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Phar Review & Comprehensive Examination > Pharmaceutical Toxicology > Flashcards

Pharmaceutical Toxicology Flashcards

1
Q

golden era of medieval toxicology.

A

Middle ages

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2
Q

She experimented on poor people by donating food with poison in it

A

Catherine de’Medici:

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3
Q

Substances known to be toxic at elevated doses may actually have beneficial effect at very low doses.

A

Theory of Hormesis

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4
Q

modern era of toxicology

A

18th TO 19th CENTURY

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5
Q

Pesticides Research and Chemical Warfare

A

Fritz Haber

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6
Q

Toxicon means

A

Arrow poison

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7
Q

refers to the dose of a chemical administered or measured in the environment?

A) External dose
B) Internal dose
C) Biological dose
D) Absorbed dose

A

A) External dose

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8
Q

refers to the amount of a chemical absorbed and found at the site of biological activity?

A) External dose
B) Internal dose
C) Absorbed dose
D) Biological dose

A

B) Internal dose

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9
Q

Which dose-response relationship describes the response of an individual organism to increasing doses of a chemical?

A) Individual “graded” dose-response relationship
B) Quantal “all or none” dose-response relationship
C) Continuous dose-response relationship
D) Population dose-response relationship

A

A) Individual “graded” dose-response relationship

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10
Q

Which dose-response relationship characterizes the distribution of individual responses to different doses in a population of organisms?

A) Individual “graded” dose-response relationship
B) Quantal “all or none” dose-response relationship
C) Continuous dose-response relationship
D) Population dose-response relationship

A

B) Quantal “all or none” dose-response relationship

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11
Q

refers to the minimal dose of any chemical that evokes a stated all-or-none response?

A) Effective dose (ED)
B) Lethal dose (LD)
C) Threshold dose
D) Population response dose (PRD)

A

C) Threshold dose

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12
Q

When death is the measured endpoint, what is the term used for the ED50?

A) Effective dose (ED)
B) Lethal dose (LD)
C) Threshold dose
D) Population response dose (PRD)

A

B) Lethal dose (LD)

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13
Q

term is used to describe the response level for the population in estimating the response to a toxic exposure, typically representing the midpoint or 50% response level?

A) Effective dose (ED)
B) Lethal dose (LD)
C) Threshold dose
D) Median response dose (MRD)

A

A) Effective dose (ED)

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14
Q

What does potency in pharmacology refer to?

A) The extent to which a chemical can elicit a response
B) The range of doses over which a chemical produces increasing responses
C) The assessment of the y-axis in a dose-response curve
D) The assessment of the x-axis in a dose-response curve

A

B) The range of doses over which a chemical produces increasing responses

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15
Q

efficacy in pharmacology refer to?

A) The extent to which a chemical can elicit a response
B) The range of doses over which a chemical produces increasing responses
C) The assessment of the y-axis in a dose-response curve
D) The assessment of the x-axis in a dose-response curve

A

A) The extent to which a chemical can elicit a response

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16
Q

selective toxicity refer to?

A) Injury caused to all forms of life by a chemical
B) Injury caused to one kind of living matter without affecting others
C) The accumulation of a chemical in the unaffected species
D) The alteration of a common cellular or biochemical feature

A

B) Injury caused to one kind of living matter without affecting others

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17
Q

Selective toxicity can occur due to which of the following reasons?

A) The chemical is equally toxic to both organisms but accumulates preferentially in the target.
B) The chemical alters a unique cellular or biochemical feature that is absent or irrelevant in the unaffected species.
C) The chemical affects all forms of life equally.
D) The unaffected species possesses unique cellular or biochemical features.
E) A & B

A

E) A & B

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18
Q

mutagenesis refer to?

A) Changes to DNA that are transmitted during cell division
B) Nonheritable mutations in all cell types
C) Cell death caused by somatic mutations
D) Transmission of genetic defects through mitotic division

A

A) Changes to DNA that are transmitted during cell division

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19
Q

What are somatic mutations?

A) Mutations that are transmitted during cell division
B) Nonheritable mutations in all cell types
C) Mutations that lead to cell death
D) Mutations that are inherited through mitotic division

A

B) Nonheritable mutations in all cell types

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20
Q

defined as the absorption, distribution, biotransformation, and elimination of a toxicant, is a critical determinant of target organ toxicity along with sensitivity of target sites to
toxicity.

A

Xenobiotic disposition

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21
Q

What is absorption in the context of toxicology?

A) The process of eliminating toxicants from the body
B) The process by which toxicants cross body membranes to enter the systemic circulation
C) The process of converting toxicants into nonionized, lipid-soluble forms
D) The process of modifying compounds directly in the gastrointestinal tract

A

B) The process by which toxicants cross body membranes to enter the systemic circulation

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22
Q

Where does absorption primarily occur along the gastrointestinal tract?

A) Stomach
B) Small intestine
C) Large intestine
D) Esophagus

A

B) Small intestine

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23
Q

What is presystemic elimination in toxicology?

A) The process of toxicants crossing body membranes to enter the systemic circulation
B) The elimination of toxicants from the body
C) The breakdown of compounds by the gastrointestinal tract
D) The elimination or modification of a compound prior to reaching the systemic circulation

A

D) The elimination or modification of a compound prior to reaching the systemic circulation

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24
Q

excretion in the context of toxicology?

A) The removal of toxicants from the body
B) The chemical transformation of toxicants
C) The process of toxicants crossing body membranes
D) The transport of toxicants to target organs

A

A) The removal of toxicants from the body

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25
Q

Which organs are primarily involved in the excretion of toxicants?

A) Kidney and liver
B) Lung and skin
C) Gastrointestinal tract and bladder
D) Heart and brain

A

A) Kidney and liver

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26
Q

What determines the route and speed of excretion?

A) Physicochemical properties of the toxicant
B) Presence of biotransformation mechanisms
C) Efficiency of target organ function
D) Rate of blood circulation

A

A) Physicochemical properties of the toxicant

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27
Q

How does reabsorption of toxicants occur in the context of renal tubules?

A) Toxicants diffuse from the glomerulus into the renal tubules.
B) Toxicants are filtered out of the blood at the glomerulus and may diffuse back into the blood through peritubular capillaries.
C) Toxicants are eliminated from the body through urine flow.
D) Toxicants are transformed into non-reabsorbable chemicals within the renal tubules.

A

B) Toxicants are filtered out of the blood at the glomerulus and may diffuse back into the blood through peritubular capillaries.

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28
Q

What is toxication in the context of xenobiotics?

A) Direct toxicity of xenobiotics
B) Indirect toxicity caused by metabolites of xenobiotics
C) Biotransformation processes that eliminate toxicants
D) Detoxification processes that prevent toxicant formation

A

A) Direct toxicity of xenobiotics

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29
Q

What is detoxication in the context of xenobiotics?

A) Biotransformation processes that eliminate toxicants
B) Indirect toxicity caused by metabolites of xenobiotics
C) Processes that compete with toxication
D) Detoxification processes that prevent toxicant formation

A

A) Biotransformation processes that eliminate toxicants

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30
Q

What is the purpose of detoxication processes?

A) To enhance the toxic effects of xenobiotics
B) To promote the formation of toxic metabolites
C) To eliminate or prevent the formation of the ultimate toxicant
D) To enhance the competition with toxication processes

A

C) To eliminate or prevent the formation of the ultimate toxicant

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31
Q

Which molecules are considered target molecules for toxicants?

A) Nucleic acids, proteins, and membranes
B) Enzymes and intracellular structures
C) Receptors and signaling molecules
D) Lipids and carbohydrates

A

A) Nucleic acids, proteins, and membranes

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32
Q

What is the purpose of an ultimate toxicant?

A) To react with target molecules and enhance their function
B) To reach an effective concentration at the target site
C) To alter the target in a way that is unrelated to observed toxicity
D) To react with target molecules and adversely affect their function

A

D) To react with target molecules and adversely affect their function

33
Q

How does an ultimate toxicant exert its effect?

A) By binding to receptors and blocking their activity
B) By altering the structure of target molecules
C) By inhibiting enzyme activity
D) By causing cell membrane rupture

A

B) By altering the structure of target molecules

34
Q

essentially irreversible and permanently alters endogenous molecules?

A) Noncovalent binding
B) Hydrogen abstraction
C) Covalent binding
D) Electron transfer

A

C) Covalent binding

35
Q

type of binding is attributed to apolar interactions or the formation of hydrogen and ionic bonds between toxicants and their targets, including membrane or intracellular receptors, ion channels, and some enzymes?

A) Noncovalent binding
B) Covalent binding
C) Hydrogen abstraction
D) Electron transfer

A

A) Noncovalent binding

36
Q

process of directly reversing certain covalent DNA modifications by enzymes called?

A) Direct repair
B) Excision repair
C) Nonhomologous end joining
D) Recombinational repair

A

A) Direct repair

37
Q

mechanisms involved in removing damaged bases from DNA?

A) Base excision and nucleotide excision repair
B) Direct repair and nonhomologous end joining
C) Homologous recombination and excision repair
D) Direct repair and homologous recombination

A

A) Base excision and nucleotide excision repair

38
Q

repair mechanism utilizes homologous recombination to repair postreplication gaps and DSBs?

A) Direct repair
B) Excision repair
C) Nonhomologous end joining
D) Recombinational repair

A

D) Recombinational repair

39
Q

primary purpose of nonhomologous end joining in DNA repair?

A) To directly reverse covalent DNA modifications
B) To remove damaged bases from DNA
C) To repair single-strand breaks (SSBs)
D) To repair double-strand breaks (DSBs)

A

D) To repair double-strand breaks (DSBs)

40
Q

purpose of autophagy in relation to damaged cell organelles?

A) To repair damaged cell organelles
B) To remove damaged cell organelles
C) To prevent cellular dysfunction
D) To promote cellular growth

A

B) To remove damaged cell organelles

41
Q

What is apoptosis?

A) Programmed cell death
B) Regeneration of tissue
C) Repair of tissue injury
D) Proliferation of cells

A

A) Programmed cell death

42
Q

the process involved in the regeneration of tissue after injury?

A) Proliferation of cells
B) Reconstitution of the extracellular matrix (ECM)
C) Reintegration of newly formed elements
D) All of the above

A

D) All of the above

43
Q

cells in the liver that are major contributors to the production of the extracellular matrix (ECM)?

A) Hepatocytes
B) Kupffer cells
C) Stellate cells
D) Sinusoidal endothelial cells

A

C) Stellate cells

44
Q

What are the hallmarks of inflammation?

A) Alteration of the microcirculation and accumulation of inflammatory cells
B) Increased tissue regeneration and cell proliferation
C) Destruction of the extracellular matrix and cellular dysfunction
D) Apoptosis and autophagy of damaged cell organelles

A

A) Alteration of the microcirculation and accumulation of inflammatory cells

45
Q

Biological process by which an organism develops increased tolerance to the harm itself.

A

Adaptation

46
Q

Excessive formation and deposition of excess connective tissue with abnormal composition of the ECM

A

Fibrosis

47
Q

They stimulate the progression of cells through the cell cycle or oppose apoptosis.

A

proto-oncogenes

48
Q

They inhibit the cell cycle progression and promote apoptosis when there is DNA damage.

A

tumor suppressor genes

49
Q

What does the volume of distribution (Vd) represent in relation to a toxicant?

A) It represents the concentration of the toxicant in blood.
B) It indicates the rate of elimination of the toxicant from the body.
C) It quantifies the distribution of the toxicant throughout the body.
D) It measures the total amount of toxicant administered to the body.

A

C) It quantifies the distribution of the toxicant throughout the body.

50
Q

outcome of hydrolysis, reduction, and oxidation reactions on a xenobiotic?

A) They introduce a functional group that can be converted into a hydrophilic conjugate.
B) They decrease the water solubility of the xenobiotic.
C) They convert the xenobiotic into a lipophilic compound.
D) They have no effect on the solubility or conjugation of the xenobiotic.

A

A) They introduce a functional group that can be converted into a hydrophilic conjugate.

51
Q

reactions that result in a modest increase in the water solubility of a xenobiotic?

A) Hydrolysis, reduction, and oxidation
B) Oxidation, reduction, hydrolysis, methylation, and acetylation
C) Glucuronidation, sulfonation, glutathionylation, and amino acid conjugation
D) Methylation and acetylation only

A

B) Oxidation, reduction, hydrolysis, methylation, and acetylation

52
Q

reactions that cause a marked increase in the water solubility of a xenobiotic?

A) Hydrolysis, reduction, and oxidation
B) Oxidation, reduction, hydrolysis, methylation, and acetylation
C) Glucuronidation, sulfonation, glutathionylation, and amino acid conjugation
D) Methylation and acetylation only

A

C) Glucuronidation, sulfonation, glutathionylation, and amino acid conjugation

53
Q

quantitative study of absorption, dis- tribution,
metabolism, and excretion (ADME) of chemicals in
biota through measurement and modeling of their
concentrations or amounts in biological matrices as
a function of time.

A

Toxicokinetics

54
Q

primary focus of classic toxicokinetics?

A) Analyzing the physiological effects of toxicants on organ systems.
B) Evaluating the toxic effects of chemicals based on their kinetics in the exposed organism.
C) Deriving parameters that describe the behavior of chemicals and their metabolites over time.
D) Developing mathematical models to simulate the distribution of toxicants in various tissues.

A

C) Deriving parameters that describe the behavior of chemicals and their metabolites over time.

55
Q

primary purpose of PBPK models?

A) To predict the long-term health effects of exposure to toxicants.
B) To determine the optimal dosage of therapeutic drugs.
C) To evaluate the environmental fate of chemicals.
D) To simulate the time-course behavior of xenobiotics and their metabolites in blood and tissues.

A

D) To simulate the time-course behavior of xenobiotics and their metabolites in blood and tissues.

56
Q

What is the first priority in the treatment of poisoning?

A) Administering specific antidotes for the toxicant.
B) Stabilizing the patient.
C) Initiating supportive care measures.
D) Assessing the extent of toxicant exposure.

A

B) Stabilizing the patient.

57
Q

initial steps in assessing a poisoned patient?

A) Administering specific antidotes for the toxicant.
B) Evaluating the patient’s mental status.
C) Assessing the patient’s airway, breathing, and circulation.
D) Performing laboratory tests to identify the toxicant.

A

C) Assessing the patient’s airway, breathing, and circulation.

58
Q

What is a “toxidrome”?

A) A medical condition caused by exposure to multiple toxic substances.
B) A specific treatment protocol for poisoning cases.
C) A set of characteristic clinical signs and symptoms associated with exposure to certain classes of toxic chemicals.
D) A diagnostic test used to identify the presence of toxic substances in the body.

A

C) A set of characteristic clinical signs and symptoms associated with exposure to certain classes of toxic chemicals.

59
Q

What is the purpose of a “nomogram” in cases of drug poisoning?

A) To identify the specific drug involved in the poisoning.
B) To estimate the plasma concentration of the drug based on the severity of poisoning.
C) To guide therapeutic interventions based on the measured plasma concentration and time elapsed from the exposure.
D) To determine the toxic effects of the drug on the body.

A

C) To guide therapeutic interventions based on the measured plasma concentration and time elapsed from the exposure.

60
Q

calculated as the difference between the serum
Na ion concentration and the sum of the serum Cl and HCO3 ion concentrations.

A

Anion Gap (AG)

61
Q

calculated as the numerical difference between the
measured serum osmolality and the serum osmolarity calculated from the clinical chemistry measurements of the serum sodium ion, glucose, and blood urea nitrogen (BUN) concentrations.

A

Osmol Gap

62
Q

Chest Radiograph?

A) To evaluate the lungs, heart, and chest wall.
B) To assess abdominal conditions and detect foreign bodies in the gastrointestinal tract.
C) To identify concurrent intracranial pathology such as trauma or hemorrhage.
D) To diagnose and monitor bone fractures in the extremities.

A

A) To evaluate the lungs, heart, and chest wall.

63
Q

When is an Abdominal Radiograph helpful?

A) When assessing head injuries and detecting intracranial pathology.
B) When evaluating lung conditions and symptoms such as shortness of breath and cough.
C) When foreign bodies are detected in the gastrointestinal tract, such as a toddler ingesting a battery.
D) When examining bone fractures and detecting fractures in the extremities.

A

C) When foreign bodies are detected in the gastrointestinal tract, such as a toddler ingesting a battery.

64
Q

purpose of a Head CT scan?

A) To evaluate the lungs, heart, and chest wall.
B) To assess abdominal conditions and detect foreign bodies in the gastrointestinal tract.
C) To identify concurrent intracranial pathology such as trauma or hemorrhage.
D) To diagnose and monitor bone fractures in the extremities.

A

C) To identify concurrent intracranial pathology such as trauma or hemorrhage.

65
Q

What is the primary purpose of physical and laboratory examinations in the context of toxicology?

A) To diagnose and manage acute toxicant exposure.
B) To visualize foreign bodies or radiopaque toxicants.
C) To detect and manage toxicant-induced pathology.
D) To assess chronic toxicant exposure and long-term effects.

A

) To diagnose and manage acute toxicant exposure.

66
Q

What is the primary utility of radiological examination in toxicology?

A) To diagnose and manage acute toxicant exposure.
B) To visualize foreign bodies or radiopaque toxicants.
C) To detect and manage toxicant-induced pathology.
D) To assess chronic toxicant exposure and long-term effects.

A

C) To detect and manage toxicant-induced pathology.

67
Q

Why has the use of syrup of ipecac declined in recent years?

A) Due to its high effectiveness as an agent for gastric decontamination.
B) Due to its low and highly variable effectiveness as an agent for gastric decontamination.
C) Due to its potential for causing allergic reactions in patients.
D) Due to its high cost and limited availability in the market.

A

B) Due to its low and highly variable effectiveness as an agent for gastric decontamination.

68
Q

What is a potential drawback of administering syrup of ipecac?

A) It may cause delayed absorption of activated charcoal.
B) It may cause severe allergic reactions in patients.
C) It may interfere with the absorption of oral antidotes.
D) It may lead to excessive vomiting and dehydration.

A

A) It may cause delayed absorption of activated charcoal.

69
Q

Which of the following statements is true about gastric lavage?
A) It should be performed within 1 hour of ingestion of the poison to optimize effectiveness.
B) It is used when activated charcoal isn’t effective for the substance ingested.

A

A) It should be performed within 1 hour of ingestion of the poison to optimize effectiveness.

70
Q

What is the primary purpose of activated charcoal?

A) To adsorb an ingested toxicant.
B) To induce vomiting.
C) To neutralize acids in the stomach.

A

A) To adsorb an ingested toxicant.

71
Q

What is a requirement for the proper use of activated charcoal?

A) The patient’s gag reflex should be intact.
B) The patient should have an empty stomach.
C) The patient should be sedated during administration.

A

A) The patient’s gag reflex should be intact.

72
Q

Which of the following is a correct statement about whole-bowel irrigation?

A) It is accomplished with a poorly absorbed, osmotically neutral polyethylene glycol electrolyte solution.
B) It is administered orally to expel the contents of the intestines via the rectal route.
C) It is used to remove ingested packets of illegal drugs swallowed by smugglers.

A

A) It is accomplished with a poorly absorbed, osmotically neutral polyethylene glycol electrolyte solution.

73
Q

Tx of exposure to radioactive heavy metals.

A) Prussian blue & Pentetate Calcium Trisodium
B) Atropine
C) Fomepizole
D) Hydroxocobalamin
E) L-carnitine

A

A) Prussian blue & Pentetate Calcium Trisodium

74
Q

mitigate the biochemical toxicity of high exposure to
valproic acid at the level of mitochondria.

A) Prussian blue & Pentetate Calcium Trisodium
B) Atropine
C) Fomepizole
D) Hydroxocobalamin
E) L-carnitine

A

E) L-carnitine

75
Q

cyanide chelating agent.

A) Prussian blue & Pentetate Calcium Trisodium
B) Atropine
C) Fomepizole
D) Hydroxocobalamin
E) L-carnitine

A

D) Hydroxocobalamin

76
Q

antidote for ethylene glycol poisoning.

A) Prussian blue & Pentetate Calcium Trisodium
B) Atropine
C) Fomepizole
D) Hydroxocobalamin
E) L-carnitine

A

C) Fomepizole

77
Q

Tx of significant systemic toxicity of LAs.

A) Prussian blue & Pentetate Calcium Trisodium
B) Intravenous lipid emulsion (ILE) therapy
C) Fomepizole
D) Hydroxocobalamin
E) Physostigmine

A

B) Intravenous lipid emulsion (ILE) therapy

78
Q

when given at an excessive dose or dosing rate, can cause a potentially fatal bradycardia that can progress to a fatal
cardiac arrest.

A) Prussian blue & Pentetate Calcium Trisodium
B) Intravenous lipid emulsion (ILE) therapy
C) Fomepizole
D) Hydroxocobalamin
E) Physostigmine

A

E) Physostigmine

Phar Review & Comprehensive Examination (17 decks)

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