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FINAL 1 Flashcards

1
Q

The gas that has poor warning properties is which of the following?

  • Hydrogen sulfide
  • Sulfur dioxide
  • Ozone
  • Carbon monoxide
A

Carbon monoxide

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2
Q

Chronic use of steroidal anti-inflammatory medications will NOT cause which of the following effects?

  • Cataracts
  • Hypoglycemia
  • Ulcers
  • Hypertension
A

Hypoglycemia

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3
Q

Which of the following is correct for carbon monoxide?

  • It binds to Hb at the N-terminus
  • It has the greatest binding affinity for adult Hb
  • It competes with oxygen for binding sites in Hb
  • It oxidizes Hb from methemoglobin
A

It has the greatest binding affinity for adult Hb

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4
Q

Which of the following are sources of carbon monoxide?

  • Cigarette smoke
  • Automobile exhaust
  • Gasoline generators
  • All of the above are correct
  • None of the above is correct
A

All of the above

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5
Q

Chronic use of steroidal anti-inflammatory medications can cause GI ulcers because of inhibition of which of the following enzymes?

  • Phospholipase A2
  • Phospholipase C
  • Cyclo-oxgenase
  • Aldehyde dehydrogenase
A

Phospholipase A2

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6
Q

Carbon monoxide inhalation

  • will reduce the amount of Hb available to transport oxygen
  • can be mis diagnosed as “Flu”
  • Can cause fetal damage
  • A and B
  • All of the above
A

All of the above

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7
Q

Chronic use of non-steroidal anti-inflammatory medications can cause GI ulcers because of inhibition of which of the following enzymes?

  • Phospholipase A2
  • Phospholipase C
  • Cyclo oxygenase
  • Aldehyde dehydrogenase
A

Cyclo oxygenase

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8
Q

Which of the following is characteristic sequelae upon dermal contact with a strong base such as lye (sodium hydroxide)

  • progressive, penetrative damage
  • superficial damage with eschar formation
  • systemic toxicity due to severe methemoglobin
  • decreased oxygen transport due to hemolytic anemia
A

progressive, penetrative damage

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9
Q

The intensity of a systemic toxic effect is directly proportional to which one of the following?

  • exposed dose
  • absorbed dose
  • plasma binding protein
  • target site concentration
A

Absorbed dose

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10
Q

Delayed- onset pulmonary toxicity is characteristic of which of the following chemical exposures?

  • Drinking water containing high arsenic contaminants
  • Ingestion of E. Coli contaminated spinach
  • Dermal contact murlactic acid
  • Inhalation of an irritant gas with low water solubility
A

Inhalation of an irritant gas with low water solubility

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11
Q

Methemoglobinemia is characterized by which of the following?

  • Oxygen transport in blood is increased
  • A blood drop on filter paper stains chocolate brown
  • It is caused by exposure to reducing chemicals
  • It protects the individual against angina episodes
A

A blood drop on filter paper stains chocolate-brown

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12
Q

Most of the particulates that get deposited in the pulmonary region of the respiratory tract are removed by which of the following?

  • mucus
  • ciliated epithelium
  • muco-ciliary system
  • alveolar macrophages
A

muco-ciliary system

maybe look this up

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13
Q

Which of the following is monitored as the index of outdoor air quality

  • carbon monoxide
  • nitrogen oxides
  • ozone
  • particulates
A

ozone

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14
Q

Carbon monoxide has the greatest binding affinity for which of the following forms of hemoglobin?

  • Major adult Hb
  • Minor adult Hb
  • Fetal Hb
  • None of the above
A

Fetal Hb

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15
Q

Well water in the midwest may cause methemoglobinemia-associated hypoxia, especially in infants, because of the presence of high concentration of

  • DDT
  • nitrates and nitrites
  • benzene
  • carbon tetrachloride
A

nitrates and nitrites

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16
Q

The risk for angina is increased upon exposure to which of the following chemicals?

  • carbon monoxide
  • nitrous oxide
  • sodium nitrite
  • amyl nitrite
A

Carbon monoxide

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17
Q

“chocolate cyanosis” will be caused upon adequate dose exposure to which of the following

  • amyl nitrite (anti-anginal med)
  • silver nitrate (used in photography)
  • nitrous oxide (dental analgesic
  • all of the above
A

All of the above

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18
Q

Excessive intake of nitrates (present in well water) can result in a

  • decrease in serum partial pressure of oxygen as measured by routine blood gas machines
  • decrease in reduced hemoglobin available for oxygen transport
  • increase in serum partial pressure of oxygen as measured by routine blood gas machines
  • none of the above
A

decrease in reduced hemoglobin available for oxygen transport

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19
Q

The first indicator of methemoglobinemia is

  • hyperthermia
  • seizures
  • coma
  • cyanosis
A

cyanosis

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20
Q

The dental anesthetic, Nitrous oxide (laughing gas) must be combined with adequate oxygen when used to perform dental procedures in order to prevent which of the following?

  • GI spasms
  • asthma
  • methemoglobinemia
  • hallucinations
A

methemoglobinemia

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21
Q

Carbon monoxide does NOT cause which of the following effects?

  • coughing
  • hypoxia
  • headache
  • bright venous blood
A

coughing

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22
Q

Highly soluble irritant gases pose the highest risk for adverse effects in patients with which of the following conditions

  • hepatic cirrhosis
  • asthma
  • hypertension
  • diarrhea
A

asthma

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23
Q

The best confirmation of carbon monoxide poisoning is which of the following?

  • cyanotic arterial blood
  • cherry venous blood
  • chocolate cyanosis
  • carboxyhemoglobin blood levels
A

carboxyhemoglobin levels

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24
Q

Chocolate cyanosis is indicative of which of the following?

  • carbon monoxide poisoning
  • methemoglobinemia
  • plumbism
  • methanol poisoning
A

methemoglobinemia

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25
Q

Which of the following categories of chemicals will cause coagulative necrosis upon contact with living tissue?

  • strong acids
  • strong bases
  • strong oxidizing agents
  • strong reducing agents
A

Strong acids

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26
Q

Methemoglobinemia is NOT characterized by which of the following?

  • It is the oxidized form of hemoglobin
  • The patient appears cherry red
  • It is caused by exposure to oxidizing chemicals
  • It causes baby blue syndrome in infants
A

the patient appears cherry red

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27
Q

Allergic reaction to aspirin is caused by increased production of which of the following

  • prostaglandins
  • prostacyclin
  • thromboxane A2
  • leukotrienes
A

leukotrienes

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28
Q

Non-steroidal anti-inflammatory medications provide palliative relief by inhibiting which of the following enzymes

  • Phospholipase A2
  • Cyclo-oxygenase
  • 5- lipoxygenase
  • prostaglandin synthase
A

cyclo oxygenase

or prostaglandin synthase

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29
Q

Acute overdose with aspirin can cause hyperthermia. This occurs because of which of the following reasons?

  • aspirin uncouples oxidative-phosphorylation
  • aspirin inhibits sweat secretion
  • aspirin stimulates thyroxine secretion
  • aspirin causes cutaneous vasoconstriction
A

aspirin uncouples oxidative-phosphorylation

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30
Q

Even low dose aspirin on a chronic basis can increase the risk for GI ulcers because of which of the following

  • aspirin inhibits phospholipase in the gastric mucosa
  • aspirin increases HCl secretion from the gastric mucosa
  • aspirin inhibits cyclo-oxygenase 1 in the gastric mucosa
  • aspirin increases pepsin secretion from the gastric mucosa
A

aspirin inhibits cyclo oxygenase 1 in the gastric mucosa

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31
Q

Which of the following is NOT an anti-inflammatory steroid?

  • cortisol
  • testosterone
  • prednisone
  • dexamethasone
A

testosterone

or cortisol or prednisone

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32
Q

Overuse of which one of the following anti-inflammatory medications with NOT cause signs & symptoms of Cushing’s syndrome?

  • hydrocortisone
  • dexamethasone
  • betamethasone
  • aspirin
A

aspirin

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33
Q

Which of the following anti-inflammatory agents will aggravate gouty arthritis

  • aspirin
  • hydrocortisone
  • dexamethasone
  • acetometophin
A

aspirin

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34
Q

Reye’s syndrome is associated with the management of viral fevers in children with which of the following anti-pyretic agents?

  • acetaminophen
  • naproxen
  • aspirin
  • codeine
35
Q

Narcotic analgesic agents will NOT cause which one of the following effects?

  • suppress coughing
  • stimulate vomiting
  • CNS depression
  • mydriasis
36
Q

MATCHING

Cyanide
Hydrogen sulfide
Carbon monoxide
Carbon dioxide
Ground level ozone
A- is a pulmonary irritant gas
B- forms carbamino-hemoglobin
C- has a smell of rotten eggs
D- forms carboxyl-hemoglobin
E- inhibits cytochrome oxidase
A

Cyanide - E (inhibits cytochrome oxidase)

Hydrogen sulfide - C (has a smell of rotten eggs)

Carbon monoxide - D (forms carboxyl-hemoglobin)

Carbon dioxide - B (forms carbamino-hemoglobin)

Ground level ozone - A (is a pulmonary irritant gas)

37
Q

MATCHING

Strong acid exposure
Carbon monoxide
Ethylene glycol
Aspirin
Dexamethasone
A- can cause hypocalcemia
B- can cause protein wasting
C- can cause gastric ulcers
D- can cause coagulative necrosis
E- can cause cherry red cyanosis
A

Strong acid exposure- D (can cause coagulative necrosis)

Carbon monoxide - E (can cause cherry red cyanosis)

Ethylene glycol- A (can cause hypocalcemia)

Aspirin - C (can cause gastric ulcers)

Dexamethasone - B (can cause protein wasting)

38
Q

Pinpoint pupil is a characteristic of which of the use of which of the following substances

  • narcotic
  • alcohol
  • aspirin
  • acetaminophen
39
Q

A 50 y/o pt is under your care and is known to have an active peptic ulcer. He has been taking the recommended dose of an analgesic to manage the pain due to osteoarthritis for the past 3 months and complains of a lack of energy. Lab data indicates he is anemic and exhibits prolonged bleeding tim. The most likely involved analgesic is

  • aspirin
  • tylenol
  • oxycontin
  • hydrocodone
  • codeine
40
Q

Which of the following gases can cause hallucinations and methemoglobinemia?

  • carbon monoxide
  • sulfur dioxide
  • ozone
  • nitrous oxide
  • chlorine
A

nitrous oxide

41
Q

A patient under your care for asthma exhibits moon facies, buffalo hump, and has mild hyperglycaemia. Which of the following is the most likely medication that this patient concurrently taking

  • aspirin
  • tylenol
  • oxycontin
  • naproxen
  • dexamethasone
A

dexamethasone

42
Q

Chronic exposure to which of the following chemicals produces behavioural changes that are likely to be mis-diagnosed as ADHD

  • arsenic
  • lead
  • mercury
  • aspirin
  • tylenol
A

arsenic, lead or mercury

43
Q

The protective function of the skin against chemical absorption is due to the presence of which of the following?

  • oily secretions from sebaceous glands
  • vascular supply to dermis
  • keratinized dead cell layers of stratum corneum
  • mixed function oxidases in the dermis
A

oily secretion from the sebaceous gland

44
Q

Delayed-onset pulmonary toxicity is characteristic of which of the following chemical exposures?

  • drinking water containing high arsenic contaminants
  • ingestion of E coli
  • dermal contact with muriatic acid
  • inhalation of irritant gas with low water solubility
A

inhalation of irritant gas with low water solubility

45
Q

Which of the following therapeutic indices represents a chemical that is most likely to cause serious toxicity upon slight overdose

  • 2
  • 5
  • 10
  • 100
46
Q

Which of the following categories of chemicals will NOT cause toxic effects at any dose?

  • medications
  • nutritional supplements
  • herbal products
  • all of the above cause toxicity
A

all of the above cause

47
Q

The has that has poor warning properties is which of the following?

  • hydrogen sulfide
  • sulfur dioxide
  • ozone
  • carbon monoxide
A

carbon monoxide

48
Q

Infants are at a high right for methemoglobinemia due to developmental deficiency of which of the following?

  • blood brain barrier
  • glutathione
  • glucose-6-phosphate dehydrogenase
  • hepatic mixed function oxidase system
A

glucose 6 phosphate dehydrogenase

49
Q

In general the ability of any chemical to produce systemic (not local) toxic effects is primarily dependent upon which of the following factors?

  • amount of detoxification enzymes in liver
  • thickness of stratum corneum
  • concentration of free chemical in plasma
  • volume of urine output over 24 hours
A

concentration of free chemical

50
Q

Irritant gases that are likely to cause “upper” respiratory tract damage

  • will have high water solubility
  • will increase respiratory tract secretions
  • will cause bronchoconstriction
  • all of the above
A

all of the above

51
Q

Particles that can cause COPD have a diameter of

> 10 microns
2 - 10 microns

52
Q

Most of the particulates that get deposited in the pulmonary region of the respiratory tract are removed by which of the following?

  • mucus
  • ciliated epithelium
  • muco-ciliary system
  • alveolar macrophages
A

muco-ciliary system

53
Q

Acid rain is said to be caused by high atmosphere concentration of which of the following

  • carbon monoxide
  • particulates
  • sulfur oxides
  • hydrocarbons
A

sulfur oxides

54
Q

Particulates deposited in the alveolar space are cleared by which of the following?

  • Nasal hair filtration
  • Muco-ciliary mechanism
  • Macrophage phagocytosis
  • Absorption into pulmonary circulation
A

Macrophage phagocytosis

55
Q

The first indicator of methemoglobinemia is

  • hyperthermia
  • seizures
  • coma
  • cyanosis
56
Q

Which of the following represents the ratio for Margin of Safety for therapeutic agents?

  • LD50/TD50
  • TD50/ED50
  • LD01/ED99
  • TD1/LD99
57
Q

A toxic chemical has a biological half-life of 24 hours. How long will it take for at least 90% of the chemical to be excreted from the body?

  • 12 hours
  • 24 hours
  • 48 hours
  • 96 hours
58
Q

MATCHING

Cyanide
Hydrogen sulfide
Carbon monoxide
Carbon dioxide
Ground level ozone
A- forms carbamino- hemoglobin
B- pulmonary infarct
C- inhibits cytochrome oxidase
D- forms carboxyl hemoglobin
E- asphyxiant
A

Cyanide - C (inhibits cytochrome oxidase)

Hydrogen sulfide - E (asphyxiant)

Carbon monoxide - D (Forms carbonyl hemoglobin)

Carbon dioxide - A (forms carbamino-hemoglobin)

Ground level ozone - B (pulmonary infarct)

59
Q

Which of the following is an initial effect of inhaling carbon monoxide?

  • dizziness
  • headache
  • difficulty breathing
  • CNS depression
60
Q

Air pollutants will cause which of the following symptoms?

  • Brochodilation
  • pulmonary edema
  • increased oxygen saturation of arterial blood
  • only A and B are correct
  • A B and C
A

Pulmonary edema

61
Q

Which of the following is the characteristic sequelae upon dermal contact with a strong acid such as muriatic acid (HCl)

  • progressive, penetrative damage
  • superficial damage with eschar formation
  • systemic toxicity due to severe methemoglobin
  • decreased oxygen transport due to hemolytic anemia
A

superficial damage with eschar formation

62
Q

Hypertensive Crisis is a serious adverse interaction involving which of the following substances

  • carbon monoxide
  • acetaminophen
  • MOA
  • oxycontin
63
Q

A person using corticosteroids for osteoarthritis over a chronic duration will have hyperglycemia due to which of the following reasons?

  • protein catabolic action
  • stimulation of gluconeogenesis
  • increased glycogenolysis
  • insufficient insulin secretion
A

stimulation of gluconeogenesis

64
Q

Exposure to organophosphate insecticide (Acetylcholinesterase inhibitor) will cause which of the following effects?

  • pupillary dilation
  • decreased muscle tone
  • increased endocrine secretions
  • increased exocrine secretions
A

increased exocrine secretions

65
Q

Mad Hatter’s disease is a consequence of chronic exposure to which of the following toxic chemicals

  • DDT
  • Mercury
  • Lead
  • Methanol
66
Q

The risk for Parkinson’s disease and angina is increased upon exposure to which of the following chemicals

  • carbon monoxide
  • nitrous oxide
  • sodium nitrite
  • amyl nitrite
A

carbon monoxide

67
Q

Daily use of low doses of aspirin is prescribed to patients to prevent intra-vascular clotting after cardiovascular surgery; the therapeutic dose to manage pain, fever, and inflammation is around 6 times this dose. This rationale for low-dose prescription is which of the following?

  • Inhibits phospholipase A2
  • Inhibits Phopholipase C
  • Inhibits cyclo- oxgenase
  • Inhibits thromboxane synthetase
A

Inhibits thromboxane synthetase

68
Q

Cheyne-Stokes respiration is caused by fluctuations in PCO2 levels. This is a characteristic effect of which of the following substances

  • narcotic analgesic overdose
  • acetaminophen overdose
  • aspirin overdose
  • cortisol overdose
A

Narcotic analgesic overdose

69
Q

Chronic use of which of the following therapeutic agents is most likely to increase the risk for fracture and osteoporosis?

  • narcotic analgesics
  • proton pump inhibitors
  • steroidal anti inflammatory agents
  • non steroidal anti inflammatory agents
A

proton pump inhibitors

70
Q

Which of the following toxic chemicals has a sweet taste?

  • carbon monoxide
  • lead acetate
  • arsenic
  • methyl alcohol
A

lead acetate

71
Q

Which of the following categories of chemicals will cause liquefactive necrosis upon contact with living tissues?

  • Strong acids
  • Strong bases
  • Strong oxidizing agents
  • Strong reducing agents
A

Strong bases

72
Q

Excessive consumption of which of the following foods will increase risk for mercury poisoning?

  • goat cheese
  • bigeye tuna
  • broccoli
  • pizza
A

bigeye tuna

73
Q

Acute overdose of with which of the following chemicals produces centrilobular hepatic necrosis?

  • arsenic
  • lead
  • mercury
  • aspirin
  • tylenol
74
Q

MATCHING

Tylenol

A. Associated with Reye's Syndrome
B. Causes hyperglycemia
C. Stimulate gluconeogenesis
D. Used to manage viral fevers in children
E. Causes hypoglycemic coma
A

D. Used to manage viral fevers in children

75
Q

MATCHING

Insulin

A. Associated with Reye's Syndrome
B. Causes hyperglycemia
C. Stimulate gluconeogenesis
D. Used to manage viral fevers in children
E. Causes hypoglycemic coma
A

Causes hypoglycemic coma

76
Q

MATCHING

Epinephrine

A. Associated with Reye's Syndrome
B. Causes hyperglycemia
C. Stimulate gluconeogenesis
D. Used to manage viral fevers in children
E. Causes hypoglycemic coma
A

B. Causes hyperglycemia

77
Q

MATCHING

Aspirin

A. Associated with Reye's Syndrome
B. Causes hyperglycemia
C. Stimulate gluconeogenesis
D. Used to manage viral fevers in children
E. Causes hypoglycemic coma
A

A. Associated with Reye’s Syndrome

78
Q

MATCHING

Prednisone

A. Associated with Reye's Syndrome
B. Causes hyperglycemia
C. Stimulate gluconeogenesis
D. Used to manage viral fevers in children
E. Causes hypoglycemic coma
A

Stimulates gluconeogenesis

79
Q

MATCHING

Synthroid

A. Can cause toxic effects during rapid weight loss
B. Can increase bio-inactivation by liver enzymes
C. Can increase toxicity due to therapeutic doses of any chemical
D. Overdoses can cause cardiac palpitations
E. Therapeutic use can cause hyperglycemia

A

D. Overdoses can cause cardiac palpitations

80
Q

MATCHING

Lipophilic chemicals

A. Can cause toxic effects during rapid weight loss
B. Can increase bio-inactivation by liver enzymes
C. Can increase toxicity due to therapeutic doses of any chemical
D. Overdoses can cause cardiac palpitations
E. Therapeutic use can cause hyperglycemia

A

Can cause toxic effects during rapid weight loss

81
Q

MATCHING

Hydrocortisone

A. Can cause toxic effects during rapid weight loss
B. Can increase bio-inactivation by liver enzymes
C. Can increase toxicity due to therapeutic doses of any chemical
D. Overdoses can cause cardiac palpitations
E. Therapeutic use can cause hyperglycemia

A

E. Therapeutic use can cause hyperglycemia

82
Q

MATCHING

Smoking

A. Can cause toxic effects during rapid weight loss
B. Can increase bio-inactivation by liver enzymes
C. Can increase toxicity due to therapeutic doses of any chemical
D. Overdoses can cause cardiac palpitations
E. Therapeutic use can cause hyperglycemia

A

Cause increase bio-inactivation by liver enzymes

83
Q

MATCHING

Inadequate water intake/ dehydration

A. Can cause toxic effects during rapid weight loss
B. Can increase bio-inactivation by liver enzymes
C. Can increase toxicity due to therapeutic doses of any chemical
D. Overdoses can cause cardiac palpitations
E. Therapeutic use can cause hyperglycemia

A

C. Can increase toxicity due to therapeutic doses of any chemical

84
Q

Exposure to cyanide can case death as a result of which of the following effects?

  • decreased oxygenation of pulmonary blood
  • decreased hemoglobin content in blood
  • increased methemoglobin content in blood
  • inhibition of cytochrome oxidase (blockade of ATP synthesis)
A

inhibition of cytochrome oxidase (blockade of ATP synthesis)

TOXICOLOGY (2 decks)

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