Pharmacology & Clinical Toxicology Answer Key-GREEN PACOP.pdf

CLINICAL TOXICOLOGY C

1. This is obtained from an examination of the tissues and organs of the dead. a. Experimental evidence c. post-mortem evidence b. Chemical evidence d. circumstantial evidence

C

2. Death may result from poisoning due to the following causes, except: a. due to interference with the carriage of oxygen b. due to inhibition of the respiratory movements by neuro muscular agents c. due to interference with the enzyme system utilizing it d. circulatory failure as a result of cardiac glucosides

B

3. The most serious potential consequence of ingestion of liquid hydrocarbon such as kerosene or gasoline is: a. paralysis of the peristaltic motion of the GI tract b. the aspiration of the poison into the respiratory tract c. destruction of body enzymes by the poison

B

4. 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 c. sodium bicarbonate b. normal saline

D

5. Catharsis as a way of removing a poison include the ff. except: a. increases intestinal injury when a corrosive is ingested b. is avoided in a patient showing disturbed electrolyte imbalance c. hypertonic cathartic and enemas are hazardous in the presence of impaired renal function d. none of the above

B

6. This is recommended in phenol poisoning as a cathartic but is contraindicated in poisoning by chlorinated insecticide, since it may increase intestinal absorption a. magnesium sulfate c. mannitol b. castor oil d. Fleet’s Phospho-soda

B

7. A poison which increases suddenly in its intensity of action after slow or gradual addition of it is a. corrosive poison c. true poison b. cumulative poison d. irritant poison

C

8. Streptomycin can cause: th a. 4 cranial damage th b. 7 cranial damage

C

9. Most accidental poisoning in children is caused by: a. detergents b. bleaches c. crayons

B 10. Antidote for iodine poisoning: a. silver nitrate b. starch

th

c. 8 cranial damage th d. 6 cranial damage d. insecticides e. salicylate analgesics

c. potassium nitrate d. sugar

A 11. The evidences to be saved in nonfatal poisoning are the following, except: a. lung d. blood b. urine e. body fat c. food B 12. A specialized field of toxicology that designates an area of professional emphasis within the realm of medical science. a. Forensic toxicology c. Environmental toxicology b. Clinical toxicology d. Regulatory toxicology C 13. This is an area of toxicology which is concerned directly with toxicity testing, which provides necessary information for safety evaluation and regulatory requirements. a. mechanistic toxicology c. descriptive toxicology b. regulatory toxicology d. forensic toxicology A 14. The quantity of medicine that can kill an organism a. fatal dose b. LD50

c. Teratology d. Threshold Limit Value

C 15. Acute poisoning includes, except: a. taking a strong poison b. taking several small doses but frequent c. taking several small doses at long intervals www.brex.us

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CLINICAL TOXICOLOGY d. taking excessive single doses D 16. When reporting cases of poisoning like eating in a public restaurant, the cases should be reported to the: a. nurse d. public health officer b. family doctor e. BFAD c. pharmacist A 17. The ff. are mechanism of poison absorption, except: a. hydrolysis b. endocytosis

c. filtration d. passive diffusion

D 18. An example of a Phase 1 Reaction in the metabolism of substances is/are: a. oxidation c. reduction b. hydrolysis d. all of the above A 19. Pneumomediasternum is a complication of the use of: a. gastric lavage b. hemodialysis

c. hemoperfusion d. emetics

C 20. Constipation caused by active charcoal can be relieved by concomitant administration of a. glycerol c. laxative b. water d. none of the above D 21. Contraindication to the use of cathartics are the ff. except: a. GI hemorrhage c. renal failure b. corrosive agents d. none of the above C 22. The percentage of oxygen which is indicated for carbon dioxide poisoning to increase the conversion of carboxyhemoglobin to hemoglobin and myoglobin and to increase oxygen saturation of the plasma is: a. 50% c. 100% b. 75% d. 10% C 23. Nail polish removers contain a. aniline b. ammonium hydroxide

c. acetone d. phosphoric acid

C 24. Convulsions caused by drug poisoning are most commonly associated with: a. Phenobarbital c. strychnine b. diazepam d. chlorpromazine A 25. Alkanizing the urine with sodium bicarbonate is useful in the treatment of poisoning with: a. ASA and barbiturates c. amphetamines b. phencyclidine d. morphine D 26. Activated charcoal may be used in the treatment of these poisoning, except a. Phenobarbital c. aspirin b. propoxyphene d. methanol D 27. These statements regarding carbon monoxide poisoning are true except: a. the oxygen carrying capacity of the blood is decreased b. the oxyhemoglobin dissociation curve becomes shifted to the left, releasing less oxygen to the tissues c. carboxyhemoglobin level of less than 30% produces minimal symptoms d. treatment with 100% carbon dioxide is effective D 28. Ototoxicity may be an adverse reaction of the following, except: a. streptomycin c. furosemide b. ethacrynic acid d. tetracyclines A 29. The major routes by which toxic agents gain access to the body are through the ff., except: a. blood d. skin b. GIT e. parenteral route c. lungs C 30. Acute exposure by inhalation refers to continuous exposure for less than 2 hours, most frequently for: a. 2 d. 5 b. 3 e. 6 hrs. c. 4 A 31. Dryness of the mouth is a side effect of: a. atropine b. aspirin www.brex.us

c. acetaminophen d. cimetidine 129

CLINICAL TOXICOLOGY

E 32. One group of thiol-containing enzymes that may play a critical role in cell injury and death as a result of oxidative inactivation (oxidative stress) is: a. Ca d. Mg b. Na e. Al transportation alpase c. K D 33. Individuals who are deficient in glucose-6-dehydrogenase experience hemolysis following the treatment with these drugs, except: a. dapsone c. primaquine b. ethacrynic acid d. tetracyclines B 34. It is known as the prussic acid a. aniline b. hydrocyanic acid c. ethyl alcohol

d. iodine e. formaldehyde

C 35. It is known as the Neutral spirit a. aniline b. cyanide c. ethyl alcohol

d. iodine e. formaldehyde

A 36. It is also known as the stink damp a. hydrogen sulfide b. carbon monoxide

c. carbon disulfide d. nitrogen oxide

B 37. Acute intermittent forphyria is an absolute contraindication to the use of: a. nitrous oxide c. ketamine b. enflurane d. thiopental sodium A 38. Direct hepatotoxicity has been observed with the ff. anesthetic agents: a. halothane c. thiopental b. nitrous oxide d. all of the above A 39. A patient has resulted in acute hypertensive crisis after eating cheese. This interaction is possible if the patient is on: a. MAO inhibitor c. tetracyclines b. aspirin d. all of the above C 40. It is used in the manufacture of smoke bomb, antiseborrheic shampoos, in the treatment of bone fracture and rickets. a. bismuth d. cesium b. boron e. chromium c. cadmium E 41. Its deficiency mimics diabetes mellitus, it is found in brown sugar & butter a. bismuth d. cesium b. boron e. chromium c. cadmium A 42. It is used in silvering of mirror and it causes metal line gum. a. bismuth d. cesium b. boron e. chromium c. cadmium C 43. It is the poison found in rust and ink eradicator a. nitrite b. naphthalene c. oxalate

d. lead e. mercury

A 44. It is used to preserve the color of meat in pickling a. nitrite b. naphthalene c. oxalate

d. lead e. mercury

E 45. It is used in fingerprint photography a. nitrite b. naphthalene c. oxalate

d. lead e. mercury

D 46. It is the choice of professional poisoners www.brex.us

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CLINICAL TOXICOLOGY a. nitrite b. naphthalene c. oxalate

d. arsenic e. beryllium

E 47. It is the most toxic metal a. nitrite b. naphthalene c. oxalate

d. arsenic e. beryllium

E 48. Ammonium salt is the antidote for a. aniline b. cyanide c. ethyl alcohol

d. iodine e. formaldehyde

A 49. Methylene blue is the antidote for a. aniline b. cyanide c. ethyl alcohol

d. iodine e. formaldehyde

A

50. Deferoxamine is an antidote for: a. iron b. methanol

c. calcium d. iodine

A

51. These are simple asphyxiants which are gases, except: a. ethyl alcohl c. nitrogen b. methane d. none of these

A

52. Toxic substance found in “tulingan” or tuna and: a. sourine b. nenerupin

c. gemblid d. potassium bromate

53. Effective therapy to rattle snake bite: a. suction and tourniquet b. antivenin

c. antivenin, suction and tourniquet d. none of these

C

B

54. A type of poison that causes blackening and severe corrosion in the mouth: a. nitric acid d. phenol b. sulfuric acid e. hydrochloric acid c. ascorbic acid

D

55. It causes Minamata disease: a. nickel b. manganese

c. molybdenum d. mercury

56. Examples of herbicides, except: a. phenoxyacetic acid b. paraquat

c. diquat d. nicotine

57. Mushroom poisoning comes from: a. belladonna b. digitalis

c. Amanita phalloides d. all of these

58. It is the poison in toilet bowl deodorant: a. nitrite b. lead

c. naphthalene d. oxalate

59. Lead can be effectively detoxified by: a. barium sulfate b. BAL with EDTA

c. ethanol d. deferroxamine

D

C

C

B

B

A

60. It is known as the rodent’ poison a. hydrogen sulide b. phosphorus c. carbon disulfide 61. An antidote to methanol poisoning: a. ethanol b. digoxin

A

d. carbon tetrachloride e. carbon monoxide

c. atropine d. naloxone

62. Induction of vomiting is accomplished by administering:

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CLINICAL TOXICOLOGY a. syrup of ipecac b. ginger ale

c. peppermint syrup d. none of these

C

63. Banned toxic substance in “pandesal”, cakes and other bakery products: a. gemblid c. potassium bromate b. venrupin d. sourine

B

64. Fatal dose of aspirin: a. 5 grains b. 5 grams

c. 5 mg. d. all of these

65. Lysergic acid poisoning has this toxic syndrome/s: a. diluted pupil b. hallucinations and dilated pupil

c. hallucinations d. none of these

66. Death due to strychnine poisoning is from: a. fatigue b. fatigue of respiratory muscle

c. cardiac failure d. exhaustion of respiratory center

B

D

D

67. The abuse of this drug is responsible for major medical and socio – economic problems: a. chloral c. nitrous oxide b. chloral hydrate and ethanol d. ethanol

B

68. Poisoning due to anticholinesterase is best managed by the administration of: a. theophylline c. salbutamol b. atropine d. ethanol

B

69. Conjuctival and bronchial irritation are primary signs of exposure to: a. ergot c. ethyl alcohol b. sulfur dioxide d. mercury

A

70. Poisonous fishes contain unedible organs or toxin such as: a. ciguatoxin c. aflatoxin b. saxitoxin d. scombroid

C

71. Activated charcoal is specifically helpful in the treatment of poisoning from: a. aromatic compounds c. alkaloid b. all of these d. none of these

B

72. Convulsions caused by drug poisoning are commonly associated with: a. diazepam c. Phenobarbital b. strychnine d. chlorpromazine

D

73. Paraquat poisoning is characterized by: a. bloody stool b. none of these

c. hematemesis d. bloody stool and hematemesis

C

74. The universal antidote usually contains tannic acid, activated charcoal and: a. calcium hydroxide c. magnesium hydroxide b. aluminum hydroxide d. all of these

C

75. A carcinogenic substance found in stale peanut: a. peroxide b. glyceryl ester

c. aflatoxin d. fatty acid

76. Black widow spider venom is called: a. neostigmine b. lactrotoxin

c. carbachol d. all of these

77. The antidote for DDT poisoning: a. adrenaline b. atropine

c. amphetamine d. barbiturate

B

D

C B

B

78. Causes digitalis-like toxicity and baritosis: a. antimony b. aluminum 79. Metal used in water purification: a. lead b. copper

c. barium d. arsenic c. gold d. gallium

80. Litharge is also known as:

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CLINICAL TOXICOLOGY a. magnesium oxide b. lead oxide B

C

C

B

D

c. arsenic trioxide d. nitrous oxide

81. Manihotoxin found in this crop root: a. yam b. cassava

c. sweet potatoes d. none of these

82. Best known physiological antidote for strychnine: a. codeine b. pilocarpine

c. barbiturate d. morphine

83. Phencyclidine has this toxic syndrome: a. violent syndrome b. coma with open eyes

c. coma with open eyes and violent syndrome d. none of these

84. Bitter almond odor is symptoms of this poisoning: a. mercury b. cyanide

c. lead d. none of these

85. Principal active alkaloid of ipecac: a. caffeine b. apomorphine

c. ergonovine d. emetine

A

86. Sweet odor of vomitus is/are due to this type of poison/s: a. chloroform and acetone c. acetone b. turpentine d. chloroform

C

87. A poisonous principle of cocculus indicus used as fish poison: a. phenacetin c. picrotoxin b. picric acid d. colchicines

B

88. Treatment of bismuth poisoning involves the use of: a. morphine b. dimecaprol

c. EDTA d. none of these

A

89. A common household substance given as antidote is milk because: a. it is amphoteric and coats the c. it is amphoteric stomach b. coats the stomach d. none of these

A

90. It causes shellfish toxicity: a. dinoflagellates b. snails

B

91. One of the ingredients in mothballs: a. oxalix acid b. naphthalene c. activated charcoal

c. jellyfish d. octopus d. arsenic e. none of the above

C

92. Poison that converts the red hemoglobin to chocolate brown color a. aniline c. both a & b b. nitrobenzene d. ether

A

93. Dilution with water is contraindicated in the poisoning with a. sulfuric acid c. hydrochloric acid b. acetic acid d. none of the above

A

94. The poisonous substance in Lysol: a. cresol b. phenol

c. resorcinol d. thymol

95. Saxitoxin is the poison found in: a. mushroom b. dried nuts

c. marine animal d. snake

96. Cobra’s venom is composed of: a. toxin b. phytotoxin

c. bufotoxin d. syntoxin

C

D

A

97. Which of the following is the toxic action of antimony? a. inhibition of enzymes through combination with –SH group b. combines with hemoglobin to form carboxyhemoglobin

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CLINICAL TOXICOLOGY c. both a & b d. all of these e. none of these C

98. A branch of toxicology which is concerned with the medical and legal consequences of poisoning: a. environmental toxicology c. forensic toxicology b. experimental toxicology d. economic toxicology

D

99. Mechanism of action of mineral oil as antidote for poisoning by kerosene a. adsorption b. neutralization c. inactivation d. lessen respiratory hazard by increasing viscosity of kerosene

A 100. Yellow or disturbed vision, disturbed respiration, eplileptiform convulsion can be caused by: a. santonin d. all of these b. muscarine e. none of these c. atropine D 101. Oxidation of pyrocatechol and hydroquinol may tint the urine color ____. a. black d. green b. yellow e. none of these c. blue B 102. Best known physiological antidote for strychnine a. pilocarpine b. atropine

c. morphine d. codeine

C 103. Side-eeffects frequently seen with benzodiazepines, except: a. ataxia c. seizures b. drowsiness d. none of these D 104. Most commonly known animal poison: a. scombroid b. venom

c. saxitoxin d. tetrodotoxin

B 105. A botanical insecticide: a. malathion b. pyrethrum

c. parathion d. none of these

A 106. An enzyme found in the snake venom is: a. hyaluronidase b. urease

c. steapsin d. ptyalin

A 107. The effects that occurs at the site of the first contact between the biological system and the toxicant. a. local toxicity c. systemic toxicity b. economic toxicity d. cumulative toxicity A 108. This drug maybe added to local anesthetic solutions in order to prolong its action: a. Epinephrine c. Atropine Sulfate b.Sodium carboxymethylcellulose d. Norepinephrine B 109. Surface contaminated with phenol can be washed by: a. water b. ethanol

c. soap d. all of these

A 110. Peculiar stimulation (tingling) and paresthesia (numbness) of the sensory in nerves are symptoms of poisoning due to: a. aconite c. atropine b. muscarine d. physostigmine C 111. Potent cord convulsant, increases the excitability of the CNS at all level a. morphine c. strychnine b. muscarine d. both a & b C 112. Obtained from coal tar a. kerosene c. both a & b b. naphthalene d. none of these C 113. Intermediate acting barbiturate/s, except: a. amobarbital b. butabarbital www.brex.us

c. pentobarbital d. vinbarbital 134

CLINICAL TOXICOLOGY

D 114. Entrance or outlet of any body cavity is termed as: a. media b. meatus A 115. Atropa belladonna belongs to family a. Solanaceae b. Rutaceae c. Ranunculaceae A 116. Poisonous substances in Paris green is: a. arsenic b. cyanide

c. oral d. orifice

d. all of the above e. none of these

c. antimony d. mercury

B 117. Insecticide, fungicide, alloys in medicine, emetic drug, astringent and caustic, purification of water, escharotic a. cadmium d. mercury b. copper e. none of these c. lead A 118. Ultra short acting barbiturates are highly lipid soluble and rapidly penetrate the brain and is capable by inducing: a. anesthesia c. none of the above b. paralysis D 119. Cocaine is commonly known as: a. coke b. lady

c. crystals d. all of the above

A 120. Tetracycline tend to form complexes with the following, except: a. belladonna c. magnesium ion b. calcium ions d. iron ions C 121. A CNS stimulant, fish or bird poison, adulterant of beverage a. muscarine d. both a & b b. atropine e. none of these c. picrotoxin C 122. Brown color of smog a. nitrogen pentoxide b. nitric oxide c. nitrogen dioxide

d. all of these e. none of these

B 123. Specific antidote for silver poisoning a. lemon juice b. saline solution

c. ammonia

B 124. Patient’s taking insulin must be monitored closely when given with anti-hypertensive drug: a. Hydralazine c. Prazosin b. Propranolol d. Methyldopa B 125. The alkaloid found in Ipecac used for amoebic dysentery were evident poisoning symptom is violent purging with bloody stools: a. ephedrine c. isoquinoline b. emetine d. methylxanthine B 126. Which of the following symptoms is not present in digitalis intoxication? a. vomiting c. visual disturbance b. vagal arrest of the heart A 127. The cardinal rule or the first step to be considered in the treatment of poisoning is to: a. remove the poison from contact with the victim b. stop the action of the poison by giving the specific antidote c. provide symptomatic or supportive care d. fight against the tendency of death B 128. Cases of heavy metal poisoning are concrete examples of: a. sub-acute poisoning c. acute poisoning b. chronic poisoning d. unknown B 129. Calcium disodium edentate is: a. BAL b. Ca-EDTA www.brex.us

c. Desferal d. Penicillamine 135

CLINICAL TOXICOLOGY C 130. Example of poison which exhibits both local and remote type of effects: a. arsenic c. both a & b b. cantharides d. none of the above C 131. Substance intendd to prevent, destroy, repel or mitigate rats, mice, etc. a. herbicides c. redenticides b. hematocides d. molluscides B 132. Fatal dose of nitrobenzene: a. 2-3 drops b. 8-15 drops

c. 60-80 drops d. 0-1 drops

A 133. Characteristic odor of phosphorous intoxication: a. garlic odor b. mousey odor

c. odor of bitter almonds d. odor of chico

A 134. The only poisonous variety of phosphorus: a. yellow b. red

c. black d. all of the above

A 135. Tamoxifen is effectively useful in which of the following type of cancer: a. estrogen receptor rich breast cancer c. testicular cancer b. ovarian cancer d. cervical cancer D 136. The mechanism by which 70% ethyl alcohol may act as a disinfectant is attributed to: a. a metabolic degradation product of ethyl alcohol b. the lack of alcohol dehydrogenase in bacterial cells c. the inebriating effect of ethyl alcohol on cells d. the ability of ethyl alcohol to denature proteins D 137. Which of the following preparations contains arsenic? a. Fehling’s solution b. Benedict’s solution

c. Nylander’s solution d. Fowler’s solution

B 138. Source of phytotoxin: a. animals b. plants

c. minerals d. insects

C 139. Which of the following animals is used for flocculant precipitates with human blood: a. cat c. rabbit b. dog d. monkey B 140. The organ of elimination for metallic poison: a. mouth b. rectum

c. liver d. skin

A 141. Strong black coffee or subcutaneous injection of Caffeine Citrate in the treatment of acute alcohol poisoning is attributed to: a. antagonistic stimulant effect of caffeine b. oxidation of alcohol c. depressant action of caffeine d. hypotensive effect of caffeine A 142. The first toxic symptoms of digitalis poisoning is: a. gastrointestinal irritation b. undue depression of heart rate c. flushing of skin

d. cerebral excitement e. colored vision

B 143. A type of insulin which causes exceptionally few allergic reactions is: a. Protamine zinc insulin d. Lente insulin b. NPH insulin e. Salicylate analgesics c. Globin insulin B 144. Atropine poisoning can be antagonized by: a. Pralidoxime c. Phentolamine b. Neostigmine d. Isoproterenol C 145. The following symptoms of poisoning from Antimony (Sb) are similar to those of arsenic poisoning, except: a. diarrhea of rice-water stool b. severe dehydration and great thirst c. garlic odor of the breath and suppression of urine d. nausea and vomiting www.brex.us

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CLINICAL TOXICOLOGY

D 146. Metallic poisons are classified as: a. corrosive poison b. irritant poison

c. cerebral neurotic poisons d. all of the above

C 147. Prussian blue is the antidote for what poisoning? a. lithium b. nitrites

c. thallium d. cyanide

A 148. Whole Bowel Irrigation is performed using: a. PEG b. Sodium Phosphates enema

c. Magnesium d. NaSO4

B 149. The following compounds have two sulfhydryl (-SH) groups, except: a. DMSA c. DMPS b. Penicillamine d. BAL C 150. Which of the following can be used for carbamate poisoning: a. Pralidoxime c. Atropine b. Neostigmine d. all of the above B 151. Poison present in DORA rat killer: a. Diphenhydramine b. Coumarin

c. Heavy metals d. 2, 4 –D

D 152. The following are used to treat anaphylaxis: a. Diphenhydramine b. Dopamine

c. Cortisone d. Epinephrine

D 153. Caluim gluconate precipitates the following salts, excepts: a. oxalate c. sulfate b. fluoride d. none of the above C 154. Causes liquifaction necrosis: a. silicones b. acids

c. alkali d. paraquat

D 155. Street names of Marijuana, except: a. grass b. mary jane

c. pot d. ice

A 156. Ecstacy is related to what drug: a. amphetamine b. opiods

c. acetylcholinesterases d. anorectic

B 157. Antidote for cyanide poisoning, except: a. methemoglobin b. EDTA

c. hydroxycobalamine d. none of the above

A 158. FPN Test indicates the presence of: a. Chlorpromazine b. Imipramine

c. Ferric chloride d. Salicylic acid

A 159. Activated charcoal is used in the treatment of phenol poisoning as a: a. mechanical antidote c. physiological antidote b. chemical antidote B 160. Morphine as a physiological antidote in methanol poisoning acts by: a. reversing acidosis b. relieving abdominal pain

c. antagonizing the action of methanol d. inducing intestinal evaluation

A 161. Nalorphine acts as a specific antagonist for opium poisoning by: a. competitive inhibition c. non-competitive inhibition b. stimulation d. sedation C 162. The mechanism of action involved in the use of EDTA as antidote for heavy metal poisoning is: a. adsorption c. chelation b. oxidation d. precipitation B 163. A red color in the pyridine layer after adding NaOH develops in the presence of: www.brex.us

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CLINICAL TOXICOLOGY a. Nitrobenzine b. Chloroform

c. Ethylene d. Phenacetin

C 164. Triad of opiod/opiate toxicity, except: a. respiratory depression b. pin-point pupil

c. convulsion d. coma

B 165. Toxic metabolite of CCl4 a. epoxides b. phosgene

c. nitrite d. cyanide

D 166. Toxic metabolite of acetonitrile: a. epoxides b. phosgene

c. nitrite d. cyanide

A 167. Enzyme which catalyzes conversion of paracetamol to n-Acetyl-paraamino-benzoquinone imine: a. Cytochrome P-450 c. Hyaluconidase b. Superoxide Dismutase d. Glucoronide transferase A 168. Poison from black widow spider: a. a-latro toxin b. saxitoxin

c. a-bungarotoxin d. picrotoxin

B 169. Protamine sulfate is a/an: a. anticoagulant b. antidote for heparin toxicity

c. basic protein d. all of the above

C 170. Capable of measuring serum concentration levels of poisons, except: a. HPLC c. TLC b. RIA d. GLC B 171. Digoxin-FAB comes from: a. pigeons b. sheep

c. fish d. cats

D 172. Thallium toxicity cause: a. coma b. respiratory depression

c. metabolic acidosis d. hair loss

C 173. Penicillin is used to treat poisoning with: a. Amanita mushrooms b. Silibinin

c. Botulinum toxin d. Salmonella enterotoxin

B 174. The process of detoxification where in the drug/substance of abuse is withdrawn gradually: a. ”cold turkey” c. “lukewarm turkey” b. “warm turkey” d. “hot turkey” C 175. “Angel dust:” a. MDMA b. LSD

c. PCP d. THC

C 176. “Roofies:” a. alprazolam b. cannabis

c. flunitrazepam d. heroin

A 177. A toxic result on the developing organism may cause adverse effect during: a. prenatal development b. postnatal development

c. prior to conception d. all of the above

A 178. Fetal alcohol syndrome is characterized by the following, except: a. long palpebral fissures c. intellectual growth retardation b. retarded psychomotor development d. microencephaly A 179. Pralidoxime can be used for poisoning for: a. parathion b. aldicarb

c. either a or b d. neither a nor b

B 180. Present in tear gas: www.brex.us

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CLINICAL TOXICOLOGY a. cyanide b. capsaicin A 181. Muscarinic agonists, except: a. hyoscine b. arecoline

c. alloin d. cysteine sulfoxide c. pilocarpine d. none of the above

C 182. Which of the following conditions can cause convulsion: a. hypoglycemia c. isopropyl alcohol toxicity b. coma d. lactic acidosis A 183. Warfare gas: a. Phosgene b. COCl2

c. Sarin d. all of the above

B 184. A patient passing out a yellow-green vomitus can be poisoned by: a. iron c. phosphorous b. chromium d. cyanide C 185. Enters the breast milk and can cause neonatal narcotic dependence: a. heroin c. both a and b b. codeine d. none of the above C 186. A characteristic of arsenic poisoning: a. black gum lines b. wrist drop

c. Mees’ lines d. acrodynia

B 187. The following are important air pollutants except: a. Carbon monoxide b. Malathion

c. ozone d. sulfur dioxide

D 188. Antipyrine has been known to cause: a. blood dyscrasias b. non-electrolyte

c. fever d. high incidence of rashes

C 189. The following antidotes could be used to treat carbamate insecticide poisoning except: a. atropine c. physostigmine b. pralidoxime d. all of these C 190. The major target organ of toxicity of benzene: a. blood b. liver B 191. Morphine and its derivatives can cause the ff. except: a. dyspnea b. diarrhea c. constipation

c. bone marrow d. heart d. respiratory paralysis e. all of these

A 192. An agent that neutralizes a poison or counteract its effect is a/an a. antidote c. counterirritant b. antiemetic d. antibiotic C 193. Ethanol acts by preventing the conversion of this drug to formaldehyde by competing for dehydrogenase: a. Chlorine c. methanol b. Iodine d. all of these C 194. Signs of barbiturate poisoning: a. Alkalosis b. diuresis A 195. An antidote for heparin overdosage: a. Protamine sulfate b. Dicumarol

c. decrease respiratory minute volume d. hypertension c. Calcium salts d. Atropine

D 196. Angina pectoris is a type of pain seen in this type of poisoning: a. Hydrochloric acid c. Mercury b. Lead d. Nicotine C 197. Nicotinic acid produces which of the following effects: www.brex.us

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CLINICAL TOXICOLOGY a. decreases VLDL clearance b. increases production of VLDL

c. increases VLDL clearance d. none of these

B 198. An antidote for acetaminophen overdosage: a. atropine b. n-acetycysteine

c. physostigmine d. all of these

A 199. Drugs of high addicting property: a. Amphetamines b. Scopolamine

c. Chloral hydrate d. ketamine

D 200. All the following metals have been found with substantial evidence to be carcinogenic in humans, except: a. arsenic c. cadmium b. beryllium d. manganese D 201. The organs adversely affected by lead, except: a. brain b. kidneys

c. blood d. lungs

B 202. Causes fetal hydantoin syndrome: a. heroin b. phenytoin

c. penicillin d. tamoxifen

A 203. Exposures at anytime during pregnancy poses a high risk of congenital structural abnormalities: a. tretinoin c. carbamazepine b. cyclophosphamide d. tamoxifen A 204. Ipecac syrup has the following adverse effect except: a. blurred vision b. persistent gastrointestinal upset

c. hemorrhagic gastritis d. all of these

D 205. Enhancement of elimination of poisoning include: a. manipulation of urine pH to accelerate urinary excretion b. hemoperfusion c. hemodialysis d. all of these B 206. The most toxic veratrine alkaloid is: a. pseudoveratrine b. protoveratrine

c. veratrine d. pseudogerbine

C 207. The following are classified as mechanical antidote, except: a. emetics c. artificial respiration b. cathartics d. stomach tube C 208. Aflatoxin is found in: a. nux vomica b. mushroom

c. improperly dried nut d. shellfish

C 209. A specific antidote for metallic poisoning like arsenic: a. Sodium nitrate b. copper sulfate

c. dimercaprol d. activated charcoal

D 210. These are chelating agents used as antidotes: a. Penicillamine b. calcium edentate

c. dimercaprol d. all of these

C 211. Atropine is useful in treating poisoning by organophosphate insecticide because it: a. stimulates receptors directly b. reactivates inhibited acetylcholinesterase c. blocks the action of acetylcholine at both central and peripheral sites d. inhibits normal ganglionic transmission C 212. Iron poisoning gives___________ coloration of stool and urine: a. brown c. black b. blue A 213. Antidote for monomethylhydrazine: a. pyridoxine b. thiamine www.brex.us

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CLINICAL TOXICOLOGY B 214. Caffeine can cause: a. respiratory paralysis b. restlessness

c. drowsiness d. all of these

B 215. An antidote for curare poisoning: a. Atropine b. Neostigmine

c. Homatropine d. all of these

B 216. Rotten egg odor is a characteristic of: a. heroin poisoning b. hydrogen sulfide

c. lead d. ethylene glycol

B 217. The most practical emetic is: a. water b. tickling the throat

c. milk d. tea

C 218. Digitoxin gives this kind of physiological action: a. local b. remote

c. local and remote effect

D 219. An antidote that acts by adsorption and is usually given when the nature of poison is unknown: a. Potassium permanganeate c. Tannic acid b. Ipecac syrup d. Charcoal D 220. The basis of understanding drug interaction is: a. Pharmacokinetics b. Pharmacodynamics

c. toxicodynamics d. all of these

D 221. Non-therapeutic chemical most commonly involved in poisoning are the following except: a. corrosives c. Solvents b. Insecticides d. Analgesics B 222. Emetics act in the following manner except: a. centrally b. peripherally C 223. The greatest threat from morphine poisoning is: a. renal shutdown b. paralysis of the spinal cord

c. locally d. none of these

c. respiratory depression

C 224. This substance is produced by the incomplete combustion of carbon or carbonaceous materials a. nitrogen material c. carbon monoxide b. sulfur oxides d. hydrogen sulfides C 225. Also known as knock out drops: a. chloroform b. trichloromethane

c. chloral hydrate d. phenol

B 226. This gas is used for execution in co-called gas chamber: a. nitrous oxide c. cyanide b. pulmonary emboli d. neoplastic disorder C 227. Streptokinase is indicated for the treatment of: a. impaired fat absorption b. pulmonary emboli

c. tuberculosis d. neoplastic disorders

D 228. When reporting cases of poisoning like eating in a public restaurant, the case should be reported to the: a. nurse d. public officer b. family doctor e. BFAD c. pharmacist A 229. The major routes by which toxic agents gain access to the body are through the following except: a. blood c. skin b. GIT d. parenteral route B 230. The most serious consequence of ingestion of liquid HC such as kerosene or gasoline is: a. paralysis of the peristaltic motion of the GI tract b. aspiration of the poison into the respiratory tract c. destruction of body enzymes by the poison A 231. Discarding outdated tetracyclines is important because they: www.brex.us

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CLINICAL TOXICOLOGY For questions 232-236, write: A - Normal saline B - Dimercaprol C- Atropine

D - Lead E - Neostigmine

A 232. The specific antidote for the treatment of poisoning due to the oral ingestion of silver nitrate D 233. Ethylenediamine-tetraacetic acid is an antidote for this poison. E 234. Antidote for curare poisoning B 235. The most effective antidote to arsenic, gold, mercury poisoning, which is a metal complexing agent C 236. The best known physiological antidote for strychnine For questions 237-241, write: A – Diazoxide B – Diazepam C – Syrup of ipecac

D – charcoal E – Sodium Bicarbonate

E 237. This is indicated for severe metabolic acidosis resulting from intoxicaton bymethanol, ethylene, glycol, salicylates and excessive lactic acid. B 238. This is indicated for anxiety, convulsions, muscle relaxant and chloroquin poisoning to antagonize cardiac toxicity. A 239. The drug is used as a oral hypoglycemic agent. D 240. An antidote that acts by adsorption and is usually given when the nature of the poison is unknown. C 241. This is usually given in poisoning to induce vomiting. For questions 242-245, write A – Ammonia water B – 2.5% sodium thiosulfate C – Atropine

D – BAL with EDTA E – Pyridoxine

C 242. The best antidote for organophosphate poisoning. B 243. The antidote for treating poisoning of bleaching agents like Zonrox. A 244. The best antidote for formaldehyde poisoning, since it forms a nonpoisonous product which is methenamine. E 245. The antidote for Isoniazid poisoning. For questions 246-250, write A – Acetylcysteine B – Sulfate C – Starch

D – activated charcoal E – Folic acid

B 246. Antidote for magnesium salts. D 247. Universal antidote contains this substance. C 248. Antidote for iodine poisoning. E 249. This B-complex vitamin when administered to patients with methanol and ethylene glycol poisoning may enhance the elimination of the toxic metabolite, formic acid. A 250. This drug is indicated for acetaminophen overdose, which acts as sulfhydryl group donor substituting for the liver’s usual sulfyldryl donor glytathione. For questions 251-254, write: A – Acetylcysteine B – Atropine C – Potassium salt

D – Thiamine E – Ethanol

B 251. This drug could be used to treat hydrocarbon insecticide poisoning. E 252. The antidote for methanol and ethylene glycol poisoning. www.brex.us

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CLINICAL TOXICOLOGY D 253. Glucose with this drug is given to alcoholic and malnourished patient but may aggravate hyperglycemic ischemia and braininjury. C 254. Used for the treatment of digitalis poisoning For the questions 255-258, write: A – Vitamin K B – Nalorphine C – Apomorphine HCL

D – BAL E – Citric Acid

B 255. The specific antagonist for narcotic poisoning C 256. An injectable emetic E 257. An antidote for sodium hydroxide poisoning A 258. An antidote for warfarin poisoning For questions 259-263, write: A – CuSO4 B – Nalorphine C – Sodium bicarconate

D – KCl E – Chlorpromazine

C 259. This is the antidote for chlorine gas poisoning. A 260. This is an antidote for phosphorous poisoning. E 261. A systemic antidote for amphetamine poisoning. D 262. A physiological antagonist for digitalis. B 263. Acts as a specific antagonist for opium poisoning. For questions 264-268, write: A – Atropine/Pralidoxime B – Magnesium hydroxide C – Ethanol

D – Naloxone E – Sodium bicarbonate

D 264. Poisoning by narcotics can be best treated by giving this drug. C 265. Surface contamination with phenol can be washed using this substance. B 266. The universal antidote usually contains tannic acid, activated charcoal and this drug. A 267. These drugs can treat poisoning with organophosphates like parathion and malathion. E 268. This drug is used for effective excretion of absorb barbiturates. B 269. A person is likely to be more susceptible to digitoxin toxicity if digitoxin is given with: a. neomycin c. Phenobarbital b. hydrochlorothiazide d. thioridazine C 270. The scientific name of the source of the very toxic ergonovine: a. Papaver somniferum c. Claviceps purpurea b. Croton tiglium d. Cantari’s vesicatoria B 271. Spoiled food brings about: a. Botulism c. Tinnitus Cureum b. Ptomaine d. none of these A 272. The “F” value for a drug product is most closely related to its: a. absolute bioavailability d. relative bioavailability b. dosing rate e. route of administration c. clearance rate B 273. Food poisoning is an example of: a. organic alkaloidal poisoning b. organic bacterial poisoning

c. organic animal poisoning d. none of the above

C 274. A condition of more or lesscomplete suspension of respiration and death may begin at the lungs: a. Syncope c. Asphyxia b. coma d. drowning www.brex.us

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B 275. Oil of mirbane is the synonym for: a. sulfuric acid b. nitrobenzene

c. potassium hydroxide d. potassium nitrate

B 276. Antidote for magnesium salts: a. 4% tannic acid solution b. insoluble sulfates

c. Nalorphine d. Copper sulfate

B 277. The primary toxicity of carbon tetrachloride a. nephrotoxicity b. hepatoxicity

c. cardiotoxicity d. pulmonary toxicity

D 278. Washing out of an organ, such as the stomach or bowel: a. intravenous c. labyrinth b. irrigation d. lavage B 279. This poison particularly affects the cardiac muscles: a. Strychnine b. Digitoxin

c. Theophylline d. Pilocarpine

C 280. Exerts their effects by interfering with the oxidation of the tissues: a. narcotics c. asphyicants b. irritants d. convulsants C 281. The function of the toxicologist covers: a. diagnosis of a poisoning case b. detection and treatment of an identified poisoning case c. all of the above d. none of the above C 282. Agents which produce exhaustion and cause marked loss of vital or muscular power: a. tetanics c. asthenics b. neurotics d. stimulants C 283. Agents which produce stupor: a. abortives b. stimulants

c. narcotics d. convulsants

C 284. Evidence obtained by examination of body organs and tissues after death: a. experimental evidence c. post-mortem evidence b. post-mortem evidence d. pre-mortem evidence C 285. Evidence contributed by the symptoms: a. chemical evidence b. post-mortem evidence

c. symptomatic evidence d. experimental evidence

B 286. The best method of isolating non-volatile poisons is by: a. distillation with a current of steam b. distillation without current steam c. extraction with water or oxalic acid d. extraction with organic acids C 287. An adverse effect commonly associated with the use of theophylline products: a. hypertensive crisis c. insomnia b. skin rash d. tardive dyskinesia D 288. Local action of poisons are best characterized by: a. Cantharidin c. Corrosive acids b. phosphorus d. all of the above C 289. Digitoxin gives this kind of physiological action: a. local b. remote

c. both a & b d. none of these

C 290. Evidence obtained by administering the suspected substance to some living animals and observing the effects: a. circumstantial evidence c. experimental evidence b. symptomatic evidence d. chemical evidence C 291. Distinguishing test of carbon disulfide from hydrogen sulfide: a. Sulphocyanate test c. Xanthogenate test b. hypochlorite test www.brex.us

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B 292. Aniline + bromine water gives this characteristic precipitation: a. pinkish-red precipitate c. blue-green precipitate b. flesh-colored precipitate d. yellowish-globules B 293. In order to detect with certainty nitrobenzene, one must: a. stream distill the sample b. reduce the sample first to aniline with iron and HCL acid, then test for aniline c. smell the liquid C 294. Nitrobenzene odor resembles that of: a. chico b. garlic

c. bitter almonds d. oil of sulfates

C 295. A type of poisoning produced by taking or absorbing for a protracted period small doses of a poison, thereby producing gradual deterioration of function of tissues: a. acute poisoning c. chronic poisoning b. sub-acute poisoning d. none of the above C 296. Dose which may be expected ordinarily to produce the therapeutic effects for which the preparation is employed: a. maximum dose c. average dose (median) b. minimum dose d. above average dose C 297. Atmospheric substance with an oxidizing power which liberate iodine from the solution of KI: a. carbon monoxide c. ozone b. oxidants d. hydrogen sulfide gas C 298. This substance is produced by the incomplete combustion of carbon or carbonaceous materials: a. nitrogen materials c. carbon monoxide b. sulfur oxide d. hydrogen sulfide C 299. Characteristic color of the ammonium phosphor-molybdate precipitate for the presence of phosphorous: a. violet precipitate c. yellow precipitate b. black precipitate d. maroon precipitate C 300. Characteristic type of precipitate of magnesium ammonium phosphate for the presence of phosphorous: a. curdy, white precipitate c. crystalline, white precipitate b. heavy, white precipitate d. white solution

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