Poison information basics MCQs With Answer

Introduction

This collection of Poison Information Basics MCQs is tailored for M.Pharm students specializing in Clinical Pharmacy Practice. It focuses on core concepts essential for poison information centers, clinical assessment, toxicokinetics and toxicodynamics, common toxidromes, laboratory evaluation, antidotes, decontamination methods, and emergency management strategies. Each question emphasizes practical decision-making, interpretation of clinical signs and investigations, and appropriate therapeutic responses used in real-world clinical toxicology. Use these MCQs to test knowledge depth, reinforce clinical reasoning, and prepare for examinations and professional roles in poison control, hospital pharmacy, and acute care settings.

Q1. Which of the following best defines a poison in clinical toxicology?

• A substance that causes irreversible damage at any dose
• A chemical that is always lethal when ingested
• A substance that can cause harm in sufficient quantity by chemical action
• A drug that has both therapeutic and toxic effects at standard doses

Correct Answer: A substance that can cause harm in sufficient quantity by chemical action

Q2. Which parameter most directly influences the onset of systemic toxicity after oral ingestion?

• Volume of distribution
• Rate and extent of gastrointestinal absorption
• Hepatic clearance
• Renal tubular secretion

Correct Answer: Rate and extent of gastrointestinal absorption

Q3. Which decontamination method is considered first-line for most recently ingested toxicants within 1 hour of ingestion?

• Whole bowel irrigation
• Activated charcoal
• Gastric lavage in all cases
• Induced emesis with syrup of ipecac

Correct Answer: Activated charcoal

Q4. For which poisoning is administration of naloxone most appropriate as an immediate antidote?

• Organophosphate insecticide poisoning
• Opioid overdose
• Acetaminophen (paracetamol) poisoning
• Carbon monoxide poisoning

Correct Answer: Opioid overdose

Q5. Which laboratory parameter is most useful in diagnosing organophosphate poisoning?

• Serum creatinine
• Blood cholinesterase (butyrylcholinesterase) activity
• Serum transaminases (AST/ALT)
• Plasma osmolarity

Correct Answer: Blood cholinesterase (butyrylcholinesterase) activity

Q6. The primary mechanism of action of pralidoxime (2-PAM) in organophosphate poisoning is:

• Competitive antagonism at muscarinic receptors
• Reactivation of acetylcholinesterase by cleaving the phosphoryl-enzyme bond
• Enhancement of acetylcholine release
• Inhibition of acetylcholine synthesis

Correct Answer: Reactivation of acetylcholinesterase by cleaving the phosphoryl-enzyme bond

Q7. Which clinical feature is most characteristic of a cholinergic toxidrome?

• Hyperthermia, dry skin, mydriasis
• Miosis, bronchorrhea, bradycardia
• Tachycardia, agitation, diaphoresis
• Seizures, hyperreflexia, mydriasis

Correct Answer: Miosis, bronchorrhea, bradycardia

Q8. In suspected methanol poisoning, which measurement is most useful to detect a toxic metabolite effect requiring antidote and dialysis?

• Serum acetaminophen level
• Anion gap and osmolar gap
• Urine ketones

Correct Answer: Anion gap and osmolar gap

Q9. The preferred antidote for cyanide poisoning in many hospital settings is:

• Amyl nitrite inhalation alone
• Hydroxocobalamin
• Sodium bicarbonate infusion
• N-acetylcysteine

Correct Answer: Hydroxocobalamin

Q10. Which statement about activated charcoal (AC) is true?

• AC reliably binds strong acids and alkalis and prevents corrosion
• AC is effective for most recent ingestions unless the substance is a heavy metal or alcohol
• Single-dose AC is contraindicated within 1 hour of ingestion
• AC increases systemic absorption of all lipophilic drugs

Correct Answer: AC is effective for most recent ingestions unless the substance is a heavy metal or alcohol

Q11. Whole bowel irrigation (WBI) is most indicated for which situation?

• Ingestion of large amounts of sustained-release or enteric-coated tablets
• Single immediate-release tablet within 30 minutes
• Dermal exposure to pesticides
• Inhalational exposure to ammonia

Correct Answer: Ingestion of large amounts of sustained-release or enteric-coated tablets

Q12. In acetaminophen overdose, which laboratory test and time frame are essential to guide N-acetylcysteine therapy?

• Serum acetaminophen concentration plotted against hours since ingestion
• Serum AST levels only at 1 hour post-ingestion
• Urine acetaminophen qualitative test within 2 hours
• Serum albumin concentration

Correct Answer: Serum acetaminophen concentration plotted against hours since ingestion

Q13. Which antidote is indicated for severe methemoglobinemia (e.g., symptomatic or methemoglobin >30%) in a non-glucose-6-phosphate dehydrogenase (G6PD) deficient patient?

• Methylene blue
• Fomepizole
• Deferoxamine
• Atropine

Correct Answer: Methylene blue

Q14. The primary role of a Poison Information Center (PIC) includes all EXCEPT:

• Providing immediate telephone-based management advice
• Stockpiling all hospital antidotes centrally for national distribution
• Collecting surveillance data on poisoning trends
• Educating healthcare professionals and the public

Correct Answer: Stockpiling all hospital antidotes centrally for national distribution

Q15. Which clinical sign suggests opioid toxicity rather than benzodiazepine overdose?

• Slurred speech without respiratory depression
• Miosis with significant respiratory depression
• Ataxia with normal respiratory rate
• Hyperreflexia and agitation

Correct Answer: Miosis with significant respiratory depression

Q16. In ethylene glycol poisoning, which finding supports the need for urgent hemodialysis?

• Normal anion gap and no acidemia
• High anion gap metabolic acidosis and elevated osmolar gap with renal dysfunction
• Isolated elevated AST
• Low serum potassium only

Correct Answer: High anion gap metabolic acidosis and elevated osmolar gap with renal dysfunction

Q17. Which chelating agent is preferred for acute inorganic lead poisoning in children with high blood lead levels?

• Dimercaprol (British anti-Lewisite, BAL) alone
• Succimer (DMSA)
• Deferasirox
• Prussian blue

Correct Answer: Succimer (DMSA)

Q18. Which statement regarding fomepizole in toxic alcohol poisoning is correct?

• Fomepizole accelerates alcohol dehydrogenase to metabolize toxins faster
• Fomepizole inhibits alcohol dehydrogenase, preventing formation of toxic metabolites
• Fomepizole is contraindicated with ethanol co-ingestion
• Fomepizole is the antidote for organophosphate poisoning

Correct Answer: Fomepizole inhibits alcohol dehydrogenase, preventing formation of toxic metabolites

Q19. When collecting biological samples for toxicology analysis, which practice is most appropriate?

• Collect only urine; blood is not useful
• Label specimens with time of collection, patient identifiers, and suspected exposure details
• Delay sample collection until antidote administration is complete
• Only send samples if patient is asymptomatic

Correct Answer: Label specimens with time of collection, patient identifiers, and suspected exposure details

Q20. In pediatric accidental ingestion of a household cleaner, which immediate action is recommended by poison control centers?

• Induce vomiting at home with finger stimulation
• Call the local poison information center or emergency services for guidance before home interventions
• Give activated charcoal routinely without consulting professionals
• Wait for symptoms to develop before seeking help

Correct Answer: Call the local poison information center or emergency services for guidance before home interventions

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