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Clin Chem Exam 2

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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  


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