3 - Specific Poisons

a. "Silent gas"

[Environmental agents]

Carbon monoxide (CO) is referred to as this because it is odorless and colorless

a. "Silent gas"
b. "Invisible killer"
c. "Silent killer"
d. "Colorless threat"

d. Odorless, colorless gas

[Environmental agents]

Physical characteristics of Carbon monoxide (CO)

a. Colored, odorous gas
b. Colorless, odorous gas
c. Colored, odorless gas
d. Odorless, colorless gas

b. Incomplete combustion of carbon containing fuels (gasoline, wood, etc.)

[Environmental agents]

Source of Carbon monoxide (CO)

a. Burning of fossil fuels and volcanoes
b. Incomplete combustion of carbon containing fuels (gasoline, wood, etc.)
c. Burning of fossil fuels only
d. Volcanoes and industrial waste

c. 200x

[Environmental agents]

Carbon monoxide has how many times greater affinity for hemoglobin (Hb)?

a. 50x
b. 100x
c. 200x
d. 300x

d. Complex IV (Cytochrome oxidase) , resulting in less ATP production

[Environmental agents]

Carbon monoxide inhibits which complex in the electron transport chain (ETC), resulting in less ATP production?

a. Complex I
b. Complex II
c. Complex III
d. Complex IV (Cytochrome oxidase)

• Hypoxia, headache, confusion, dizziness,

• Rosy/cherry-red complexion

[Environmental agents]

Presentation of carbon monoxide toxicity includes _______ [2]

b. Hyperbaric oxygen (100% – high pressure oxygen)

[Environmental agents]

Treatment for carbon monoxide toxicity is:

a. Oxygen mask only
b. Hyperbaric oxygen
c. Antibiotics
d. Antidote

• Burning of fossil fuels

• Volcanoes

[Environmental agents]

Sulfur dioxide (SO₂) sources include:

a. Burning of fossil fuels and volcanoes
b. Forest fires and smoking
c. Industrial waste and mining
d. Agriculture and livestock

b. Sulfurous acid (H₂SO₃)

[Environmental agents]

Sulfur dioxide (SO₂) + Water (H₂O) forms:

a. Sulfuric acid
b. Sulfurous acid (H₂SO₃)
c. Sulfonic acid
d. Hydrogen sulfide

b. Bronchoconstriction → COPD

[Environmental agents]

Presentation of sulfur dioxide toxicity includes:

a. Bronchodilation
b. Bronchoconstriction → COPD
c. Pulmonary fibrosis
d. Asthma

b. Smoking

[Environmental agents]

The most common cause of COPD is:

a. Pollution
b. Smoking
c. Sulfur dioxide exposure
d. Carbon monoxide exposure

a. True

[Environmental agents]

Smoking and pollution can cause COPD.

a. True
b. False

• Cassava

• Seeds of Prunus spp. (almonds, cherries, apricot, peaches, etc.)

• Apples

[Environmental agents]

Sources of cyanide include _______ [3]

d. Complex IV (Cytochrome oxidase) , resulting in less ATP production?

[Environmental agents]

Cyanide inhibits which complex in the electron transport chain (ETC), resulting in less ATP production?

a. Complex I
b. Complex II
c. Complex III
d. Complex IV (Cytochrome oxidase)

• Bitter almond breath

• Respiratory depression

[Environmental agents]

Presentation of cyanide toxicity include ______ [2]

• IV Hydroxocobalamin

• Cyanide kit

[Environmental agents]

Treatment for cyanide toxicity includes:

a. IV Hydroxocobalamin and Cyanide kit
b. Hyperbaric oxygen and activated charcoal
c. Naloxone and flumazenil

a. Cyanocobalamin

[Environmental agents]

Hydroxocobalamin + Cyanide (CN) forms:

a. Cyanocobalamin
b. Cyanide complex
c. Vitamin B12
d. Hydroxycobalamin

• Amyl nitrite (inhalational)

• Sodium nitrite (IV)

• Sodium thiosulfate (IV)

📌Cyanide Kit

[Environmental agents]

Less preferred treatments for cyanide toxicity than IV hydroxocobalamin include:

a. Amyl nitrite (inhalational), Sodium nitrite (IV), Sodium thiosulfate (IV)
b. Hyperbaric oxygen
c. Activated charcoal
d. Naloxone

d. Hydroxocobalamin (IV)

[Environmental agents]

Which of the following is the preferred treatment for cyanide toxicity?

a. Amyl nitrite (inhalational)
b. Sodium nitrite (IV)
c. Sodium thiosulfate (IV)
d. Hydroxocobalamin (IV)

a. Colorless with a rotten egg odor

[Environmental agents]

Hydrogen sulfide (H₂S) is:

a. Colorless with a rotten egg odor
b. Colorless with a sweet odor
c. Yellow with a pungent odor
d. Colorless with no odor

• Sewage

• Liquefied Petroleum Gas (LPG)

[Environmental agents]

Sources of hydrogen sulfide include:

a. Sewage and Liquefied Petroleum Gas (LPG)
b. Cassava and apple seeds
c. Incomplete combustion of fuels
d. Burning of fossil fuels and volcanoes

b. Detect leakage immediately

[Environmental agents]

Liquefied Petroleum Gas (LPG) is intentionally spiked with hydrogen sulfide to:

a. Increase its flammability
b. Detect leakage immediately
c. Improve its odor
d. Enhance combustion

d. Complex IV (Cytochrome oxidase) , leading to decreased ATP production

[Environmental agents]

Hydrogen sulfide inhibits which complex in the electron transport chain (ETC), leading to decreased ATP production?

a. Complex I
b. Complex II
c. Complex III
d. Complex IV (Cytochrome oxidase)

• Mucosal irritation

• Green line on gums

• Photophobia

• Darkening of silverware

[Environmental agents]

Presentation of hydrogen sulfide toxicity includes [4]

b. Corrosives (only if very strong)

[Environmental agents]

Acids are also known as:

a. Caustics
b. Corrosives
c. Oxidizers
d. Reducers

b. Protein denaturation (destroy secondary to quaternary structure)

[Environmental agents]

The mechanism of toxicity (MOT) of acids is:

a. Saponification of lipids
b. Protein denaturation
c. Inhibition of cytochrome oxidase
d. Alkylation of DNA

b. Coagulative necrosis

[Environmental agents]

Acids have no effect on lipids, so only the inside of the cell is damaged, not the phospholipid cell membrane, resulting in:

a. Liquefactive necrosis
b. Coagulative necrosis
c. Caseous necrosis
d. Fat necrosis

b. Caustics

[Environmental agents]

Bases are also known as:

a. Corrosives
b. Caustics
c. Oxidizers
d. Reducers

c. Protein denaturation + saponification of lipids

[Environmental agents]

The mechanism of toxicity (MOT) of bases is:

a. Protein denaturation only
b. Saponification of lipids only
c. Protein denaturation + saponification of lipids
d. Inhibition of cytochrome oxidase

b. Liquefactive necrosis

[Environmental agents]

Bases damage both the inside and outside of the cell, resulting in:

a. Coagulative necrosis
b. Liquefactive necrosis
c. Caseous necrosis
d. Fat necrosis

a. True

[Environmental agents]

Acids denature proteins and damage only the inside of the cell, while bases denature proteins and saponify lipids, damaging both the inside and outside of the cell.

a. True
b. False

b. Rotten egg odor

[Environmental agents]

Hydrogen sulfide has a:

a. Bitter almond odor
b. Rotten egg odor
c. Sweet odor
d. Pungent odor

c. Hydrogen sulfide

[Environmental agents]

A green line on the gums is a presentation of toxicity from:

a. Carbon monoxide
b. Cyanide
c. Hydrogen sulfide
d. Sulfur dioxide

c. Hydrogen sulfide

[Environmental agents]

Darkening of silverware is a presentation of toxicity from:

a. Carbon monoxide
b. Cyanide
c. Hydrogen sulfide
d. Sulfur dioxide

a. FD & C Yellow 5

[Environmental agents]

Tartrazine is also known as:

a. FD & C Yellow 5
b. FD & C Red 3
c. FD & C Blue 1
d. FD & C Green 3

b. Lemon yellow

[Environmental agents]

Tartrazine is described as:

a. Cherry red
b. Lemon yellow
c. Brilliant blue
d. Forest green

b. Thyroid cancer

[Environmental agents]

Tartrazine can cause:

a. Colorectal cancer
b. Thyroid cancer
c. Liver cancer
d. Lung cancer

b. FD & C Red 3

[Environmental agents]

Erythrosine is also known as:

a. FD & C Yellow 5
b. FD & C Red 3
c. FD & C Blue 1
d. FD & C Green 3

b. Cherry red

[Environmental agents]

Erythrosine is described as:

a. Lemon yellow
b. Cherry red
c. Brilliant blue
d. Forest green

b. Colorectal cancer (declared carcinogenic since January 25, 2025)

[Environmental agents]

Erythrosine causes:

a. Thyroid cancer
b. Colorectal cancer
c. Liver cancer
d. Lung cancer

c. 2027

[Environmental agents]

Erythrosine must be totally banned by:

a. 2025
b. 2026
c. 2027
d. 2028

b. Carcinogen

[Environmental agents]

The mechanism of toxicity for both Tartrazine and Erythrosine is:

a. Neurotoxin
b. Carcinogen
c. Hepatotoxin
d. Nephrotoxin

a. Vetsin

[Environmental agents]

Monosodium glutamate (MSG) is also known as:

a. Vetsin
b. Ajinomoto
c. Salt
d. Sugar

b. Flavorant

[Environmental agents]

Monosodium glutamate (MSG) is used as a:

a. Preservative
b. Flavorant
c. Colorant
d. Sweetener

b. Anaphylactoid reaction (non-IgE mediated)

• force release of histamine without the need for receptor)

[Environmental agents]

Mechanism of toxicity of MSG is:

a. IgE-mediated anaphylaxis
b. Anaphylactoid reaction (non-IgE mediated)
c. Cytotoxic reaction
d. Immune complex reaction

b. Anaphylactic

[Environmental agents]

IgE mediated

a. Anaphylactoid

b. Anaphylactic

a. Anaphylactoid

[Environmental agents]

Non IgE mediated

a. Anaphylactoid

b. Anaphylactic

• Wheals (hives)

• Shortness of Breath (dyspnea)

• Chinese restaurant syndrome

[Environmental agents]

Clinical presentation of MSG toxicity includes _____ [3]

• Migraines

• Allergies

• Low IQ

• Haux (not medically recognized)

[Environmental agents]

Chinese restaurant syndrome is associated with:

a. Wheals and hives
b. SOB and dyspnea
c. Migraines, allergies, and low IQ
d. All of the above

c. Chinese restaurant syndrome

[Environmental agents]

Clinical syndrome associated with MSG toxicity presentation

a. Woolsorter's disease
b. Chinese fried rice syndrome
c. Chinese restaurant syndrome
d. Malignant pustule syndrome