Pharmaceutical Poisoning MCQ Quiz | Poisonings & Environmental

Welcome to this specialized quiz on Pharmaceutical Poisoning, a critical topic within the Poisonings & Environmental subject for MBBS students. This quiz is designed to challenge your understanding of the toxicology, clinical presentation, diagnosis, and management of common drug overdoses. You will encounter 25 multiple-choice questions covering a range of agents from over-the-counter analgesics to potent prescription medications. This assessment will help you solidify your knowledge for both examinations and clinical practice. After submitting your answers, you’ll receive your score and a detailed review of each question. For your convenience, an option to download all questions with their correct answers in PDF format is available at the end. Good luck!

1. A 22-year-old female is brought to the emergency department after ingesting an unknown quantity of paracetamol. Which of the following is the primary mechanism of hepatotoxicity in paracetamol overdose?

2. A patient with salicylate toxicity presents with tinnitus, hyperventilation, and fever. Which acid-base disturbance is typically seen in the early stages of adult salicylate poisoning?

3. A 30-year-old male is found unresponsive with pinpoint pupils and shallow breathing. His friend admits they were using “street heroin.” What is the most appropriate initial pharmacological intervention?

4. Which of the following ECG findings is most characteristic of severe tricyclic antidepressant (TCA) toxicity?

5. A patient who intentionally ingested a large amount of benzodiazepines is brought to the hospital. He is drowsy but has stable vital signs. The specific antidote for benzodiazepine overdose is Flumazenil. In which scenario is its use generally contraindicated?

6. A 70-year-old man on digoxin for heart failure presents with nausea, vomiting, confusion, and visual disturbances described as “yellow halos around lights.” Which electrolyte abnormality is most likely to potentiate digoxin toxicity?

7. A 3-year-old child ingests a handful of his mother’s iron supplement tablets. Which of the following is the specific chelating agent used for severe iron poisoning?

8. A patient on long-term lithium therapy for bipolar disorder presents with tremor, ataxia, confusion, and polyuria. Which of the following interventions is most effective for rapidly lowering serum lithium levels in severe toxicity?

9. A farmer is brought to the emergency room with salivation, lacrimation, urination, defecation, GI distress, and emesis (SLUDGE syndrome), along with miosis and muscle fasciculations. This clinical picture is most consistent with exposure to which class of compounds?

10. In the management of organophosphate poisoning, atropine is administered to counter the muscarinic effects. Which agent is given to reactivate the acetylcholinesterase enzyme?

11. A patient presents with severe hypotension and bradycardia after an overdose of a beta-blocker. In addition to atropine and fluids, which of the following is considered a first-line antidote for this condition?

12. An individual who consumed homemade liquor presents with blurred vision, central scotoma, and a severe anion gap metabolic acidosis. This presentation is highly suggestive of poisoning with:

13. The antidote Fomepizole is used in methanol and ethylene glycol poisoning. What is its mechanism of action?

14. A patient presents with dry mouth, blurred vision, tachycardia, flushed skin, and urinary retention after taking an over-the-counter sleep aid. This toxidrome is best described as:

15. What is the role of sodium bicarbonate in the management of tricyclic antidepressant (TCA) overdose?

16. The Rumack-Matthew nomogram is used to assess the need for N-acetylcysteine therapy following an acute overdose of which substance?

17. A patient with a history of hypertension accidentally takes a double dose of their calcium channel blocker. They present with hypotension and bradycardia. The primary antidote for this condition is:

18. High-dose insulin euglycemic therapy (HIET) is an increasingly used treatment for severe toxicity from which two classes of drugs?

19. A patient is brought in after an overdose of phenobarbital, a long-acting barbiturate. They are comatose with respiratory depression. Besides supportive care, which method can enhance the elimination of phenobarbital?

20. Serotonin syndrome is a potentially life-threatening condition. Which of the following drug combinations poses the highest risk for developing this syndrome?

21. A patient with ethylene glycol poisoning is found to have calcium oxalate crystals in their urine. This finding is associated with which major complication?

22. What is the primary life-threatening toxicity associated with acute theophylline overdose?

23. For which of the following ingested poisons is activated charcoal generally considered ineffective?

24. The specific antidote for heparin overdose is:

25. A patient who overdosed on an unknown substance presents with agitation, tachycardia, hypertension, mydriasis, and diaphoresis. Which toxidrome do these findings suggest?