in the medulla

b)

increasing osmotic pressure of the intestinal contents

c)

binding to the poison molecules

d)

shortening transit time through the gut

65.

Part of the triad of opioid/opiate toxicity, except:

a)

respiratory depression

b)

convulsion

c)

pinpoint pupil

d)

coma

66.

The impairment of hepatic function can have numerous consequences. Which of the following is likely NOT caused by impaired hepatic function?

a)

hypercholesterolemia

b)

hyperglycemia

c)

hypoalbuminemia

d)

jaundice

67.

Hypoglycemia is a recognized symptom or complication of: (Multiple Answer)

a)

Addison’s disease

b)

chlorpropamide therapy

c)

high dose of penicillin therapy

d)

chlorpromazine therapy

68.

Which of the following is NOT true for iron poisoning in children?

a)

less likely to be caused by ferrous gluconate than by ferrous sulfate

b)

causes melena

c)

causes respiratory acidosis

d)

causes jaundice

69.

The following are clinical signs consistent with heroin intoxication. Which is NOT?

a)

hypertension

b)

slurred speech

c)

pinpoint pupils

d)

hypothermia

e)

E

70.

Chronic use of anabolic steroids is associated with:

a)

peripheral neuropathy

b)

ototoxicity

c)

hepatic tumors

d)

pancreatitis

71.

Match the most appropriate antidote/specific measure:

methanol

a)

acetylcysteine

b)

ethanol

c)

desferrioxamine

d)

urinary alkalinization

e)

calcium chloride

72.

Match the most appropriate antidote/specific measure:

Aspirin

a)

Acetylcysteine

b)

Ethanol

c)

Desferrioxamine

d)

urinary alkalinization

e)

calcium chloride

73.

Match the most appropriate antidote/specific measure:

verapamil

a)

acetylcysteine

b)

ethanol

c)

desferrioxamine

d)

urinary alkalinization

e)

calcium chloride

74.

Match the most appropriate antidote/specific measure:

Iron

a)

acetylcysteine

b)

ethanol

c)

desferrioxamine

d)

urinary alkalinization

e)

calcium chloride

75.

Match the most appropriate antidote/specific measure:

paracetamol

a)

acetylcysteine

b)

ethanol

c)

desferrioxamine

d)

urinary alkalinization

e)

calcium chloride

76.

The route of administration of amyl nitrate in cyanide poisoning is:

a)

intramuscular

b)

intravenous

c)

subcutaneous

d)

inhalation

77.

For DNA test liquid blood is preserved in:

a)

sodium citrate

b)

potassium oxalate

c)

EDTA

d)

sodium fluoride

78.

With regards to the management of paracetamol poisoning, which of the following is not correct?

a)

the main antidote used is NAC

b)

methionine is less effective than NAC in patients who are vomiting or present >8 h after overdose

c)

patients taking anticonvulsants or with cystic fibrosis are at increased risk

d)

consider giving activated charcoal if overdose has been taken >4 hrs ago.

79.

The most serious potential consequence of ingestion f a liquid hydrocarbon such as kerosene or gasoline is:

a)

dissolution of the mucoid coat of the esophagus

b)

the corrosive action of the poison on the stomach lining

c)

the paralysis of peristaltic motion of the GI tract

d)

the aspiration of the poison into the respiratory tract

80.

The major routes by which toxic agents gain access to the body are through the following EXCEPT:

a)

blood

b)

GIT

c)

lungs

d)

skin

81.

The following should be routinely administered to the ED patient with an altered LOC.

a)

thiamine, glucose, metoclopramide

b)

thiamine, glucose, naloxone

c)

vitamin K, glucose, ipecac

d)

niacin, glucose, naloxone

82.

What is the antidote of choice in organophosphate/carbamate poisoning?

a)

BAL

b)

atropine

c)

diazepam

d)

acetylcysteine

83.

This method is useful in enhancing elimination of heavy metal poisoning.

a)

alkaline dieresis

b)

hemodialysis

c)

chelation therapy

d)

hemoperfusion

84.

This test is done on any substance to find its effects on fetus.

a)

carcinogenicity

b)

teratogenicity

c)

mutagenicity

d)

LD50

85.

Occupational asthma is typically caused by all of the following EXCEPT:

a)

cotton dust

b)

zinc oxide

c)

nickel

d)

isocyanates

86.

Formate intoxicates due to formaldehyde alone should be treated with:

a)

pantothenic acid

b)

folic acid

c)

pyridoxine

d)

ascorbic acid

87.

The reliable indicator of a coumarin anticoagulant effect:

a)

below normal blood glucose

b)

decreased PT

c)

elevated ABGs

d)

increased PT

88.

The toxic substance present in tubang-bakod plant.

a)

ricin

b)

curcin

c)

abrin

d)

nisin

89.

Quinidine toxicity includes all of the following EXCEPT:

a)

thrombocytopenia

b)

ventricular fibrillation

c)

hypertension

d)

cinchonism

e)

E

90.

The agent of choice to inactivate coelenterate nematocyst toxin (such as jellyfish) is:

a)

5% acetic acid (vinegar)

b)

ambient temperature fresh water

c)

ambient temperature seawater

d)

ammonia

91.

Match the common adverse effects:

Activated charcoal

a)

thrombocytopenia, increased prothrombin time

b)

constipation, empyema, perforation

c)

CNS depressant, respiratory arrest

d)

blurred vision, dry eyes, dilated pupils

e)

cardiomyopathy, skeletal myopathy

92.

Match the common adverse effects:

Dimercaprol

a)

thrombocytopenia, increased prothrombin time

b)

constipation, empyema, perforation

c)

CNS depressant, respiratory arrest

d)

blurred vision, dry eyes, dilated pupils

e)

cardiomyopathy, skeletal myopathy

93.

Match the common adverse effects:

Diazepam

a)

thrombocytopenia, increased prothrombin time

b)

constipation, empyema, perforation

c)

CNS depressant, respiratory arrest

d)

blurred vision, dry eyes, dilated pupils

e)

cardiomyopathy, skeletal myopathy

94.

Match the common adverse effects:

Atropine

a)

thrombocytopenia, increased prothrombin time

b)

constipation, empyema, perforation

c)

CNS depressant, respiratory arrest

d)

blurred vision, dry eyes, dilated pupils

e)

cardiomyopathy, skeletal myopathy

95.

Match the common adverse effects:

Ipecac

a)

thrombocytopenia, increased prothrombin time

b)

constipation, empyema, perforation

c)

CNS depressant, respiratory arrest

d)

blurred vision, dry eyes, dilated pupils

e)

cardiomyopathy, skeletal myopathy

96.

Which one of the following exhibits chemical antagonism or inactivation?

a)

Charcoal is given to prevent the absorption of a toxicant

b)

Dimercaprol chelates with mercury to decrease its toxicity

c)

Osmotic diuretic increases the excretion of chemical

d)

Norepinephrine is gin to barbiturate intoxication

97.

Lithium toxicity in newborns is manifested by: (Multiple Answer)

a)

poor suck and Moro reflexes

b)

lethargy

c)

cyanosis

d)

hepatomegaly

98.

Exposure to benzene has been associated with all of the following EXCEPT:

a)

acute nonlymphocytic leukemia

b)

bronchogenic carcinoma

c)

aplastic anemia

d)

testicular atrophy

99.

Lithium toxicity can be precipitated by all of the following EXCEPT:

a)

sodium depletion

b)

thiazide therapy

c)

ACE inhibitors

d)

NSAIDs

100.

Which of the following conditions is described by the idiom as “mad as a hatter”?

a)

lead poisoning

b)

cadmium poisoning

c)

mercury poisoning

d)

beryllium poisoning

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