POISONING of the year . must know — UPSC CMS MCQs (Medicine)

Question 1

In a child with acute organophosphorus poisoning, which one of the following drugs will act as anti-sialagogue and peripheral parasympatholytic agent?

Accepted Answer

B. Atropine

Answer

Carbamates

Answer

Benzodiazepine

Answer

Pralidoxime

Question 2

A 21-year-old female was brought to the Emergency Department with a history of unknown substance ingestion. She was having vomiting, profuse diarrhea, bronchorrhea, and excessive sweating. On examination, miosis and muscular fasciculations were present. What is the most likely diagnosis?

Accepted Answer

D. Organophosphorus poisoning

Answer

Corrosive substance poisoning

Answer

Aluminum phosphide poisoning

Answer

Zinc phosphide poisoning

Question 3

A young female of 22 years old presented to the medical emergency with complaints of nausea, vomiting, abdominal pain, diarrhea, and convulsions along with methemoglobinemia. What is the likely diagnosis?

Accepted Answer

C. Copper sulphate poisoning

Answer

Aluminium phosphide poisoning

Answer

Zinc phosphide poisoning

Answer

Lead poisoning

Question 4

According to King’s College criteria, which of the following are the indicators for referring to liver transplantation following acetaminophen toxicity?
Transaminase levels > 4000 IU/L
Acidemia (Serum pH < 7.3) after adequate fluid resuscitation
Coagulopathy (INR > 6)
Renal dysfunction (creatinine > 3-4 mg/dL)
Select the correct answer using the code below:

Accepted Answer

D. 2, 3, and 4

Answer

1, 2, and 3

Answer

1, 2, and 4

Answer

1, 3, and 4

Question 5

Urinary alkalinization is used for enhancing excretion of which of the following poisoning?

Accepted Answer

A. Phenobarbitone

Answer

Alprazolam

Answer

Phenytoin

Answer

Lithium

Question 6

Urinary alkalinization as a method for enhancing excretion for poisoning is aimed at achieving

Accepted Answer

B. urine pH 7.5–8

Answer

serum pH 7.5–8

Answer

serum pH > 8

Answer

urine pH > 8

Question 7

Exchange transfusion as a method to enhance excretion of poison is indicated in

Accepted Answer

A. methemoglobinemia

Answer

carbamazepine poisoning

Answer

theophylline poisoning

Answer

barbiturate poisoning

Question 8

In case of a child with acute poisoning by ingestion, activated charcoal may be used in which one of the following situations?

Accepted Answer

B. Antiepileptic ingestion

Answer

Iron ingestion

Answer

Corrosive ingestion

Answer

Lithium ingestion

Question 9

Consider the following statements regarding paracetamol toxicity:
1. Toxicity is caused by an intermediate reactive metabolite that binds covalently to cellular proteins causing cell death.
2. Antidotes for paracetamol act by replenishing hepatic glutathione and should be administered to all patients with acute poisoning.
3. Intravenous acetyl cysteine is a highly efficacious antidote if administered within 8 hours of the overdose.
4. Methionine may be used as an alternative antidote but it is less effective than acetyl cysteine.
Which of the statements given above are correct?

Accepted Answer

D. 1, 2, 3 and 4

Answer

1 and 4 only

Answer

1, 2 and 3 only

Answer

2, 3 and 4 only

Question 10

Whole Bowel Irrigation (WBI) as a method of gastrointestinal decontamination is useful for poisoning with:

Accepted Answer

B. Iron

Answer

Alcohol

Answer

Kerosene

Answer

Organophosphorus

Question 11

Poisoning with which of the following drugs causes hypothermia?

Accepted Answer

B. Chlorpromazine

Answer

Digoxin

Answer

Iron

Answer

Alcohol

Question 12

Consider the following pairs:
| Urine colour | Possible causative agent (suspected poisoning) |
| --- | --- |
| 1. Pink | Cephalosporin |
| 2. Brown | Chloroquine |
| 3. Greenish blue | Phenazopyridine |
| 4. Red-orange | Amitriptyline |
How many of the pairs given above are correctly matched?

Accepted Answer

A. Only one pair

Answer

Only two pairs

Answer

Only three pairs

Answer

All four pairs

Question 13

Consider the following agents and the cardiac effects in case of overdose or poisoning:
| Cardiac Effect | Agent |
| --- | --- |
| 1. Prolonged PR interval | Lithium |
| 2. Prolonged QTc interval | Amiodarone |
| 3. Wide QRS complex | Kerosene ingestion |
| 4. Tachycardia | Organophosphates |
How many of the pairs given above are correctly matched?

Accepted Answer

B. Only two pairs

Answer

Only one pair

Answer

Only three pairs

Answer

All four pairs

Question 14

Which one of the following is the correct description of Mee’s lines, seen in chronic arsenic poisoning ?

Accepted Answer

A. Transverse white lines on nails of fingers and toes

Answer

Transverse red lines on the skin of palms and soles

Answer

Transverse white lines on the skin of palms and soles

Answer

Transverse red lines on the nails of fingers and toes

Question 15

A 45 year old farmer came with accidental consumption of a pesticide. He complained of frequent urination and excessive salivation. Which one of the following toxidromes is most likely to be associated with this poisoning ?

Accepted Answer

B. Cholinergic

Answer

Serotonergic

Answer

Adrenergic

Answer

Hypnotic

Question 16

A radiopaque density may be noticed in poisoning by which of the following agents ?

Accepted Answer

D. Chloral hydrate

Answer

Phenazopyridine

Answer

Ethylene glycol

Answer

Chloroquine

Question 17

An 8 year old child has consumed a few tablets of a drug that were being taken by his mother on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and hepatic necrosis. Which is the most likely drug?

Accepted Answer

D. Iron

Answer

Multivitamins

Answer

Calcium carbonate

Answer

Folic acid

Question 18

Gastric aspiration and lavage is contraindicated in which of the following poisonings?
1. Strong acids
2. Alkalis
3. Petroleum distillates
4. Ethanol
Select the correct answer using the code below:

Accepted Answer

A. 1, 2 and 3

Answer

1, 2 and 4

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 19

Which of the following statements are correct regarding scorpion stings?
Scorpion injects venom from a stinger on their tail.
Most stings are painful, but relatively harmless.
Anticholinergics can be used if antivenom is unavailable.
Select the correct answer using the code below.

Accepted Answer

A. 1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Answer

1, 2 and 3

Question 20

Consider the following statements about elapid snakebite:
Regardless of the anatomic site of the bite, walking of the victim should be discouraged.
Pressure immobilization should be used, wherever possible.
Ptosis can be present after the elapid bite.
Which of the statements given above are correct?

Accepted Answer

D. 1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Question 21

Consider the following statements regarding organophosphate-induced delayed polyneuropathy (OPIDN):
1. It is a rare complication and occurs 2–3 weeks after acute exposure.
2. It is a feature of poisoning with certain organophosphorus compounds such as triorthocresyl phosphate.
3. Inhibition of acetylcholinesterase causes motor polyneuropathy with no evidence of sensory loss.
4. There is no specific therapy although regular physiotherapy may limit deformity caused by muscle wasting.
Which of the statements given above are correct?

Accepted Answer

C. 1, 2 and 4

Answer

1 and 2 only

Answer

1, 2 and 3

Answer

2, 3 and 4

Question 22

Which one of the following prevents gastrointestinal absorption of thallium ?

Accepted Answer

B. Prussian blue

Answer

Calcium carbonate

Answer

Penicillamine

Answer

Potassium permanganate

Question 23

Early hypotension in venomous snakebite is due to which of the following?

Accepted Answer

A. Pooling of blood in the pulmonary and splanchnic circulation

Answer

Systemic bleeding

Answer

Hemolysis

Answer

Loss of intravascular volume into the soft tissues

Question 24

Which of the following are correct regarding acetaminophen?
1. It does not interfere with platelet function.
2. It is toxic to the liver in high doses.
3. It is a non-narcotic analgesic. Select the answer
using the code given below:

Accepted Answer

D. 1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Q1. In a child with acute organophosphorus poisoning, which one of the following drugs will act as anti-sialagogue and peripheral parasympatholytic agent?

Q2. A 21-year-old female was brought to the Emergency Department with a history of unknown substance ingestion. She was having vomiting, profuse diarrhea, bronchorrhea, and excessive sweating. On examination, miosis and muscular fasciculations were present. What is the most likely diagnosis?

Q3. A young female of 22 years old presented to the medical emergency with complaints of nausea, vomiting, abdominal pain, diarrhea, and convulsions along with methemoglobinemia. What is the likely diagnosis?

Q5. Urinary alkalinization is used for enhancing excretion of which of the following poisoning?

Q6. Urinary alkalinization as a method for enhancing excretion for poisoning is aimed at achieving

Q7. Exchange transfusion as a method to enhance excretion of poison is indicated in

Q8. In case of a child with acute poisoning by ingestion, activated charcoal may be used in which one of the following situations?

Q10. Whole Bowel Irrigation (WBI) as a method of gastrointestinal decontamination is useful for poisoning with:

Q11. Poisoning with which of the following drugs causes hypothermia?

Q12. Consider the following pairs: | Urine colour | Possible causative agent (suspected poisoning) | | --- | --- | | 1. Pink | Cephalosporin | | 2. Brown | Chloroquine | | 3. Greenish blue | Phenazopyridine | | 4. Red-orange | Amitriptyline | How many of the pairs given above are correctly matched?

Q14. Which one of the following is the correct description of Mee’s lines, seen in chronic arsenic poisoning ?

Q15. A 45 year old farmer came with accidental consumption of a pesticide. He complained of frequent urination and excessive salivation. Which one of the following toxidromes is most likely to be associated with this poisoning ?

Q16. A radiopaque density may be noticed in poisoning by which of the following agents ?

Q17. An 8 year old child has consumed a few tablets of a drug that were being taken by his mother on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and hepatic necrosis. Which is the most likely drug?

Q18. Gastric aspiration and lavage is contraindicated in which of the following poisonings? 1. Strong acids 2. Alkalis 3. Petroleum distillates 4. Ethanol Select the correct answer using the code below:

Q19. Which of the following statements are correct regarding scorpion stings? Scorpion injects venom from a stinger on their tail. Most stings are painful, but relatively harmless. Anticholinergics can be used if antivenom is unavailable. Select the correct answer using the code below.

Q22. Which one of the following prevents gastrointestinal absorption of thallium ?

Q23. Early hypotension in venomous snakebite is due to which of the following?

Q24. Which of the following are correct regarding acetaminophen? 1. It does not interfere with platelet function. 2. It is toxic to the liver in high doses. 3. It is a non-narcotic analgesic. Select the answer using the code given below: