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Emergency toxicology
Clin Chem Exam 2
| 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 |
Created by:
aenewsom
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