Category Archives: MCQs

MCQs On Forensic Toxicology

1. Which of the following is NOT a side effect of Digoxin toxicity?

A. Bradycardia
B. Yellow vision changes
C. Scooping of the T segment on ECG
D. Hypokalemia

2. Which information can be obtained from an acute toxicity study?

A. Median toxic dose (TD50)
B. Median lethal dose (LD50)
C. No Observed Adverse Effect Level (NOEL)
D. Target organ
E. All of the above

3. A particular dose of a substance X is minimal toxic to animal. Substance Y is also minimal toxic to the animals at the same dose, but when both the substances are administered together they show the toxicity several orders of magnitude higher than compared with individual administrations. This is an example of:

A. Potentiation
B. Synergism
C. Additivity
D. Acute Toxicity
E. Agonism

4. Which of the following chelating agents is recommended for acute Lead poisoning with signs of encephalopathy?

A. Succimer
B. Penicillamine
C. Dimercaprol
D. Calcium EDTA
E. Dimercaprol + Calcium EDTA

5. Which of the following dermatologic findings and potential causes is INCORRECT?

A. Cyanosis- Methemoglobinemia
B. Erythroderma – Boric Acid
C. Pallor – Carbon Monoxide
D. Jaundice – Hypercarotinemia (excess carrot intake)

6. All of the following symptoms can occur with Ciguatera poisoning EXCEPT…

A. Myalgias
B. Flushing
C. Metallic taste
D. Reversal of temperature sensation

7. Which of the following is true with regard to Acetaminophen toxicity?

A. The Rumack-Matthew Normogram may be used for both acute and chronic ingestions.
B. The APAP level should ideally be checked within 1-4 hours of ingestion.
C. The Rumack-Matthew Normogram applies for ingestions up to 48 hours post-ingestion.
D. N-Acetylcysteine (NAC) should be started within 8 hours of ingestion if an APAP level cannot be obtained.

8. All of the following are treatment options for toxic alcohol poisoning, EXCEPT…

A. Fomepizole
B. Hydroxocobalamin
C. Thiamine
D. Folic Acid

9. Which one of the following are the main targets of lead toxicity?

A. Liver and kidneys
B. Nervous system and hematopoietic system
C. Heart and lung
D. Bones and muscles

10. ‘Itai-itai’ disease is caused by______

A. Cadmium
B. Mercury
C. Lead
D. Copper


Answers with Explanation:

1. Answer: D.

Despite the number of patients who come in taking Digoxin, it is important to remember that this medication comes with a large range of side effects. Bradycardia (along with any of the other SLUDGE Toxidrome symptoms) is a common effect due to the Parasympathetic activity of Digoxin. (Note: This is also the reason it works as a second-line agent for rate control of Atrial Fibrillation.) Yellow, halo-like vision changes (think Van Gogh’s ‘Starry Night’) are a more rare, but classic finding.

2. Answer: E.

In an acute toxicity study any end point parameter such as death, brain damage, liver damage etc. can be used to obtain information regarding a particular toxicant.


References:

Wright RO et al. Methemoglobinemia: etiology, pharmacology, and clinical management. Ann Emerg Med. 1999 Nov;34(5):646-56.

Prescott LF, Illingworth RN, Critchley JA, et al. Intravenous N-acetylcysteine: the treatment of choice for paracetamol poisoning. BMJ. 1979 Nov 3;2(6198):1097-100.

Yeates PJ, Thomas SH. Effectiveness of delayed activated charcoal administration in simulated paracetamol (acetaminophen) overdose. Br J Clin Pharmacol. 2000 Jan;49(1):11-4.

Sivilotti ML, Burns MJ, McMartin KE, et al. Toxicokinetics of ethylene glycol during fomepizole therapy: implications for management. For the Methylpyrazole for Toxic Alcohols Study Group. Ann Emerg Med. 2000 Aug;36(2):114-25.

Brent J. Fomepizole for ethylene glycol and methanol poisoning. N Engl J Med. 2009 May 21;360(21):2216-23.

Lheureux P, Penaloza A, Gris M. Pyridoxine in clinical toxicology: a review. Eur J Emerg Med. 2005 Apr;12(2):78-85.

Forensic Science – Multiple Choice Questions (Fingerprint)

By @forensicfield

I.) Who first explained the Friction Ridge Skin Pattern with drawings:-

1.) Sir Francis Galton
2.) J.C.A. Mayer
3.) Henry Faulds
4.) William Herschel

II.) “Life on the Mississippi” is wrote by:-

1.) Mark Twain
2.) Thompson
3.) Henry Faulds
4.) J.C.A. Mayer

III.) First case of identical twins with no resemblance in their Fingerprints:-

1.) William & Will West
2.) William & Windy Wells
3.) Mark & Monty Wells
4.) William & William Wells

IV.) Ridge ending, Bifurcation, Eye, Triangle, etc. are the terminologies used for:-

1.) Class Characteristics of Fingerprint
2.) Individual Characteristics of Fingerprint
3.) Fingerprint
4.) Galton Classification

V.) Fingerprints on plastic metal, glass and skin can be placed in a developing jar with this chemical that reacts with amino acids to make the print appear white.

1.) Silver nitrate
2.) Ninhydrin
3.) Iodine fuming
4.) Cyanoacrylate

VI.) The skin layer between the epidermis and dermis is the _________ layer.

1.) Cuticle
2.) Subcutaneous
3.) Basal
4.) Top

VII.) Sweat glands near the hair follicle:

1.) Apocrine
2.) Friction ridges
3.) Touch receptor
4.) Eccrine

VIII.) How many Biological Principle followed by Fingerprints:-

1.) 5
2.) 7
3.) 1
4.) 3

IX.) Fingerprint Left by the offender at the SoC is known as:-

1.) Patent Prints
2.) Chance Prints
3.) Plastic Prints
4.) Latent Prints

X.) Fingerprints used since centuries as ________ for protection if documents and Identification of Individual:-

1.) Signature
2.) Tradition
3.) Fingerprints
4.) Symbol

***************************************************

Answer

I.) 2.) J.C.A. Mayer

Explanation- German Doctor and anatomist Book:
• First to write that friction ridge skin was unique
• Book contained detailed drawings of friction ridge skin

II.) 1.) Mark Twain

Explanation- The first American writer to use fingerprints in solving crime was the famous Mark Twain in his perhaps-embellished memoir about life as a steamboat pilot, titled Life on the Mississippi, published in 1883.

III.) 1.) William & Will West

Explanation – They looked identical and even shared the same name, but the two prisoners pictured were actually different people and their remarkable case helped bring in the era of fingerprint identification.

IV.) 2.) Individual Characteristics of Fingerprint

V.) 4.) Cyanoacrylate

Explanation – Cyanoacrylate fuming is a method which is used to develop latent fingerprints. Cyanoacrylate fuming is performed in a developing chamber using super glue and water which allows the vapors to adhere to the fingerprint, The reaction forms a visible white polymer along the ridges of the fingerprint.

VI.) 3.) Basal Layer

Explanation – The basal layer is the innermost layer of the epidermis, and contains small round cells called basal cells.

VII.) 1.) Apocrine

Explanation – The sweat glands which is associated with hair follicles.

VIII.) 4.) 3

IX.) 2.) Chance Prints

Explanation – Chance prints which is also known as latent fingerprints, are the invisible patterns made by fingerprints.

X.) 1.) Signature