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Clin Chem Exam 2

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