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MCPHS MEDCHEM 1 E2
MCPHS - MedChem I Exam 2 (a)
| Question | Answer |
|---|---|
| Tx for Strong Acid Burns | Flush w/ H2O |
| Alkali on Skin feels like? | Nothing/Itch (too late) |
| Why not Tx w/ Chems? | Exothermic Rxn' burns more |
| Why does Acetone turn skin white? | Solu Lipids in Skin |
| DMSO will? | Carry other Chem's thru skin |
| Cyanide ? | Binds Ox. Cytochrome blocking respiration in Mitochondria |
| Tx's for Cyanide? | Methylblue, Nitrates, O2, Thiosulfate |
| What is Mitochondrial Sulfotransferase? | Rhodanese enzyme that converts Thiosulfate & CN- to SCN- (Tox.: 500 mg/kg rather than 3 mg/kg for CN-) |
| What does nitrates do? | Makes MetHb |
| What does MetHb do? | Reduces O2 capacity of blood (30% opt. for Tx) |
| Why can thiosulfate be used to tx for CN- poisoning? | B/c CN-Hb3+ is reversable (CN- then binds w/ S making SCN- w/ low toxicity) |
| What is Kelocyanor? | Dicobalt Edetate (Tx CN- Poisoning) |
| What is Vit B12? | Cyanocobalamin (Cyanide & Cobalamin) |
| Iron Sulfide & Acid make? | H2S (stink bomb) Deadly Gas. Heavier than Air. HS ion binds w/ Cytochrome Oxidase (Oder Tolerance Builds Up) Tx w/ Nitrates to 30% level (Kills Fisherman) |
| Why can't Tx H2S gas w/ Thiosulfate? | HS-MetHb is not reversable |
| What is Ferrous and Ferric? | Ferrous (Fe2+ Reduced) & Ferric (Fe3+ Ox.) |
| Oxygen binds to? | Reduced Hb |
| What is Diaphorase 1? | NADH-MetHb Reductase (Converts Hb3+ to Hb2+) |
| Methylene Blue is in what state? | Oxidized |
| What is Reduced form of Methylene Blue? | Leuko Methylene Blue (colorless) |
| What can Leuko Methylene Blue Do? | Converts Hb3+ to Hb2+ |
| What converts Methylene Blue to Leuko Methylene reduced state? | NADPH & Diaphorase II |
| What is the name of Diaphorase II? | NADPH-Methemoglobin Reductase |
| What is the source of NADPH? | G-6-P + NADP via G-6-P dehydrogenase |
| Where does Methylene Blue Coupled Reaction take place? | In the RBC |
| CO deaths/year? | 500 accidents 2000 suicide |
| Lasting CO poison Effects? | Apathy, Disorienttion, Amnesia = 100%, Irritability = 90%, Insomnia & Depression = 15 - 20% |
| CO is? | Colorless, Odorless, Tasteless, Insolu aq, Misc w/air, Weak Carotid Recptr Effect (low/no chemo receptor response) |
| Color of skin w/ co poisoning? | Pink |
| How is CO made? | Incomplete Combustion of Carbon. Complete makes CO2 |
| Sources of CO ? | Fireplaces, Hibachi, autos, cigarette... |
| Who has high carboxiheme levels in blood? | smokers |
| Endogenous production of co? | hemoglobin breakdown |
| How fast will CO bind w/ Hb? | 1/10 th rate of O2 & Hb |
| What is Dissociation Rate of CO-Hb? | 1/2100 that of O2-Hb |
| What is the net affinity of CO for Hb? | 2100/10 = 200 X's that of O2 |
| Prediction of %CO-Hb? | %CO-Hb = 20,000x[CO] / ([O2] + 200[CO]) |
| %O2-Hb = ? | 100 - %CO-Hb |
| What is conc of O2 in air? | 20% O2 in Air |
| %O2Hb / %COHb ? | [O2} / 200[CO] |
| What is Venous & Arterial Press? | 40 & 80 |
| What does CO do to Oxyheme Dissociation Curve? | Shifts to Left |
| How many Hemes per Globin? | 4 |
| S & Sx at 1-10 %CO-Hb? | 0-10 % CO-Hb = None |
| S & Sx at 10-20 %CO-Hb? | 10-20% = Forehead Tight, Slight HA, Cutaneous Dilation |
| S & Sx at 20-30 %CO-Hb? | HA, Throbbing Temples |
| S & Sx at 30-40 %CO-Hb? | 30-40% = Severe HA, Weak, Dizzy, Dim Vision, N&V, Collapse |
| S & Sx at 40-50 %CO-Hb? | 40-50% = All Prior Sx & Increased Respiration & Pulse |
| S & Sx at 50-60 %CO-Hb? | 50-60 % = Syncope (Unconsciousness), Coma, Intermit Convulsions, Cheyne-Stokes Respiration (Start-Stop) |
| S & Sx at 60-70 %CO-Hb? | 60-70 % = Coma, Depressed HR & Respiration, Poss. Death |
| S & Sx at 70-80 %CO-Hb? | 70-80% = Weak Pulse, Slow Resp., Resp. Failure, Death |
| Smokers Ox-He%? | 10% (May not get HA as S & Sx with CO Poisoning) |
| When checking Pulse w/ CO poisoning is it different? | Pulse w/CO poisoning can be the same. Pulse Oximetry reads CO as O2 |
| Tx. for CO poisoning? | Min O2 Demand, Restore Tissue O2, Hyperbaric O2, Transfusion, Hypothermia |
| T 1/2 life of COHb? | Rm Air 4-6 hr, 100% O2 40-80 min, HypBar O2 15-30 min. |
| What is the product of Redox Cycling? | Free Radicals |
| What happens when a free radical attacks lipids? | Lipid Oxidation = oxidative stress |
| What does oxidative stress do to? | Uses up antiOxidants |
| Where can Exogenous free radicals come from? | Ionizing Radiation & Metabolites of Xenobiotics |
| Do free radical properties differ from the parent compound? | when the outer shell electron is lost the properties do change |
| Whas is a good Radical Scavenger? | Glutathione, Vit E & C, SH Compounds, Nu: |
| List of Free Radical compounds? | Alcohols, O3, Paraquat, CCl4, Nitrogen Oxides, Bleomycin, adriamycin, Nitrofuratioin, Doxorubicin |
| What is the danger of free radical rxn's in the body? | accelearation of reaction: oxygen & catalytic ions Fe2+, Cu+, Cr5+, Mn2+ (create more and more in body) |
| Most Dangerous Free Rad? | Superoxide Rad, Hydoxy & Hydoperoxy Rads. O2-, OH, OOH (Target Cells or Macrophages have these) |
| Sources of Oxygen Rad? | Endogenous: Cytochromes Ox-Phosphorylation, CYP450's, Macrophages. Exogenous: Ionizing Radiation & Xenobiotics (quinones - rapid redox cycle) |
| What does SuperOxide Dismutase do? | SOD converts 2(O2's) to HOOH (Hydogen Peroxide). It is found in Cytosol & Mitochondria |
| What happens to HOOH ? | GSH Peroxidase (Cytosol Enzyme "Selenoenzyme") converts it to 2(H2O's) using 2 Glutathiones |
| When is HOOH not converted to water? | When protective SOD Rxn' takes place near cytochrome or metal ions Fenton Reation occurs spontaneously converting back to OH & OH- |
| What met'l ions in Fenton Reaction? | Fe2+, Cu+, Cr5+, Ni2+, Mn2+ |
| How is GSH (Glutathione) converted to GSSG to make 2 H2O's? | GSH is oxidized by GSH peroxidase |
| What reduces GSSG ? | Glutathione Reductase & NADPH converts GSSG back to GSH (reducing it in the RBC) |
| What can Catalase in peroxisomes do? | Convert HOOH to 2 H2O's & O2 Using "Gatalase" |
| Over all, what is depleted with Free Radical conversion? | Free Radical Protection uses up a lot of NADPH |
| What does Glutathione normally do when not converting HOOH to water? | Glutathione Regulates Protiens (turns rxn's on & off) |
| What happens if glutathione is low and Pt. takes too much APAP ? | APAP is not cleared and becomes very toxic to body |
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