Chapter 31 - Medical Toxicology Flashcards Preview

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Flashcards in Chapter 31 - Medical Toxicology Deck (126):
0

Which of the following is true regarding acetaminophen overdose during pregnancy?

A. There is no fetal risk because acetaminophen does not cross the placenta

B. The risk to the fetus from N-actulcysteine is higher than that from acetaminophen

C. The risk for fetal liver damage is highest during the first trimester

D. The fetal liver will have decreased CYP450-mediated metabolism of acetaminophen compared to an adult

D. The fetal liver will have decreased CYP450-mediated metabolism of acetaminophen compared to an adult

1

If a patient presents to an emergency room with elevated transaminases and an uncertain time of overdose acetominophen ingestion, the appropriate next step would be...

A. Repeat transaminase in 8 hrs

B. Begin N-acetylcysteine

C. Place patient on transplant list

D. Obtain liver biopsy

B. Begin N-acetylcysteine

2

All of the following are true regarding acetaminophen toxicity in alcoholics except...

A. The treatment nomogram is modified for alcoholics

B. The presence of alcohol in the body may be protective

C. Chronic alcoholics have induction of CYP2E1

D. Alcoholics have decreased glutathione stores because of malnutrition

A. The treatment nomogram is modified for alcoholics

3

All of the following statements are true regarding acetaminophen overdose except...

A. Renal toxicity can occur

B. Minor prolongations of the prothrombin time can occur in the absence of hepatotoxicity

C. The mortality is less than 0.5%

D. Use of 4 g acetaminophen per day over 4 weeks is associated with a high risk of hepatotoxicity

D. Use of 4 g acetaminophen per day over 4 weeks is associated with a high risk of hepatotoxicity

4

All of the following are indications for hemodialysis in salicylate overdose except...

A. Acute lung injury

B. Hearing loss

C. Renal failure

D. Hepatic injury with coagulopathy

B. Hearing loss

5

In salicylate toxicity, alkalinization of the serum with intravenous sodium bicarbonate produces all of the following effects except...

A. Correction of metabolic acidosis

B. Removal of salicytate from the CNS

C. Enhanced urinary excretion of salicytate

D. Displacement of salicylate from alpha-1-acid glycoprotein

D. Displacement of salicylate from alpha-1-acid glycoprotein

6

The settings on a ventilator in a salicylite-poisoned patient must be constantly adjusted to maintain preventilator levels of...

A. Hypocarbia

B. Oxygen partial pressure

C. Tidal volume

D. Alveolar oxygen

A. Hypocarbia

7

The mechanism for increased cardiovascular risk in users of selective cyclooxygenase 2 inhibitors may involve...

A. Increased activity of vitamin K-dependent clotting

B. Decreased fibrinolysis

C. Inhibition of endothelial-derived PGI2

D. Inhibition of PGE2

C. Inhibition of endothelial-derived PGI2

8

The antiplatelet effects of COX-1 inhibitors are due to effects on...

A. TXA2

B. PGF

C. PGD

D. Leukotrienes

A. TXA2

9

The treatment of intentional nonasprin NSAID overdose usually includes all of the following except...

A. Serum acetaminophen concentration

B. Activated charcoal

C. Protein pump inhibitors

D. Hemodialysis

D. Hemodialysis

10

The most logical treatment to prevent iron absorption in significant overdose situations is...

A. Whole bowel irrigation

B. Induced emesis

C. Activated charcoal

D. Magnesium hydroxide

A. Whole bowel irrigation

11

A rare form of injury from iron overdose that can occur 2 to 8 weeks after ingestion is...

A. Peripheral neuropathy

B. Gastric outlet obstruction

C. Pancreatitis

D. Bronchiolitis obliterans

B. Gastric outlet obstruction

12

The target organ for deferoxamine toxicity is the...

A. Liver

B. Lung

C. Kidney

D. Peripheral nervous system

B. Lung

13

During the 6 hr period following a significant iron overdose, which of the following almost always occurs?

A. Bradycardia

B. Respiratory depression

C. Vomiting

D. Asymptomatic period

C. Vomiting

14

All of the following may be indicated in the treatment of vitamin A toxicity except...

A. Dexamethasone

B. Intravenous Ca

C. Loop diuretics

D. Activated charcoal

B. Intravenous Ca

15

All of the following may be indicated in the treatment of Vitamin D overdose except...

A. Bisphosphonates

B. Corticosteroids

C. Calcitonin

D. Thiazide diuretics

D. Thiazide diuretics

16

Neuropathy is most likely associated with an overdose of...

A. Vitamin E

B. Vitamin C

C. Pyridoxine

D. Niacin

C. Pyridoxine

17

A coagulopathy is least likely to develop following toxic doses of...

A. Vitamin A

B. Vitamin E

C. Pyridoxine

D. Niacin

C. Pyridoxine

18

Which of the following best describes the association between vitamin C and risk of oxalate neprolithiasis?

A. It is a significant clinical concern in all patients

B. It is a significant clinical concern in children and not adults

C. It is a significant clinical concern in adults and not children

D. It is not a significant clinical concern

D. It is not a significant clinical concern

19

Which of the following drug classes in an overdose situation is least likely to cause hypoglycemia?

A. First-generation sulfonylureas

B. Meglitinides

C. Alpha-glucosidase inhibitors

D. Second-generation sulfonureas

C. Alpha-glucosidase inhibitors

20

Hypoglycemia in the presence of high-insulin plasma levels, high C-peptide plasma levels and absent insulin-binding antibodies is most likely the result of overdose of...

A. Exogenous insulin

B. Sulfonylureas

C. Corticosteroids

D. All of the above

B. Sulfonylureas

21

Glucagon is the drug of choice for overdose from...

A. Sulfonylureas

B. metformin

C. Alpha-glucosidase inhibitors

D. None of the above

D. None of the above

22

Overdose of aminoglycosides may produce...

A. Aseptic meningitis

B. acute lung injury

C. Hepatotoxicity

D. Neuromuscular blockade

D. Neuromuscular blockade

23

An unusual adverse effect of fluoroquinolone therapy is...

A. Sleep paralysis

B. nonproductive cough

C. Alopecia

D. Tendon rupture

D. Tendon rupture

24

Lactic acidosis is a serious adverse effect associated with overdose of...

A. Nucleosideanalog reverse transcription inhibitors

B. penicillin

C. Vancomycin

D. Aminoglycosides

A. Nucleosideanalog reverse transcription inhibitors

25

The Jarich-Herxheimer reaction occurs after administration of...

A. Amphotericin B

B. Erythromycin

C. Ciprofloxacin

D. Procaine penicillin G

D. Procaine penicillin G

26

Which of the following statements is true regarding acute ingestions of long-acting anticoagulant rodenticides?

A. The risk of coagulation abnormalities is the same in both intentional and small nonintentional overdoses

B. Coagulation problems can persist for weeks in intentional overdose

C. The 4 hr post-ingestion INR is more clinically relevant than the 48 hr measure

D. All children should be hospitalized for 12 hrs after a single unintentional dose

B. Coagulation problems can persist for weeks in intentional overdose

27

The ideal immediate antidote for life-threatening bleeding in a hemodynamically stable patient with warfarin overdose is...

A. Intravenous vitamin K

B. Whole blood transfusion

C. Prothrombin complex concentrate infusion

D. Fresh frozen plasma infusion

C. Prothrombin complex concentrate infusion

28

Theoretically, the duration of coagulopathy in long-acting anticoagulant overdose will be shortened by the administration of...

A. Phenobarbital

B. Cimetidine

C. Omeprazole

D. Quinine

A. Phenobarbital

29

In patients with gastrointestinal hemorrhage secondary to warfarin-like anticoagulants, the ideal route for vitamin K administration is...

A. Sublingual

B. Intramuscular

C. Subcutaneous

D. Intravenous

C. Subcutaneous

30

All of the following have a place in the treatment of acute thryoid hormone overdose except...

A. High-dose asprin

B. acetominophen

C. Activated charcoal

D. Beta-adrenergic blockers

A. High-dose asprin

31

In patients with asthma, an alternative drug for use in thyroid hormone overdose is...

A. Nifidipine

B. nicardipine

C. diliazen

D. Nimodipine

C. diliazen

32

A drug that can sedate a patient with thyroid hormone overdose and also theoretically provide enhanced thyroid elimination is...

A. Midazolam

B. Phenobarbital

C. Propofol

D. Mannitol

B. Phenobarbital

33

Which of the following is considered primary therapy for thyroid hormone overdose?

A. Corticosteroids

B. Propylthiouricil

C. Iodine contrast media

D. None of the above

D. None of the above

34

All of the following may be indicated in the management of overdose with a histamine 1 receptor antagonist except...

A. Lorazepam

B. Physostigmine

C. Warming blankets

D. Sodium bicarbonate

C. Warming blankets

35

Which of the following is least important in the management of an intentional histamine 1 receptor antagonist overdose?

A. Serum gamma glutamyl transpeptidase

B. ECG

C. Creatine phosphokinase

D. Serum acetaminophen levels

A. Serum gamma glutamyl transpeptidase

36

Oral overdose of histamine 2 receptor antagonists...

A. Are treated identically as histamine receptor 1 receptor antagonist overdoses

B. Require gastric lavage

C. Require seizure prophylaxis with phenytoin

D. Generally have a good outcome

D. Generally have a good outcome

37

Which of the following should be avoided in the treatment of decongestant overdose?

A. Activated charcoal

B. Benzodiazipines

C. Phentolamine

D. Propranolol

D. Propranolol

38

First-line drugs for the treatment of ventricular dyshythmias from decongestant overdose include...

A. Verapamil and diltiazem

B. Aminodarone and lidocane

C. Quinidine and procainamide

D. Atropine and magnesium sulfate

B. Aminodarone and lidocane

39

Vasoconstriction from excessive doses of triptan antimigraine therapy can be treated with all of the following except...

A. Metoprolol

B. Phentolamine

C. Nitroglycerine

D. Sodium nitroprusside

A. Metoprolol

40

Triptan overdose differs from ergot overdose in that...

A. Calcium channel blockers are contraindicated

B. Vomiting is less

C. Coronary ischemia does not occur

D. Diuretics are indicated in the management of hypertension

B. Vomiting is less

41

Weight loss drugs, methylsergide, and ergotamine have all been associated with...

A. Amyotropic lateral sclerosis

B. Parkinson's disease

C. Myocardial valvular abnormalities

D. Hepatic angiosarcoma

C. Myocardial valvular abnormalities

42

Nonanion gap metabolic acidosis is seen following overdose of...

A. Phenytoin

B. Gabapentim

C. Topiramate

D. Levetiracetam

C. Topiramate

43

Which of the following is least likely to cause the drug rash with eosinophilia and systemic symptoms (DRESS) syndrome?

A. Valproic acid

B. Phenytoin

C. Carbamazepine

D. Primidone

A. Valproic acid

44

In calcium channel blocker overdose, what serum laboratory parameter may correlate with the severity of poisoning?

A. Elevation of potassium

B. Decrease in bicarbonate

C. Elevation in ionized Ca

D. Elevation in glucose

D. Elevation in glucose

45

The calcium channel blocker with the most negative ionotropic effect on the heart in overdose is...

A. Nicardipine

B. Nifedipine

C. Diltiazen

D. Verapamil

D. Verapamil

46

All of the following are true regarding calcium channel blocker overdose except...

A. Nausea and vomiting are common early manifestations

B. Hypotension is common

C. CNS depression is uncommon without severe hypotension

D. All types can produce severe bradycardia in significant overdoses

A. Nausea and vomiting are common early manifestations

47

All of the following are useful in the treatment of calcium channel blocker overdose except...

A. Glucagon

B. Euglycemia insulin therapy

C. Physostigmine

D. Calcium

C. Physostigmine

48

Patients with a history of sustained release calcium channel blocker ingestion should undergo all of the following except...

A. Hospital admission for at least 24 hrs

B. Whole bowel irrigation

C. Continuous ECG monitoring

D. Digoxin therapy

D. Digoxin therapy

49

In patients overdosing on beta-blockers alone and not taking any concomitant medication, what property of beta-blockers would render them most toxic?

A. Water solubility

B. Membrane-stabilizing activity

C. Vasodilatory activity

D. Cardiac selectivity

B. Membrane-stabilizing activity

50

Magnesium infusions may be necessary in overdoses of...

A. Propranolol

B. Naldolol

C. Sotolol

D. Metoprolol

C. Sotolol

51

In patients with beta-blocker overdose who do not respond to atropine and fluids, the next drug most recommended for treatment is...

A. Glucagon

B. theophylline

C. Lidocane

D. Dopamine

A. Glucagon

52

In beta-blocker overdose with QRS widening, a useful therapy could be...

A. Hypertonic sodium bicarbonate

B. Vasopressin

C. Potassium

D. Isoproterenol

A. Hypertonic sodium bicarbonate

53

Which of the following has been shown to be the safest beta-blocker in overdose situations?

A.Propranolol

B. Timolol

C. Sotalol

D. Atenolol

D. Atenolol

54

Naloxone has been used in the treatment of overdoses of...

A. Clonidine

B. ACE inhibitors

C. Ethanol

D. All of the above

D. All of the above

55

In overdoses of direct-acting vasodilators like minoxidil and hydralazine, which peripherally acting alpha-adrenergic agent should be avoided?

A. Dopamine

B. Norepinephrine

C. Phenylephedrine

D. All of the above

A. Dopamine

56

Newer uses of clonidine that may contribute to a resurgence in cases of toxicity include all of the following except...

A. ADHD

B. Opioid withdrawal

C. Erectile dysfunction

D. Nicotine withdrawal

C. Erectile dysfunction

57

Exposure to nitrous oxide has been associated with all of the following except...

A. Leukopenia

B. Polyneuropathy

C. Increased rate of spontaneous abortions

D. Scleroderma

D. Scleroderma

58

Enflurane and desflurane can degrade to...

A. CO

B. fluorine gas

C. Ozone

D. Phosgene

A. CO

59

All of the following are true of halothane hepatitis except...

A. 80% of cases occur after a single exposure

B. it is more common in women

C. There may be a genetic predisposition

D. Obesity is a risk factor

A. 80% of cases occur after a single exposure

60

Chronic angiotensin receptor blocking therapy can cause hypotension during anesthesia that can be refractory to traditional vasoconstrictors but can respond to...

A. Ephedrine

B. Aldosterone

C. Vasopressin

C. Glucagon

C. Vasopressin

61

Hypotension would be least likely following overdose of...

A. Diazoxide

B. Hydrochlorothiazide

C. Clonidine

D. Nifedipine

B. Hydrochlorothiazide

62

All of the following may be helpful in the setting of poisoning with class 1 antidysrhythmics except...

A. Flecainide

B. Hypertonic sodium bicarbonate

C. Magnesium sulfate

D. Overdrive pacing

A. Flecainide

63

Viscous lidocane is particularly toxic when swallowed because...

A. It has a pleasant taste

B. It has a high percentage of propylene glycol

C. It acts as a delayed release form in the gut

D. The ingestor can receive a very large dose

D. The ingestor can receive a very large dose

64

All of the following may be helpful in the setting of poisoning with class 1 antidysrhymtics except...

A. Hypertonic sodium bicarbonate

B. aminodarone

C. Cardiopulmonary bypass

D. Procainamide

D. Procainamide

65

Hyperkalemia during digioxin overdose is best treated with all of the following except...

A. Dextrose

B. Sodium polysyrene sulfonate

C. Calcium

D. Sodium bicarbonate

C. Calcium

66

The endogenous digoxin-like substance that has been identified in humans is similar to a toxin found in...

A. Puffer fish

B. Potato

C.Toads

D. Scorpions

C.Toads

67

Measures to enhance digoxin elimination from the body would include all of the following except...

A. Activated charcoal

B. Acidification of the urine

C. Cholestyramine

D. Colestipol

B. Acidification of the urine

68

Drugs useful in the treatment of dysrhythmias secondary to digoxin overdose include all of the following except...

A. Quinidine

B. Lidocane

C. Phenytoin

D. Artopine

A. Quinidine

69

All of the following would be expected to occur following treatment of digoxin toxicity with digoxin-specific Fab except...

A. A decrease in serum potassium concentration

B. A decrease in total serum digoxin concentration

C. An increase in renal clearance of digoxin

D. A decrease in serum free digoxin

B. A decrease in total serum digoxin concentration

70

In acute digoxin overdose, the best predictor of lethality has been shown to be...

A. Serum potassium concentration

B. Serum total digoxin concentration

C. PR interval

D. Serum free digoxin concentration

A. Serum potassium concentration

71

All of the following are useful in the treatment of hemodynamically unstable ventricular tachycardia secondary to digoxin overdose except...

A. Lidocaine

B. digoxin specific Fab

C. Cardioversion

D. Transvenous pacemaker overdrive suppression

D. Transvenous pacemaker overdrive suppression

72

A distinguishing feature of the serotonin syndrome from the neuroleptic malignant syndrome is...

A. Altered mental status

B. Elevated core temperature

C. Tachycardia

D. Myoclonus

D. Myoclonus

73

All of the following could be useful in the treatment of severe neuroleptic malignant syndrome except...

A. Acidification of urine

B. Dantrolene

C. Prophylactic dose of low molecular weight heparin

D. Benzodiazepines

A. Acidification of urine

74

All of the following are appropriate in the management of acute antipsychotic overdose except...

A. Intravenous fluids

B. Syrup of ipecac

C. Activated charcoal

D. Cardiac monitoring

B. Syrup of ipecac

75

The antipsychotic with the highest degree of QT prolongation is...

A. Aripiprazole

B. Olanzapine

C.Thioridazine

D. Risperidone

C.Thioridazine

76

The antipsychotic with the lowest incidence of tardive dyskinesia is...

A. Haloperidol

B. Fluphenazine

C. Chlorpromazine

D. Clozapine

D. Clozapine

77

All of the following are useful in eliminating drug from carbamazipine overdose except...

A. Multiple doses of activated charcoal

B. Urine alkalinization

C. Hemodialysis

D. Charcoal hemoperfusion

B. Urine alkalinization

78

Cardiac toxicity from intravenous phenytoin preparations thought to be due in part to...

A. Phenytoin degradation products

B. Oxalic acid

C. Propylene glycol

D. Cetyl alcohol

C. Propylene glycol

79

A predictor of persistent neurologic dysfunction in patients with lithium toxicity is...

A. Elevated creatinine

B. Polyuria

C. Hyperpyrexia

D. Hypothyroidism

C. Hyperpyrexia

80

The recommended treatment for gastrointestinal lithium elimination after ingestion of sustained release preparations is...

A. Whole bowel irrigation

B. Multiple doses of activated charcoal

C. Orogastric lavage

D. Cholestyramine

A. Whole bowel irrigation

81

Hemodialysis should be considered in the management of patients with lithium toxicity and concurrent...

A. Severe neurotoxicity

B. Renal failure and neurotoxicity

C. Congestive heart failure

D. All of the above

D. All of the above

82

A treatment that has no role in the management of a patient with lithium toxicity is...

A. Peritoneal dialysis

B. Saline infusion

C. Continuous renal replacement therapy

D. All of the above

A. Peritoneal dialysis

83

Toxicity may develop because of a drug interaction between lithium and...

A. Thiazide diuretics

B. ACE inhibitors

C. NSAIDs

D. All of the above

D. All of the above

84

All of the following are indicated in MAO inhibitor-induced serotonin syndrome except...

A. Dopamine

B. Cooling measures

C. Benzodiazepines

D. Cyproheptadine

A. Dopamine

85

Serious drug interactions can occur between MAO inhibitors and all of the following except...

A. Dextromethorphan

B. Tramadol

C. Acetaminophen

D. Meperidine

C. Acetaminophen

86

The interaction of tyramine in food with first-generation MAO inhibitors produces...

A. Serotonin syndrome

B. Malignant neurleptic syndrome

C. Hyperadrenergic crisis

D. All of the above

C. Hyperadrenergic crisis

87

The hyperthermia from MAO-induced serotonin syndrome is best treated with...

A. Acetaminophen

B. Phenothiazines

C. Dantrolene

D. None of the above

D. None of the above

88

Seizures refractory to benzodiazepines following large overdoses of phenelzine should be treated with...

A. Pyridoxine

B. Phenytoin

C. Aripiprazole

D. None of the above

A. Pyridoxine (vitamin B6)

89

A unique toxicity of trazodone is...

A. Inhibition of CYP2C19

B. Hypothyroidism

C. Cholestatic hepatitis

D. Priapism

D. Priapism

90

The drug most commonly associated with drug discontinuation syndrome is...

A. Paroxetine

B. Venlafaxine

C. Fluoroxine

D. Trazodone

A. Paroxetine

91

The SSRI with the highest incidence of QT prolongation is...

A. Sertraline

B. Paroxetine

C. Citalopram

D. Fluoxetine

C. Citalopram

92

The SSRI with the highest incidence of seizures is...

A. Sertraline

B. Escitalopram

C. Fluvoxamine

D. Fluoxetine

B. Escitalopram

93

An atypical antidepressant with a low incidence of seizures is...

A. Bupropion

B. Trazodone

C. Duloxetine

D. Venlafaxine

B. Trazodone

94

Patients die from cyclic antidepressant overdose primarily as a result of...

A. CNS toxicity

B. Cardiovascular toxicity

C. Anticholinergic toxicity

D. Pulmonary toxicity

B. Cardiovascular toxicity

95

Risk factors for the development of ventricukar tachycardia during tricyclic antidepressant overdose include all of the following except...

A. Hypoxia

B. Acidosis

C. Concurrent beta-adrenergic agonist therapy

D. Concurrent beta-adrenergic antagonist therapy

D. Concurrent beta-adrenergic antagonist therapy

96

Life-threatening toxicity from tricyclic antidepressant overdose usually occurs with levels at or above...

A. 10 ng/ml

B. 100 ng/ml

C. 200 ng/ml

D. 1000 ng/ml

D. 1000 ng/ml

97

All of the following have a role in the management of cyclic antidepressant toxicity except...

A. Dantrolene

B. Sodium bicarbonate

C. Benzodiazepines

D. Magnesium sulfate

A. Dantrolene

98

The cyclic antidepressant with a lower incidence of serious cardiac toxicity, but a higher incidence of seizures is...

A. Norteiptuline

B. Protriptylene

C. Amoxapine

D. Imipramine

C. Amoxapine

99

Significant dermal absorption can occur after exposure to...

A. Chlorhexidine

B. benzalkonium chloride

C. Sodium hypochloride

D. Phenol

D. Phenol

100

The 'boiled lobster rash' is characteristic of ingestion of...

A. Glutaraldehyde

B. Boric acid

C. Sodium chlorate

Formaldehyde

B. Boric acid

101

Lavage with a starch solution may be useful in preventing toxicity from oral ingestion of products containing...

A. Iodine

B. Potassium permanganate

C. Sodium hypochlorite

D. Boric acid

A. Iodine

102

Oxygen embolus is a toxic effect from poisoning with...

A. Potassium permanganate

B. Glutaraldehyde

C. Hydrogen peroxide

D. Sodium hypochlorite

C. Hydrogen peroxide

103

Methemoglobinemia may result from ingestion of...

A. Phenol and sodium chlorate

B. Mercurochrome and thimerosal

C. Hexachlorophene and benzalkonium chlorate

D. Isopropanol and boric acid

A. Phenol and sodium chlorate

104

Orogastric lavage is possibly indicated for all of the following hydrocarbon ingestions except...

A. Camphor

B. Carbon tetrachloride

C. Those associated with spontaneous vomiting

D. Benzene

C. Those associated with spontaneous vomiting

105

Which of the following is indicated in the initial management of nearly all hydrocarbon ingestions?

A. Corticosteroids

B. Prophylactic antibiotics

C. Benzodiazepines

D. None of the above

D. None of the above

106

All of the following would be indicates in a patient with hematemesis secondary to methylxanthine toxicity except...

A. Cimetidine

B. Ranitidine

C. Pantoprazole

D. Omeprazole

A. Cimetidine

107

Seizures from methylxanthine toxicity can be treated with all of the following except...

A. Benzodiazepines

B. Barbituates

C. Phenytoin

D. Propofol

C. Phenytoin

108

Which of the following drugs would be inappropriate for the treatment of supraventricular arrhythmias from methylxanthine overdose...

A. Benzodiazepines

B. Esmolol

C. Verapamil

D. Physostigmine


D. Physostigmine

109

Toxicity from methylxanthine involves all of the following activities except...

A. Inhibition of phosphodiesterase

B. Stimulation of beta-adrenergic receptors

C. Antagonism at adenosine receptors

D. Nicotinic cholinergic receptor blockade

D. Nicotinic cholinergic receptor blockade

110

All of the following are effective ways to enhance the elimination of methylxanthines except...

A. Urinary acidification

B. Hemodialysis

C. Charcoal hemoperfusion

D. Multiple doses of activated charcoal

A. Urinary acidification

111

The most common form of toxicity from beta 2 selective adrenergic agonist overdose is from children ingesting oral...

A. Terbutaline

B. albuterol

C. Clenbuterol

D. Salmeterol

B. albuterol

112

All of the following are suggested indications for hyperbaric oxygen therapy in CO poisoning except...

A. Duration of exposure of 24 hrs or longer

B. Unconciousness

C. Age less than 36 yrs

D. COHb level greater than 30%

C. Age less than 36 yrs

113

The most significant toxicity with CO poisoning is...

A. Delayed neurologic or neuropsychiatric sequelae

B. seizures

C. Acute lung injury

D. Cardiomyopathy

A. Delayed neurologic or neuropsychiatric sequelae

114

Which of the following chemical-chemical weapon class pairs is incorrect...

A. 1-chloacetophenone - riot control agent

B. Phosgene - nerve gas

C. Lewisite - vesicant

D. 3-quinuclidinyl benzilate - incapacitating agent

B. Phosgene - nerve gas

115

The most serious common consequence of camphor ingestion is...

A. Seizure

B. TSS

C. Hepatic necrosis

D. Esophageal perforation

A. Seizure

116

All of the following are true of succimer except...

A. It can be given orally

B. It can be co-administered with iron

C. It can be used for lead, mercury, and arsenic toxicity

D. It is contraindicated in G6PD-deficient patients

D. It is contraindicated in G6PD-deficient patients

117

An association between denture creams and neurologic toxicity has recently been described which is presumed to be due to an excess of...

A. Zinc

B. Copper

C. Chromium

D. Selenium

A. Zinc

118

All of the following can cause an increased osmol gap except...

A. Methanol

B. Asprin

C. Ethanol

D. Isopropanol

B. Asprin

119

All of the following can cause a primary metabolic acidosis except...

A. Quinidine

B. Paraldehyde

C. Toluene

D. Iron

A. Quinidine

120

Methylsalicylate has a characteristic order of...

A. Vinyl

B. Garlic

C. Wintergreen

D. Bitter almonds

C. Wintergreen

121

A patient who overdoses on a drug with a significant enterohepatic recirculation and the formation of active recirculating metabolites would most benefit from...

A. Dialysis

B. Multiple doses of activated charcoal

C. Exchange transfusion

D. Acidification of urine

D. Acidification of urine

122

The major concern with intravenous administration of N-acetylcysteine is..

A. Anaphylactoid reaction

B. Vein phlebitis

C. Hypotension

D. Cardiac arrhythmia

A. Anaphylactoid reaction

123

A cofactor used in the treatment of methanol overdose is...

A. Thiamine

B. Vitamin B12

C. Folic acid

D.Pyridoxine

C. Folic acid

124

The ECG parameter that correlates best with severity in tricyclic antidepressant overdose is...

A. PR interval

B. Heart rate

C. ORS interval

D. T wave height

C. ORS interval

125

Patients with significant caustic ingestion are at an increased risk of all of the following except...

A. Esophageal stricture

B. Esophageal carcinoma

C. Esophageal varices

D. Esophageal perforation

C. Esophageal varices