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Drugs of Abuse

100

A person was brought by police from the railway platform. He is talking irrelevant. He is having dry mouth with hot skin, dilated pupils, staggering gait and slurred speech. The most probable diagnosis is a. Alcohol intoxication b. Carbamates poisoning c. Organophosphorous poisoning d. Dhatura poisoning

d. Dhatura poisoning

200

Regarding methanol poisoning Assertion: Administration of ethanol is one of the treatment modalities Reason: Ethanol inhibits alcohol dehydrogenase Please select the most correct option from the following: a. Both assertion and reason are true, and the reason is the correct explanation for the assertion b. Both assertion and reason are true, and the reason is not the correct explanation for the assertion c. Assertion is true, but the reason is false d. Assertion is false, but the reason is true

a. Both assertion and reason are true, and the reason is the correct explanation for the assertion

300

All of the following are treatment options for toxic alcohol poisoning except a. Fomepizole b. Hydroxycobalamin c. Thiamine d. Folic acid e. Pyridoxine

b. Hydroxycobalamin

400

Ecstasy toxicity causes a. Hypereflexia b. Trismus c. Dilated pupils d. Visual hallucinations e. All of the above

e. All of the above

500

Hyperthermia in a patient of poisoning is a pointer to all except a. Ecstasy b. Selective serotonin reuptake inhibitor c. Salicylates d. Chlorpromazine

d. Chlorpromazine

Pesticide Poisoning

100

Phosphine liberated in the stomach in aluminum phosphide poisoning is toxic to all except a. Lungs b. Kidneys c. Liver d. Heart

b. Kidneys

200

A housewife ingests a rodenticide white powder accidentally. She is brought to hospital where the examination shows generalized, flaccid paralysis and an irregular pulse. electrocardiogram shows multiple ventricular ectopics, generalized changes with ST-T. Serum potassium is 2.5 mEq/L. The most likely ingested poison is: a. Barium carbonate b. Super warfarins c. Zinc phosphide d. Aluminum phosphide

a. Barium carbonate

300

Paraquat poisoning causes a. Renal failure b. Cardiac failure c. Respiratory failure d. Multiple organ failure

d. Multiple organ failure

500

10.With regards to organophosphates and carbamates which is false a) both inactivate acetyl cholinesterase b) both cause an acute cholinergic syndrome c) both respond to treatment with atropine d) both respond to treatment with pralidoxime e) if there is associated CNS signs and muscle weakness the cause is likely to be organophosphates.

d) both respond to treatment with pralidoxime

General

100

Which of the following is the best Indicator for the degree of poisoning? a. Age of Person b. Route of Exposure c. Dose of the substance d. Form of the substance e. C and D

e. Dose of the substance

200

Which of the following Corrosives can produce both Local and systemic effects?

a. HCL b. H2SO4 c. Oxalic acid d. All of the above

400

18.In a child who definately ingested some household dishwashing powder your treatment would consist of? a) inserting a NGT and aspirating stomach contents b) giving ipecac c) giving the child 150 ml of water to drink d) admitting for observation e) urgent gastroscopy regardless of the time of day or night

c) giving the child 150ml of water to drink

500

68. All of the following substances bind well to activated charcoal EXCEPT: a. thioridazine b. atenolol c. cyanide d. benztropine e. tetrahydrocannabinol (THC)

c. cyanide

Miscellaneous

100

69. In paracetamol poisoning: a) There are theoretical advantages to giving the antidote at 2 hours post ingestion b) Toxicity is less likely in children than adults c) The initial dose of N‑acetylcysteine is given over 5 minutes d) N‑acetylcysteine is not indicated more than 20 hours post ingestion e) Activated charcoal is not used more than 1 hour after ingestion

b) Toxicity is less likely in children than adults

200

85. The patient with these electrolytes: Na+ 144 mmol/L K+ 4 mmol/L HCO3 26mmol/L Cl- 100 mmol/L could be suffering from all of the following EXCEPT: a. Acute renal failure b. Methanol poisoning c. Lower limb crush injury d. Salicylate poisoning e. Severe diarrhoea

e. Severe diarrhoea

300

4.Which is false regarding salicylate poisoning? a) At pH 7.4 salicylic acid is in the unionized form b) Patients are often hyperthermic c) When alkalinizing the urine, serum K+ replacement may be required d) Haemodialysis is of benefit e) A serum salicilate level of 2.0 at 6 hours is sufficient for medical discharge

e) A serum salicilate level of 2.0 at 6 hours is sufficient for medical discharge

400

With regard to the alcohols which is false? a) Methanol causes snow storm vision in severe intoxication b) Ingestion of both methanol and ethylene glycol causes a metabolic acidosis with an increased anion gap and an increased osmolar gap c) Neither methanol or ethylene glycol are absorbed through the skin d) You might expect to find oxalate crystals in the urine of a pt who had an ethylene glycol OD e) Methanol is not found in Australian methylated spirits

c) Neither methanol or ethylene glycol are absorbed through the skin

Miscellaneous

100

1. All of the following statements concerning decontamination of the poisoned patient are TRUE, EXCEPT A. Ipecac syrup continues to be a front-line tool in home management of poisoning. B. Gastric lavage is of limited utility except in very rare overdoses when the airway has been adequately protected. C. Current superactivated charcoal has 3 times the absorptive area of older preparations. D. Cathartics may cause electrolyte derangements and dehydration. E. Whole bowel irrigation is a highly effective method for dealing with body “packers” or “stuffers” and overdoses with enteric-coated or sustained release medications.

A. ipecac syrup continues to be a front-line tool in home management of poisoning.

200

The best predictor of serious toxicity in TCA poisoning is: a) Drug plasma levels b) GCS less than 8 c) Estimates of ingested drug dose d) Rightward deviation of the QRS vector e) QRS duration of >100msec

e ) QRS duration of >100msec

500

12. The following blood gases pH 7.17, PC02 59, Bic 21, P02 130 are most likely to be consistent with: a) diabetic ketoacidosis b) diuretic overdose c) premature twin baby d) camphor ingestion with seizures e) oliguria and renal failure

d) camphor ingestion with seizures