ABT Clinical Toxicology 3

Question 1

The QRS widening seen in tricyclic antidepressant (TCA) overdose is treated with which agent?

Accepted Answer

Sodium bicarbonate

Answer

Sodium bicarbonate alkalinizes the blood and increases sodium concentration, reversing TCA-induced sodium channel blockade and QRS prolongation.

Question 2

Which toxin causes a characteristic 'garlic breath' odor and is associated with Mees' lines on fingernails?

Accepted Answer

Arsenic

Answer

Chronic arsenic poisoning produces a garlic-like odor and Mees' lines (transverse white bands on nails) due to arsenic deposition in keratin.

Question 3

Physostigmine is the preferred antidote for severe toxicity from which drug class?

Accepted Answer

Anticholinergics

Answer

Physostigmine, an acetylcholinesterase inhibitor that crosses the blood-brain barrier, reverses both central and peripheral anticholinergic toxicity.

Question 4

Which laboratory finding is most consistent with iron toxicity in the GI phase?

Accepted Answer

Leukocytosis and elevated glucose

Answer

During the early GI phase of iron toxicity, leukocytosis and hyperglycemia are predictive of serious toxicity due to direct GI mucosal injury and iron's metabolic effects.

Question 5

Whole bowel irrigation with polyethylene glycol is most appropriate for which type of poisoning?

Accepted Answer

Enteric-coated or sustained-release drug overdose

Answer

Whole bowel irrigation is indicated for sustained-release or enteric-coated formulations, body packers, and metals (iron, lead) not adsorbed by activated charcoal.

ABT - American Board of Toxicology Practice Test

ABT - American Board of Toxicology Practice Test

ABT Clinical Toxicology 3