1 - Introduction to Toxicology

c. Toxicology

[Introduction]

Study of poisons
a. Pharmacology
b. Microbiology
c. Toxicology
d. Pathology

c. Toxicology

[Introduction]

Study of the adverse effects that arise from physical and chemical agents.
a. Pharmacology
b. Microbiology
c. Toxicology
d. Pathology

d. Poison

[Introduction]

Any substance which injures health or destroys life.
a. Toxin
b. Toxicant
c. Pollutant
d. Poison

d. Paracelsus

[Introduction]

Famous quote "all things are poison" is attributed to:
a. Hippocrates
b. Lister
c. Pasteur
d. Paracelsus

• Toxin

• Toxicant

[Introduction]

Poison can be _____ [2]

d. Toxin

[Introduction]

Naturally occurring poisons produced by living organisms.
a. Toxicant
b. Pollutant
c. Poison
d. Toxin

• Botulinum toxin

• Tetanus

• Latrotoxin

[Introduction]

Example of a toxin produced by living organisms [3]

d. Toxicant

[Introduction]

Synthetic or man-made poisons.

a. Toxin

b. Poison

c. Venom

d. Toxicant

• All drugs

• Pesticide

• Factory waste

• Pollutant

[Introduction]

Example of toxicant [4]

c. Descriptive toxicology

[Branches of Toxicology]

Branch of toxicology that deals with the poison and its effects

a. Forensic toxicology

b. Mechanistic toxicology

c. Descriptive toxicology

d. Clinical toxicology

b. Mechanistic toxicology

[Branches of Toxicology]

Branch of toxicology that tells about the mechanism of toxicity

a. Forensic toxicology

b. Mechanistic toxicology

c. Descriptive toxicology

d. Clinical toxicology

c. Regulatory toxicology

[Branches of Toxicology]

Branch of toxicology that imposes restrictions on substances
a. Descriptive toxicology

b. Clinical toxicology

c. Regulatory toxicology

d. Forensic toxicology

c. Regulatory toxicology

[Branches of Toxicology]

Branch of toxicology that establishes standards of safe exposure

a. Descriptive toxicology

b. Clinical toxicology

c. Regulatory toxicology

d. Forensic toxicology

b. Threshold

[Branches of Toxicology]

Term for the limit or standard of safe exposure established by regulatory toxicology.

a. LD50

b. Threshold

c. TD50

d. MEC

d. Regulatory toxicology

[Branches of Toxicology]

Fluoride in water system is beneficial at low amount to ensure healthy teeth. This is an example of:

a. Clinical toxicology

b. Forensic toxicology

c. Occupational toxicology

d. Regulatory toxicology

b. Beneficial at low amount to ensure healthy teeth

[Branches of Toxicology]

Example of regulatory toxicology involving fluoride in water system.

a. Harmful at low amount

b. Beneficial at low amount to ensure healthy teeth

c. Toxic at all amounts

d. Beneficial at high amount only

d. Clinical toxicology

[Branches of Toxicology]

Branch of toxicology that involves diagnosis and management of poisoning and administering antidotes.

a. Forensic toxicology
b. Descriptive toxicology
c. Regulatory toxicology
d. Clinical toxicology

d. Forensic toxicology

[Branches of Toxicology]

Branch of toxicology that determines the manner of poisoning , whether this type of poisoning is accidental or intentional.
a. Clinical toxicology
b. Occupational toxicology
c. Environmental toxicology
d. Forensic toxicology

c. Environmental toxicology

[Branches of Toxicology]

Branch of toxicology that covers contaminants of the environment (water, air, and soi)
a. Occupational toxicology
b. Forensic toxicology
c. Environmental toxicology
d. Regulatory toxicology

d. Environmental toxicology

[Branches of Toxicology]

Branch of toxicology that also covers food toxicology.
a. Occupational toxicology
b. Forensic toxicology
c. Regulatory toxicology
d. Environmental toxicology

b. Aflatoxin

[Branches of Toxicology]

Contaminant commonly found in peanuts that causes liver cancer.
a. Botulinum toxin
b. Aflatoxin
c. Tetanus toxin
d. Latrotoxin

d. Liver cancer

[Branches of Toxicology]

Disease associated with aflatoxin contamination in peanuts.
a. Kidney cancer
b. Lung cancer
c. Colon cancer
d. Liver cancer

c. Occupational toxicology

[Branches of Toxicology]

Branch of toxicology that deals with workplace chemicals.

a. Environmental toxicology

b. Forensic toxicology

c. Occupational toxicology

d. Regulatory toxicology

c. Hypersensitivity

[Adverse Effects]

Adverse effect referring to an exaggerated immune response.
a. Idiosyncrasy
b. Teratogenicity
c. Hypersensitivity
d. Anaphylaxis

d. Idiosyncrasy

[Adverse Effects]

Adverse effect classified as Type B ADR referring to abnormal genetically predetermined response to various medications.
a. Hypersensitivity
b. Teratogenicity
c. Idiosyncrasy
d. Anaphylaxis

b. Type B

[Adverse Effects]

ADR type classification of idiosyncrasy.
a. Type A
b. Type B
c. Type D
d. Type C

• Stevens-Johnson syndrome (SJS)

• Redman syndrome

[Adverse Effects]

Example of Idiosyncratic Reactions [2]

d. Redman syndrome

[Adverse Effects]

Idiosyncratic reaction caused by vancomycin.
a. SJS
b. Anaphylaxis
c. Teratogenicity
d. Redman syndrome

b. Vancomycin

[Adverse Effects]

Drug that causes Redman syndrome as an idiosyncratic reaction.
a. Penicillin
b. Vancomycin
c. Tetracycline
d. Erythromycin

c. Teratogenicity

[Adverse Effects]

Adverse effect classified as Type D ADR referring to ability to cause defects in a developing fetus.

a. Idiosyncrasy

b. Hypersensitivity

c. Teratogenicity

d. Fetotoxicity

c. Type D

[Adverse Effects]

ADR type classification of teratogenicity.
a. Type A
b. Type B
c. Type D
d. Type C

• Human studies

• Animal studies

US FDA pregnancy category include _____ [2] studies

a. Category A

[US FDA PREGNANCY CATEGORY]

FDA Pregnancy Category with positive human studies and positive animal studies.
a. Category A
b. Category B
c. Category C
d. Category D

b. Category B

[US FDA PREGNANCY CATEGORY]

FDA Pregnancy Category with no risk in human studies and positive animal studies OR no human studies available.
a. Category A
b. Category B
c. Category C
d. Category D

c. Category C

[US FDA PREGNANCY CATEGORY]

FDA Pregnancy Category with no human studies and negative animal studies OR no human studies available.
a. Category A
b. Category B
c. Category C
d. Category D

d. Category D

[US FDA PREGNANCY CATEGORY]

FDA Pregnancy Category where benefit outweighs risk with negative human and animal studies.
a. Category A
b. Category B
c. Category C
d. Category D

d. Category X

[US FDA PREGNANCY CATEGORY]

FDA Pregnancy Category that is absolutely contraindicated in patients.
a. Category B
b. Category C
c. Category D
d. Category X

c. Thalidomide

[Example of Teratogenic Agents]

Drug originally used for morning sickness that is a teratogenic agent.
a. Warfarin
b. Tetracycline
c. Thalidomide
d. Fluoroquinolone

d. Phocomelia (malformed limbs)

[Example of Teratogenic Agents]

Teratogenic effect of Thalidomide.
a. Fetal warfarin syndrome
b. Bone deformation
c. Enamel hypoplasia
d. Phocomelia

• Leprosy (Hansen disease)

• Certain kind of Cancer

[Example of Teratogenic Agents]

Current use of Thalidomide [2]

d. S-enantiomer

[Example of Teratogenic Agents]

Teratogenic enantiomer of Thalidomide.
a. R-enantiomer
b. Both enantiomers
c. Neither enantiomer
d. S-enantiomer

c. Fetal warfarin syndrome

[Example of Teratogenic Agents]

Teratogenic syndrome caused by Warfarin in a developing fetus.
a. Phocomelia
b. Aplasia cutis
c. Fetal warfarin syndrome
d. Enamel hypoplasia

b. LMW heparin

[Example of Teratogenic Agents]

Alternative anticoagulant to Warfarin in pregnancy.
a. Heparin sodium
b. LMW heparin
c. Aspirin
d. Dabigatran

• Hypoplastic nose

• Frontal bossing

• Syndactyly (fused fingers)

[Example of Teratogenic Agents]

Characteristic of fetal warfarin syndrome include ____ [3]

c. Chelation

[Example of Teratogenic Agents]

Tetracyclines and Fluoroquinolones are restricted with calcium rich food due to:

a. Oxidation

b. Hydrolysis

c. Chelation

d. Precipitation

d. Sequester calcium

[Example of Teratogenic Agents]

Effect of Tetracyclines and Fluoroquinolones on calcium leading to bone deformity.

a. Oxidize calcium

b. Excrete calcium

c. Absorb calcium

d. Sequester calcium

c. Enamel hypoplasia

[Example of Teratogenic Agents]

Teratogenic effect of Tetracyclines and Fluoroquinolones on teeth.
a. Dental caries
b. Tooth loss
c. Enamel hypoplasia
d. Tooth discoloration

c. Azithromycin

[Example of Teratogenic Agents]

Alternative drug to doxycycline used as prophylactic in pregnant patients.
a. Penicillin
b. Amoxicillin
c. Azithromycin
d. Erythromycin

d. Aplasia cutis

[Example of Teratogenic Agents]

Teratogenic effect of Methimazole on the skin of a developing fetus.
a. Enamel hypoplasia
b. Syndactyly
c. Phocomelia
d. Aplasia cutis

c. Propylthiouracil (PTU)

[Example of Teratogenic Agents]

Preferred anti-thyroid drug in the first trimester of pregnancy.

a. Methimazole (MMI)

b. Carbimazole

c. Propylthiouracil (PTU)

d. Radioactive iodine (RAI)

b. Hepatotoxic

[Example of Teratogenic Agents]

Adverse effect of PTU that limits its use beyond first trimester.

a. Aplasia cutis

b. Hepatotoxic

c. Bone deformity

d. Phocomelia

d. Methimazole

[Example of Teratogenic Agents]

Anti-thyroid drug used in the second trimester of pregnancy.
a. PTU
b. Radioactive iodine
c. Carbimazole
d. Methimazole

c. Methimazole causes aplasia cutis

[Example of Teratogenic Agents]

Reason PTU is preferred over Methimazole in first trimester.
a. PTU causes aplasia cutis
b. PTU is hepatotoxic
c. Methimazole causes aplasia cutis
d. Methimazole is hepatotoxic

c. PTU is hepatotoxic

[Example of Teratogenic Agents]

Reason Methimazole is used in second trimester instead of PTU.
a. Methimazole causes aplasia cutis
b. PTU causes aplasia cutis in second trimester
c. PTU is hepatotoxic
d. Methimazole is safer in all trimesters

b. Ebstein's anomaly

[Example of Teratogenic Agents]

Teratogenic effect of Lithium on the heart.
a. Ventricular septal defect
b. Ebstein's anomaly
c. Tetralogy of Fallot
d. Patent ductus arteriosus

d. Displaced tricuspid valve

[Example of Teratogenic Agents]

Cardiac defect in Ebstein's anomaly caused by Lithium.

a. Displaced mitral valve

b. Displaced aortic valve

c. Displaced pulmonic valve

d. Displaced tricuspid valve

c. Right atrium enlargement

[Example of Teratogenic Agents]

Cardiac enlargement associated with Ebstein's anomaly.

a. Left ventricle enlargement

b. Left atrium enlargement

c. Right atrium enlargement

d. Right ventricle enlargement

c. Neural tube defects (spina bifida)

[Example of Teratogenic Agents]

Teratogenic effect of:

• Valproic acid

• Carbamazepine.

a. Ebstein's anomaly

b. Aplasia cutis

c. Neural tube defects (spina bifida)

d. Phocomelia

b. Bulge in spine containing only CSF

[Example of Teratogenic Agents]

Characteristic of spina bifida caused by Valproic acid and Carbamazepine.
a. Hole in the heart
b. Bulge in spine containing only CSF
c. Malformed limbs
d. Displaced tricuspid valve

c. Folic acid during first trimester and 3 months before pregnancy

[Example of Teratogenic Agents]

Prevention of neural tube defects caused by Valproic acid and Carbamazepine.
a. Vitamin B12 during first trimester
b. Vitamin C during pregnancy
c. Folic acid during first trimester and 3 months before pregnancy
d. Vitamin D during second trimester

d. Green leafy vegetables

[Example of Teratogenic Agents]

Food source recommended to prevent neural tube defects.
a. Red meat
b. Dairy products
c. Citrus fruits
d. Green leafy vegetables

c. Synthetic estrogen

[Example of Teratogenic Agents]

Classification of Diethylstilbestrol as a teratogenic agent.
a. Synthetic progesterone
b. Synthetic androgen
c. Synthetic estrogen
d. Synthetic corticosteroid

d. Cancer of the vagina or cervical cancer

[Example of Teratogenic Agents]

Teratogenic effect of Diethylstilbestrol on female babies during puberty.
a. Infertility
b. Bone deformity
c. Aplasia cutis
d. Cancer of the vagina or cervical cancer

b. Infertility

[Example of Teratogenic Agents]

Teratogenic effect of Diethylstilbestrol on male babies.
a. Cancer of testes
b. Infertility
c. Bone deformity
d. Aplasia cutis

c. Renal dysgenesis

[Example of Teratogenic Agents]

Teratogenic effect of ACEIs and ARBs on the kidneys.
a. Renal agenesis
b. Renal cancer
c. Renal dysgenesis
d. Renal calculi

c. Fetal hydantoin syndrome

[Example of Teratogenic Agents]

Teratogenic syndrome caused by Phenytoin.

a. Fetal warfarin syndrome

b. Fetal alcohol syndrome

c. Fetal hydantoin syndrome

d. Ebstein's anomaly

• Microcephaly

• Upturned nose

• Cleft lip and palate

[Example of Teratogenic Agents]

Characteristic of fetal hydantoin syndrome include _____ [3]

d. Fetal alcohol syndrome

[Example of Teratogenic Agents]

Teratogenic syndrome caused by Alcohol.
a. Fetal warfarin syndrome
b. Fetal hydantoin syndrome
c. Ebstein's anomaly
d. Fetal alcohol syndrome

• Low IQ

• Smooth philtrum (normally has depression)

• Clinodactyly (curved fingers)

[Example of Teratogenic Agents]

Characteristic of fetal alcohol syndrome include ______ [3]

a. True

[Example of Teratogenic Agents]

Drinking alcohol is contraindicated in breastfeeding.

a. True
b. False

c. Increased risk of autism

[Example of Teratogenic Agents]

Risk to offspring when father drinks alcohol during pregnancy.
a. Fetal warfarin syndrome
b. Fetal hydantoin syndrome
c. Increased risk of autism
d. Ebstein's anomaly

d. Ingestion

[Route of Poison Exposure]

Most common route of poison exposure in children.
a. Inhalation
b. Dermal
c. Parenteral
d. Ingestion

c. Paracetamol

[Route of Poison Exposure]

Most common poison ingested in the Philippines.
a. Rugby
b. Heroin
c. Paracetamol
d. Glutathione

b. Inhalation

[Route of Poison Exposure]

Route of poison exposure associated with rugby

a. Ingestion

b. Inhalation

c. Dermal

d. Parenteral

c. Dermal

[Route of Poison Exposure]

Route of poison exposure associated with skin care products.

a. Ingestion

b. Inhalation

c. Dermal

d. Parenteral

d. Parenteral

[Route of Poison Exposure]

Route of poison exposure associated with

• Heroin

• Illegal drugs

• Glutathione (GSH)
  

a. Ingestion
b. Inhalation
c. Dermal
d. Parenteral

a. True

[Route of Poison Exposure]

Glutathione (GSH) should be used in low doses only

a. True

b. False

d. Glutathione (GSH)

[Route of Poison Exposure]

Parenteral substance that is hepatotoxic when used in high doses as whitening agent.
a. Heroin
b. Rugby
c. Paracetamol
d. Glutathione (GSH)

c. Hepatotoxic

[Route of Poison Exposure]

Glutathione used in high doses as whitening agent results in:

a. Nephrotoxic

b. Cardiotoxic

c. Hepatotoxic

d. Neurotoxic

a. Acute

[Timing of Poison Exposure]

<24 hrs

a. Acute

b. Subacute

c. Subchronic

d. Chronic

b. Subacute

[Timing of Poison Exposure]

1 day - 1 month

a. Acute

b. Subacute

c. Subchronic

d. Chronic

c. Subchronic

[Timing of Poison Exposure]

1 - 3 months

a. Acute

b. Subacute

c. Subchronic

d. Chronic

d. Chronic

[Timing of Poison Exposure]

>3 months

a. Acute

b. Subacute

c. Subchronic

d. Chronic

d. Immediate

[Effects of Poison Exposure]

Effect of exposure that occurs after one exposure.

a. Delayed

b. Reversible

c. Irreversible

d. Immediate

c. Acids and bases

[Effects of Poison Exposure]

Example of immediate effect of exposure.
a. Air pollutant
b. Carcinogens
c. Acids and bases
d. Teratogens

b. Delayed

[Effects of Poison Exposure]

Effect of exposure that occurs after repeated exposures.

a. Immediate

b. Delayed

c. Reversible

d. Irreversible

• Air pollutant

• Carcinogens

[Effects of Poison Exposure]

Example of delayed effect of exposure include _______ [2]

d. Reversible

[Effects of Poison Exposure]

Effect of exposure managed by discontinuing medication or use of antidote.

a. Immediate

b. Delayed

c. Irreversible

d. Reversible

b. Isoniazid-induced peripheral neuropathy

[Effects of Poison Exposure]

Example of reversible effect of exposure with antidote pyridoxine.
a. Carcinogens
b. Isoniazid-induced peripheral neuropathy
c. Methanol blindness
d. Sulfur dioxide COPD

b. Peripheral neuropathy

[Effects of Poison Exposure]

Isoniazid causes:

a. Optic neuritis
b. Peripheral neuropathy
c. Hyperuricemia
d. Ototoxicity

c. Pyridoxine (Vit. B6)

[Effects of Poison Exposure]

Antidote for Isoniazid-induced peripheral neuropathy.
a. Naloxone
b. Folic acid
c. Pyridoxine
d. N-acetylcysteine

d. Irreversible

[Effects of Poison Exposure]

Effect of exposure that is permanent.
a. Immediate
b. Delayed
c. Reversible
d. Irreversible

• Carcinogen

• Teratogens

[Effects of Poison Exposure]

Examples of irreversible effects of exposure.
a. Acids and bases
b. Air pollutant and carcinogens
c. Carcinogen and teratogens
d. Peripheral neuropathy

d. Local

[Effects of Poison Exposure]

Effect of exposure that occurs at the site of exposure.
a. Systemic
b. Delayed
c. Irreversible
d. Local

c. Systemic

[Effects of Poison Exposure]

Effect of exposure that occurs other than the site of exposure.
a. Local
b. Delayed
c. Systemic
d. Irreversible

• Immediate

• Reversible

• Systemic

[Effects of Poison Exposure]

Effects of Heroin causing pinpoint pupil
a. Delayed, irreversible, local
b. Delayed, reversible, systemic
c. Immediate, irreversible, local
d. Immediate, reversible, systemic

b. Naloxone

[Effects of Poison Exposure]

Antidote for Heroin as a reversible effect of exposure.
a. Pyridoxine
b. Naloxone
c. N-acetylcysteine
d. Folic acid

• Delayed

• Irreversible

• Local (inhalational)

[Effects of Poison Exposure]

Effects of Sulfur dioxide causing COPD.

a. Immediate, reversible, systemic

b. Immediate, irreversible, local

c. Delayed, irreversible, local (inhalational)

d. Delayed, reversible, systemic

• Immediate

• Irreversible damage to optic nerve

• Systemic

[Effects of Poison Exposure]

Effects of Methanol exposure from contaminated coconut wine.

a. Delayed, reversible, local

b. Immediate, irreversible damage to optic nerve, systemic

c. Delayed, irreversible, local

d. Immediate, reversible, local

c. Blindness

[Effects of Poison Exposure]

Methanol found in contaminated coconut wine causes:
a. Deafness
b. Anosmia
c. Blindness
d. Paralysis