Toxicology is a very important topic and if u try reading each poisons Separately , u will definitely forget them. So best way to remember them more is to practice MCQs and then read topics by correlating. That’s what I think…. It may or may not apply for u….. But atleast try once like this and then choose your own way .

1. - DR.AKIF A.B

2. 1. All are features of Cocaine intoxication EXCEPT:
A Tactile hallucinations
B Pinpoint pupil
C Restlessness
D Tachycardia and tachypnoea

3. Ans. B Pinpoint pupil
Cocaine poisoningQ-
tactile hallucinations (Magnan's symptoms = Cocaine bugs),
visual hallucinations,
black staining of tongue & teeth,
ulceration of the nasal septum due to sniffing,
dilated pupils : Since cocaine acts by increasing epinephrine/dopamine which
are sympathomimetics and sympathomimetics dilates pupil.

4. -CNS Stimulant
-Mech. ; Dopamine/Serotonin/Nor epinephrine
-Vasoconstrictor
-Derives from leaves of erythoxylum cocca
-Tactile hallucinations: also k/a Cocaine bugs/magnan bugs
-Paranoid delusions : is the fixed, false belief that one is being
harmed or persecuted by a particular person or group of people.
-If sniffed can cause Nasal septum perforation
-On oral intake : Black jet tongue
-Antidote = Amyl Nitrate

6. COCAINE ORAL INTAKE
Black Jet Tongue /Teeths

7. 2. Dhatura causes intoxication when there is intake of:
A Seeds
B Flowers
C Leaves
D Resinous intake

8. Ans. A Seeds
Dhatura fastuosa-
Fatal dose = 0.6 – 1 gm (100 – 120 seeds),
Fatal period = 24 hrs.

9. -Principle : Hyoscine/Atropine/Hyoscyamine/Scopola
-So all anti-cholinergic effects are seen
-Lethal Dose = 100-125seeds
-Seeds resembles chilly seeds
Antidote: Physostigmine/Pilocarpine

10. DATURA SEEDS
CHILLY SEEDS

11. 3.Q. All are features of Acute Morphine poisoning EXCEPT:
A Pin point pupil
B Respiratory depression
C Hyperpyrexia
D Fall in blood pressure

12. Ans. C Hyperpyrexia
Opium poisoning
-if taken by mouth, symptoms begin in ½ hr,
-if taken by inj. Symptoms begin in 3-4 minutes.
1. Stage of excitement- sense of well-being, talkativeness, restlessness,
flushing.
2. Stage of Stupor- headache, n, v, tiredness, drowsiness, contracted pupils,
cyanosis, itching.
3. Stage of Coma- deep coma, flaccidity of muscles, pupils pin-point,
no secretions except sweat, skin cold,
temperature- subnormal, pulse slow, breathing slow,
Cheyne-Stokes respiration.

13. 4.Q. Cyanide poisoning occurs due to:
A Inhibition of transmission at myoneural junction
B Inhibition of cellular respiration
C Combination with sulphydryl radical of tissue enzyme
D Interfering with calcium metabolism

14. Ans. B Inhibition of cellular respiration
Cyanides/HCNQ- ↓ cytochrome oxidase, carbonic anhydrase,
thus blocks the final step of oxidative phosphorylation and prevents the
formation of ATP.
It reduces oxygen carrying capacity of the blood by combining with the Ferric
iron.

15. HYDROCYANIC ACID
-Also k/a Prussic Acid
-Derived from Linseed Plant
-Bitter almond smell
-Inhibits enzymes of respiratory chain : 1) Carbonic anhydrase
2) superoxide dismutase
3) Cytochrome oxidase
4) Succinate dehydrogenase
-Rx: Amyl Nitrite
+
Vit. B12
+
Na. Thiosulphate
Triple Antidote
Amyl nitrite + CN = Meth-Hb
Vit.B12 + CN = Cyanocobalamine
Na.thiosulphate +CN= Thiocyanate

16. 5.Q.Gastric lavage is contraindicated in all EXCEPT:
A Comatose patient
B Sulphuric acid poisoning
C Oxalic acid poisoning
D Strychnine poisoning

17. Ans. C Oxalic acid poisoning
C/I
Absolute- corrosive poisons except oxalic acid
Relative- Convulsions (strychnine, tetanus), coma, volatile poisons,
esophageal varices.

18. 6.Q. Anterior horn cells are affected in:
A Strychnine poisoning
B Dhatura poisoning
C Botulism
D None of the above

19. Ans. A Strychnine poisoning (StrychnineQ (Strychnos nux vomica = kuchila)-
1. Spasm of abdominal muscles may bend the body forward
(emprosthotonus) or to the side (pleurosthotonus), action is noted in
anterior horn cells
2. convulsions affect all muscles at a time
3. consciousness is not lost
4. Brain is preserved
5. Postmortem caloricity is seen.)

20. -nux vomica/ kuchila
-Fatal dose = 1 crushed seed or 1 mg/kg
-Principle : Brucine/strychnine
-Inhibits glycine which is a inhibitory neurotransmitter and thus
inhibition of muscles is lost and all muscles contracts simultaneously.
-Acts at anterior horn cells of spinal cord
-Resembles tetanus
-Animal poison
-Arrow poison
- Increases Libido = Aphrodisiac property

21. -Pleurosthotonus/Ophistotonus/ Emprosthotonus
-Risus sardonicus
-Postmortem caloricity : Strychnine increases body temperature after death
-Post-synaptic block
-Rigor mortis : Appears early and stays for long time
Note: Anything which leads to fatigue of muscles leads to early rigor and
since strychnine increases muscle contraction leads to early fatigue.
-Antidote : Diazepam
- Alkalinisation of Urine is done.
‘Ine’ containing substances:
alkalinisation is done for
treatment

23. - Botulism is a rare and potentially fatal illness caused by a toxin, produced by the
bacterium Clostridium botulinum.
- Botulinum inhibits the release within the nervous system of acetylcholine,
a neurotransmitter, responsible for communication between motor
neurons and muscle cells.
- All forms of botulism lead to paralysis that typically starts with the muscles
of the face and then spreads towards the limbs.
- In severe forms, botulism leads to paralysis of the breathing muscles and
causes respiratory failure.
- Honey can contain the organism, and for this reason, honey should not be fed to
children under 12 months.
-Treatment is with an antitoxin.
-In those who lose their ability to breathe on their own, mechanical ventilation may be
necessary for months.

25. Pleurothotonus
Risus sardonicus is a highly characteristic, abnormal, sustained
spasm of the facial muscles that appears to produce grinning.
- Also seen with tetanus.
Risus sardonicus

26. 7.Q.Golden hair’ is seen in poisoning with:
A Arsenic
B Lead
C Mercury
D Copper

27. Ans. D (Copper.) > Arsenic

28. 8.Q. Organophosphorus compounds act by:
A Inhibiting cholinesterases
B Stimulating cholinesterases
C Stimulating acetylcholine receptors
D Stimulating acetylcholine synthesis

29. Ans. A Inhibiting cholinesterases
(OrganophosphatesQ- ↓ acetylcholinesterase
true cholinesterase in RBCs, nervous tissue, skeletal muscle, and
Pseudocholinesterase in plasma, liver, heart, pancreas, brain.)
Read O.P poisoning in detail.

30. 9.Q. True about Strychnine poisoning is:
A All muscles affected at the same time
B Shoulder girdle affected first
C Pelvic girdle affected first
D None of the above

31. Ans. A All muscles affected at the same time
StrychnineQ (Strychnos nux vomica = kuchila)-
-spasm of abdominal muscles may bend the body forward (emprosthotonus)
or to the side (pleurosthotonus), action is noted in anterior horn cells
convulsions affect all muscles at a time
consciousness is not lost
Brain is preserved
Postmortem caloricity is seen

32. 10.Q. Sodium bicarbonate is used for gastric lavage in poisoning with:
A Methyl alcohol
B Ethyl alcohol
C Oxalic acid
D Morphine

33. Ans. A Methyl alcohol
Methyl alcoholQ- Gastric lavage with Sod. Bicarbonate, Ethyl alcohol 50%
in dose of 1 ml/kg i.v. every 2 hrs till 5 days, serum alcohol levels maintained
at 100-150 mg% at all times,
Haemodialysis.

34. -Fatal dose = 80-120ml
Responsible for symptoms
-TOC : Hemodialysis
-Antidote : Ethanol > Fomepizole
Inhibits alcohol
dehydrogenase
- Causes Putamen necrois