1.

The first priority step in the treatment of poisoned patient is:

A.Clinical evaluation D.Supportive care and clinical follow-up
B.Prevention of further toxin absortion E.Stabilization of the patient
C.Administration of antidote

2. Characterisitcs odor of garlic detected on the poisoned patients breath or clotting may point toward exposures
or poisoning of which of the following?
A.Cyanide D.Naphthalene
B.Hydrogen Sulfide E.methyl salicylate
C.Organophosphates

3.This term denotes the disposition of poison in the body.

A.Toxicodynamics D.Toxidrome
B.Pharmacokinetics E.clinical toxicology
C.Toxicokinetics

4.The following are the four primary methods to prevent continued absorption of an oral poison except:
A.Induction of emesis with syrup of ipecac D.Oral administration of activated charcoal
B.Oral administration of MgO E.Whole bowel irrigation
C.Gastric lavage

5.The difference between the serum concentrations of the major cations (Na+/K+) and anions (HCOO3/Cl) an
increase of this value the presence of extra anions and is most commonly caused by metabolic acidosis:
A.Osmolar gap D.Osmosis gap
B.Anion gap E.Metabolic gap
C.Cation gap

6.Hepatic lipid accumulation can occur as the result of one or more of the fllowing. EXCEPT:
A.Increased fatty acid supply to the liver D.Increased fatty acid oxidation
B.Increased fatty acid transporter expression E. Decreased synthesis is and/or secretion of VLDL
C.Increased de novo fatty acid and triglyceride synthesis

7.Characteristic odor of bitter almond detected on the poisoned patients breath or cloting may point toward
exposure or poisoning of which of the following?
A.Cyanide D.Naphthalene
B.Hydrogen sulfide E.Methyl salicylate
C.Organophosphates

8.Denotes the injurious effects of toxins and is very important in the diagnosis and management of poisoning
A.Toxicodynamics D.Toxidrome
B.Pharmacokinetics E.Clinical toxicology
C.toxicokinetics

9.Which of the following plant may cause nausea,emesis,hypotension, and bradycardia on ingestion?
A.Veratrum californicum D.Ricinus communis
B.Convallaria majalis E.Podophyllum peltatum
C.Digitalis purpurea

10.For many years, Orally administered activated charcoal ha been routinely incorporated into the initial
treatment of a poisoned by otal route. The term “activated” means
A.Inorganic impurities are removed D.The charcoal comes from a synthetic source
on the charcoal to prevent intoxication
B.The charcoal has been specially processed E.The charcoal isconverted to the active form when exposed
to be more efficient at absorbing toxins into acidic pH of the stomach
C.The charcoal is sterilized to increase effectiveness

11.The most frequently result of the drugs with antimuscarinic actions, the salicylates, or symphatomimetics
A.Hypotension D.Respiratory depressiom
B.Hyperthermia E.Coma
C.Mydriasis

12.Ingestion of this fungus causes vasoconstriction. In extreme cases, the vasoconstrictor was severe enough
that gangrene would develop in the extremities. Abortion in pregnant women is also common after ingestion of
this grains contaminated with this fungus
A.Veratrum album D.Candida albicans
B.Claviceps purpurea E.Amanita phalloides
C.Histoplasma capsulatum

13.All of the following are primary methods to enhance the elimination of specific poisons or drugs EXCEPT:
A.Alkalinization of the urine D.Hemofiltration
B.Hemodialysis E.Plasma eexchange or exchange transfusion
C.Chelation

14.The most commonly endangered or impaired vital function in a poisoned patient is:
A.Heart rate D.Blood circulation
B.Respiration E.Blood pressure
C.Temperature

15.Which of the following substance is the most frequently involved in human poisoning exposure?
A.Personal care products D.Sedatives,hypnotics,antipsychotics
B.Analgesics E.Cough and cold medications
C.Cleaning substance

16.The difference between the measured serum osmolality that is calculated from serum concentration oof
sodium,glucose, and BUN an increase of this value is associated with poisoning due to ethanol and other alcohols
A.Glucose gap D.Osmolar gap
B.Serum gap E.Anion gap
C.BUN gap

17.The CNS depression produced by barbiturates is largely predictable in a dose dependent fashion and the
progression of clinical effects goes from anxiolysis to sedation to somnolence to coma. This therapeutic drug
toxicity is best classified as:
A.Pathological toxicity D.Pharmacological toxicity
B.Genotoxic effects E.Idiosyncratic reactions
C.Allergic reactions

18.Administered to prevent Wernicke’s syndrome in patient with suspected alcoholism or malnourishment:

A.Methanol D.Thiamine
B.Fomepizole E.Pyridoxine
C.Activated charcoal

19.Ionizing radiation and may environmental chemicals are known to injure DNA and may lead to mutagenc or
carcinogenic toxicities. This therapeutic drug toxicity is best classified as:
A.Pathological toxicity D.Pharmacological toxicity
B.Genotoxic effects E.Idiosyncratic reactions
C.Allergic reactions
 20.In patients with signs of respiratory or CNS depression,intravenous administration of this drug offsets possible
effect of opioid analgesics overdose.
A.Thiamine D.Phenobarbital
B.Flumazenil E.Morphine
C.Naloxone

21.Initial treatment approach for acute poisoning includes all of the following, EXCEPT
I, Airway maintain patency
II Breathing maintain adequate oxygenation and ventilation
III Ciculation Maintain perfusion of vital organs
IV Disability assess for central nervous system dysfunction
V Exposure assess toxidrome
A.I only D.III and IV
B.I and II E.None of this
C.II and III

22.Agitation and increase in heart rate, blood pressure and pupil size are best associated with what drug
poisoning
A.Anticholinergics D.Salicylate
B.Symphatomimetics E.Sedative hypnotics
C.Opioid

23.Smnolence/coma and decrease in heart rate respiratory rate and pupil size are best associated with what
drug poisoning?
A.Anticholinergics D.Salicylate
B.Symphatomimetics E. Sedative hypnotics
C.Opioid

24.Drug that can hyperkalemia include all of the following excpt

A.B-adrenoceptor D.Lithium
B.Digitalis E. Potassium-sparing diuretics
C.Flouride

25.Manihot esculenta(Euphorbiaceae) raw root contains this cyanogenic glucoside that must be removed during
processing of the root for human consumption
A.Argemone D.Linamarin
B.Circutoxin E.Fumonisin
C.Xanthium

26.Delirium,ileus, flushing and increase in heart reate blood pressure, temperature and pupil sizeare best
associated with what drug poisoning?
A.Anticholinergics D.salicylate
B.Symphatomimetics E.Sedative hypnotics
C.Opioid

27.Fleshy tubers of this plant material contains a neurotoxins that upon consumption can result in fatal poisoning,
characterized by tonic-cloni convulsions, owing to the neurotoxins binding to GABAgated chloride channels
A. Cicuta maculate D .Nicotinia tobacum
B. Manihot esculenta E. Strychnos nux vomica
C. Amanita muscarita

28.Drug associated with hypokalemia include all of the following. EXCEPT:

A .barium D. Lithium
B. Methylxanthines E. Toluene
C.Loop diuretics
g/kg of body weight
29.The recommended dose for activated charcoal is:
A.0.5g/kg of body weight D.10-12 g/kg of body weight
B 1-3 g/kg of body weight E.20-25 g/kg of body weight
C.5-6 g/kg of body weight

30.Poisons that can be remove by multiple treatment with activated charcoal include all of the following EXCEPT:
I. Amitriptyline
II. Barbiturates
III. Digitalis glycoside
IV. Iron
V. Lithium
A. I and II D. IV and V
B. II and III E I and IV
C. III and IV

31.Decontamination method of poisoned patient that involves the enteral administration of large amounts of a
high molecular weight, Iso-osmotic polyethylene glycol electrolyte solution with the goal of passing poison by the
rectum before it can be absorbe.
A. Gastric lavage D. Administration of cathartic
B Ion trapping E. Whole bowel irrigation
C. Extracorporeal drug removal

32. Confusion, lethargy, coma, seizure, hyperventilation, hyperthermia, dehydration,hypokalemia, anion gap
metabolic acidosis are clinical features of toxicity with what agent?
A Opioids D. Antimuscarinic drugs
B. Salicylates E. Sedative-hypnotics
C. Tricyclic antidepressant

33. Antidote used for beta-adrenergic antagonist poisoning

A. Fomepizole D Ocreotide acetate
B. Glucagon hydrochloride E. Pralidoxime chloride
C. Leucovorin calcium

34 Hallucinations, dilated pupils and hypertension are toxic features of which agent?
A Acetaminophen D. Lysergic acid(LSD)
B. Carbon monoxide E. Mercury
C. Lead

35. Abdominal pain ,hypertension, seizures, muscle weakness, metallic taste, anorexia, encephalopathy, delayed
motor neuropathy and changes in renal and reproductive function are toxic features of which agent?
A. Mercury D. Phencyclidine (PCP)
B. Methanol E. Lead
C. Cyanide

36. Antidote used for organophosphosporus pesticides poisoning:

A. Fomepizole D. Ocreotide acetate
B. Glucagon hydrochloride E. Pralidoxime chloride
C. Leucovorin calcium

37.An extracorporeal circulation procedure in which a patients blood is pumped through a column containing a
semipermeable membrane hat allow the removal of many toxic compounds
A. Ion trapping D. Whole bowel irrigation
B. Hemodialysis E. Gastric lavage
C. Peritoneal dialysis

38. Used an antidote for caffeine, theophylline and sympathomimetics overdose

A. Flumazenil D. Ethanol
B. Fomepizole E Esmolol
C. Naloxone

39. Antidote used for sulfonylurea-induced hypoglycemia

A. Sodium thiosulfate D. Vit. K
B. Penicillamine E. Leucovorin calcium
C. Ocreotide acetate

40. Useful in treating hyperthermia and rhabdomyolysis caused by drug-induced mascular hyperactivity that is
not controlled by usual cooling measures or neuromascular paralysis. Primary indicated for the treatmentof
malignant hyperthermia.
A. Bromocrptine D.Fomepizole
B. Dantrolene E. Glucagon
C. Leucovorin calcium

41. Used for rapid reversal benzodiazepine overdose-induced coma and respiratory depression.

A. Epinephrine
B. Isoproterenol
C. Leucovorin calcium
D. Potassium iodide
E. Flumazenil

42. Ingestion of this plant material may result into tachycardia, dry mouth, dilated pupils, and decreased
gastrointestinal motility of an individual.

A. Atropa belladonna
B. Thermopsis montana
C. Solanum malacoxylon
D. Leucaena leucocephala
E. Cassia obtusifolia

43. Antidote used for methotrexate poisoning.

A. Sodium thiosulfate
B. Penicillamine
C. Ocreotide acetate
D. Vitamin K
E. Leucovorin calcium

44. inidicated for the treatment of hypertension, bradycardia, or conduction impairment caused by beta-adrenergic
blocker intoxication:

A. Glucagon
B. Activated charcoal
C. Labetalol
D. Magnesium
E. Fomepizole
45. A widely-used solvent for metal degreasing associated with a number of non-cancer toxicities including
autoimmune disorders, immune system dysfunction, and is also potentially a male reproductive toxicant.

A. Tetrachloroethylene
B. Trichloroethylene
C. Methylene chloride
D. Carbon Tetrachloride
E. Chloroform

46. Inidicated for acute management of seizures caused by intoxication with isoniazid, hydrazine, Gyromitra
mushrooms or possibly cycloserine:

A. Pyridoxine
B. Thiamine
C. Vasopressin
D. Nitroprusside
E. Metoclopramide

47. The most studied protein from Latrodectus mactans (female black widow spider) that is toxic only to
vertebrates and not to insects for crustaceans:

A. Hyaluronidase
B. Protoxin I
C. Apyrase
D. a-Latrotoxin
E. Formic acid

48. Indicated for patients with carbon monoxide poisoning to increase the conversion of carboxyhemoglobin and
carboxymyoglobin to hemoglobin and myoglobin.

A. Helium
B. Ferrous sulphate
C. 100% oxygen
D. Nitrogen
E. Carbon dioxide

49. Used for the reversal of the anticoagulant effect of heparin when an excessively large dose has been
administered inadvertently:

A. Warfarin
B. Hirudin
C. Vitamin K
D. Protamine
E. Ocreotide

50. Used primarily in the production of the refrigerant which is also a hepatotoxic and nephrotoxic agent. It can
involve CNS a symptoms at sub-anesthetic concentrations similar to those of alcohol intoxication and can
sensitize the myocardium to catecholamine, possibly resulting in cardiac arrhythmias.

A. Tetrachloroethylene
B. Trichloroethylene
C. Methylene Chloride
D. Carbon tetrachloride
E. Chloroform
51. Indicated for severe pain associated with black widow spider envenomation, rattlesnake envenomation, or
other bites or sting:

A. Acetaminophen
B. Morphine
C. Propofol
D. Dantrolene
E. Cyproheptadine

52. Indicated for internal contamination with plutonium, americium, and curium. It has also been used for
treatment of internal contamination with califormium and berkelium

A. EDTA
B. DTPA
C. BAL
D. KI
E. Unithiol

53. The hematopoietic toxicity of chronic exposure to this agent may manifest initially as anemia, leukopenia,
thrombocytopenia, or a combination of these:

A. Xylenes
B. Benzene
C. Toluene
D. Ethylbenzene
E. Ethanol

54. This drug is to treat intractable nausea and vomiting particularly when the ability to administer activated
charcoal or antidotal therapy (e.r, N-acetylcysteine) is compromised.

A. Penicillamine
B. Protamine
C. Prussian blue
D. Ipecac
E. Ondansetron

55. A copper containing glycoprotein, oxidase in plasma that converts ferrous iron to ferric iron, which then binds
to transferrin. This protein also stimulates iron uptake by a transferrin independent mechanism:

A. Ceruplasmin
B. Trasferrin
C. Ferritin
D. Metallothioneins
E. Albumin

56. Cmponent of food supplements that is possibly effective as adjuvant therapy in case of acute hepatic injury
cause by Amaita phalloides mushroom ingestion, acetaminophen toxicity and potentially other chemical and drug-
induced liver diseases:

A. Silymarin
B. Botulinum
C. Ocreotide
D. Ortistat
E. L-carnitine

57. The most typical strategy used to treat metal poisoning is thru the administration of:

A. Antacids
B. Neutralizers
C. Chelators
D. Pharmacologic antagonist
E. Emetic

58. which of the following is a characteistics of arsenic poisoning?

A. Arenate’s lines
B. Acrgomegaly
C. Chronic nephropathy
D. Foot drop and wrist drop
E. Mee’s lines

59. An alkaloid salt derived from morphine that is a dopaminergic agonist with minimal analgesic properties but
marked emetic efficacy. Previously used for induction of emesis in the acute management of oral poisoning, but it
has been abandoned because of its potential for respiratory depression.

A. Ondansentron
B. Metoclopramide
C. Apomorphine
D. Cyproheptadine
E. Ipecac

60. The major target organ in chronic inorganic arsenic exposure:

A. Liver
B. Skin
C. Bone
D. Lungs
E. Brain

61. Indicated foe excessive anticoagulation caused by coumarin and indanedione derivatives, as evidenced by
elevated prothrombin time

A. Protamine
B. Phytonadione
C. Heparin
D. hirudin
E. Lepirudin

62. Oral chelator used in removing arsenic from a poisoned patient:

A. Succimer
B. Methylene blue
C. Sodium thiosulfate
D. Magnesium oxide
E. Activated charcoal

63. Agent used to trat methemoglobenimia, in whicj the patient has symptoms or signs of hypoxemia (eg,
dyspnea, confusion, or chest pain) or has a methemoglobin level greater than 30%

A. Succimer
B. Dantrolene
C. Sodium thiosulfate
D. Methylene blue
E. Nitroprusside

64. Classic manifestation of lead toxicity in adults:

A. Encephalopathy
B. Peripheral neuropathy
C. Ataxis
D. Footdrop and wristdrop
E. Mental retardation

65. Caused by ingestion of botulism spores (nit preformed toxin) followed by in vivo production of toxin (typically
type A or B) in the immature infant gut. Risk factors include ageless than 1 year breast-feeding, and ingestion of
honey (which commonly contains botulism spore)

A. Food-borne botulism
B. Infant botulism
C. Wound botulism
D. Adult intestinal colonization(adukt-infant)botulism
E. Water botulism

66. Which of the following is true regarding mercury poisoning?

I. Mercury vapor is less hazardous than liquid form
II. Consumption of fish is the major route of exposure of methylmercury
III. The kidney is the major target organ for inorganic mercury
IV. The major human health affect from exposure to methylmercury is neurotoxicity
A. I only
B. I and II
C. II and III
D. I, II and III
E. II, III and IV

67. Which of the following is the mechanism of toxicity of mercury?

A. High affinity binding to sulfhydryl groups of protein in the cells

B. Inhibition of enzymes
C. Destruction of hepatocytes
D. Uncoupling of mitochondria oxidative phosphorylation
E. Prevention of acetylcholine release

68. Occurs after ingestion of preformed toxin in contaminated food initial symptoms are nonspecific and may
include nausea, vomiting, sore throat, and abdominal discomfort

A. Food-borne botulism
B. Infant botulism
C. Wound botulism
D. Adult intestinal colonization (adult-infant) botulism
E. Water Botulism

69. Excess dietary intake of this essential metal is associated with damage to exocrine pancreas. Deficiency on
the other hand may alter an antioxidant enzyme resulting in excess free radicals that are damaging o cell
membranes

A. Zinc
B. Lead
C. Platinum
D. Chromium
E. Aluminum

70 Derived from castor bean and may be delivered as a powder or dissolved in water and may be inhaled,
ingested, or injected. Clinical effects of toxin include nausea, vomiting,abdominal pain and diarrhea, often bloody:

A. Gossypol
B. Ricin
C. Quinine
D. Castorin
E. Mycotoxin

71. Chronic excessive use and large IV doses of this vitamin produce increased levels of the metabolite oxalic
acid. Urinary acidification promotes calcium oxalate crystal formation, which can result in nephropathy or acute
renal failure.

A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
E. Vitamin E

72. An autosomal recessive genetic disorder of copper metabolism characterized by the excessive accumulation
of copper in liver, brain, kidneys, and cornea

A. Plumbism
B. Menke’s disease
C. Asthenic- vegetative syndrome
D. Wilson’s disease
E. Cuprism

73. Chronic ingestion of excessive amounts of this Vitamin enhances calium absorption and produces
hypercalcemia

A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
E. Vitamin E

74. Toxicity of this vitamin is characterized by dry, peeling skin, alopecia, and signs of increased intracranial
pressure,, Bulging fontanelles have been described in infants. Liver may cause jaundice and ascites:

A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
E. Vitamin E

75. The most common initial complaint of patient having this disease is pain and stiffness of the jaw, progressing
to trismus, risus sardonicus and opisthotonus over several days

A. Metal fume fever

B. Methemoglobinemia
C. Hymenoptera
D. Tetanus
E. Botulism

76. Chronic overdose of this vitamin may alter neuronal conduction, resulting in parosthesias and mascular
incoordination

A. Thiamine
B. Riboflavin
C. Niacin
D. Pyridoxine
E. Folic acid

77. Major toxic side effect of this anti-arrythmic drug is hypotension cause by inhibition of cathecolamine release.
Orthostatic hypotension may persist for several hours.

A. Tocainide
B. Mexiletine
C. Flecainide
D. Bretylium
E. Bretylium

78. Bradykinin-mediated effects in patient taking therapeutic doses of these antihypertensive drugs include dry
cough(generally mild but often persistent and annoying) and acute angioedema, usually involving the tounge, lips
and face, which lead to life threatening airway obstruction

A. ACE inhibitor
B. Angiotensin II receptor blockers
C. Beta blockers
D. Calcium channel blockers
E. Vasodilator

79. Toxicity of these antibacterial agents includes ototoxicity to vestibular and cochlear cells, nerphrotoxicity
causing proximal tubular damage and acute tubular necrosis and competitive neuromuscular blockade if given
rapidly intravenously with other neuromuscular blocking drugs.

A. Cephalosporins
B. Penicillins
C. Macrolides
D. Glycopeptide
E. Aminoglycosides

80. Symptoms of alcohol withdrawal include which of the following?

I. Decrease in blood pressure
 II. Decrease in heart rate
III. Flushinh and temperature elevation
IV. Anxiety and confusion
V. Tremor
A. I and II
B. II and III
C. III and IV
D. I, II, III
E. III, IV and V

81. Symptoms of opioid withdrawal include which of the following?

I. Sweating
II. Dilated pupils
III. Diarrhea
IV. Decrease blood
V. Decrease heart rate
A. I and II
B. II and III
C. III and IV
D. I, II, III
E. III, IV and V

82. This antibiotic may cause abdominal pain idiosyncratic hepatotoxicity with estolate salt and administration of
more than 4g/day may cause tinnitus and ototoxicity:

A. Azithromycin
B. Nalidixic acid
C. Metronidazole
D. Erythromycin
E. Ampicillin

83. Permits mechanistic toxicologist to identify and protect genetically susceptible individuals from harmful
environment exposures, and to customize drug therapies based on their individual genetic makeup:

A. Mechanistic toxicology
B. Descriptive toxicology
C. Regulatory toxicology
D. Toxicogenomics
E. Toxidrome

84. Concerned directly with toxicity testing, which provides information for safety evaluation and regulatory
requirements:

A. Clinical toxicologist
B. Mechanistic toxicologist
C. Descriptive Toxicologist
D. Regulatory toxicologist
E. Forensic toxicologist

85. A hybrid of analytic chemistry and fundamental toxicologic principles that focuses primarily on the medicolegal
aspects of the harmful effects of chemicals on human and animals:

A. Forensic toxicology
B. Clinical toxicology
C. Environmental toxicology
D. Developmental toxicology
E. Reproductive toxicology

86. LD50 of ethyl alcohol:

A. 150mg/kg
B. 900 mg/kg
C. 1,500mg/kg
D. 4,000 mg/kg
E. 10,000 mg/kg

87.LD50 of phenobarbital sodium

A. 150mg/kg
B. 900 mg/kg
C. 1,500mg/kg
D. 4,000 mg/kg
E. 10,000 mg/kg

88. Toxic substances that are produced by or are a y product of human activities

A. Toxins
B. Toxicants
C. Toxic
D. Poisons
E. Antidote

89. The study of adverse effects of exogenous chemicals on blood and blood forming tissues

A. Mutagenecity
B. Hematotoxicology
C. Genotoxicology
D. Carcinogenecity
E. Developmental toxicology

90. This life threatening disorder is characterized by peripheral blood pancytopenia, reticulocytopenia, and bone
marrow hypoplasia:

A. Megaloblastic anemia
B. Aplastic anemia
C. Pure red cell aplasia
D. Sideroblastic anemia
E. Iron deficiency anemia

91. Deficiency of folate and/or vitamin B12 results in this condition:

A. Megaloblastic anemia
B. Aplastic anemia
C. Pure red cell aplasia
D. Sideroblastic anemia
E. Iron deficiency anemia
92. Generally refers to toxic sustances that are produced by biological system such as plants, animals, fungi or
bacteria:

A. Toxins
B. Toxicants
C. Venom
D. Poison
E. Antidote

93. Environmental and therapeutic agents ssociated with methemoglobinemia include which of the following?
I. Benzocaine
II. Dapsone
III Nitrates
IV. Chlorampenicol
V. Allopurinol
A. I and II
B. I, II, and III
C. II. III. And IV
D. III, IV and V
E. IV and V

94. Drugs associated with development of aplastic anemia include which of the following?
I. Benzocaine
II. Dapsone
III Nitrates
IV. Chlorampenicol
V. Allopurinol
A. I and II
B. I, II, and III
C. II. III. And IV
D. III, IV and V
E. IV and V

95. An immunologically mediated adverse reaction to a chemical resulting from previous sensitization to that
chemical or to a structurally similar one:

A. Deleterious reaction
B. Chemical allergy
C. Chemical idiosyncrasy
D. Hypoxia
E. Anaphylactic shock

96. Xenobiotics associated with oxidative injury which of the following?

I. Acetaminophen
II. Ascorbic acid
III. Mefenamic acid
IV. Phenol
V. Nitrobenzene
A. I and II
B. I, II, and III
C. II. III. And IV
D. III, IV and V
E. IV and V
97. Proliferative disorders of hematopoietic tissue that are monoclonal and originate from individual bone marrow
cells:

A. Anemia
B. Leukemia
C. Agranulocytosis
D. Neutropenia
E. Methemoglobinemia

98. A state of decrease responsiveness to a toxic effect of a chemical resulting from prior exposure to that
chemical or to a structurally related chemical:

A. Potentiation
B. Tolerance
C. Antagonism
D. Immediate toxicity
E. Delayed Toxicity

99. Metals capable of immunosppresion include which of the following

I. Magnesium
II. Calcium
III. Arsenic
IV. Cobalt
V. Gold

A. I, II and III
B. II, III, and IV
C. III.IV. and V
D. I and V
E. IV and V

100. Defined as exposure to a chemical for more than 3 months:

A. Acute exposure
B. Subacute exposure
C. Subchronic exposure
D. Chronic exposure
E. Repeated exposure

101. Structurally diverse secondary metabolites of fungi which comprise toxins such as aflatoxin, achratoxin, and
the trichothecenes

A. Mycotoxin
B. Neurotoxin
C. Cytotoxin
D. Necrotoxin
E. Cyanotoxin

102. A centrally acting symphatoltic drug that has been widely used for the treatment of essential hypertension,
but with the advent of newer antihypertensive drugs, are use of this drug has declined due to incidence of
thrombocytopenia and hemolytic anemia:

A. Captopril
B. Methyldopa
C. Guanadrel
D. Catapres
E. Losartan

103. Hydralazine, isoniazid and procainamide produce autoimmunity, which is manifested as which of the following

A. Systemic lupus erythematosus-like syndrome

B. Hypersensitivity reaction
C. Leukemia
D. Gray baby syndrome
E. Aplastic anemia

104. Defined as exposure to a chemical for less than 24 hour

A. Acute exposure
B. Subacute exposure
C. Subchronic exposure
D. Chronic exposure
E. Repeated exposure

105. Who determined the onset of action, potency, specificity, site of action and effects of toxic agentsby testing
them on the poor and the sick:

A. Paracelsus
B. Orfila
C. Catherine de Medici
D. Mithridates
E. Bernardo ramazinni

106. He correlated exposure to polyaromatic hydrocarbons and the prevalence of scrotal cancer among chimney
sweeps:

A. Bernardo Ramazinni
B. Louis lewin
C. Orfila
D. Percival pott
E. Ostwald Schiedeberg

107. It is a branch of toxicology which is a hybrid of analytical chemistry and fundamental toxicological principles
that focuses primarily on the medico legal aspects of the harmful effects of chemicals:

A. Environmental toxicology
B. Reproductive toxicology
C. Developmental toxicology
D. Clinical toxicology
E. Forensic toxicology

108. A decrease in the therapeutic index f a drug ___________

A. Increase the potential of a drug to become toxic

B. Increase the efficacy of a drug
C. Decrease the lethality of a drug
D. Increase the volume of distribution of a drug
E. All of these

109. It is concerned with identifying and understanding the cellular, biochemical, and molecular mechanism by
which chemicals exert toxic effects on living organism.

A. Mechanistic toxicology
B. Descriptive toxicology
C. Regulatory toxicology
D. Environmental toxicology
E. Food Toxicology

110. Which statement refers to a toxicant?

I Toxic substances that are produces by biological system as such plants ,animal fungi or bacteria
II. Toxic substances that are produced by or are a by product of anthropogenic activities
III. Toxic substances that are produces by or are a by product of human-made activities

A. I only
B. I an II
C. II and III
D. III only
E. I, II and III

111. Capable of eliciting antibodies, and usually atleast 1-2 weeks is required for the synthesis of antibodies
I. antigen
II. hapten
III. hapten-protein complex

A. I only
B. I and II
C. I and III
D. II and III
E. III only

112. Analyze the given statements:

I. Tissue such as liver, which has high ability to regenerate, most injuries are reversible
II. Injury to the CNS is largely irreversible because differentiated cells of the CNS cannot divide and be
replaced
III. Carcinogenic and teratogenic effects of chemicals,once they occur are usually considered irreversible
toxic effects.

A. Statement I is correct
B. Statement II is correct
C. Statement I and II are correct
D. Statement I and III are correct
E. All statement are correct

113. Which statement is true regarding synergic effects?

I. Carbon tetrachloride and ethanol are hepatotoxic compounds, but together they produce much more liver injury
than the mathematical sum of their individual effects on liver at a given dose would suggest
II. Isopropanol, is not hepatotoxic, but when it is administered in addition to a carbon tetrachloride, the
hepatotoxicity of cabon tetrachloride is much greater than when it is given alone
III. Promethazine, an antihistamine, when given with a ppainkilling narcotic such as Demerol intensifies its effects,
thereby cutting down the amount of narcotic needed.
A. I only
B. II only
C. I and II
D. I and III
E. II and III

114. All of the following statements described functional antagonism EXCEPT:

I. Occurs when two chemicals counterbalance each other by producing opposite effects on the same physiologic
function
II. Use of the strongly basic low molecular-weight protein protamine sulfate to form a stable complex with heparin,
which abolishes its anticoagulant activity
II. Chemical reaction between two compounds that produces a less toxic product
IV. Blood pressure, can markedly fall during severe barbiturate intoxication, which can be effectively antagonized
by the intravenous administration of a vasopressor agent such as norepinephrine or metaraminol

A. I only
B. I and II
C. II and III
D. III and IV
E. IV only

115. Dimercaprol chelates metal ions such as arsenic, mercury, and lead and decreases their toxicity. What kind
of antagonism the example describes?

A. Functional Antagonism
B. Chemical Antagonism
C. Receptor Antagonism
D. Dispositional Antagonism
E. Physiological Antagonism

116.Distribution of toxicants to specific sites may be hindered by several processes. These include the following,
EXCEPT:
I. Binding to plasma protein
II. Non-specialized barrier
III. Distribution to storage sites
IV. Association with intracellular binding proteins

A. I only
B. II only
C. I and II
D. II and IV
E. III and IV

117. Choose the correct statement/s which describe Margin of safety

I. LD1/ED99
II. LD50/ED50
III. Ratio of the dose required to produce a toxic effect amd the dose needed to elicit the desired therapeutic
response
IV. Chemical produces injury to one kind of living matter without harming another form of life

A. I only
B. I and II
C. II and III
D. I and III
E. II and IV

118. It is define as the removal of xenobiotics from blood and their return to the external environment

A. Clearance
B. Excretion
C. Metabolism
D. Disintegration
E. Liberation

119. Chemical carcinogenesis involves insufficient function of various repair mechanisms. These include:
I Failure of DNA repair
II. Failure of apoptosis
III Failure to terminate cell proliferation

A. I only
B. I and II
C. II and III
D. I and III
E. I, II and IIII

120. Adaptation of toxicity may result from biological changes causingwhich of the following?
I. Diminished delivery of the toxicant to the target
II. Increased size or susceptibility of the target
III. Increased capacity of the organism to repair itself
IV. Strengthened mechanism to compensate the toxicants-inflicted dysfunction

A. I and II
B. II and III
C. III and IV
D. I, II and III
E. I, II and IV

121.The discovery of sulfanilamide was heralded as a major event in combating bacterial diseases. However, it
was soon discovered that the drug was more soluble in diethylene glycol. The drug was sold in the diethylene
glycol solution but was labelled as an elixir, and several patients died of acute renal failure resulting from the
metabolism of the glycol. What is the ultimate toxicant of glycol?

A. Oxalic acid
B. Formic acid
C. Ethanol
D. Arsenite
E. Acetone

122. What is the topical treatment for skin contamination of white phosphorus?

A. Calcium soak
B. Mineral oil
C. Ethyl alcohol
D. 1% copper sulfate
E. None of these

123. All of the following are precautionary measures regarding skin decontamination EXCEPT:
A. Wear protective gears such as gloves, gown and goggles
B. Remove contaminated clothing
C. Flush with hot water
D. All of these
E. None of these

124. All of the following are precautionary measures regarding eye decontamination, EXCEPT

A. Flush exposed eyes with copious quantities of saline

B. Instill local anesthetic drops to facilitate irrigation
C. Instill neutralizing solution
D. Remove contact lenses
E. None of these

125. All of the following can be given and/or done gastrointestinal decontamination, EXCEPT

A. Ipecac syrup
B. Activated charcoal
C. Gastric lavage
D. Cathartics
E. None of these

126. If activated charcoal and cathartic was used as GI decontamination and there is no charcoal in stool after 6-
8hrs. What actions will you employ?

A. Repeat administration of cathartic same of the original dose

B. Repeat administration of cathartic twice of the original dose
C. Repeat administration of cathartic one half of the original dose
D. No need to administer another dose of cathartic
E. None of these

127.It is concerned with the toxic effects of chemical and physical agents on populations and communities of
living organism within defined ecosystem:

A. Environmental Toxicology
B. Ecotoxicology
C. Occupational Toxicology
D. Forensic Toxicology
E. Descriptive Toxicology

128. If intake of a long-lasting contaminant by an organism exceeds the latter’s ability to metabolize or excrete the
substance, the chemical accumulates within the tissue of the organism. This called:

A. Bioaccumulation
B. Biomagnification
C. Biosystem
D. Contaminant
E. Toxicant

129. The following are treatment in case of acute intoxication of carbon monoxide, except:
I. Removal of the individual from the exposure source
II. Administration of carbon dioxide
III. Use of hyperbaric oxygen chamber
A. I only
B. II only
C. III only
D. I and II
E. II and III

130. These are examples of organophospate pesticides, except:

I. malathion
II. parathion
III. dimethoate
IV. isolan

A. I and II
B. II and III
C. I, II and III
D. III only
E. IV only

131. A water-soluble analog of dimercaprol

I. Succimer
II. DMSA
III. BAL
IV. EDTA

A. I and II
B. II and III
C. III and IV
D. II only
E. III only

132. Used in the treatment of Wilson’s disease.

A. Deferoxamine
B. BAL
C. EDTA
D. Penicillamine
E. Methylene blue

133. Regarding Deferoxamine

I. Deferoxamine is isolated from Streptomyces pilosus
II. It is the parenteral chelator of choic for Iron poisoning
III. Deferoxamine plus hemodialysis may also be useful in the treatment of aluminum toxicity in renal failure

A. Only statement I is correct

B. Only statement II is correct
C. Only statement III is correct
D. Statement I and II are correct
E. All statement are correct

134. This is the antidote used in treating of poison caused by theophylline, caffeine and metaproterenol

A. Ethanol
B. Esmolol
C. Naloxone
D. Pralidoxime
E. Deferoxamine

135. Flumazenil is the antidote used in treating poisoning caused by:

A. Benzodiazepines
B. Ethylene glycol
C. Acetaminophen
D. Digoxin
E. Cyanide

136. Suggested treatment for delirium caused by anticholinergic agent:

A. Sodium bicarbonate
B. Atropine
C. Physostigmine
D. Hydroxocobalamine
E. Pralidoxime

137. Large doses of this drug opposes the muscarinic effects of extremely potent agent like parathion and
chemical warfare nerve gases.

A. Glucagon
B. Atropine
C. Physostigmine
D. Naloxone
E. Oxygen

138. It prevents and reverses arsenic-induced inhibition of sulfhydryl-containing enzymes

A. Dimercaprol
B. Penicillamine
C. Unithiol
D. Deferasirox
E. Prussian blue

139. In 2003, The FDA approved this for the treatment of contamination with radioactive cesium(137Cs) and
intoxication with thalium salt

A. Methylene blue
B. Malachite green
C. Crystal violet
D. Prussian blue
E. Methyl orange

140. Which is true regarding EDTA?

I. Ethylenediamintetraacetic acid
II. A dimercaprol chelating agent
III. D-dimethylcysteine
IV. Ferric hexacyanoferrate

A. I only
B. II only
C. III only
D. IV only
E. I and II

141. It is a gas that has a similar mechanism of toxicity with cyanide and has a smell of rotten eggs:

A. Carbon monoxide
B. Hydrogen sulfide
C. Nitrogen oxide
D. Sulfur dioxide
E. Ammonia

142. Which of the following is a mismatch?

I. Methamphetamine-crystal
II. MDMA-ecstasy
III. Cocaine-crank

A. I only
B. II only
C. III only
D. I and II
E. II and III

143. This is typical among opioids, clonidine, phenothiazines, and cholinesterase inhibitors:

A. Dry mouth
B. Sneezing
C. Bradycardia
D. Mydriasis
E. Miosis

144. In poisoning with atropine and other antimuscarinic agents, skin often appears
I. flushed
II. hot
III. dry
IV. wet

A. I and II
B. II and III
C. I, II, III
D. I,II, IV
E. I and IV

145. Antidote for acetaminophen

A. Ambolar
B. Acetylsalicylic acid
C. Flumazenil
D. Mucomyst
E. Flunisolide

146. Antidote for organophospate cholinesterase inhibitor

A. Atropine
B. @-PAM
 C. Ma huang
D. Desipramine
E. Doxepin

147. An opioid antagonist that reverses the effects of adose of morphine or heroin within a minute

A. Naloxone
B. Nalbuphine
C. Manfine
D. Meperidine
E. Nabilone

148. Biotransformation that eliminate the ultimate toxicant or prevent its formation is called

A. Metabolic activation
B. Toxication
C. Metabolic transformation
D. Detoxification
E. Xenobiotic elimination

149. Chemicals can oxidize Fe(II) in hemoglobin to Fe(III) producing methemoglobinemia. The typre of reaction is:

A. Hydrogen abstraction
B. Electron transfer
C. Enzymatic reaction
D. Non covalent binding
E. Covalent binding

150. Clinical manifestation such as altered mental status, increased muscle tone, hyperreflexia, hyperthermia and tremors
is associated with what toxic syndrome?

A. Sympathomimetic
B. Anticholinergic
C. Opiate
D. Cholinergic
E. Serotonin

151. A pathologic condition characterized by excessive deposition of an extracellular matrix of abnormal composition and
is a specific manifestation of disrepair of the chronically injured tissue:

A. Tissue necrosis
B. Carcinogenesis
C. Tumor
D. Apoptosis
E. Fibrosis

152. CNS excitation, seizures, tachycardia, hypotension and mydriasis are associated with which of the following?

I. Cocaine
II. Caffeine
III. Acetylcholine
IV. Codeine
V. SSRI
 A. I and II
B. II and III
C. III and IV
D. IV and V
E. I and V

153. The systematic scientific characterization of potential adverse health effects resulting from human exposures to
hazardous agents or situations

A. Risk
B. Risk assessment
C. Risk management
D. Risk systematics
E. Risk communication

154. 4-methypyrazole is used as an antidote for________toxicity

A. Cholinesterase inhibitors
B. Digitalis
C. Fluoride
D. Isoniazid
E. Methanol

155. One of the most widely studied of the drugs inducing autoimmunity, it is an inhalation anesthetic that can induce
autoimmune hepatitis

A. Propofol
B. Sevoflurane
C. Halothane
D. Isofurane
E. ketamine

156. Defined as the probability of an adverse outcome under specified conditions

A. Risk
B. Risk assessment
C. Risk management
D. Hazard
E. Risk potential

157. Hepaobiliary injury caused by amiodarone, CCl4, ethanol,tamoxifen,valproic acid

A. Fatty liver
B. Hepatocellular death
C. Canalicular cholestasis
D. Bile duct damage
E. Fibrosis and cirrhosis

158. Hepaobiliary injury caused by acetaminophen, allyl alcohol ,Cu, dimethylfornamide and ethanol

A. Hepatocyte death
B. Tumors
C. Sinusoidal disorder
 D. Canicular cholestasis
E. Bile duct damage

159. Refers to the process by which policy actions are chosen to control hazards

A. Risk
B. Hazard
C. Risk management
D. Risk systematics
E. Risk communication

160. Mechanism of toxicants induced injury to liver cells include which of the following?
I. Lipid peroxidation
II. Mitochondrial damage
III. Disruption of the cytoskeleton
IV. Massive potassium influx

A. I and II
B.II and II
C. III and IV
D. I, II and III
E. IV only

161. Consumption of high amount of____ will result to orange coloration of skin.

A. Carotene
B. Vitamin B
C. Lycopene
D. Citric acid
E. Carica papaya

162. Factors that influence the absorption of toxicants through the skin include all of the following EXCEPT:

A. Integrity of the stratum corneun

B. Hydration state of the stratum corneum
C. Solvents as carriers
D. Molecular size
E. Volume of distribution of toxicants

163. Drug that impairs glomerular filtration without significant loss of structural integrity and decrease GFR include which
of the following?
I. Cyclosporine
II. Amphotericin B
III. Gentamicin
IV. Cefalexin

A. I and II
B. Ii and III
C. III and IV
D. I, II and III
E. II, III, IV

164. Substances that exist predominantly in the gas phase at body temperature and volatile liquids are eliminated mainly
by which organ?
 A. Skin
B. Lungs
C. Kidney
D. Liver
E. Stomach

165. The most common site of toxicants induced renal injury:

A. Glomerular injury
B. Proximal tubular injury
C. Loop of henle injury
D. Papillary injury
E. Collecting duct injury

166. Defined as a heritably altered, relatively autonomous growth of tissue with abnormal regulation of gene expression

A. Cancer
B. Neoplasm
C. Metastases
D. Carcinogen
E. Fibroma

167. This group of antibiotic consist of two or more amino sugars joined in glycosidic linkage to a central hexose nucleus.
Although they are drugs of choice for many gram negative infections, their use is primarily limited by their nephrotoxicity:

A. Penicillins
B. Aminoglycosides
C. Macrotides
D. Cephalosporin
E. Radiocontrast agents

168. An agent whose administration to previously untreated animals leads to a statistically significant increased incidence
of neoplasms of ine or more histogenetic types ascompared with the incidence in appropriate untreated animals

A. Teratogen
B. Neoplasm
C. Metastases
D. Carcinogen
E. Fibroma

169. This toxicant may cause shaver disease, corundum smelter’s and bauxite lung

A. Acrolein
B. Aluminum abrasive
C. Ammonia
D. Arsenic
E. Asbestos

170. A disease of cellular mutation, proliferation, and aberrant cell growth.

A. Cancer
B. Neoplasm
C. Metastases
 D. Carcinogen
E. Fibroma

171. This toxicant may cause framer lung, compost lung, malt worker’s lung:

A. Aspergillus
B. Beryllium
C. Ammonia
D. Arsenic
E. Asbestos

172. Carcinogens that interact with DNA resulting in mutation:

A. Malignant
B. Neoplasia
C. Genotoxic
D. Nangenotoxic
E. Metastases

173. Lessions characterized by expansive growth, frequently exhibiting slow rate of proliferation that do not invade
surrounding tissues.

A. Benign
B. Malignant
C. Tumor
D. Neoplasia
E. Neoplasm

174. Lessions demonstrating invasive growth capable of metastases to other tissues and organs.

A. Adenoma
B. Carcinoma
C. Benign
D. Malignant
E. Sarcoma

175. Features of a genotoxic agent include which of the following?

I. mutageni
II. can be complete carcinogen
III. tumorigenicity is dose responsive
IV. no direct DNA damage
V. may function at tumor promotion stage

A. I and II
B. II and III
C. I, II, and III
D. II, III, IV
E. IV and V

176. Byssinosis which is characterized by chest tightness, wheezing and dyspnea is caused by:

A. Coal dust
B. Cotton dust
 C. Hydrogen fluoride
D. Iron oxide
E. Isocyanates

177. The second stage of the carcinogenesis process that involves the selective clonal expansion of initiated cells to
produce a paraneoplastic lesion.

A. Promotion
B. Initiation
C. Mutation
D. Cloning
E. Progression

178. Genes that stimulates the transformation of normal cells into cancer cells:

A. Tumor
B. Oncogenes
C. Hapten
D. Fibroblast
E. Somatic cells

179. Sillo-filler’s diseases which can induce immediate or delayed pulmonary edema is caused by which toxicant?

A. Phosgene
B. Perchloroethylene
C. Manganese
D. Nickel
E. Nitrogen oxide

180.Encompasses the study of pharmacokinetics, mechanism, pathogenesis, and outcomes following exposure to agents
or conditions leading to abnormal development

A. Development toxicology
B. Environmental toxicology
C. Regulatory toxicology
D. Clinical toxicology
E. Forensic toxicology

181. Chronic effect of this toxicant include fibrosis, pleural calcification, lung cancer and mesothelioma

A. Aspergillus
B. Ammonia
C. Asbestos
D. Chlorine
E. Isocyanate

182. In 1960, a large increase in newborns with rare limb malformations of amelia (absence of the limbs) or various
degrees of phocomelia (reduction of the long bones of the limbs) was recorded in west Germany, The identified causative
agent is:

A. Nuclear radiation
B. Thalidomide
C. Acetaminophen
D. Isoretinoin
 E. Tacrolimus

183. Toxicant induced irreversible loss of neurons, including its cytoplasmic extension, dendrites, and axons, and the
myelin ensheating the axon:

A. Axonopathy
B. Neuropathy
C. Wallerian degeneration
D. Myelinopathy
E. Encephalopathy

184. A synthetic nonsteroidal estrogen widely used from the 1940s to the 1970s in the United staes to prevent threatened
miscarriage that was soon linked to clear cell adenocarcinoma of the vagina

A. Estradiol
B. Progesterone
C. Diethylstilbestrol
D. Estrogen
E. Progestin

185. Neurotoxicant that may cause optic neuritis and peripheral neuropathy:

A. Chloramphenicol
B. Carbon tetrachloride
C. Cyanide
D. Doxorubicin
E. Manganese

186. High exposure to this vitamin during pregnancy can cause malformation of the face, limbs, heart, central nervous
system, and skeleton of the infant, spontaneous abortion, live-born infants having atleast one major malformation, and
numerous exposed children having full-scale IQ scores below 85 at age 5 years have been documented:

A. Vitamin A
B. Vitamin B1
C. Vitamin B2
D. Vitamin B3
E. Vitamin C

187. Nystagmus, ataxia and dizziness are caused by which agent?

A. Phenytoin
B. Quinine
C. Streptomycin
D. Manganese
E. Doxorubicin

188. A quinone containing anthracycline antibiotic which is one of the most effective antmitotics in cancer chemotherapy,
Clinical application of this drug is greatly limited due to incidence of acute and chronic cardiotoxicity:

A. Methotrexate
B. Vincristine
C. Doxorubicin
D. Chlorambucil
 E. Cyclophosphamide

189. 4-aminoquinoline derivatives used as antimalarial and anti-mflammatory drugs that can cause irreversible loss of
retinal function

A. Artemissin
B. Chloroquine
C. Primaquine
D. Digoxin
E. Naphthalene

190. This drug is used in the treatment of congestive heart disease and in certain cardiac arrhythmias, It may cause
system abnormalities which include decreased vision, flickering scotomas, and altered color vision

A. Nifedipine
B. Digoxin
C. Dobutamine
D. Minoxidil
E. Nitroglycerine

191. A nonsteroidal anti-imflammatory drug with analgesic and antipyretic properties that is frequently used for the
management of arthritis, gout, and musculoskeletal discomfort. Chronic administration of 50 to 200 mg/day of this agent
for 1 to 2 years has been reported to produce corneal opacities, paramacular depigmentation, decrease in visual aculty,
altered visual fields, increases in the threshold for dark adaptation and blue-yellow color deficits

A. Aspirin
B. Piroxicam
C. Indomethacin
D. Mefenamic acid
E. Acetaminophen

192. Acute poisoning of tis agent may result in profound and permanent structural alterations in the retina and visual
impairments, ranging from blurred vision to decreased visual acuity and light sensitivity to blindness

A. Lead
B. Methanol
C. Vigabatrin
D. Tamoxifen
E. Aspirin

193. An antimycobacterial drug for the treatment of tuberculosis that is known to produce dose related alterations in the
visual system, such as blue-yellow and red-green dyschromatopsias, decreased contrast sensitivity, reduced visual acuity
and visual field loss

A. Rifampicin
B. Isoniazid
C. Streptomycin
D. Ethambutol
E. Cycloserine

194. An increased size of cardiac myocytes in which new contractile protein units are assembled in series resulting
relatively greater increase in the length than in the width of individual myocytes

A. Cardiomyopathy
 B. Concentric cardiac hypertrophy
C. Eccentric cardiac hypertrophy
D. Heart failure
E. Chronic cardiac toxicity

195. The inability of the heart to maintain cardiac output sufficient to meet metabolic and oxygen demands of peripheral
tissues, including changes in systolic and diastolic function that reflect specific alterations in ventricular function and
abnormalities in a variety of subcellular processes

A. Cardiomyopathy
B. Concentric cardiac hypertrophy
C. Eccentric cardiac hypertrophy
D. Heart failure
E. Chronic cardiac toxicity

196. Common mechanism of vascular toxicity inclue which of the following?

I. Alterations in membrane structure and function
II. Redox stress
III. Vessel specific bioactivation of protoxicants
IV. Preferential accumulation of the active toxin in vascular cells

A. I and II
B. II and III
C. III and IV
D. I and IV
E. I, II, III, and IV

197. The ultimate response of the heart to toxic exposure, which can be measured by both morphologic and functional
degenerative phenotypes:

A. Myocardial adaptation
B. Myocardial degeneration
C. Sudden cardiac death
D. Cardiomyopathy
E. Myocardial ischemic injury

198. Biomarkers for cardiac toxicity include which of the following?

I. myoglobin
II. BNP
III. CRP
IV. ALT

A. I and II
B. II and III
C. III and IV
D. I, II, and III
E. II, III and IV

199. Cardiotoxic manifestation of this class of antiarrhythmic drugs include bradycardia and heart block:

A. Class I
B. Class II
C. Class III
D. Class IV
 E. Class V

200. A vasoconstrictor released from the posterior pituitary gland in response to volume depleting conditions, such as
hemorrhage:

A. Atrial natriuretic peptide

B. Antidiuretic hormone
C. Renin
D. Angiotensin
E. Aldosterone

201. Used to relief of symptoms caused by excessive histamine effect (e.g ingestion of scombroid-contaminated fish or
niacin and rapid intravenous administration of acetylcysteine)

A. Bromocriptine
B. Diphenhydramine
C. Dantrolene
D. Benztropine
E. Glucagon

202. A first-generation histamine-1 receptor blocker that is beneficial in alleviating mild to moderate symptoms in cases of
suspected serotonin syndrome:

A. Phenylephrine
B. Fexofenadine
C. Loratadine
D. Cimetidine
E. Cyproheptadine

203. Used to increased blood pressure, cardiac output, and urine flow in patients with shock who have not responded to
intravenous fluid exchange, correction of hypothermia, or reversal of acidosis

A. Epinephrine
B. Dopamine
C. Metoprolol
D. Isosorbide dinatrate
E. Digitoxin

204. It is an endogenous cathecolamine with alpha and beta-adrenergic agonist properties that is used primarily in
emergency situations to treat anaphylaxis or cardiac arrest:

A. Flumazenil
B. Activated charcoal
C. Dimercaprol
D. Epinephrine
E. Esmolol

205. A B-comples vitamin that is essential for protein synthesis and erythropoiesis. Also used as adjunctive treatment for
methanol poisoning

A. Thiamine
B. Pyridoxine
C. Riboflavin
 D. Floic acid
E. Niacin

206. Synthetic form of vitamin B12 that is also used for the treatment of pernicious anemia. This agent is also indicated for
the treatment of acute cyanide poisoning or patients suspected to be at high risk for cyanide poisoning

A. Retinol
B. Folic acid
C. Hydroxycobalamin
D. Ascorbic acid
E. Thiamine

207. A derivative of penicillin that has no antimicrobial activity but effectively chelates some heavy metals. Ssuch as lead,
mercury, and copper

A. Penicillamine
B. BAL
C. Dimercaprol
D. Succimer
E. Unithiol

208. Condition that arises from the direct contact of agents on the skin and accounts for nearly 80% of contact dermatitis
cases:

A. Allergic contact dermatitis

B. Granulomatous reaction
C. Irritant dermatitis
D. Urticarial
E. Anaphylactic reaction

209. All the following conditions are associated with abnormal synthesis of vitamin K-dependent coagulation factors,
except

A. Warfarin and analogs

B. Rodenticides
C. Intravenous a-tocopherol
D. Ascorbic acid
E. Dietary deficiency

210.Major complication associated with heparin therapy is

A. Thrombosis
B. Bleeding
C. Nausea
D. Abdominal camps
E. Migraine

211. Which of the following is not a function of liver?

A. Protein synthesis
B. Xenobiotics absoption
C. Bioactivation and detoxification
D. Formation of bile
E. Biliary secretion
212. Aflatoxin, androgens, arsenic, thoriumdioxide and vinyl chloride cause this type of liver injury:

A. Fatty liver
B. Hepatocyte death
C. Bile duct damage
D. Tumors
E. Canalicular cholestasis

213. Characterized by cell swelling, leakage, nuclear disintegration (karyolysis) and an influx of inflammatory cells in the
liver

A. Necrosis
B. Apoptosis
C. Cholestasis
D. Fatty liver
E. Tumor

214. Defined physiologically as a decrease in the volume of bile formed or an impaired secretion of specific solutes into
bile, characterized biochemically by elevated serum levels of compounds normally concentrated in bile, particularly bile
salts and bilirubin

A. Steatosis
B. Apoptosis
C. Cholestasis
D. Fatty liver
E. Sinusoidal damage

215. An antifungal agent that causes nephrotoxicity characterized by ADH-resistant polyuria, renal tubular acidosis,
hypokalemia, and either acute or chronic renal failure

A. Nystatin
B. Amphoterin B
C. Amoxicillin
D. Cyclosporine
E. Ketoconazole

216. A valuable drug in the treatment of solid tumors, with nephrotoxicity limiting its clinical use:

A. Cyclosporine
B. Cisplatin
C. Methotrexate
D. Tetracycline
E. Doxycycline

217. Casein, B-lactoglobulin and a-lactalbumin are allergic proteins found in:

A. Egg whites
B. Egg yolks
C. Soybeans
D. Codfish
E. Cow’s milk

218. Hypertension, cardiac enlargement and sodium retention may be observed in individuals after intake of this food
 A. Licorice
B. Cassava roots
C. Soybeans
D. Peanut
E. Chicken liver

219. Given as antidote/treatment for fluoride, hydrofluoric acid, ethylene glycol, CCBs, and B-adrenergic antagonist
overdose/poisoning:

A. Atropine
B. Benzodiazepine
C. Calcium gluconate
D. Cyproheptadne
E. Dantrolene

220. treatment for poisoning caused by cardioactive steroids

A. Digoxin-specific antibody fragments

B. Dimercaprol
C. Diphenhydramine
D. Insulin
E. Iodide

221. Glucaridase is given as a treatment for overdose of which of the following?

A. Cyanide
B. Cisplatin
C. Methotrexate
D. Clonidine
E. Epinephrine

222. Prussian blue (radiogardase) is given for the management of which poisoning?

A. Thallium
B. Insulin
C. Cyanide
D. Warfarin
E. Ethylene glycol

223. Given as a treatment for amatoxin mushroom ppoisoning

A. Protamine
B. Pyridoxine
C. Folinic acid
D. Silibinin
E. Succimer

224. Analog of somatostatin that inhibits pancreatic insulin secretion. It currently is the essential complement to dextrose
for the treatment of refractory hypoglycemia induced by overdosed of insulin secretagogues:

A. Leucovorin
B. Ocreotide
C. Physostigmine
D. Deferoxamine
 E. Activated charcoal

225. Indicated for the reversal of an elevated prothrombin time (PT) or an international normalized ratio (INR) in patients
with xenobiotic induced vitamin K deficiency.

A. Phytonadione
B. Beta carotene
C. Alpha tocopherol
D. Ascorbic acid
E. Calctiol

226. A rapidly acting antidote that is used primarily to reverse the anticoagulant effects of unfractionated heparin (UFH).

A. Lepirudin
B. Vitamin k1
C. EDTA
D. Warfarin
E. Protamine

227. A safe effective pyridoxine regimen for INH overdoses in adults is:

A. 5g of pyridoxine for each gram of INH ingested

B. 4g of pyridoxine for each gram of INH ingested
C. 3g of pyridoxine for each gram of INH ingested
D. 2g of pyridoxine for each gram of INH ingested
E. 1g of pyridoxine for each gram of INH ingested

228. Glucagon is indicated for which of the following?

I. Management of overdoses of antipsychotics
II. Management of overdoses of beta adrenergic antagonist
III. Management of calcium channel blocker over dose
IV/ Reversal of hypoglycemia

A. I and II
B. II and III
C. III and IV
D. I, II and III
E. II, III, and IV

229. What is the initial dose of dantrolene for the treatment of acute malignat hyperthermia?

A. IV bolus 2-3 mg/kg

B. IV bolus 5-6 mg/kg
C. IV bolus 0.3-0.5 mg/kg
D. IV bolus 0.5-1mg/kg
E. IV bolus 8-10 mg/kg

230. An antidote most extensively studied for the treatment of local anethetics systemic toxicity. This agent is also
investigated for the treatment of overdose from lipophilic xenobiotics such as calcium channel blockers,cyclic
antidepressant, and B-adrenergic antagonist, among other:

A. Dantrolene
B. Intravenous fat emulsion
C. Leucovorin
 D. Folic acid
E. Pralidoxime

231. Flumazenil is used in the management of the following. EXCEPT

I. benzodiazepine overdose
II. Hepatic encephalopathy
III. Parodixical reactions
IV. Nephrotoxicity

A. I and II
B. II and III
C. III and IV
D. III only
E. IV only

232. Indication for thiamine hydrochloride includes which of the following?

I. Wernicke encephalopathy
II. Ethylene glycol poisoning
III. Malignant hyperthermia

A. I only
B. I and II
C. II and III
D. I and III
E. III only

233. For prevention of Wernicke encephlopathy, initial therapy usually consist of the immediate parenteral administration
of how mg of thiamine hydrochloride

A. 50mg
B. 100 mg
C. 200mg
D. 250mg
E. 300mg

234. Calcium preparation is used in the management of following conditions, except:

I. Calcium channel blocker toxicity
II. B-adrenergic antagonist toxicity
III. Hypocalcemia due to hydrofluoric acid exposure
IV. Hypomagnesemia

A. I and II
B. II and III
C. III and IV
D. I and IV
E. IV only

235. Problems encountered with the administration of ethanol include which of the following?
I. risk of central nervous system (CNS) depression
II. Behavioral disturbances
III. Hepatitis and pancreatitis
IV. hyperglycemia

A. I and II
 B. II and III
C. III and IV
D. I, II and III
E. II, III and IV

236. In a patient with presumed cyanide poisoning, the adult dose of sodium thiosulfate is:

A. 5g
B. 10g
C. 12.5g
D. 15g
E. 20g

237. The initial dose of hydroxocobalamin for cyanide poisoning in adults is

A. 5g
B. 10g
C. 12.5g
D. 15g
E. 20g

238. Antidote to radioactive iodine that may be released into the atmosphere following a nuclear incident:

A. Activated charcoal
B. Methylene blue
C. Deferoxamine
D. Potassium iodide
E. BAL

239. Xenobiotics commonly implicated in gastritis and peptic ulcer disease includes which of the following?
I. corticosteroids
II. ethanol
III. acetaminophen
IV. NSAIDs

A. I and II
B. I and III
C. I, II and IV
D. I, III and IV
E. IV only

240. Xenobiotics implicated in esophagitis and esophageal ulcerations include all of the following EXCEPT:

A. Antipsychotics
B. Potassium iodide
C. Tetracycline
D. NSAIDs
E. Antacids

241. Chlorhexidine oral rinse can cause what color of stain in the teeth?

A. Yellow
B. Brown
C. Green
 D. Doxycycline
E. Blue

242. Xenobiotics causing discoloration of the teeth and gums includes all of the following, EXCEPT

A. Cadmium
B. Ciprofloxacin
C. Doxycycline
D. Lead
E. Aspirin

243. Refers to a concretion formed anywhere in the alimentary system and may be a complication of overdose

A. Pancreatitis
B. Enteritis
C. Bezoar
D. Esophagitis
E. Dysphagia

244. Xenobiotics commonly associated with pancreatitis include which of the following?
I. Ethanol
II Isoniazid
III. Carbamazepine
IV. Amoxicillin

A. I and II
B. II and III
C. I, II and III
D. I, III and IV
E. II and IV

245. A yellow to yellow-orange macular discoloration of the skin, it can be caused by xenobiotics such as carotenoids,
which deposit in the stratum corneum and cause carotenodema

A. Cyanosis
B. Xanthoderma
C. Pruritus
D. Flushing
E. Sweating

246. Poorly localized, unpleasant sensation that elicits a desire to scratch. It is a common manifestation of urticarial
reactions, but it may also be non- immunologic origin

A. Cyanosis
B. Xanthoderma
C. Pruritus
D. Flushing
E. Sweating

247. It is an acute self-limited disease characterized by target-shaped, erythematous macules and patches on the palms
and soles, as well as the trunk and extremities:

A. Urticarial
B. Erythema Multiforme
 C. Stevens-Johnson Syndrome
D. Stevens-Johnson Syndrome
E. Bullous reactions

248. Xenobiotics commonly associated with Erythema multiforme include all of the following, EXCEPT:

A. Allopurinol
B. Cimetidine
C. Furosemide
D. NSAIDs
E. Arsenic

249. Xenobiotics commonly associated with alopecia include all of the following, EXCEPT:

A. Anticoagulants
B. Phenytoin
C. Antineoplastics
D. Retinoids
E. Sulfonamides

250. Drugs causing bradycardia include which of the following?

I. a1-Adrenergic agonists
II. a2-Adrenergic agonists
III. B-Adrenergic antagonists
IV. Cholinergics
V. Phosphodiesterase inhibitors

A. I and II
B. I, II and III
C. I, II, III and IV
D. II, III and IV
E. II, III, IV and V

251. Agents causing sinus tachycardia and tachydysrhythmias include which of the following?
I. Anticholinergics
II. Hydrocarbons
III. Sympathomimetics
IV. Opioids
V.Sedative hypnotics

A. I and II
B. I, II, and III
C. I, II, III, and IV
D. II, III and IV
E. II, III and V

252. Drugs causing hypertension include all of the following, EXCEPT:

A. Epinephrine
B. Metoprolol
C. Amphetamine
D. Dopamine
E. Cocaine
253. Agents associated with aplastic anemia include all of the following, except:

A. Diclofenac
B. Chloramphenicol
C. Carbamazepine
D. Cimetidine
E. Famotidine

254. Uncommon condition in which erythrocyte precursors are absent from an otherwise normal bone marrow, It results in
a normocytic anemia with inappropriately low reticulocyte count

A. Erythrocytosis
B. Megaloblastic anemia
C. Pernicious anemia
D. Pure red cell aplasia
E. Aplastic anemia

255. The abnormal accumulation of fat in hepatocytes

A. Acute hepatocellular necrosis

B. Steatosis
C. Venooclusive disease
D. Chronic hepatits
E. Cirrhosis

256. Disease is caused by xenobiotics that injure the endothelium of terminal hepatic venules, resulting in intimal
thickening, edema, and nonthrombotic obstruction

A. Chronic hepatitis
B. Cirrhosis
C. Steatosis
D. Acute hepatocellular necrosis
E. Venoocclusive disease

257. Defined as a rapid onset of liver injury progressing over 2 to 3 weeks that results in altered mental status, kidney and
pulmonary failure, frequent infection and a poor outcome without transplantation

A. Acute liver failure

B. Hepatic encephalopathy
C. Chronic hepatitis
D. Venoocclusive disease
E. Steatosis

258. All of the following agent may cause acute hepatocellular necrosis EXCEPT

A. APAP
B. Carbon tetrachloride
C. Methotrexate
D. Phenytoin
E. Salicylates

259. Type of hepatic injury caused by phosphorus

 A. Angiosarcoma
B. Acute necrosis
C. Acute cholestasis
D. Steatohepatitis
E. Granulomatous hepatitis

260. The following agents listed below may induce parkinsonism EXCEPT:

A. Antipsychotics
B. CCB
C. Dopaminergic agonist withdrawal
D. NSAIDs
E. Cyclosporine

261. Olfactory fatigue which is manifested by failure to detect odor is caused by which agent?

A. Hydrogen sulphide
B. Amiodarone
C. Botulinum toxin
D. Strychnine
E. Ethylene glycol

262. Patients taking ethambutol is know to experience this type of ocular abnormality:

A. Alteration of color vision

B. Cataracts
C. Corneal deposits
D. Cortical blindness
E. Macular edema

263. Cortical blindness is associated with the following xenobiotics listed below, EXCEPT

A. Cisplatin
B. Busulfan
C. Cyclosporine
D. Glycine
E. Tacrolimus

264. Xenobiotics reported to cause visual loss after acute exposure include which of the following?
I. caustics
II. Methanol
III. quinine
IV. lead

A. I and II
B. II and III
C. III and IV
D. I, II and III
E. I, II, III and IV

265. It is the inability to perceive odor or a lack of functioning olfaction the loss of the sense of smell:

A. Anosmia
B. Hyposmia
 C. Dysosmia
D. Cacosmia
E. Phantosmia

266. Defined as distorted perception of smell

A. Anosmia
B. Hyposmia
C. Dysosmia
D. Cacosmia
E. Phantosmia

267. This antihypertensive drug commonly cause gustary impairment, usually hypogeusia and dysgeusia

A. ARB
B. ACEi
C. Beta blockers
D. Vasodilators
E. Alpha blockers

268. This drug causes caogeusia (perceived foul, perverted, or metallic taste) when carbonated beverages are consumed

A. Spinorolactone
B. Acetazolamide
C. Ethambutol
D. Pencillamine
E. Phenytoin

269. Irreversible xenobiotics-induced hearing loss is commonly associated with which of the following?
I. Aminoglycoside
II. Chemotherapeutics(bleomycin, cisplatin)
III. Bromates
IV. NSAIDs

A. I and II
B. II and III
C. I, II and III
D. III only
E. IV only

270. Drugs associated with tinnitus include all of the following, EXCEPT

A. B-adrenergic antagonist
B. Antigungals: amphotericin B
C. Cinchona alkaloids : quinie, quinidine
D. Salicylates
E. Anticholinergics

271. Pregnancy category for drugs with positive risk on fetus, but benefit from the drug may outweigh the risk

A. Category A
B. Category B
C. Category C
D. Category D
 E. Category X

272. Studies in animals or humans or investigational or post marketing reports have shown fetal risk that clearly outweigh
any possible benefit to the patient. It is contraindicated in pregnancy

A. Category A
B. Category B
C. Category C
D. Category D
E. Category X

273.Acetaminophen and penicillin is under what pregnancy category?

A. Category A
B. Category B
C. Category C
D. Category D
E. Category X

274. Isotretinoin is under what pregnancy category?

A. Category A
B. Category B
C. Category C
D. Category D
E. Category X

275. Tetracycline is under what pregnancy category?

A. Category A
B. Category B
C. Category C
D. Category D
E. Category X

276. A synthetic nonsteroidal estrogen that stimulates estrogen receptor-containing tissue and may cause misplaced
genital tissue with a propensity to develop cancer.

A. Diethystilbetrol(DES)
B. Progesterone
C. Estrogen
D. Clomiphene
E. Tamoxifen

277. Drug responsible for fetal hdantoin syndrome. This is characterized by microcephaly, intellectual disability, cleft lip or
palate, hypoplastic nails or phalanges, characteristic facies-low nasal bridge, inner epicanthal folds, ptosis, strabismus,
hypertelorism, low-set ears and wide mouth

A. Quinine
B. Phenytoin
C. Methimazole
 D. Fluconazole
E. Ethanol

278. This agent is know to cause limb phocomelia, amelia, hypoplasia, congenital heart defects, renal malformations,
cryptorchidism, abducer paralysis, deafness, microtia, and anotia

A. Tetracycline
B. Trimethoprim
C. Valproic acid
D. Thalidomide
E. Vitamin D

279. A preservative added to liquid pharmaceutical preparations that is known to cause gasping syndrome on children

A. Benzoic acid
B. Benzyl alcohol
C. Ethanol
D. Propanol
E. Parabens

280. Poisoning by this agent in children is associated with hypoglycemia because of reduced hepatic glycogen stores

A. Chloramphenicol
B. Ethanol
C. Benzyl alcohol
D. Clonidine
E. Oxymetazoline

281. A 1kg premature infant required sedation for a diagnostic study. A high dose of chloral hydrate, 10 mg/kg was
miscalculated to 1g(1000mg) instead of 100mg. The child had a cardiopulmonary arrest and dies. When drugs require
miligam per kilogram dosing. It is easy to make decimal mistakes in the calculation or in the transcription. This is an
example of what type of medication error?

A. Wrong drug
B. Wrong drug information
C. Wrong dose
D. Wrong route
E. Wrong dose

282. In one nursery, an epidemic mimicking neonatal sepsis was caused when racemic epinephrine wasinadvertently
administered instead of vitamin E, because both drugs were manufactured by the same company, distributed in nearly
identical bottles and stored near each other inside the nursery refrigerator. This is an example of what type of medication
error.

A. Wrong drug
B. Wrong drug information
C. Wrong dose
D. Wrong route
E. Wrong dose

283. A 17 month old girl with a central venous line (CVL) and a gastrostomy tube required and upper gastrointestinal
series. Barium sulfate was inadvertently injected into the CVL instead of the gastrostomy tube. The patient had several
episodes of vomiting and developed fever and rigors but ultimately recovered. This is an example of what type of
medication error?
 A. Wrong drug
B. Wrong drug information
C. Wrong dose
D. Wrong route
E. Wrong dose

284. It is the study of the identification, distribution, and quantification of xenobiotics after ddeath

A. Forensic toxicology
B. Environmental toxicology
C. Postmortem toxicology
D. Clinical toxicology
E. Regulatory toxicology

285. gastic emptying may usually be indicated using the following conditions, EXCEPT

A. There is reason to believe that given the time of ingestion a significant amount of the ingested xenobiotics is still
present in stomach
B. The ingested xenobiotics is not adsorebed by activated charcoal or activated charcoal is unavailable
C. The xenobiotics has limited toxicity at almost any dose
D. The patient has not had spontaneous emesis
E. No highly effective specific antidote exist or alternative therapies(eg, hemodialysis) pose a significant risk to the
patient

286. Gastri emptying is usually not indicated if:

I. Although the xenobiotic ingested is potentially toxic, the dose ingested is likely less than that expected to produce
significant illness
II. The ingested xenobiotics is well adsorbed by activated charcoal and the amount ingested is not expected to exceed the
adsorptive capacity of activated charcoal
III. The patient presents many hours post ingestion and has minimal signs or symptoms of poisoning
IV. No highly effective specific antidote exist or alternative therapies (eg. Hemodialysis) pose a significant risk to the
patient

A. I and II
B. II and III
C. III and IV
D. I, II, and III
E. II, III and IV

287. Contraindications for orgastic lavage include which of the following?

I. the patient has lost or will likely lose his or her airway protective reflexes and has not been intubated
II. Ingestion of a xenobiotic with aspiration potential
III. ingestion of a xenobiotic in a form know to be too large to fit into the lumen of the lavage tube
IV. the patient meets criteria for gastric emptying

A. I and II
B. II and III
C. III and IV
D. I, II, and III
E. II, III and IV
288. Indications of single-dose activated charcoal therapy without gastric emptying include which of th following
I.Activated charcoal is known not to adsorb a clinically meaningful amount of the ingested xenobiotic
II. Gastric emptying is likely to be hamful
III. The ingestion has occurred within a time frame amenable to adsorption by activated charcoal or clinical factors are
present that suggest hat not all of the xenobiotic has already been systemically absorbed
IV. Gastrointestinal perforation is likely as in cases of caustic ingestions

A. I and II
B. II and III
C. III and IV
D. I, II, and III
E. II, III and IV

289. Contraindications of whole-bowel irrigation include which of the following?

I. airway protective reflexes are absent or expected to become so in patient who has not been intubated
II. GI tract is not intact. There are signs of ileus obstruction significant GI
III. Persistent vomiting
IV. Ingestion of a toxic amount of a xenobiotic that is not adsorbed to activated charcoal when other methods of GI
decontamination are not possible or not efficacious

A. I and II
B. II and III
C. III and IV
D. I, II, and III
E. II, III and IV

290. Enhanced elimination of xenobiotics may be indicated for several types of patients which include
I. patiens who fail to respond adequately to comprehensive supportive care
II. patients whom the normal are out of elimination of the xenobiotic is impaired
III. patients whom the normal are out of elimination of the xenobiotic is impaired
IV Adult patents associated with low risk of morbidity or mortality from drug overdose

A. I and II
B. II and III
C. III and IV
D. I, II, and III
E. II, III and IV

291. It is an ion exchanger resin that is used regularly for hyperkalemia in patients with chronic kidney disease.

A. Sodium polystyrene sulfonate

B. Chlestyramine
C. Sodium chloride
D. Sodium bicarbonate
E. Ammonium chloride

292. Characteristics of xeno biotics that allow clearance by hemodialysis includes;

I. MW>500Da
II. Water soluble
III. Not bound to plasma proteins

A. I only
 B. I and II
C. II and III
D. I and III
E. III only

293. Defines by a rectal temperature greater than 106F(41.1`C) in the setting of neurologic disturbances manifested by
mental status changes.

A. Heatstroke
B. Hypothermia
C. Frostbite
D. Rewarming
E. Afterdrop

294. Clearance of xenobiotics is affected by the following, except.

A. Organ perfusion
B. Enzyme activity
C. Protein binding
D. PKa
E. None of these

295. The deficiency of this vitamin adversely affects the hypothalamus and leads to hypothermia because of inefficient
glucose metabolism.

A. Cyanocobalamin
B. Ascorbic acid
C. Thiamine
D. Biotin
E. Vitamin P

296. The primary function of lungs is to exchange gases, specifically, this involves the transport_____into the blood and
elimination of______

A. Carbon dioxide-oxygen
B. Oxygen-carbon dioxide
C. Oxygen-nitrogen
D. Oxygen-hydroxide
E. Carbon monoxide-oxygen

297. A severe extrapyramidal syndrome associated with muscle rigidity, autonomic dysfunction and altered mental status.
This disorder develops during the administration of antipsychotics or the withdrawal of dopaminergic xenobiotics

A. Serotonin toxicity
B. Malignant hyperthermia
C. Neuroleptic malignant syndrome
D. Hypothermia
E. Neuropsychiatric impairment

298. Drugs cause hypoventilation include which of the following?

I. Ethanol
II. Strychnine
III. Clonidine
IV. Methylxanthines
 A. I and II
B. II and III
C. I, II and III
D. I, II and IV
E. II, III, and IV

299. Inhaled solution of 2% of this agent may provide symptomatic relief for patients with pulmonary exposure to
hydrogen chloride or to chlorine:

A. Sodium carbonate
B. Sodium chloride
C. Supplemental oxygen
D. Neostigmine
E. Pralidoxime

300. Acute tubular necrosis (ATN) is the most common cause of acute kidney injury in hospitalized patients. ATN is
manifested pathologically by patchy necrosis of the tubular epithelium and occlusion of the lumen by cast and cellular
debris. All of the following agents listed below may cause ATN, EXCEPT

A. Aluminum phosphide
B. Deferoxamine
C. Arsenic
D. Ibuprofen
E. APAP