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Paracelsus (1493-1541)
Introduction
the organism.
Dose, of a particular substance, is an important factor in Various xenobiotics mimic the function of and interfere
determining whether a substance will have an adverse effect on with the biosynthesis of hormones which are essential for the
the organism or be eliminated from the body without any effect. normal physiological functions, growth and reproduction. This
Dose also depends on the route of exposure, through which a kind of xenobiotics is known as endocrine disruptors. Exposure to
substance gets entry into the biological system. such kind of chemicals is a matter of concern as they show their
effects at very low doses. Release of these chemicals into
Most of the xenobiotics cause an obvious alteration in environment is, sometime, unavoidable as some of them are used
redox status of the cell or tissue by accelerating free radical as pesticides, in plastic industry and other chemical
generation processes or active metabolite formation of the manufacturing units.
xenobiotics itself. Moreover, it may alter the expression of various
genes and proteins involved in normal cell growth and Xenobiotics under the category of mutagens and
functioning. In this context a toxicological agent is capable of carcinogens3 are capable of altering the DNA sequences in such a
interfering with the normal physiological activities in an organism way that the cells lose their regulation of cell division and
by any one or a combination of the above mentioned interactions. proliferate in an uncontrolled manner. This condition can lead to
In fact the generation of free radicals that is involved in oxidative tumor formation and metastasis. These effects are lethal and a
cellular injuries and alterations of gene function (either major cause of deaths worldwide.
genetically or epigenetically) are not two separable events. They
occur simultaneously. In other words, the effect a xenobiotics Alterations in neurophysiology can be responsible for
exhibit in a biological system is due to a combination of genetic debilities in cognitive function and behavioral alterations.
and extragenetic interactions within the cell. Neurotoxic4 agents are capable of inducing such kind of
deleterious effects and can lead to development of
Inflammation is the most common response in higher neurodegenerative diseases like Alzheimer’s and Parkinson’s.
animals when there is an exposure to a toxic agent. It is simply a They can affect peripheral or central nervous system and can
protective response but persistence for a longer period (a chronic induce different neuropathies depending on the part affected.
condition) may result into a variety of diseases. Chronic These effects are mainly associated with low level of exposure.
Obstructive Pulmonary Disease (COPD), pulmonary fibrosis, High level of exposure to neurotoxicants can lead to coma and
Arthritis etc. are the examples of chronic2 inflammatory diseases sudden death.
which may result after repeated episodes of acute inflammation
caused by a xenobiotics. Moreover, chronic inflammation is also
3 All carcinogens are mutagens, but all mutagens are not carcinogens.
involved in cancer development.
This is because every mutation does not result in cancer.
2 A condition, which persists for a period of more than three months. In 4 Agents which cause damages to nervous tissue and disrupts central and
most of the chronic diseases the period may be in years. peripheral nervous systems.
There is an ample generation of endogenous toxic
metabolites5, like ammonia, CO2 etc. to cause serious toxicities if Multiple Choice Questions (MCQs)
not excreted out immediately.
Multiple choice questions provide a great deal of revision of a
particular subject area, whenever there is a need. The present
Excretory processes are an integral part of the body
book contains a number of MCQs from toxicology and divided
functioning. Kidneys are the main organ involved in excretion of into sets of 20 MCQs each. At the end of every set the answer
not only endogenous harmful metabolites but also of the keys are given.
xenobiotics and their metabolites. Lungs are mainly involved in
exhalation of CO2 and other volatile substances such as ethanol. In addition to the answer keys, whenever it was needed a brief
explanation of the answer is also given. Full explanations of all the
Liver is involved in xenobiotics metabolism and also in excretion
positive or negative answers are out of scope of this book.
of certain kind of xenobiotics through bile. Injury to these organs
by a xenobiotic would hamper the excretion of endogenous
metabolites at one end, and debility in their other essential
functions at the other.
13. Which of the following will have the most damaging effects? 17. Which information can be obtained from an acute toxicity study?
A A hydrophilic chemical via inhalation route. A Median toxic dose (TD50)
B A lipophilic chemical via dermal route. B Median lethal dose (LD50)
C A lipophilic chemical via inhalation route. C No Observed Adverse Effect Level (NOEL)
D A hydrophilic chemical via oral route. D Target organ
E A hydrophilic chemical via dermal route. E All of the above
Answer keys MCQs Set 1:
18. A particular dose of a substance X is minimal toxic to animal. 1. A
Substance Y is also minimal toxic to the animals at the same dose, 2. B
but when both the substances are administered together they
3. D – Intraperitoneal route of administration is used in various
show the toxicity several orders of magnitude higher than
compared with individual administrations. This is an example of: experimental and clinical administrations where a test substance/drug is
A Potentiation delivered into the peritoneal cavity with the help of a syringe and
B Synergism needle.
C Additivity 4. C
5. D
D Acute Toxicity
6. E
E Agonism
7. B
8. B
19. 1 ppm is equivalent to: 9. E
A 1 g/kg 10. C
B 1 μg/kg 11. B
C 1 mg/kg 12. B
D 1 mg/100g 13. C
E None of the above 14. E
15. E – Theoretically toxicants/metabolites can be eliminated along with
any secretion from the body.
20. Which is true about the LD50?
16. B
A Dose of a substance to which 50% of animals do not
17. E – In an acute toxicity study any end point parameter such as death,
show any response.
brain damage, liver damage etc. can be used to obtain information
B Dose of a substance which kills 50% of animals
regarding a particular toxicant.
exposed.
C 50% of the dose of a substance which can kill an
18. B – In potentiation a non-toxic substance increases the toxicity of a
animal.
relatively less toxic substance. In synergism a substance shows unusually
D Dose of a substance which can kill 50 animals. high toxicity in presence of a less toxic substance, it is much greater than
E 50 mg/kg dose of a substance to test the toxic additive effect. In agonism a substance (agonist) mimics the mechanism
responses in animals. of action of other substance, its opposite is known as antagonism.
3 The term ‘toxin’ generally refers to toxic substances that are _____
A Any kind of poisons.
B Produced by biological systems such as plants, animals,
fungi, or bacteria.
C Toxicants released as industrial effluents.
D Toxic elements of inorganic origin such as mercury,
lead, arsenic etc.
E All substances except gases.
4 The term ‘toxicant’ is used in speaking of toxic substances that are 7 Threshold dose
A Specifically toxic to humans. A The dose level at which mortality starts occurring.
B Nonlethal in their effects. B A threshold for lethal dose.
C produced by organisms. C The dose below which no effects appear.
D produced by anthropogenic activities. D A and B
E Toxic to organisms such as plants, animals, fungi or E The dose at which 50% animals exhibit toxicity signs
bacteria.
14. E
15. C
16. C
17. E – represents the levels of a particular hazardous substance.
19. C
20. A – Itai itai is a cadmium poisoning disaster occurred around 1912 in
Japan. The disease affected kidneys and bones causing severe pain in
joints and spine, hence the name itai itai (“Ouch, Ouch” or “It hurts, it
hurts”).
TOXICOLOGY
MCQs SET 3
MCQs Set 3
6 Tetrodotoxin, a deadly toxin, is found in _________ 10 What is the most common toxicity target of ethanol (beverage
A Rattle snake alcohol) in humans?
B Shellfish A Brain
C Mussels B Fetus
D Puffer fish C Liver
E Scorpion D Kidneys
E Heart
8 Gastrointestinal tract does not have any profound effect on nature 12 Methanol consumption is associated with permanent blindness.
of ingested chemicals Following comment is true regarding methanol toxicity.
A True A Methanol, unlike ethanol, causes direct toxicity to
B False optical nerves after absorption.
C Maybe B Apart from the blindness, methanol is less toxic than
D Gut-microflora plays important role in ethanol.
biotransformation of ingested chemicals C Alcohol dehydrogenase converts methanol into
E It does not matter whether gastrointestinal tract have formaldehyde which causes blindness.
any effects on chemicals D Aldehyde dehydrogenase converts methanol into
formaldehyde which causes blindness.
E Alcohol dehydrogenase and aldehyde dehydrogenase
converts methanol into formic acid which causes
blindness. 17 Who is the father of occupational medicine?
A Louis Lewin
B Paracelsus
13 Which part of the body is primarily affected by caffeine C Mathieu Orfila
intoxication?
D Bernardino Ramazzini
A Heart
E Oswald Schmiedeberg
B Brain
C Liver
D Kidneys 18 Exposure to __________ is associated with occupation.
E Gastrointestinal tract A Aflatoxins
B Cigarette smoke
C Formaldehyde
14 Leaves from the following plants are the significant source of
D Ethanol
caffeine.
A Coffea arabica E Acetaminophen
B Erythroxylum coca
C Cola acuminata 19 Exposure to __________ is associated with lifestyle.
D Camellia sinensis A Chromium
E Theobroma cacao B Benzene
C Benzidine
D Nicotine
15 Who first of all described the association between chemical
exposure and cancer? E Asbestos
A Percival Pott
20 Mesothelioma (cancer of lining covering internal organs) is
B Paracelsus
associated with exposure to ____
C Mathieu Orfila A Benzene
D Bernardino Ramazzini B Nickel
E Oswald Schmiedeberg C Mercury
D Arsenic
16 Who is the father of forensic toxicology? E Asbestos
A Louis Lewin
B Paracelsus
C Mathieu Orfila
D Bernardino Ramazzini
E Oswald Schmiedeberg
Answer keys MCQs Set 3:
1. C
2. C - Malachite green is used as a dye in leather and paper industries.
3. B
4. C
5. A
6. D – Liver, intestine and skin of puffer fish is known to be source of
tetrodotoxin, a potent neurotoxin, which is produced by symbiotic
bacteria Pseudoalteromonas tetraodonis and species of Vibrio and
Pseudomonas.
7. B TOXICOLOGY
8. D
9. E MCQs SET 4
10. C
11. C – After liver and brain, the ethanol causes fetal toxicity known as
Alcohol Fetal Syndrome (AFS) causing severe mental and physical
damages in developing babies.
12. E
13. B
14. D
15. A
16. C
17. D
18. C – Formaldehyde is used in shoe industry and has been associated
with nasal cancer.
19. D
20. E
MCQs Set 4
5. B
6. E
7. D
8. D
9. A
10. E
11. E
12. A
13. D – Ethanol is agonist for methanol and competes with it for
metabolism by alcohol dehydrogenase and aldehyde dehydrogenase,
thus minimizes the formation of toxic metabolites of methanol,
formaldehyde and formic acid.
14. B
15. C – Carbon monoxide has around 200 times greater affinity for
hemoglobin than oxygen.
16. A – SO2 reacts with aqueous layer on lung epithelium to form
sulfurous acid.
17. D
4. B
5. A
6. E
7. B
8. D – Oxidants exert their effect by damaging cellular macromolecules.
9. D
10. C
11. D – Lithium is used as medicine in mental illnesses like depression,
schizophrenia and bipolar disorder.
12. C
13. E
14. B - N-acetyl-p-benzoquinone imine is reactive metabolite of
acetaminophen which is responsible for liver damage and other
associated toxic effects.
CYP 2E1 (Liver damage)
Acetaminophen ----------------> N-acetyl-p-benzoquinone imine (NAPQI)
(Glutathione)
---------------> NAPQI-glutathione conjugates ---------> Excretion
15. D
16. B
17. E
18. E
19. B
20. C – Botulinum causes paralysis of respiratory muscles.
TOXICOLOGY
MCQs SET 6
MCQs Set 6
19 What are the effects, other than the systemic effects of the
smoke?
15 Morphine is obtained from the following plant A Thermal damage to the airways
A Nicotiana tabacum B Irritation
B Erythroxylum coca C Asphyxia
C Atropa belladonna D A, B and C
D Papaver somniferum E B and C
E Datura alba
6. A
7. D TOXICOLOGY
8. E
9. A MCQs SET 7
10. D
11. B
12. A
13. B – Nitrates cause vasodilation and reduces blood pressure.
14. C
15. D
16. C
17. D
18. B
19. D
20. D – In first order kinetics excretion is directly proportional to the
concentration of the substance.
MCQs Set 7
15 Which is not a part of phase I biotransformation of toxicants? 19 Which one is the most common conjugation reaction in phase II
A Oxidation biotransformation?
B Hydrolysis A Glucuronidation
C Reduction B Sulfonation
D Glutathione conjugation C Acetylation
E Epoxide hydrolase D Methylation
E Glutathione conjugation
2. E
3. C
4. A
5. E
6. C
7. B
8. E - Fuller’s earth works as an adsorbent and reduces the absorption of
paraquat into the system.
TOXICOLOGY
9. A
10. B – lower value of therapeutic index (LD50/ED50) indicates higher risk MCQs SET 8
of toxicity of therapeutic drugs. It is also expressed as TD50/ED50.
(ED = Effective dose; LD = Lethal dose; TD = Toxic dose)
11. A
12. E
13. E
14. B - Xenobiotic metabolism basically alters the chemical structure in
order to increase the exretion of the substance which ultimately may
lead to increased or decreased toxicity.
16. B
17. E
18. C
19. A
20. B
MCQs Set 8
5 Sulfonation involves the transfer of the following to the xenobiotic 9 Following are the examples of adverse effects of toxicants except
A SH‾ _____.
B SO4‾ A Decreased lifespan
C S2‾ B Increased incidences of limb injuries
D SO3‾ C Altered physiology and biochemistry
E SO42‾ D Behavioral instability
E Decreased growth
4. D
5. D
6. A TOXICOLOGY
7. B
8. E MCQs SET 9
9. B
10. C
11. D
12. C – greyish or dark grey pigmentation due to accumulation of silver
in tissues.
2 What is ‘bioavailability’?
A Availability of biological entities for exposure to
toxicants.
B Ability of chemicals to be absorbed by organisms.
C Chemicals in an approachable vicinity.
D Availability of biologically produced agents.
E None of the above.
7 ‘Environmental medicine’ encompasses the management of 13 ‘Half-life’ and ‘Half time’ are different parameters.
damages caused by toxicants to the environment. A True
A True B False
B False
14 ‘Hazard’ indicates inherent toxic properties of a substance, in
8 In ‘first order kinetics’ reaction rate is indirectly proportional to other words a ‘source of danger’.
the concentration of the substance. A True
A True B False
B False
15 ‘Hormesis’ is a phenomenon where generally toxic/non-essential
9 ‘First pass effect’ is the biotransformation of chemicals in the substances show beneficial effects at low doses.
intestine before reaching to the circulation. A True
A True B False
B False C maybe
10 Genotoxicity involves ________. 16 An adverse condition is called ‘iatrogenic’ when it arises from
A alteration in DNA sequence. lack of medical treatment.
B toxic damages to the DNA, such as DNA strand breaks. A True
C Chromosomal abnormalities. B False
D A&B
E All of the above
17 When an individual show unusually high sensitivity towards a Answer keys MCQs Set 9:
substance, the condition is known as _________. 1. D
A Idiopathic 2. B
B Icterus 3. C
C Anaphylaxis 4. A
D Idiosyncrasy 5. C – Endotoxins are integral part of cell walls of certain Gram-negative
E Hypersensitivity bacteria. They are also known as lipopolysaccharides (LPS).
20. B
TOXICOLOGY
MCQs SET 10
MCQs Set 10
15 Which one of the following is not an ionizing radiation? 19 Alternative medicine includes only herbal medicine.
A X rays A True
B infrared rays B False
C Gamma rays
D UV rays 20 Herbal formulations are always safe and do not need any
E Alpha rays toxicological evaluation and regulation.
A False
16 Chemical carcinogenesis has following stages (select all that B True
applies).
A Initiation
B Immigration
C Promotion
D Metastasis
E Progression
3. C
4. C
5. D
6. C
7. E
8. B
9. E
10. C
11. D Bibliography
12. B
13. A – UV C has shortest wave length and highest energy level in UV
group and, UV B comes second and the UV A is third in the order.
However, in natural conditions only UV A reaches to the ground in
significant amount, which is damaging to the life. Ozone layer filters out
UV C completely and UV B partially.
14. C
15. B
16. A,C,D,E
17. C
18. E
19. B
20. A
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