Toxicology

Question 1

Results from a single, short-term exposure to a substance causing immediate toxic effects

Answer 1

Acute toxicity

Question 2

Results from repeated, prolonged exposure at doses insufficient to cause immediate response; may affect different systems

Answer 2

Chronic toxicity

Question 3

THERAPEUTIC DRUGS COMMONLY ABUSED

Analgesic, antipyretic, anti-inflammatory; causes mixed acid-base disorders (metabolic acidosis → respiratory alkalosis), Reye’s syndrome

Answer 3

Acetylsalicylate (Aspirin)

Question 4

THERAPEUTIC DRUGS COMMONLY ABUSED

Preferred over aspirin in patients with bleeding disorders; toxic effect: hepatotoxicity

Answer 4

Acetaminophen (Tylenol)

Question 5

ILICIT DRUGS

Stimulants: Local anesthetic, primary metabolite: benzoylecgonine; short half-life of 1-2 hours

Answer 5

Cocaine

Question 6

ILICIT DRUGS

Used to treat narcolepsy, commonly known as ‘shabu’

Answer 6

Stimulants: Amphetamines (Methamphetamine)

Question 7

ILICIT DRUG

Designer drugs: Euphoria-producing synthetic phenylethylamine

Answer 7

MDMA (Ecstasy)

Question 8

ILICIT DRUGS

Depressants classification: Barbiturates (Secobarbital, Pentobarbital, Amobarbital, Phenobarbital)

Answer 8

Sedative-hypnotics

Question 9

THERAPEUTIC DRUGS COMMONLY ABUSED

Depressants classification: benzodiazepines (Diazepam, Chlordiazepoxide, Lorazepam)

Answer 9

Minor tranquilizers

Question 10

THERAPEUTIC DRUGS COMMONLY ABUSED

Depressants: Not structurally similar to barbiturates but has similar properties

Answer 10

Methaqualone (Quaalude)

Question 11

THERAPEUTIC DRUGS COMMONLY ABUSED

Opiates/Narcotics: Naturally occurring (Opium, Morphine, Codeine), Chemically modified (Heroin, Hydromorphone, Oxycodone)

Answer 11

Used for sedation, analgesia, anesthesia

Question 12

THERAPEUTIC DRUGS COMMONLY ABUSED

Opiates/Narcotics classification: Fully synthetic (Meperidine, Methadone, Propoxyphene, Pentazocine, Fentanyl)

Answer 12

Pain relievers

Question 13

THERAPEUTIC DRUGS COMMONLY ABUSED

Primary cannabinoid component of Marijuana (Cannabis sativa)

Answer 13

THC; major urinary metabolite: THC-COOH

Question 14

THERAPEUTIC DRUGS COMMONLY ABUSED

Structurally similar to serotonin, produces panic reactions and undulating vision

Answer 14

Lysergic acid diethylamide (LSD)

Question 15

THERAPEUTIC DRUGS COMMONLY ABUSED

Tricyclic compound with paradoxical symptoms

Answer 15

Phencyclidine (PCP)

Question 16

THERAPEUTIC DRUGS COMMONLY ABUSED

Used as anesthetic for short surgical procedures in pediatric medicine

Answer 16

Ketamine

Question 17

THERAPEUTIC DRUGS COMMONLY ABUSED

Derivatives of serotonin with hallucinogenic properties

Answer 17

Tryptamines (e.g., dimethyltryptamine, psilocin/psilocybin)

Question 18

THERAPEUTIC DRUGS COMMONLY ABUSED

Produce effects similar to amphetamines

Answer 18

Piperazines

Question 19

THERAPEUTIC DRUGS COMMONLY ABUSED

Psychoactive designer drugs that produce amphetamine- or cocaine-like effects, can give false positive meth result

Answer 19

Synthetic cathinones (Bath salts)

Question 20

THERAPEUTIC DRUGS COMMONLY ABUSED

Used as sleep aids

Answer 20

Non-benzodiazepine agents (e.g., Zolpidem, Zopiclone)

Question 21

THERAPEUTIC DRUGS COMMONLY ABUSED

CNS depressants used in pain management of musculoskeletal conditions

Answer 21

Muscle relaxants (e.g., Carisoprodol, Meprobamate)

Question 22

OTHER TOXIC SUBSTANCES

Most commonly abused substance in the world, chronic exposure associated with toxic hepatitis and cirrhosis

Answer 22

Ethanol

Question 23

OTHER TOXIC SUBSTANCES

Subclinical impairment, no obvious impairment

Answer 23

0.01-0.05% w/v BAC

Question 24

OTHER TOXIC SUBSTANCES

Mild euphoria, some impairment of motor skills

Answer 24

0.03-0.12% w/v BAC

Question 25

# OTHER TOXIC SUBSTANCES Legal intoxication in the US

Answer 25

>0.1% w/v BAC

Question 26

# OTHER TOXIC SUBSTANCES Loss of critical judgment, memory impairment

Answer 26

0.09-0.25% w/v BAC

Question 27

# OTHER TOXIC SUBSTANCES Mental confusion, strongly impaired motor skills

Answer 27

0.18-0.30% w/v BAC

Question 28

# OTHER TOXIC SUBSTANCES Impaired consciousness

Answer 28

0.27-0.40% w/v BAC

Question 29

# OTHER TOXIC SUBSTANCES Complete unconsciousness, deep, possibly fatal coma

Answer 29

0.35-0.50% w/v BAC

Question 30

# OTHER TOXIC SUBSTANCES Respiratory arrest

Answer 30

>0.45% BAC

Question 31

Enzymatic method for ethanol detection: Ethanol + NAD ADH → acetaldehyde + NADH instrument

Answer 31

UV

Question 32

Reference method for ethanol detection

Answer 32

Gas-liquid chromatography (GLC)

Question 33

Method for ethanol detection, measures osmolal gap

Answer 33

Osmometry

Question 34

# OTHER TOXIC SUBSTANCES Causes acidosis, blindness, and death due to formaldehyde and formic acid formation

Answer 34

Methanol

Question 35

# OTHER TOXIC SUBSTANCES Produces severe, acute ethanol-like symptoms that persist for a long period

Answer 35

Isopropanol

Question 36

# OTHER TOXIC SUBSTANCES Causes severe metabolic acidosis and renal tubular damage

Answer 36

Ethylene glycol

Question 37

# OTHER TOXIC SUBSTANCES 245x greater affinity for Hb compared to oxygen, shifts oxyhemoglobin dissociation curve to the left (hypoxia)

Answer 37

Carbon monoxide

Question 38

# OTHER TOXIC SUBSTANCES Typical in nonsmokers COHb (%)

Answer 38

0.5% COHb

Question 39

# OTHER TOXIC SUBSTANCES Range of values seen in smokers COHb (%)

Answer 39

5-15% COHb

Question 40

# OTHER TOXIC SUBSTANCES Shortness of breath with vigorous exercise COHb (%)

Answer 40

10% COHb

Question 41

# OTHER TOXIC SUBSTANCES Shortness of breath with moderate exercise COHb (%)

Answer 41

20% COHb

Question 42

# OTHER TOXIC SUBSTANCES Severe headaches, fatigue, impairment of judgment COHb (%)

Answer 42

30% COHb

Question 43

# OTHER TOXIC SUBSTANCES Confusion, fainting on exertion COHb (%)

Answer 43

40-50% COHb

Question 44

# OTHER TOXIC SUBSTANCES Unconsciousness, respiratory failure, death with continuous exposure COHb (%)

Answer 44

60-70% COHb

Question 45

# OTHER TOXIC SUBSTANCES Immediately fatal COHb (%)

Answer 45

80% COHb

Question 46

Cyanide characteristic odor

Answer 46

bitter almonds

Question 47

Arsenic characteristic odor

Answer 47

garlic odor and metallic taste

Question 48

Cadmium exposure effects

Answer 48

renal tubular damage (acute tubular necrosis)

Question 49

Lead enzymes inhibited in heme synthesis pathway

Answer 49

ALA dehydrogenase/ PBG synthase (high urinary delta-ALA); ferrochelatase/heme synthase (high EEP - free erythrocyte porphyrin)

Question 50

Mercury forms

Answer 50

Elemental (Hg°); Cationic/inorganic (Hg+ and Hg2+); Organic (alkyl, aryl, alkoxyalkyl forms)

Question 51

Most toxic mercury form

Answer 51

methyl-Hg (associated with Minamata disease)

Question 52

Garlic Breath

Answer 52

Selenium, arsenic, organophosphate