E02_05 Clinical Toxicology

Question 1

2018_Clinical Toxicology

Withdrawn because of adolescent girls developing vaginal CA when exposed to it in utero

A. Thalidomide
B. Melamine
C. Diethylstilbestrol
D. Terfinadine

Answer 1

C. Diethylstilbestrol

Question 2

2018_Clinical Toxicology

Children may be exposed to lead through the following

A. Dental amalgam
B. Vaccination
C. Soil and dust
D. Thermometers

Answer 2

C. Soil and dust

Question 3

2018_Clinical Toxicology

Which breath odor and poison is correctly matched?

A. Bitter almonds: Arsenic
B. Rotten egg: Cyanide
C. Garlic: isopropanol
D. Pears: chloral hydrite

Answer 3

D. Pears: chloral hydrite

Question 4

2018_Clinical Toxicology

A child was seen unconscious with an empty bottle of jewelry cleaner. What is the suspected toxicant?

A. Sodium hypochlorite
B. Kerosene
C. Mercury
D. Cyanide

Answer 4

D. Cyanide

Question 5

2018_Clinical Toxicology

A random drug screening for methamphetamine may be falsely negative in the following situation:

A. Urine pH = 8
B. Urine sample is contaminated with bacteria
C. Cross reaction with other drugs occurs
D. Urine collection is done in the evening

Answer 5

Answer: BONUS

I think the question meant to say that by acidifying the urine, a meth user may be able to fool a urine drug screen. Unfortunately it seems the question only fooled itself since a urine pH of 8 means that you alkalinized your urine instead of acidifying it.

Question 6

2018_Clinical Toxicology

Aside from GI and cardiovascular effects, iron toxicity may also cause

A. Hair loss
B. Hemolytic anemia
C. Peripheral neuropathy
D. Caustic injury

Answer 6

D. Caustic injury

Question 7

2018_Clinical Toxicology

A drug addicted teen was brought to the ER and found to have pinpoint pupils and decreased heart rate and respiratory rate. What is the suspected toxidrome?

A. Anticholinergic
B. Cholinergic
C. Sympathomimetic
D. Opiate

Answer 7

D. Opiate

Question 8

2018_Clinical Toxicology

Treatment for convulsions of unknown origin

A. Vitamin B1
B. Vitamin B6
C. Vitamin B12
D. Vitamin C

Answer 8

B. Vitamin B6

You may give vitamin B1 for patients with coma of unknown origin

Question 9

2018_Clinical Toxicology

Which of the following is correctly paired?

A. Inert complex formation: pyridoxine
B. Competitive inhibition at receptor site: DMSA
C. Reduction in conversion to more toxic compounds: ethanol
D. Bypassing effect of poison: antivenin

Answer 9

C. Reduction in conversion to more toxic compounds: ethanol

Correct pairings would be:
> Inert complex formation – DMSA
> Competitive inhibition at receptor sites – pralidoxime or atropine
> Bypassing the effects of poison – pyridoxine or oxygen
> Antibody interacting with poison – digibind or antivenin.

Question 10

2018_Clinical Toxicology

After eating shellfish, your friend experienced perioral numbness. What first aid treatment may be given at home?

A. Baking soda solution
B. Milk and eggs
C. Egg whites
D. Burnt toast, tea, and Maalox

Answer 10

A. Baking soda solution

Question 11

2014_Clinical Toxicology

Management for salicylate overdose

A. Acidify the urine
B. N-acetylcysteine
C. Alkalinize the urine
D. Penicillamine

Answer 11

C. Alkalinize the urine

Question 12

2014_Clinical Toxicology

Antidote for organophosphate toxicity:

A. Physostigmine
B. Atropine
C. Penicillamine
D. Flumenazil

Answer 12

B. Atropine

Atropine is the physiologic antidote for organophosphate toxicity

Question 13

2014_Clinical Toxicology

Overdose of paracetamol can precipitate life threatening abnormalities in which of the following organs?

A. lungs
B. liver
C. kidney
D. adrenal glands

Answer 13

B. liver

Paracetemol is primarily metabolized by the liver.

Question 14

2014_Clinical Toxicology

A lethargic 18 year old female was brought to the ER who intentionally took an unknown number of sedatives. What would be an appropriate antidote?

A. methylene blue
B. flumazenil
C. 100%oxygen
D. naloxone

Answer 14

B. flumazenil

Flumazenil is used at reversing both benzodiazepine induced sedation and amnesia. (Pubmed)

Question 15

2014_Clinical Toxicology

Management for amphetamine toxicity:

A. acidify the urine by giving ascorbic acid
B. alkalanize the urine with sodium bicarbonate
C. peritoneal dialysis
D. hyperbaric oxygen

Answer 15

A. acidify the urine by giving ascorbic acid

Acidification therapy is used for methamphetamine and ammonium chloride toxicity.

Question 16

2014_Clinical Toxicology

The major toxic effect of cyanide exposure is:

A. Hemoglobin alteration
B. Lipid peroxidation
C. Hemolysis of red blood cells
D. Inhibition of mitochondrial respiration

Answer 16

d. Inhibition of mitochondrial respiration

Cyanide inhibits mitochondrial respiration leading to anaerobic respiration

Question 17

2014_Clinical Toxicology

Which of the following is incorrect regarding lead poisoning?

A. has lead lines on gingival and on epiphysis of long bones on x-ray
B. shows erythrocyte basophilic stippling
C. manifests with wrist and foot drop
D. may lead to megaloblastic anemia

Answer 17

D. may lead to megaloblastic anemia

Elevated levels of lead in the body can be detected by the presence of changes in blood cells visible with a microscope and dense lines in the bones of children seen on X-ray.

Question 18

2014_Clinical Toxicology

Which form of mercury was the predominant cause of Minamata disease?

A. metallic mercury
B. mercuric salts
C. mercurous salts
D. organic mercury compounds

Answer 18

D. organic mercury compounds

Minamata disease is due to the exposure to methyl mercury which is an organic mercury compound.

Question 19

2014_Clinical Toxicology

Antidote for iron toxicity:

A. EDTA
B. Succimer
C. Penicillamine
D. Deferoxamine

Answer 19

D. Deferoxamine

Question 20

2014_Clinical Toxicology

Wernicke’s encephalopathy and Korsakoff’s syndrome are clinical conditions that result from sever deprivation of:

A. thiamine
B. calcium
C. riboflavin
D. nicotinic acid

Answer 20

A. thiamine

Wernicke’s encephalopathy results from Vit. B1 (thiamine) deficiency.