Chem Path - Alcohol + Drugs

Question 1

All of the following are treatment options for toxic alcohol poisoning, EXCEPT…
Question 1Select one or more:
a.
Thiamine
b.
Fomepizole
c.
Hydroxocobalamin
d.
Folic Acid
e.
Pyridoxine

Answer 1

Hydroxocobalamin and Folic Acid

Question 2

You suspect a person had died of carbon monoxide poisoning when the area of hypostasis (where the blood has pooled in the body after death) is:
Question 2Select one or more:
a.
Cherry pink
b.
Greenish
c.
Bluish purple

d.
Orange-tan

Answer 2

Cherry pink

Question 3

A comatose 27-year-old woman is brought to the emergency room by paramedics, and the strong odor of better almond is present. The differential diagnosis must include the possibility of poisoning by:
Question 3Select one or more:
a.
Cyanide

b.
Carbon monoxide
c.
Benzene
d.
Arsenic
e.
Ethylene glycol

Answer 3

Cyanide

Question 4

A patient is admitted with suspected digoxin toxicity. Which of the symptoms below is UNLIKELY to be due to digoxin.
Question 4Select one or more:
a.
Gynaecomastia

b.
Hypokalaemia
c.
Bradycardia
d.
Scooping of the T segment on ECG
e.
Yellow vision

Answer 4

Hypokalemia

Causes HIGH POTASSIUM

Question 5

A patient brought by ambulance 2 hours after a suspected paracetamol overdose. Her flatmate the estimates patient consumed 20 to 30 tablets of 500-mg paracetamol. You request a serum paracetamol level and immediately:
Question 5Select one or more:
a.
Start a sodium bicarbonate infusion

b.
Administer N-acetylcysteine
c.
Arrange haemodialysis
d.
Perform gastric lavage

Answer 5

Administer N-acetylcysteine

Question 6

A 35-year-old woman presents following an intentional overdose. She called an ambulance and admits to taking sertraline but refuses to give any further details. On examination she is irritable, uncooperative and abusive. Her BP is 125/87 mmHg, pulse 112/min and temperature 37.2°C. In addition to β-hCG, which one of the following is the most important investigation?
Question 6Select one or more:
a.
ECG

b.
Urine drug screen
c.
Arterial blood gas
d.
Alcohol level
e.
Paracetamol level

Answer 6

Paracetemol level

Question 7

Which one of the following statements regarding paracetamol overdose is false?
Question 7Select one or more:
a.
The toxic metabolite in paracetamol overdose is NAPQI

b.
N-acetyl cysteine is the antidote to paracetamol overdose
c.
Kidney injury occurs by metabolite other than NAPQI
d.
Patients getting anticonvulsant like phenytoin is high risk of liver injury from paracetamol overdose
e.
Lab results can be normal in day 1

Answer 7

Kidney injury occurs by metabolite other than NAPQI

Question 8

A 3-year-old girl was brought into the Emergency Room. She was cold and clammy and was breathing rapidly. She was obviously confused and lethargic. Her mother indicated that she had accidentally ingested methanol while playing in the garage. Following gastrointestinal lavage and activated charcoal administration, a nasogastric tube for ethanol was administered. How will ethanol help in reliving the symptoms?

Question 8Select one or more:
a.
Conjugate with methanol to form a soluble compound
b.
Competitively inhibit the metabolism of methanol

c.
Promote the excretion of a metabolite of methanol
d.
Induce the alcohol dehydrogenase enzyme

Answer 8

Competitively inhibit the metabolism of methanol