Chapter 43 - Drugs, Toxins, & Chemical Agents Flashcards
Tetanospasmin interferes with the function of the reflex arc by blockade of which neurotransmitter? A. GABA B. Acetylcholine C. Dopamine D. Norepinephrine
A. GABA (p. 1216)
This structure in the spinal cord is preferentially affected in tetanus A. Renshaw cell B. Alpha motor neuron C. Gamma motor neuron D. Dorsal root ganglion
A. Renshaw cell (p. 1216)
Most common form of tetanus A. Generalized tetanus B. Local tetanus C. Cephalic tetanus D. All have more or less equal prevalence
A. Generalized tetanus (p. 1216)
Most benign form of tetanus A. Generalized tetanus B. Local tetanus C. Cephalic tetanus D. All are equally benign
B. Local tetanus (p. 1216)
Most fatal form of tetanus A. Generalized tetanus B. Local tetanus C. Cephalic tetanus D. All are equally fatal
C. Cephalic tetanus (p. 1216)
Most characteristic EMG finding in generalized tetanus
A. loss of silent period that occurs after reflex contraction
B. intermittent bursts of large motor unit potentials
C. decrementing response to repetitive nerve stimulation
D. none of the above
A. loss of silent period that occurs after reflex contraction (p. 1216)
Which of the following is NOT true regarding treatment of opioid overdose?
A. Nalmefene is a specific antidote to opiates and the synthetic analgesics.
B. Naloxone is given at 0.05 mg and repeated in larger increments q2min to a dose of 15 mg IV
C. Children need lower initial dose of naloxone
D. Failure of naloxone to produce improvement should cast doubt on the diagnosis of opioid intoxication
C. Children need lower initial dose of naloxone (p. 1202)
The following are advantages of naltrexone over naloxone EXCEPT A. Longer effect B. Almost free of agonist effects C. Can be given orally D. None of the above
D. None of the above (p. 1205)
Most important medical complication of opioid use A. HIV infection B. Endocarditis C. Septicemia D. Viral hepatitis
A. HIV infection (p. 1205)
This neurologic complication of opioid use is due to particulate matter injected with heroin
A. Occlusive stroke
B. Amblyopia
C. Peripheral neuropathy
D. Subacute progressive leukoencephalopathy
E. Transverse myelopathy
A. Occlusive stroke (p. 1205)
This neurologic complication of opioid use is due to quinine in heroine mixtures
A. Occlusive stroke
B. Amblyopia
C. Peripheral neuropathy
D. Subacute progressive leukoencephalopathy
E. Transverse myelopathy
B. Amblyopia (p. 1205)
This neurologic complication of opioid use is due to inhalation of heated heroin vapor/“chasing the dragon”
A. Occlusive stroke
B. Amblyopia
C. Peripheral neuropathy
D. Subacute progressive leukoencephalopathy
E. Transverse myelopathy
D. Subacute progressive leukoencephalopathy (p. 1205)
Most common extrapyramidal complication of phenothiazines and butyrophenones
A. Parkinsonian syndrome
B. Acute dyskinetic and dystonic reactions
C. Akathisia
D. Tardive dyskinesia
E. Neuroleptic malignant syndrome
A. Parkinsonian syndrome (p. 1209)
Most common adverse effect of all MAOI A. Unwanted stimulation B. Postural hypotension C. Convulsions D. Skin rash
B. Postural hypotension (p. 1211)
Which among the SNRIs should not be given in individuals with a history of seizures A. Venlafaxine B. Mirtazapine C. Citalopram D. Bupropion
D. Bupropion (p. 1212)
Mechanism of action of exotoxin of Clostridium botulinum A. Interferes with release of Ach B. Acetylcholinesterase inhibitor C. Blocks post-synaptic Ach receptor D. All of the above
A. Interferes with release of Ach (p. 1218)
EMG-NCV findings in botulism
A. Reduced amplitude of evoked muscle potentials and increase in amplitude with RNS
B. Reduced amplitude of evoked muscle potentials and reduced amplitude with RNS
C. Increase in amplitude of evoked muscle potentials and increase in amplitude with RNS
D. Increase in amplitude of evoked muscle potentials and reduced amplitude with RNS
A. Reduced amplitude of evoked muscle potentials and increase in amplitude with RNS (p. 1218)
Mechanism of action of neurotoxin fish poisoning (ciguatera) A. Block neural Na channels B. Block Cl channels C. Block K channels D. All of the above
A. Block neural Na channels (p. 1219)
Toxin found in pufferfish A. Tetrodotoxin B. Ciguatoxin C. Saxitoxin D. Brevetoxin E. C and D
A. Tetrodotoxin (p. 1219)
Toxin found in snails A. Tetrodotoxin B. Ciguatoxin C. Saxitoxin D. Brevetoxin E. C and D
B. Ciguatoxin (p. 1219)
Toxin found in shellfish A. Tetrodotoxin B. Ciguatoxin C. Saxitoxin D. Brevetoxin E. C and D
E. C and D (p. 1219)
The following clinical manifestations are seen in lead poisoning in children EXCEPT:*
A. Anorexia
B. Memory loss
C. Intermittent vomiting, vague abdominal pain
D. Seizures
B. Memory loss (p. 1221)
The usual manifestations of lead poisoning in adults are the following EXCEPT A. Colic B. Anemia C. Peripheral neuropathy D. Dementia
D. Dementia (p. 1222)
Mees lines are more often seen in poisoning with this metal: A. Lead B. Arsenic C. Manganese D. Mercury
B. Arsenic (p. 1223)
Drug of choice for the treatment of chronic mercury poisoning A. Penicillamine B. Succimer C. BAL D. L-dopa
A. Penicillamine (p. 1224)
Most important toxic side effect of vincristine, and is also the one that limits its use as a chemotherapeutic agent A. Peripheral neuropathy B. Constipation C. Impotence D. Orthostatic hypotension E. Seizures
A. Peripheral neuropathy (p. 1227)
This drug is thought to cause neuropathy by its action as an inhibitor of the depolymerization of tubulin, thereby promoting excessive microtubule assembly within the axon A. Vincristine B. Cisplatin C. Paclitaxel D. Procarbazine
C. Paclitaxel (p. 1227)
This drug is said to cause ischemic and hemorrhagic infarcts and cerebral venous and dural sinus thrombosis due to transient deficiencies in plasma proteins that are important in coagulation and fibrinolysis A. Cisplatin B. Paclitaxel C. Procarbazine D. L-asparaginase E. 5-FU
D. L-asparaginase (p. 1228)
Not seen in lithium toxicity* A. Dulled mentation B. Confusional psychosis C. Constipation D. Polymyoclonus E. Vertical nystagmus
C. Constipation (p. 1212)
