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MOD 4 (PCOL) > DRILLS > Flashcards

DRILLS Flashcards

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1
Q

A patient presents with miosis, respiratory depression, and altered mental status. What is the most immediate intervention?

Atropine
Activated charcoal
Naloxone
Flumazenil

A

Naloxone

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2
Q

A patient exposed to an unknown toxin
presents with mydriasis, dry mucous membranes, urinary retention, and hyperthermia. Which toxidrome is most
likely?

Anticholinergic
Sedative-hypnotic
Opioid
Cholinergic

A

Anticholinergic

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3
Q

In a patient with suspected cyanide poisoning, which of the following is the most appropriate first-line antidote?

Hydroxycobalamin
N-acetylcysteine
Flumazenil
Naloxone

A

Hydroxycobalamin

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4
Q

Which of the following factors increases the
efficacy of hemodialysis for toxin removal?

High volume of distribution
Low molecular weight
High protein binding
Lipophilicity

A

Low molecular weight

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5
Q

Which toxin is least likely to be effectively adsorbed by activated charcoal?

Tricyclic antidepressants
Iron
Calcium channel blockers
Beta-blockers

A

Iron

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6
Q

Which of the following clinical signs
suggests a cholinergic toxidrome?

Respiratory depression and pinpoint pupils
Dry skin and tachycardia
Diaphoresis and miosis
Hyperthermia and mydriasis

A

Diaphoresis and miosis

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7
Q

A patient is exposed to an organophosphate insecticide. What is the primary treatment approach?

Activated charcoal
Benzodiazepines
Atropine and pralidoxime
Hemodialysis

A

Atropine and pralidoxime

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8
Q

Which of the following substances is not effectively removed via hemodialysis?

Benzodiazepines
Methanol
Lithium
Salicylates

A

Benzodiazepines

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9
Q

A patient presents with metabolic acidosis and an elevated anion gap after ingesting antifreeze. Which antidote is most appropriate?

Naloxone
Glucagon
Fomepizole
Sodium bicarbonate

A

Fomepizole

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9
Q

In serotonin syndrome, which physical exam finding differentiates it from neuroleptic malignant syndrome?

Hyperreflexia and clonus
Autonomic instability
Altered mental status
Hyperthermia

A

Hyperreflexia and clonus

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10
Q

Which of the following substances produces a garlic odor on breath or skin?

Cyanide
Organophosphates
Methanol
Carbon monoxide

A

Organophosphates

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11
Q

Which of the following toxidromes is characterized by hypertension, tachycardia, mydriasis, diaphoresis, and agitation?

Opioid
Cholinergic
Sedative-hypnotic
Sympathomimetic

A

Sympathomimetic

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11
Q

In severe salicylate toxicity, which of the following interventions enhances elimination?

Urinary alkalinization
Hemodialysis
Whole bowel irrigation
Activated charcoal

A

Urinary alkalinization

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12
Q

Which of the following toxic ingestions can result in profound metabolic acidosis with an increased anion gap?

Methanol
Beta-blockers
Iron overdose
Benzodiazepines

A

Methanol

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13
Q

A patient presents with acute lithium toxicity. Which of the following treatments is most appropriate for severe toxicity?

Activated charcoal
Sodium bicarbonate
Whole bowel irrigation
Hemodialysis

A

Hemodialysis

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14
Q

A patient is brought to the emergency department with a bitter almond odor on breath. Which toxin is the most likely cause?

Methanol
Cyanide
Carbon monoxide
Organophosphates

A

Cyanide

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15
Q

A 25-year-old patient presents with agitation, hyperthermia, mydriasis, and tachycardia. He also has flushed skin and dry mucous membranes. Which is the most likely diagnosis?

Anticholinergic toxicity
Serotonin syndrome
Sympathomimetic toxicity
Opioid overdose

A

Anticholinergic toxicity

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16
Q

A patient with suspected opioid overdose is
found unresponsive with pinpoint pupils and a respiratory rate of 6. What is the most appropriate next step?

Administer naloxone
Perform gastric lavage
Give sodium bicarbonate
Administer flumazenil

A

Administer naloxone

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17
Q

A toxic ingestion of beta-blockers can cause severe bradycardia and hypotension. What is the first-line antidote?

Sodium bicarbonate
Naloxone
Glucagon
Flumazenil

A

Glucagon

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18
Q

Which of the following poisons is not effectively treated with activated charcoal?

Beta-blockers
Lithium
Theophylline
Tricyclic antidepressants

A

Lithium

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19
Q

A patient presents with suspected carbon monoxide poisoning. What is the most definitive treatment?

Sodium bicarbonate
Hyperbaric oxygen therapy
Glucagon
Activated charcoal

A

Hyperbaric oxygen therapy

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20
Q

In a patient with tricyclic antidepressant (TCA) overdose, which ECG abnormality is most concerning?

Peaked T waves
Depressed ST segments
Prolonged PR interval
Widened QRS complex

A

Widened QRS complex

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21
Q

A patient ingests ethylene glycol. What lab finding is most characteristic?

Elevated anion gap metabolic alkalosis
Respiratory alkalosis
Calcium oxalate crystals in urine
Hyperkalemia

A

Calcium oxalate crystals in urine

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22
Q

Which of the following is the best indicator for hemodialysis in salicylate poisoning?

Seizures
Persistent metabolic acidosis
Vomiting
Diaphoresis

A

Persistent metabolic acidosis

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23
A patient is suspected to have neuroleptic malignant syndrome (NMS). Which distinguishing feature helps differentiate it from serotonin syndrome? Lead-pipe muscle rigidity Clonus Autonomic instability Hyperthermia
Lead-pipe muscle rigidity
24
A patient with an overdose of calcium channel blockers presents with hypotension and bradycardia. Which treatment is most appropriate? Atropine alone Calcium gluconate and high-dose insulin therapy Hemodialysis Naloxone
Calcium gluconate and high-dose insulin therapy
25
Which of the following toxic syndromes is most likely to cause bradycardia? Beta-blocker overdose Anticholinergic toxicity Sympathomimetic overdose Salicylate poisoning
Beta-blocker overdose
26
A patient presents with flaccid paralysis, ptosis, and descending muscle weakness after consuming home-canned food. What is the most likely toxin? Organophosphates Tetrodotoxin Botulinum toxin Cyanide
Botulinum toxin
27
A patient presents with an odor of rotten eggs on breath, along with sudden collapse and respiratory failure. Which of the following toxins is most likely? Hydrogen sulfide Methanol Salicylates Theophylline
Hydrogen sulfide
28
Which poison is associated with pink skin discoloration and a cherry-red hue post-mortem? Methanol Hydrogen sulfide Carbon monoxide Cyanide
Carbon monoxide
28
What is the primary goal of biopharmaceutics? To determine the safest drug formulation To analyze drug toxicity levels To optimize the chemical synthesis of drugs To study the relationship between drug formulation and therapeutic response
To study the relationship between drug formulation and therapeutic response
29
Which of the following is NOT a pharmacokinetic process? Absorption Distribution Metabolism Receptor binding
Receptor binding
30
The fraction of an administered drug that reaches systemic circulation is called: Clearance Volume of distribution Bioavailability Half-life
Bioavailability
31
A drug administered intravenously has a bioavailability of: Variable 0 100% 0.5
100%
32
Which pharmacokinetic parameter is used to describe drug distribution in the body? Half-life (t½) Clearance (CI) Bioavailability (F) Volume of distribution (Vd)
Volume of distribution (Vd)
33
Which organ is primarily responsible for drug metabolism? Pancreas Kidney Lungs Liver
Liver
34
The movement of a drug from the bloodstream to the tissues is called: Absorption Distribution Elimination Metabolism
Distribution
35
What is the major route of drug excretion? Lungs Kidney Liver Skin
Kidney
36
The rate and extent of drug absorption depend on: Route of Administration Drug Solubility pH of the gastrointestinal tract All of the choices
All of the choices
37
The time required for a drug to reach steady state is dependent on: Half-life Route of administration Volume of distribution Clearance
Half-life
38
A loading dose is used to: Increase first-pass metabolism Prolong drug half-life Maintain steady-state concentration Achieve therapeutic levels quickly
Achieve therapeutic levels quickly
39
First-pass metabolism occurs primarily in the: Small Intestines Liver Kidney Lungs
Liver
39
Drugs following zero-order kinetics: Have a half-life independent of concentration Have a constant rate of elimination Are excreted at a rate proportional to drug concentration Are eliminated more quickly at higher doses
Have a constant rate of elimination
40
The renal clearance of a drug is affected by: Tubular secretion Glomerular filtration rate Tubular reabsorption All of the choices
All of the choices
41
A drug with a high hepatic extraction ratio: Has high bioavailability Is minimally metabolized Is mostly excreted by the kidneys Is largely removed during first-pass metabolism
Is largely removed during first-pass metabolism
42
Which of the following drugs is a purely muscarinic agent? Nicotine Pilocarpine Atropine Arecoline
Pilocarpine
43
Which of the following describes the action of succinylcholine? CNS acting anticholinergic CNS acting anticholinesterase Non-depolarizing, reversible, competitive nicotinic antagonist Depolarizing, irreversible, non-competitive nicotinic antagonist
Depolarizing, irreversible, non-competitive nicotinic antagonist
44
Which of the following drugs is an acetylcholinesterase inhibitor? Albuterol Ipratropium Atropine Donepezil
Donepezil
44
Mr. Lee, a 45-year-old man, presents to the emergency room with severe muscle spasms and twisting movements of his neck. He has been taking an antipsychotic medication for his schizophrenia. The attending physician diagnoses him with acute dystonia. Which of the following treatments would be most appropriate for Mr. Lee's acute dystonia? Diphenhydramine IV Metoclopramide Lorazepam Haloperidol
Diphenhydramine IV
45
Mr. Anderson, a 55-year-old man, presents with severe muscle rigidity, fever, and altered consciousness after starting an antipsychotic medication. The physician diagnoses him with neuroleptic malignant syndrome (NMS) and decides to initiate treatment. Which of the following treatments is appropriate for Mr. Anderson's condition? Metoclopramide Bromocriptine Haloperidol Diphenhydramine
Bromocriptine
46
All of the following are low potency antipsychotics except: Chlorpromazine Chlorprothixene Fluphenazine Mesoridazine
Fluphenazine
47
Which of the following mechanisms explain why combining ARBs and ACE inhibitors is not recommended? i. Both inhibit the effects of angiotensin II ii. Both can lead to increased bradykinin levels iii. Both can cause significant hypotension iv. Both affect renal function i and iii i, iii, and iv ii and iii i and iv
i, iii, and iv
48
Cardiac biomarkers indicative of STEMI include all of the following except: Troponin Brain natriuretic peptide (BNP) Lactate dehydrogenase (LDH) CKMB (Creatine kinase MB
Brain natriuretic peptide (BNP)
49
ACE inhibitors lead to an increase in levels of which peptide? Renin Angiotensin I Aldosterone Bradykinin
Bradykinin
50
Which of the following are venodilators used in the treatment of heart failure? i. Isosorbide dinitrate ii. Nitroglycerin iii. Hydralazine iv. Enalapril i and iii i, iii, and iv i and ii i and iv
i and ii
50
All of the following are storage locations of histamine except: Mast cells and basophils Skeletal muscle cells Enterochromaffin-like cells in the stomach Brain tissues
Skeletal muscle cells
51
All of the following are diagnostic criteria for diabetes except: HbA1C level ≥ 6.5% Random blood sugar levels ≤ 100 mg/dL Fasting blood sugar levels > 126 mg/dL Oral glucose tolerance test > 200 mg/dL
Random blood sugar levels ≤ 100 mg/dL
52
A 60-year-old patient with a history of cirrhosis presents with bleeding esophageal varices. The healthcare provider prescribes a somatostatin analog. Which drug is being used, and what is its primary effect? Somatropin; promotes growth Octreotide; vasoconstriction Corticotropin; increases cortisol secretion Bromocriptine; reduces prolactin levels
Octreotide; vasoconstriction
52
What class of drug does Orlistat belong to? GLP-1 receptor agonist Gastrointestinal lipase inhibitor Melanocortin receptor agonist Sympathomimetic amine
Gastrointestinal lipase inhibitor
53
All of the following are characteristics of fentanyl except: Used for severe pain management Rapid onset of action Causes histamine release Acts as a µ-opioid receptor agonist
Causes histamine release

MOD 4 (PCOL) (5 decks)

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