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Clinical Chem Snoopy style > Toxicology > Flashcards

Toxicology Flashcards

1
Q

T/F highest incidence is with adults, then teens then kids

A

False, highest incidence is with Kids <5yrs, then teens then adults

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2
Q

Describe Toxicology

A

study of adverse effects of xenobiotics in humans

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3
Q

Describe Xenobiotics

A

chem/drug not normally found in human body/nor produced

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4
Q

What are the three disiplines of toxicology

A

Mechanistic
Descriptive
Regulatory

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5
Q

Describe mechanistic toxicology
wdrb

A

cellular/molecular/biochem effects with dose response basis for developement

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6
Q

Describe Descriptive toxicology

A

Animal experiments to predict levels in humans/risk assesment

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7
Q

Describe regulatory Toxicology

A

combined data with mechanistic/descriptive to create standards, levels of exposures and works with most government agencies

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8
Q

Briefly describe the Specialities in toxicology
Forensics: A
Clinical: DS
Environmental

A

Forensics: establish analytical test methods, cause of death

Clinical: Relationship xeno/disease states/diagnosis

Environmental: Chemicals/enviroments

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9
Q

Describe Xeno poisons
hint: what kind of agents

A

exogenous Agents

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10
Q

T/F: xeno environment exposures are ABX, anti-depr

A

true

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11
Q

Describe poisions

Toxins

Toxic

A

animal/plant/mineral/gas

Toxins - endogenous, biosynth in living cells (botulism/snakes)

Toxic - not produced in living cells

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12
Q

T/F 50% of poisions are by suicides
30% accidental
rest is occupational/homicides

A

true

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13
Q

What are common routes in posionings

A

ingestion,inhalation,transdermal

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14
Q

Describe Ingestions briefly
what kind of effect?
how is it diffused?
must be able to?
what kind of lipid solubility?

A

systemic effect - must be absorbed into circulation
PASSIVELY DIFFUSED
must be able to cross barrier
hydrophobic

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15
Q

T/F toxins not absorbed are local effects with diarrhea and bleeding

A

true since it is not in cirulatory system

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16
Q

Describe dose response relation
central theme
establish/correlate?

A

central theme: all substances have possibility to cause harm
establish index
must correlate with dose that will cause harmfull effect

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17
Q

Describe oral dose responses and their lethal compounds
single acute dose…..
most xenos…
super toxic

A

single acute dose w probability of lethal compound in a 154lb male
most xenobiotics produce pathos other than death
SUPER TOXIC <5MG/DL

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18
Q

Describe TD50
LD50
ED50

A

Toxic dose 50%
lethal/death 50%
Effective dose 50%

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19
Q

What is the theraputic index

Large TI

Quantal dose relationship

A

ratio of TD50 to LD50 to the ED50

Large TI: fever/toxic/adverse effects when dose is in T.R

Q-dose: change in health effects of a defined population based on exposure to xenobiotic

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20
Q

Acute vs Chronic Toxicity

A

A- single short term exp to substance, dose is sufficient to cause immed toxic effect
C - repeated exp. to peroids of time, doses insufficient to cause response

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21
Q

T/F chronic toxicity may affect different systems than acute

A

true

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22
Q

Analysis of agents
D
H
Targetting:
e
s
c

A

drug screen
heavy metal panels
Targetting: environmental risk, supportive invest
clinical susp

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23
Q

Analysis of agents: Specific types
examples of samples

A

blood/urine
forensic: serum/plasma/hair

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24
Q

Describe Toxokinetics
unique?
coordinates with?
t?

A

uniqure absorb, distrib, metab, elim
Coordinate w selection of specimen
timing of collection

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25
Q

T/F “trace elements free” blood collect tubes - ROYAL BLUE TOPS

Tan tops - lead testing

A

True

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26
Q

Describe the two step process

GC-MS
LC-MS
ICP-MS

A

screening/rapid/simple
LACK SPECIFICITY
Confirmatory

GC-MS (organic)
LC-MS (analytical tech)
ICP-MS (inorganic)

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27
Q

Describe Alcohols
Toxic effect
most common what
biotransformation

Met pathway

A

toxic effect gen/specific
most have sim effect to equiv. [ ]
MOST COMMON DEPRESSANT ON CNS
biotransf of alc - toxic

met path:
ALC - ADH - ADLEHYDE - ALDH ACID

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28
Q

Describe Ethanol
Exposure
top 10…
affects what organ
Key role

Met pathway

A

exposure common
excessive consumption
Top 10 causes of hosp. admission
LIVER
adduct formation w/ ACETALDEHYDE (KEY ROLE)

ETH - ACETALD - ACE- ACETALD ADDUC

29
Q

What is the legal limit for Alc/eth

A

.08mg/dl

30
Q

Describe Methanol
common in
ingestion of what
whats the bad acid in it and what does it cause

A

common lab solvent
house hold cleaner
accidental ingest w homemade liquor
FORMIC ACID - severe met. acidosis

31
Q

Describe Isopropanol
what kind of product
similar to?
acute phase?

A

end product of acetone
similar CNS depressant like ethanol
severe acute phase

32
Q

Describe Ethylene glycol
what is it found in
taste?
who?
causes?

A

hydrolic fluid/antifreeze
sweet
alcohol dependency/kids
severe met acidosis/renal damage

33
Q

T/F Ethanol uniformly distributes in body - use serum to test BAL

A

true

34
Q

What do you use on a sample to prevent bacterial fermentation

A

Sodium Fluoride

35
Q

What are some analytical methods of toxicology
what kind of testing? (ex. osm)
increase osmolarity =
increae serum osmo =

A

osmom,chromatography,enzyme

Incr osmolarity = inc ethanol
Incres serum osmo = 10/60 ethanol

36
Q

T/F osmol gap = measured - calc osmo and is not specific to ethanol

A

true

37
Q

T/F enzymatic methods dont use non human term of ADH to oxidize ethanol to acetaldehyde and NAD - NADH

A

false, they do use non human

38
Q

Headspace GC coupled w flame ionization —
ref method?
v?
compared to?

A

ref method saturation sodium chloride - volitile into headspace
compared to standard n-propanol

39
Q

Describe Carbon Monoxide
imcomplete combustion of
characteristics
COHB
binding sites

Ingestion vs aspiration

A

incompl. combustion of carbon containing substances
Colorless/tasteless/smellless
COHB - 200x affinity for O2
Competes for binding sites (treat w 100% O2 therapy)

INGESTION GREATEST HAZARD
aspiration pulmonary edema

40
Q

Describe Cyanide
toxic?
common in?
high what levels
binds to?
clearance in?

A

supertoxic
common suicide agent
HIGH LACTIC LEVELS
binds to heme iron

Clearance in kidney

41
Q

Describe Arsenic
where is it found
people?

3 groups

organic is found in?

A

natural/manmade
env. exposure/occupational
homicide/suicide

Groups:
Arsine gas
ingorganic form
organic form

Organic in seafood

42
Q

t/f arsenic does not bind to proteins and cant change structures

A

false it does bind to proteins and can change structures

43
Q

Describe Cadmium
Electro…galu
found in
hazards?
foods?
toxic to which organ
what dysfunction

A

electro/galunizing
paint/plastics
batteries
Environmetal hazard - tobacco
Cadmium rice
Toxic to kidneys
PARATHYROID DYSFUNC AND VIT D

44
Q

Describe Lead
found in?
wide
inhibits
accum?
whos at worse risk?

A

indust. products
paint/gasoline
widely dissem. in body
inhibits enzymes

Accum in kidneys
infants at worst risk/kids

45
Q

Describe mercury
what 3 metal forms

how does it get inside people?

Elemental form
Calfonic form
organic form?

A

metal 3 forms:
environ.
inorgan salts
compound of organic compounds

Accidental igestion industrial setting common

Elemental mercury - poor effects
caflonic mercury - moderatley toxic
Organic mercury - toxic extreme

46
Q

T/F Most common route of mercury is ingestion

A

true

47
Q

What are some disease states mercury posioning causes?

organic forms?

A

thyroditis and necrosis of intestines
binary inhibits enzymes

Organic forms are rapidly absorbed and increased in the brain

48
Q

Describe pesticides

where is it found
toxic effects? how long does it last?

Where is the most frequent route

A

insecticides..etc
occupational and in homes
potential toxic effects
short term

contaminated food - frequent route of exposure

49
Q

Describe Salicylate
type of drug?
common name?
what syndrome?

Acute injestion causes?

Treatment?

A

Theraputic drugs
Asprin
Reyes syndrome w/ viral infection in kids

Acute injestion: metabolic acidosis (hyperventilation)

Treatment: neutralize acid

50
Q

T/F common method of salicylate testing is with chromogenic assay

A

true

51
Q

Describe Acetomenophen
common name
overdose causes?
binds to?

most concern?

A

Tylenol - common analgesic
Overdose - hepatictoxicity
Bind high to proteins/low free fractions

MOST CONCERN MPO onset hepatic damage - 3-5 days

52
Q

Describe drugs of abuse
d/o
substance abuse:
typically found:

A

drug overdose (ID agent)

Substance abuse: OTC
use of recreational drugs

Typically found in urine (recent drug abuse)

53
Q

T/F DOA testing cant show difference between acute/chronic abuse/time frame/dosage

A

true

54
Q

Describe DOA testing
what kind of approach
may auto detect?

screening pannel

A

two tiered approach screen and spot test/may auto detect chemicals of related substances

High spec/sensitivity
GC-MS

Screening pannel: + drug above cut off
- drug blow cut off

55
Q

Describe methaphetimines/amphetimines
therapy for?
Stim?

Chronic use?

Overdose?

Otc?

Cross reactivity?

Confirmation?

A

Therapy for ADD/narcolepsy
Stimulator with high abuse potential

Chronic use: dependancy/tolerance

Overdose rare

OTC-ephedrine/pseudo are related chemicals

Urine cross react with OTC

Confirm with GC-MS

56
Q

Describe sedatives/hypnotics
What do they do?

What types are most common for abuse and most found?

what does it cause?

What increases potency?

A

CNS depressants
wide roles/abuse

BARBITURATES/BENZODIAZEPINES
(most common for abuse and most found)

Respiratory depression - serious toxic effect

Potency increased with ethanol use

57
Q

Describe Barbiturates
how quick?
presence?

A

Sleep inducers
“downers” after cocaine high
fast acting
presence use within 3 days

58
Q

Describe Benzodiazapines
addiction?
met?
found?
diazapam?
+?

A

CNS depressants
eff/low addiction
metabolized quickly
only found in urine
5-20 +

DIAZAPAM - IN URINE WITHIN 30 MIN

59
Q

Describe Cannaboids THC
what type of compound
most abundant?
chronic use/elim?

major product?
testing sensitivity?

A

phsychoactive compound in weed
THC most abunt - hashish
Chronic use not well established
Slow elimination

MAJOR PRODUCT - THC-COOH

tetsing is sensitive: passive inhalation

60
Q

T/F THC is not rapidly removed by lipophine

A

false it is?

61
Q

T/F THC is passively diffused into the brain and fats

A

true

62
Q

Describe Cocaine
local?
high?
alk…

acute tox

rapid?

A

local anesthetic
High concentration potent CNS stimulator
Alkaloid salt

Acute toxicity- hypertension

Rapid hepatic hydrolysis to inactive metabolism excreted in urine

63
Q

T/F cocaines primary factor that determines toxicity is dose and route?

whats worse?

A

true, worse is IV then smoking

64
Q

Describe Opioids
an
related
chem mod:
common synth:

abuse?

acute overdose/high level overdose?

A

anesthesia
related to opium poppy

Chem mod: heroine, oxy

Common synth: Fentanyl

High abuse

Acute overdose: respiratory acidosis
High level overdose: death

65
Q

Describe TCAs

attemps
blocks?

A

depression/mood disorders
suicide attempts
block serotonin/noepinephrine
3 ring chemical structure

66
Q

Describe MDMA
how is it taken?
eliminated?
how much in urine?

A

ecstacy
200 types
orally, eliminated hepatic
20% in urine

67
Q

Describe PCP
what kind of drug?

adverse effects?
chronic use?

A

“angel dust”
illicit drug/anetsthetic

Adverse: paranoia/agitation
Chronic heavy use 30 times a day

68
Q

T/F PCP laced things are lipophilic

A

true and they go to your brain and fat

69
Q

Describe Anabolic steroids

A

testosterone
increase muscle mass
underground labs -
toxic hepatitis/stroke/myocardial infarction

Enlarged heart

Males: testicular atrophy/sterility
Females: breast reduction/masculine traits

Clinical Chem Snoopy style (8 decks)

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