Medical Toxicology Flashcards

1
Q

what is the most common cause of poisoning among adults?

A

opioid overdose

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2
Q

branch of toxicology that does therapeutic drug monitoring, and emergency toxicology

A

medical toxicology

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3
Q

which branch of toxicology is patient consent not required?

A

medical toxicology

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4
Q

branch of toxicology that does performance testing, workplace drug testing, and postmortem drug analysis

A

forensic toxicology

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5
Q

in which branch of toxicology does the subject have to consent to be tested?

A

forensic toxicology

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6
Q

in which branch of toxicology is the identity of the specimen presumed?

A

medical toxicology

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7
Q

in which branch of toxicology must the identity of the specimen be proven?

A

forensic toxicology

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8
Q

the material may be fatal if it comes in contact with the skin, is inhaled, or ingested

A

acute toxicity

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9
Q

what is the most common metallic poisoning in children younger than 6 years?

A

iron

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10
Q

a patient presents with nausea, vomiting, diarrhea, abdominal pain, metabolic acidosis, sepsis, shock, drowsiness, coma, respiratory failure, and hepato/nephrotoxicity. what are they likely experiencing?

A

iron poisoning

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11
Q

what is a complication of iron poisoning?

A

GI corrosive damage

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12
Q

what is the cause of an iron overdose in adults?

A

suicide attempt

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13
Q

what is the treatment of an iron overdose?

A

deferoxamine (chelation therapy)

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14
Q

what is the most common adverse effect of taking iron?

A

constipation

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15
Q

what should be given with an iron prescription?

A

stool softener

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16
Q

what is the most important environmental health problem for children younger than 6 years?

A

lead poisoning

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17
Q

a patient presents with developmental/learning delays, irritability, muscle cramps, nausea, vomiting, and pica. what are they experiencing?

A

lead poisoning

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18
Q

what is the complication of lead poisoning?

A

slow absorption

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19
Q

what is the most serious metallic poisoning?

A

lead

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20
Q

when are kids screened for lead?

A

1 and 2 years old

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21
Q

what is the treatment for lead poisoning?

A

chelation therapy

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22
Q

binds to protein sulfhydryl groups and the inorganic compounds it contains is highly toxic and linked to cancer

A

arsenic

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23
Q

substance that is dubbed “inheritance powder”

A

arsenic

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24
Q

where is the highest concentration of arsenic located?

A

in seafood and contaminated water

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25
Q

what 3 specimen are used to test for arsenic?

A

urine
hair
nails

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26
Q

what is the treatment for arsenic poisoning?

A

chelation therapy

27
Q

what is the most common cause of gaseous poisoning?

A

carbon monoxide

28
Q

substance that is colorless, tasteless, and non-irritating

A

carbon monoxide

29
Q

substance that replaces O2 in Hb and may bind to myoglobin and other heme containing enzymes

A

carbon monoxide

30
Q

what are the 2 primary toxic effects of carbon monoxide?

A

cellular hypoxia
anoxia

31
Q

a patient presents with cyanosis, hyperventilation, increased heart rate, decreased mental status. what are the experiencing?

A

carbon monoxide poisoning

32
Q

what happens to the patient if there is 60-70% saturation of carboxyhemoglobin?

A

patient is comatose

33
Q

what happens to the patient if there is 70-80% saturation of carboxyhemoglobin?

A

respiratory failure and death

34
Q

what is the treatment for carbon monoxide poisoning?

A

100% O2 to increase PO2 and displace CO from Hgb

35
Q

what is the specimen of choice to test for carbon monoxide poisoning?

A

whole blood (okay if clotted)

36
Q

CNS depressant that is the #1 date rape drug

A

alcohol

37
Q

what is the most commonly abused drug?

A

alcohol

38
Q

what should we worry about during a detox of alcohol?

A

seizures

39
Q

% ethanol equation

A

proof / 2

40
Q

what are the signs and symptoms of alcohol overdose?

A

Mental confusion
Unresponsive
Snoring
Throwing up

Hypothermia
Erratic breathing
Loss of consciousness
Paleness of skin

41
Q

what 3 specimens can be used for an alcohol assay?

A

serum
plasma
whole blood

42
Q

what is the ideal method of an alcohol assay?

A

gas chromatography

43
Q

what should be avoided when getting a blood sample of an alcohol assay?

A

alcohol wipes

44
Q

alcohol assay that is used to monitor an alcoholic’s long-term compliance

A

GGT

45
Q

alcohol assay that is converted to blood alcohol concentration

A

breathalyzer

46
Q

strong minerals that produce chemical burn on contact and do not vaporize quickly

A

acids and bases

47
Q

where does acid ingestion cause superficial necrosis?

A

esophagus

48
Q

why is the esophagus epithelium resistant to acid?

A

has slightly alkaline pH

49
Q

what is the site of major injuries of acid ingestion?

A

stomach

50
Q

why is the stomach the site of major injury in acid ingestions?

A

gastric juices cannot neutralize acids

51
Q

where are the 2 sites of major injury for alkali ingestion?

A

esophagus
oropharynx

52
Q

what type of ingestion produces deep tissue injuries?

A

alkali ingestion

53
Q

what is the management for aspirin toxicity?

A

correct metabolic acidosis

54
Q

when can activated charcoal be used in aspirin toxicity?

A

if exposure occurred less than 1 hour ago

55
Q

what is the treatment for acetaminophen toxicity?

A

mucomyst (n-acetylcysteine)

56
Q

what is the 2nd most common cause of liver failure, requiring transplantation?

A

acetaminophen toxicity

57
Q

a patient presents with abdominal pain, nausea, vomiting, and diarrhea. what are they likely experiencing?

A

acetaminophen poisoning

58
Q

what would liver enzymes look like 24-48 hours after an acetaminophen poisoning?

A

elevated

59
Q

what occurs 3-5 days after an acetaminophen poisoning? (3)

A

liver failure, coma, and death

60
Q

when is therapeutic drug monitoring useful? (2)

A

drugs with narrow TI
drugs taken on chronic basis

61
Q

what the body does to the drug

A

pharmacokinetics

62
Q

what occurs to the drug if pH > pK?

A

reabsorbed

63
Q

what occurs to the drug if pH < pK?

A

excreted