Question | Answer |
Emergency Toxicology | Deal with drugs in suspected overdose cases and concerned mainly with qualitative screening |
What is the most common cause of gaseous poisoning? | Carbon monoxide |
Carbon monoxide replaces what in hemoglobin? | Oxygen |
Primary toxic effect of Carbon monoxide? | Cellular hypoxia and anoxia |
CO + hemoglobin -------> | Carboxyhemoglobin |
Specimen for carbon monoxide detection? | Whole blood |
Sodium hydrosufite reduces what? | MetHgb, oxyHgb but not carboxyhgb to deoxyhgb |
What Inactivates the respiratory enzymes, inhibits cellular respiration and causes a quick death? | Cyanide |
Diagnosis of cyanide poisoning | "Oil of bitter almond" breath |
Volatiles? | Ethanol, methanol, ethylene glycol |
What enzyme converts ethanol to acetaldehyde? | ADH |
Dram SHop Law | Used to deter drivers from driving while intoxicated |
Methanol is metabolized to?? | formaldehyde and formic acid causing metabolic acidosis |
How many mL of methanol is toxic? fatal? | toxic: 10mL Fatal: 60-240mL |
MEthanol assay yields what color? | Violet |
Common ingredient of antifreeze? | Ethylene glycol |
Treatment of ethylene glycol poisoning? | Ethanol, sodium bicarbonate |
What does ethylene glycol do in toxic amounts? | Depresses CNS |
Lab findings for Ethanol? | POSITIVE alcohol, INCREASED osmolal gap, UNCHANGED anion gap |
Lab findings for methanol, isopropanol, ethylene glycol | NEGATIVE alcohol, INCREASED osmolal gap, INCREASED anion gap |
The coagulative destruction of the skin or mucous membrane | Burns |
Site of major injuries from acid ingestions? | The stomach because gastric juices are unable to neutralize and lesions are produced |
Site of major injuries of alkali ingestion? | Esophagus & oropharynx. |
Reinsch test: dull black | Arsenic |
Reinsch test: blue or purple black | Antimony |
Reinsch test: shiny black | Bismuth |
Reinsch test: silver gray | Mercury |
Most common metallic poisoning in children? | Iron |
Clinical toxicity of iron? | >20mg/kg |
Hyperphosphatemia | Found in renal failure and lymphoblastic leukemia |
Hypophosphatemia | Found in people ingesting antacids and alcohol withdrawals |
Toxic effects of phosphorus? | fatty liver, tissue necrosis, garlic breath |
What does APAP stand for? | N-acetyl-p-aminophenol |
Toxicity of tylenol? | NAPQI binding to deplete glutathione stores |
Therapeutic range for tylenol? Toxic? Lethal? | <200mg/L.........toxic: >300mg/L..........Lethal: >600mg/L |
Treatment of acetaminophen poisoning? | Mucomyst (N-acetylcysteine) |
Salicylates therapeutic range | 10-30 mg/L |
Screen test for salicylate poisoning? | FeCl3 using Trinder's reagent----->purple at 540nm |
ToxiLab A detects? (5) | Basic & neutral drugs pH 9, acetaminophen, morphine, strychnine, amphetamine |
ToxiLab B detects? (3) | Acidic & neutral drugs pH 4.5, phenobarbital, dilantin |
ToxiLab drug ID is based on? | Matching unknowns with standards for migrating pattern and color characteristics |