General principles of treatment of poisoning MCQs With Answer

General principles of treatment of poisoning MCQs With Answer are vital for B.Pharm students learning emergency toxicology, antidote selection, and evidence-based management. This introduction emphasizes stabilization (airway, breathing, circulation), decontamination methods, enhanced elimination, pharmacologic antidotes, and monitoring of organ systems. Key topics include activated charcoal use, gastric lavage indications, whole bowel irrigation, hemodialysis, urine alkalinization, and chelation therapy, plus specific management for acetaminophen, organophosphates, methanol/ethylene glycol, cyanide, and heavy metals. These MCQs focus on mechanism-based reasoning, toxicokinetics, contraindications, and clinical decision points to strengthen practical prescribing and emergency response skills. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the first priority in initial management of a poisoned patient?

• Gastric decontamination with activated charcoal
• Establishing airway, breathing, and circulation
• Administering antidote empirically
• Obtaining serum drug levels

Correct Answer: Establishing airway, breathing, and circulation

Q2. Single-dose activated charcoal is most effective when administered within which timeframe after oral ingestion?

• Within 1 hour of ingestion
• After 24 hours for sustained-release drugs
• Only if the patient is symptomatic
• Only for liquid poisons

Correct Answer: Within 1 hour of ingestion

Q3. Which of the following is a contraindication to giving activated charcoal?

• Ingestion of a sustained-release tablet
• Caustic (acid or alkali) ingestion
• Recent co-ingestion of an opioid
• Asymptomatic ingestion of a large tablet

Correct Answer: Caustic (acid or alkali) ingestion

Q4. Whole bowel irrigation is preferred for which scenario?

• Recent ingestion of a small immediate-release tablet
• Body packers (drug packets) or ingestion of sustained-release/iron tablets
• Simple ethanol intoxication
• Topical exposures to chemicals

Correct Answer: Body packers (drug packets) or ingestion of sustained-release/iron tablets

Q5. Gastric lavage may be considered under which condition?

• All asymptomatic overdoses regardless of time
• Within 1 hour of a potentially life-threatening ingestion with secure airway
• For hydrocarbon ingestion in children
• As routine decontamination for pill-induced nausea

Correct Answer: Within 1 hour of a potentially life-threatening ingestion with secure airway

Q6. Which toxins are well removed by hemodialysis?

• Large protein-bound molecules only
• Ethylene glycol, methanol, and lithium
• All lipophilic agents
• Most benzodiazepines

Correct Answer: Ethylene glycol, methanol, and lithium

Q7. Urine alkalinization (with sodium bicarbonate) is an effective enhanced elimination strategy for which poisoning?

• Organophosphate insecticides
• Salicylate (aspirin) poisoning
• Immediate-release acetaminophen overdose
• Digoxin toxicity

Correct Answer: Salicylate (aspirin) poisoning

Q8. What is the specific antidote for acetaminophen toxicity?

• Flumazenil
• N-acetylcysteine (NAC)
• Pralidoxime
• Fomepizole

Correct Answer: N-acetylcysteine (NAC)

Q9. The recommended antidotal therapy for organophosphate poisoning includes:

• Atropine and pralidoxime (2-PAM)
• Naloxone alone
• Activated charcoal only
• Hydroxocobalamin

Correct Answer: Atropine and pralidoxime (2-PAM)

Q10. Which antidote is first-line for acute cyanide poisoning?

• Sodium nitrite and sodium thiosulfate only
• Hydroxocobalamin
• Deferoxamine
• Dimercaprol

Correct Answer: Hydroxocobalamin

Q11. The preferred pharmacologic inhibitor of alcohol dehydrogenase for methanol or ethylene glycol poisoning is:

• Ethanol only
• Fomepizole
• N-acetylcysteine
• Naloxone

Correct Answer: Fomepizole

Q12. Which agent is a benzodiazepine receptor antagonist used to reverse benzodiazepine effects in selected patients?

• Flumazenil
• Flumethasone
• Pralidoxime
• Naloxone

Correct Answer: Flumazenil

Q13. The immediate antidote for opioid-induced respiratory depression is:

• Flumazenil
• Naloxone
• Atropine
• Pralidoxime

Correct Answer: Naloxone

Q14. Intravenous lipid emulsion therapy is indicated primarily for toxicity from which class of drugs?

• Hydrophilic antibiotics
• Lipid-soluble local anesthetics (e.g., bupivacaine) and other lipophilic drug overdoses
• All beta-lactam antibiotics
• Heavy metals like lead

Correct Answer: Lipid-soluble local anesthetics (e.g., bupivacaine) and other lipophilic drug overdoses

Q15. Acute carbon monoxide poisoning is initially treated with:

• 100% normobaric oxygen; consider hyperbaric oxygen for severe cases
• Nitrites to induce methemoglobinemia
• Immediate chelation therapy
• Activated charcoal

Correct Answer: 100% normobaric oxygen; consider hyperbaric oxygen for severe cases

Q16. Which chelating agent is commonly used orally for lead poisoning in outpatient children?

• Calcium disodium EDTA intravenously
• Dimercaprol (British anti-Lewisite)
• Succimer (DMSA)
• Deferoxamine

Correct Answer: Succimer (DMSA)

Q17. The antidote recommended for acute severe arsenic poisoning is:

• Deferoxamine
• Dimercaprol (British anti-Lewisite)
• Digoxin-specific Fab
• N-acetylcysteine

Correct Answer: Dimercaprol (British anti-Lewisite)

Q18. An early useful laboratory clue suggesting methanol or ethylene glycol ingestion is:

• Low anion gap with normal osmolar gap
• Elevated osmolar gap with high anion gap metabolic acidosis
• Isolated hyperkalemia
• Marked leukocytosis only

Correct Answer: Elevated osmolar gap with high anion gap metabolic acidosis

Q19. Indications for hemodialysis in severe salicylate poisoning include:

• Mild tinnitus without metabolic disturbance
• High serum salicylate concentration with metabolic acidosis, altered mental status, or renal failure
• Asymptomatic ingestion regardless of level
• Only if activated charcoal fails

Correct Answer: High serum salicylate concentration with metabolic acidosis, altered mental status, or renal failure

Q20. Which decontamination method is contraindicated after hydrocarbon ingestion with high aspiration risk?

• Observation and supportive care
• Gastric lavage
• Supplemental oxygen
• Chest radiography

Correct Answer: Gastric lavage

Q21. Activated charcoal poorly adsorbs which of the following substances?

• Large nonpolar drugs like digoxin
• Small polar molecules such as ethanol
• Many antibiotics
• Tricyclic antidepressants

Correct Answer: Small polar molecules such as ethanol

Q22. Pralidoxime (2-PAM) reverses organophosphate toxicity by which mechanism?

• Competitive antagonism at muscarinic receptors
• Reactivation of acetylcholinesterase by dephosphorylation
• Binding free organophosphate molecules in plasma
• Inducing hepatic metabolism of the toxin

Correct Answer: Reactivation of acetylcholinesterase by dephosphorylation

Q23. The optimal therapeutic window for maximum efficacy of N-acetylcysteine after acetaminophen overdose is:

• Within 8 hours of ingestion
• Only after 48 hours
• Between 24 and 72 hours exclusively
• There is no time dependency

Correct Answer: Within 8 hours of ingestion

Q24. An increased osmolar gap is most suggestive of ingestion of which substances?

• Acetaminophen and aspirin
• Methanol and ethylene glycol
• Organophosphates
• Lead and arsenic

Correct Answer: Methanol and ethylene glycol

Q25. Carbon monoxide causes tissue hypoxia primarily by:

• Inducing methemoglobinemia
• Competing with oxygen at cytochrome oxidase
• Binding hemoglobin with high affinity to form carboxyhemoglobin, reducing oxygen delivery
• Causing pulmonary edema directly

Correct Answer: Binding hemoglobin with high affinity to form carboxyhemoglobin, reducing oxygen delivery

Q26. After corrosive (acid/alkali) ingestion, the most appropriate immediate action is:

• Induce vomiting to remove the agent
• Do not induce emesis; secure airway and arrange early endoscopy if indicated
• Administer activated charcoal routinely
• Perform whole bowel irrigation

Correct Answer: Do not induce emesis; secure airway and arrange early endoscopy if indicated

Q27. The specific antidote for severe digoxin toxicity is:

• Digoxin-specific antibody fragments (Digibind)
• Calcium gluconate infusion
• Atropine only
• Pralidoxime

Correct Answer: Digoxin-specific antibody fragments (Digibind)

Q28. The recommended first-line therapy for severe beta-blocker overdose causing bradycardia and hypotension is:

• High-dose insulin with glucose and supportive care; consider glucagon
• Immediate dialysis
• Activated charcoal only
• N-acetylcysteine infusion

Correct Answer: High-dose insulin with glucose and supportive care; consider glucagon

Q29. Which clinical sign is most characteristic of opioid overdose?

• Hyperreflexia without respiratory depression
• Pinpoint pupils (miosis) and respiratory depression
• Fever and severe hypertension
• Profuse sweating and dilated pupils

Correct Answer: Pinpoint pupils (miosis) and respiratory depression

Q30. For pediatric oral poisoning, the commonly recommended single-dose activated charcoal regimen is:

• 0.1 g/kg body weight
• 1 g/kg body weight (commonly up to a maximum of ~50 g)
• 10 g fixed dose for all children
• 3 g/kg body weight with no maximum

Correct Answer: 1 g/kg body weight (commonly up to a maximum of ~50 g)

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

Mail- Sachin@pharmacyfreak.com