Lab 4 & 5 MCQs | Quizlet

A 3-year-old French Bulldog presents 2 hours after ingestion of an unknown quantity of motor oil. Which of the following is the most appropriate recommendation?

a. Induce emesis using apomorphine

b. Induce emesis using ropinirole

c. Gastric lavage after activated charcoal administration

d. Avoid emesis because aspiration pneumonia is a major risk

d. Avoid emesis because aspiration pneumonia is a major risk

Which patient is the BEST candidate for emesis induction?

a. Rabbit presenting with salivation after ingestion of unknown plant material

b. Dog that ingested chocolate 3 hours previously and remains asymptomatic

c. Cat with megaesophagus following accidental exposure to xylitol gum

d. Dog presenting with repeated spontaneous vomiting after toxin ingestion

b. Dog that ingested chocolate 3 hours previously and remains asymptomatic

Which statement regarding ocular decontamination is CORRECT?

a. Neutralizing agents should be used whenever the chemical nature of the toxicant is known

b. Ocular decontamination should be delayed until a complete ophthalmic examination is performed

c. Flushing with isotonic saline or tepid water is recommended

d. Rubbing the eye assists toxin removal

c. Flushing with isotonic saline or tepid water is recommended

Activated charcoal would be expected to have the LOWEST efficacy following poisoning by

a. Phenobarbital

b. Atropine

c. Ethylene glycol

d. Amphetamine

c. Ethylene glycol

Which substance is poorly adsorbed by activated charcoal?

a. Carbamate insecticides

b. Organophosphate insecticides

c. Ethanol

d. Phenobarbital

c. Ethanol

A dog presents unconscious after ingestion of metaldehyde. The preferred decontamination method is

a. Oral hydrogen peroxide

b. Gastric lavage under anesthesia

c. Sorbitol administration only

d. Ropinirole eye drops

b. Gastric lavage under anesthesia

Which of the following is a contraindication to activated charcoal administration?

a. Exposure to phenobarbital

b. Exposure to atropine

c. Gastrointestinal perforation

d. Exposure to pesticides

c. Gastrointestinal perforation

Cholestyramine is particularly useful because it

a. Accelerates renal elimination

b. Interrupts enterohepatic circulation

c. Causes urine alkalization

d. Directly neutralizes organophosphates

b. Interrupts enterohepatic circulation

Which toxicant would be MOST likely to benefit from intravenous lipid emulsion therapy?

a. Cadmium

b. Lidocaine

c. Ethylene glycol

d. Ammonia

b. Lidocaine

Intravenous lipid emulsion therapy is primarily indicated for

a. Water-soluble toxins

b. Lipophilic toxins

c. Protein toxins

d. Corrosive toxicants

b. Lipophilic toxins

Which statement regarding hemodialysis is CORRECT?

a. It is most effective for large protein-bound toxicants

b. It requires no anticoagulants

c. It is useful for water-soluble, low-molecular-weight toxicants

d. It is contraindicated in ethylene glycol poisoning

c. It is useful for water-soluble, low-molecular-weight toxicants

Hemoperfusion differs from hemodialysis because it

a. Is dependent on water solubility

b. Is dependent on molecular size

c. Utilizes adsorbent materials such as activated charcoal

d. Cannot remove protein-bound compounds

c. Utilizes adsorbent materials such as activated charcoal

Which of the following toxicants would be expected to respond best to urine alkalization?

a. Amphetamine

b. Strychnine

c. Aspirin

d. Propranolol

c. Aspirin

Urine acidification may enhance elimination of

a. Barbiturates

b. Ethylene glycol

c. Amphetamine

d. Salicylates

c. Amphetamine

Ion trapping is most effective when the toxicant

a. Is extensively protein bound

b. Is predominantly eliminated unchanged via the kidneys

c. Has extensive tissue distribution

d. Undergoes complete hepatic metabolism

b. Is predominantly eliminated unchanged via the kidneys

Which patient would require the MOST cautious fluid administration?

a. Dog with pyrethroid poisoning

b. Dog with cardiac disease

c. Dog with xylitol ingestion

d. Dog with chocolate poisoning

b. Dog with cardiac disease

The principal goal of forced diuresis is to

a. Increase hepatic metabolism

b. Increase renal elimination of toxicants

c. Increase gastrointestinal transit

d. Increase protein binding

b. Increase renal elimination of toxicants

Which statement regarding bentonite is CORRECT?

a. It may contribute to hypernatremia

b. It enhances absorption of medications

c. It is a specific antidote

d. It should only be used intravenously

a. It may contribute to hypernatremia

Surgical decontamination should be strongly considered when

a. Ethanol has been ingested

b. A battery has been swallowed

c. Activated charcoal has already been administered

d. The patient has received oxygen therapy

b. A battery has been swallowed

A dog with severe hypernatremia secondary to salt poisoning requires correction of serum sodium

a. As rapidly as possible

b. At approximately 0.3-0.5 mEq/L per hour

c. Only with isotonic saline

d. Only using furosemide

b. At approximately 0.3-0.5 mEq/L per hour

Which equation is used to estimate serum osmolarity?

a. 2(Na + K) + BUN/2.8 + glucose

b. ALT + AST + ALP

c. Creatinine + BUN

d. PT + bilirubin

a. 2(Na + K) + BUN/2.8 + glucose

Which intervention belongs to the "D" component of ABCD supportive care?

a. Oxygen administration

b. Blood pressure monitoring

c. Convulsion control

d. Tracheal intubation

c. Convulsion control

Which antagonistic pair is correctly matched?

a. Morphine — nalorphine

b. Atropine — neostigmine

c. Tubocurarine — atropine

d. Organophosphates — physostigmine

a. Morphine — nalorphine

Pharmacological antagonism in organophosphate poisoning is represented by

a. Atropine administration

b. Activated charcoal administration

c. Gastric lavage

d. Hemoperfusion

a. Atropine administration

A dog presents 8 hours after ingestion of a large quantity of iron tablets. Radiographs reveal multiple tablets within the stomach. The most appropriate decontamination method is

a. Activated charcoal administration

b. Sorbitol administration

c. Surgical decontamination

d. Urine alkalization

c. Surgical decontamination

Which toxicant would be LEAST likely to benefit from activated charcoal administration?

a. Phenobarbital

b. Atropine

c. Methanol

d. Amphetamine

c. Methanol

A clinician chooses hemoperfusion instead of hemodialysis because the toxicant is

a. Small and water-soluble

b. Highly protein-bound

c. Rapidly metabolized by the liver

d. Poorly absorbed from the gastrointestinal tract

b. Highly protein-bound

Which statement best describes plasmapheresis?

a. Blood is filtered through activated charcoal

b. Plasma is separated from blood cells and removed

c. The peritoneum acts as a dialysis membrane

d. Urine production is pharmacologically increased

b. Plasma is separated from blood cells and removed

Which characteristic makes a toxicant a poor candidate for ion trapping?

a. Weak electrolyte

b. Renal excretion largely unchanged

c. Extensive protein binding

d. Suitable pKa

c. Extensive protein binding

Urine alkalization would be expected to enhance elimination of

a. Amphetamine

b. Strychnine

c. Aspirin

d. Lidocaine

c. Aspirin

Which agent may be used for urine alkalization?

a. NH₄Cl

b. Arginine chloride

c. Sodium bicarbonate

d. Magnesium sulfate

c. Sodium bicarbonate

Urine acidification may be considered following poisoning by

a. Salicylates

b. Barbiturates

c. Ethylene glycol

d. Amphetamine

d. Amphetamine

Which agent may be administered for urine acidification?

a. Sodium bicarbonate

b. Ringer lactate

c. Ammonium chloride

d. Mannitol

c. Ammonium chloride

A major advantage of intravenous lipid emulsion therapy is

a. Direct chemical neutralization of toxins

b. Increased renal filtration rate

c. Redistribution of lipophilic toxins away from vital organs

d. Increased hepatic metabolism

c. Redistribution of lipophilic toxins away from vital organs

Which poisoning would be MOST appropriate for intravenous lipid emulsion therapy?

a. Cadmium

b. Lidocaine

c. Cyanide

d. Mercury

b. Lidocaine

Which adverse effect should be monitored during intravenous lipid emulsion administration?

a. Methemoglobinemia

b. Fever

c. Polycythemia

d. Hypocalcemia

b. Fever

A dog poisoned with pyrethroids develops hypothermia. Why is temperature monitoring particularly important?

a. Hypothermia may increase toxicity

b. Hyperthermia is impossible in pyrethroid poisoning

c. Pyrethroids cause severe dehydration

d. Hypothermia increases renal elimination

a. Hypothermia may increase toxicity

Which statement regarding forced diuresis is CORRECT?

a. It should never be combined with fluid therapy

b. It is contraindicated in all poisoned patients

c. It may increase renal elimination of toxicants

d. It replaces supportive care

c. It may increase renal elimination of toxicants

A dog with severe congestive heart failure presents after toxin ingestion. Which treatment should be used cautiously?

a. Oxygen therapy

b. Fluid therapy

c. Activated charcoal

d. Gastric lavage

b. Fluid therapy

Sorbitol is classified as

a. An adsorbent

b. A saline cathartic

c. An osmotic cathartic

d. A chelating agent

c. An osmotic cathartic

Which cathartic is classified as a saline cathartic?

a. Sorbitol

b. Magnesium sulfate

c. Activated charcoal

d. Cholestyramine

b. Magnesium sulfate

The primary purpose of cathartics is to

a. Increase toxin metabolism

b. Increase gastrointestinal transit

c. Enhance hepatic detoxification

d. Increase urinary excretion

b. Increase gastrointestinal transit

Bentonite administration may interfere with

a. Gastric acid production

b. Absorption of concurrently administered medications

c. Renal blood flow

d. Hepatic metabolism

b. Absorption of concurrently administered medications

Carbotox combines activated charcoal with

a. Cholestyramine

b. Sorbitol

c. Montmorillonite

d. Magnesium hydroxide

c. Montmorillonite

The active component of Carbotox clay should comprise at least

a. 25%

b. 50%

c. 75%

d. 95%

c. 75%

A patient poisoned with an organophosphate is actively seizuring and unconscious. The most appropriate method of gastric decontamination would be

a. Apomorphine

b. Ropinirole

c. Gastric lavage under anesthesia

d. Hydrogen peroxide

c. Gastric lavage under anesthesia

Which procedure requires anticoagulant administration?

a. Activated charcoal

b. Hemodialysis

c. Gastric lavage

d. Sorbitol administration

b. Hemodialysis

Which statement best distinguishes hemoperfusion from hemodialysis?

a. Hemoperfusion relies on diffusion only

b. Hemoperfusion effectiveness is less dependent on protein binding

c. Hemoperfusion requires no vascular access

d. Hemoperfusion is limited to water-soluble toxins

b. Hemoperfusion effectiveness is less dependent on protein binding

Which patient would be the BEST candidate for hemodialysis?

a. Dog poisoned with a small water-soluble drug

b. Dog poisoned with a highly lipophilic pyrethroid

c. Dog poisoned with a highly protein-bound toxin

d. Dog with a gastric foreign body

a. Dog poisoned with a small water-soluble drug

Which supportive intervention belongs primarily to "A" in the ABCD approach?

a. Oxygen therapy

b. Blood pressure monitoring

c. Tracheal intubation

d. Convulsion control

c. Tracheal intubation

Which supportive intervention belongs primarily to "C" in the ABCD approach?

a. Pulse oximetry

b. Arrhythmia management

c. Oxygen therapy

d. Mechanical ventilation

b. Arrhythmia management

A poisoned patient develops severe metabolic acidosis. The amount of sodium bicarbonate required is calculated using

a. Base deficiency × 0.3 × body weight

b. Body weight × serum sodium

c. Creatinine × body weight

d. Glucose × 0.5

a. Base deficiency × 0.3 × body weight

Which poisoning may ultimately require surgical decontamination because the source continues releasing toxicant?

a. Fentanyl patch ingestion

b. Ethylene glycol ingestion

c. Carbon monoxide exposure

d. Nitrite poisoning

a. Fentanyl patch ingestion

Which statement regarding superglue exposure is CORRECT?

a. Immediate forcible separation is recommended

b. Ingestion is usually highly toxic

c. Warm water soaking may aid removal

d. Acids should be applied to dissolve the adhesive

c. Warm water soaking may aid removal

Following cyanoacrylate exposure to the eye, the most appropriate recommendation is

a. Force eyelid separation immediately

b. Apply activated charcoal

c. Flush with warm water and protect the eye

d. Use acetone directly in the eye

c. Flush with warm water and protect the eye

Which statement regarding corrosive poisoning is CORRECT?

a. Emesis is recommended within one hour

b. Gastric lavage is preferred

c. Water or milk may be used for dilution

d. Activated charcoal completely prevents injury

c. Water or milk may be used for dilution

Which toxicant is specifically listed as a potential indication for surgical removal due to bezoar formation?

a. Ethanol

b. Iron tablets

c. Amphetamine

d. Organophosphates

b. Iron tablets

Which of the following combinations is correctly matched?

a. Hemoperfusion — activated charcoal filter

b. Plasmapheresis — peritoneal membrane

c. Hemodialysis — removal of plasma only

d. Forced diuresis — activated charcoal

a. Hemoperfusion — activated charcoal filter

A pelican contaminated with an oil-based toxicant should be bathed using

a. Cold water only

b. Lukewarm water and dishwashing detergent

c. Acetone and soap

d. Activated charcoal suspension

b. Lukewarm water and dishwashing detergent

A long-haired dog contaminated with a dermal toxicant that cannot be adequately bathed should undergo

a. Aggressive scrubbing

b. Neutralization therapy

c. Gentle clipping of contaminated hair

d. Gastric lavage

c. Gentle clipping of contaminated hair

Initial management of a bee sting includes

a. Activated charcoal

b. Removal of the stinger and venom sac

c. Emesis induction

d. Gastric lavage

b. Removal of the stinger and venom sac

Pulse oximetry is primarily used to monitor

a. Renal perfusion

b. Oxygenation and ventilation

c. Hepatic metabolism

d. Blood glucose concentration

b. Oxygenation and ventilation

Gastric lavage may be preferred over emesis when

a. Controlled decontamination is required

b. The patient is conscious and stable

c. Activated charcoal is unavailable

d. The toxicant is well adsorbed by charcoal

a. Controlled decontamination is required

Before passing an orogastric tube during gastric lavage, the tube should be measured to

a. The xiphoid process

b. The last rib

c. The shoulder

d. The pelvic brim

b. The last rib

Activated charcoal is commonly prepared as

a. 1 g in 1 mL water

b. 1 g in 10 mL suspension

c. 10 g in 1 mL water

d. 100 g in 10 mL water

b. 1 g in 10 mL suspension

Which mechanism contributes most to the efficacy of cholestyramine in toxicology?

a. Enhanced renal filtration

b. Inhibition of hepatic metabolism

c. Interruption of enterohepatic recirculation

d. Increased gastric emptying

c. Interruption of enterohepatic recirculation

Which adjunctive treatment may be particularly useful in phenobarbital poisoning?

a. Cholestyramine

b. Hydrogen peroxide

c. Urine acidification

d. Gastric lavage only

a. Cholestyramine

Compared with healthy adults, neonates generally require

a. Reduced fluid rates

b. Increased fluid rates

c. No fluid therapy

d. Only colloids

b. Increased fluid rates

Which poisoning is specifically listed as a potential indication for hemodialysis?

a. Paracetamol

b. Pyrethroids

c. Organophosphates

d. Amitraz collar ingestion

a. Paracetamol

Peritoneal dialysis is

a. More commonly used than hemodialysis

b. Rarely used

c. Indicated only in horses

d. Performed without a dialysis membrane

b. Rarely used

Compared with hemodialysis, plasmapheresis is characterized by

a. Smaller membrane pores

b. Larger membrane pores

c. No anticoagulant requirement

d. Use of activated charcoal cartridges

b. Larger membrane pores

In salt poisoning, serum sodium concentration should generally decrease at a rate of

a. 2-3 mEq/L/h

b. 1-2 mEq/L/h

c. 0.3-0.5 mEq/L/h

d. As rapidly as possible

c. 0.3-0.5 mEq/L/h

A poisoned patient with hypoglycemia should receive

a. Short-acting insulin

b. Intravenous glucose

c. Activated charcoal

d. Hemoperfusion

b. Intravenous glucose

Which pair is an example of pharmacological antagonism?

a. Morphine — nalorphine

b. Muscarine — atropine

c. Organophosphate — atropine

d. Tubocurarine — neostigmine

c. Organophosphate — atropine

Which pair represents displacement of a toxic substance from its receptor?

a. Morphine — nalorphine

b. Organophosphate — atropine

c. Aspirin — sodium bicarbonate

d. Pyrethroid — lipid emulsion

a. Morphine — nalorphine

Following cyanoacrylate exposure to the eye, the most appropriate recommendation is

a. Force eyelid separation immediately

b. Apply activated charcoal

c. Flush with warm water and protect the eye

d. Use acetone directly in the eye