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L 4 , food poisoning, Toxicology

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1)-The GIT manifestations of food born botulism are all of the following except:

a) Dry mouth.
b) Diarrhea.
c) Abdominal pain.
d) Dysphagia.

2)-The Mechanism of action of botulism is

a) Increasing release of acetylcholine
b) Reversible binding of the peripheral neuromuscular junc
c) Achieving presynaptic block
d) Achieving postsynaptic block

3)-Cases of botulism present with all the following except

a) Dysphagia
b) Constricted pupils
c) Diplopia
d) Constipation

4)-Clinical picture of botulism include the following except

a) Dry mouth and urine retention
b) Diarrhea and excessive sweating 
c) Dysphagia and dysarthria 
d) dilated fixed pupil 


5)- Most serious form of botulism is : 

(a) Intestinal adult botulism
(b) Intestinal infant botulism
(c) food- born botulism
(d) Wound botulism 

6)-In case of ciguatera poisoning ,Myalgia most often in 

a) UL 
b) LL 
c) back 
d) all over the body

7)-The rarest form of botulism is 

(a) Intestinal adult botulism
(b) Intestinal infant botulism
(c) food- born botulism
(d) Wound botulism

8) -As regard infant Botulism all true except

a) It is the most common form
b) Honey is implicated in some cases
c) Symptoms are less dangerous than food born
d) Poisoning is usually due to ingestion of already performed

9) - Botulism is characterized by presence of

a) Altered mental status.
b) Fever.
c) Dilated fixed pupil.
d) Tachycardia.

10-Referred to trivalent botulinum antitoxin, all are true except

a) Effective in food born and intestin
b) Not effective in infant botulism
c) Rapidly reverse established neurological manifestations.
d) Hypersensitivity reaction is a common adverse effect.

11 -As regard botulism all true except 

a) Mental status and alertness are preserved 
b) Ingestion of food containing the performed toxin is the most serious form
c) the formed toxin inhibits the cholinesterase enzyme leads to cholenergic crisis 
d) Ocular manifestations include diplopia, blurring of vision and dilated fixed pupils

12- All of the following is true about botulinum toxin except:

a) It is a neurotoxin
b) Produced by gram negative organism
c) Produced by spore forming organism
d) Produced by anaerobic organism

13 -All of the following are true about botulin toxin except:

a) There are 8 serological types
b) Reversibly bind to its receptor 
c) Elaborated in the intestine 
d) present in uncooked, salted fish

14- Food poisoning Caused by bacterial toxins that are ingested with food or  
elaborated in the intestine by bacteria contaminating food: 

a)- Salmonella 
b)- Shigella 
c)- E.coli 
d)- C.botulinum

15- All of the following is true about the mechanism of action of botulism except:

a) Has a curare like action
b) Impairs the presynaptic release of acetylcholine
c) Toxin binds reversibly to the NMJ
d) Due to preformed toxin.

16-Cases of botulism present with the following except:

a) Dry mouth
b) Fever
c) Abdominal pain
d) Constipation

17-Cases of botulism neurotoxicity present with the following except

a) Asymmetrical muscle weakness
b) Bilateral muscle weakness
c) Descending muscle weaknes
d) Squint

18-Cases of botulism present with the following except:

a) Diaphoresis
b) Dysarthria
c) Dysphagia
d) Dysphonia

19 -Cases of botulism present with the following except:

a) Dry mouth
b) Diarrhea
c)Tachycardia
d) Dysphagia 

20- Cases of botulism present with the following except:

a) Squint
b) Salivation
c) Diarrhea 
d) Constipation

Written 


1.Explain your clinical approach for a rapid differential diagnosis of a case of food poisoning.

2. Botulin toxin gives its action by interfering with acetylcholine on its receptor (true or false with explanation)

Case 1 : 
A family formed of a father, mother and 2 children transferred to hospital an hour after having a meal, vomiting several times, with abdominal pain and recurrent diarrhea. On examination children were pallor, sweaty tachycardic, hypotensive with body temperature 36.7'C.
1- What is your professional diagnosis? evaluate?
2- Explain the initial management of children?
3- List the Differential Diagnosis of this case?
4- Regarding botulism, enumerate the followings:
a)-Its clinical presentation.
b)- Its antidotal therapy.   

Answers 

1-b
2-c
3-b
4-b
5-c
6-b
7-a
8-d
9-c
10-c
11-c
12-b
13-b
14-d
15-c
16-b
17-a
18-a
19-c
20-b







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