Environmental Toxicity

Question 1

What binds heme iron in hemoglobin 200-fold more strongly than O2

Answer 1

Carbon monoxide

Question 2

Carboxyhemoglobin shifts dissociation curve for oxyhemoglobin _____.

Answer 2

Left, this impedes the dissociation of O2

Question 3

What what level (percent) of COHb concentration will you have collapse and convulsions?

Answer 3

50-60%

Question 4

At what level of COHb concentration will you have death?

Answer 4

70%

Question 5

At what levels of COHb concentrations will you have severe headache, vomiting, visual disturbance?

Answer 5

30-40%

Question 6

How does hyperbaric oxygen therapy help with carbon monoxide posioning?

Answer 6

Reduces the half life of COHb from 5 hours to 20 minutes

Protect against long term brain injury

Question 7

What is found in fruits and leaves of the Prunus species (almonds, apricoits, cherries, peaches, and plums)? and some other plants, apples, cassava, elderberry, hydrangea and others?

Answer 7

Cyanide

Question 8

What are some industrial uses for cyanide?

Answer 8

Gold and silver ore extraction, stainless steel manufacturing, and petroleum refining

Question 9

What does cyanide form complexes with?

Answer 9

Cation-containing enzymes

Question 10

What is the most significant rapid and irreversible binding of cyanide to?

Answer 10

Ferric ion (Fe 3+) contained in mitochondrial cytochrome oxidase

Question 11

When cyanide inhibits mitochondrial cytochrome oxidase the generation of what stops?

Answer 11

ATP, this leads to tissue anoxia

Question 12

With cyanide poisoning there is an accumulation of ____ acid due to the cessation of aerobic metabolism.

Answer 12

Lactic

Question 13

What are some initial symptoms of cyanide poisoning?

Answer 13

Flushing
Tachycardia
Tachypnea
Headache
Dizziness
N/V

Question 14

What can happen with worsening toxicity w/ cyanide poisoning?

Answer 14

Loss of consciousness
Coma
Hemodynamic comprimise
Arrythmias
Seizures
Apnea
Cardiac arrest
Death

Question 15

Elevated oxygen where is often present in cyanide poisoning?

Answer 15

Venous blood

Question 16

There is a serum lactate of > or = to _____ in cyanide poisoning.

Answer 16

10 mmol/ L

Question 17

What are the three steps to treat cyanide poisoning?

Answer 17

Decontamination
Stabilization
Antidote

Question 18

What is the antidote for cyanide poisoning?

Answer 18

Hydroxocobalamin

Question 19

Each molecule of Hydroxocobalamin binds one cyanide ion forming _________.

Answer 19

cyanocobalamin

Question 20

What type poisoning is at highest risk for young children and causes a disruption of the BBB?

Answer 20

Lead

Question 21

What does lead encephalopathy result in?

Answer 21

Lethargy, vomiting, irritability, and dizziness

can progress to altered mental status, coma, and death

Question 22

Lead toxicity interferes w/ the synthesis of ______

Answer 22

hemoglobin

Question 23

What are three chelators used to treat lead toxicity?

Answer 23

EDTA
DImercarprol (BAL)
Succimer

Question 24

What 2 chelators binds lead, arsenic, and mercury?

Answer 24

Dimercaprol (BAL)

Succimer

Question 25

What are 2 antidotes for iron toxicity?

Answer 25

Defuroxamine, Deferasirox

Question 26

What are 2 antidotes for Copper, used in Wilson's disease.

Answer 26

Penicillamine | Trientine

Question 27

What are three common pesticides?

Answer 27

Parathion Malathion Diazinon

Question 28

What do pesticides do?

Answer 28

Inhibit acetylcholinesterase, producing acute muscarinic and nicotinic toxicity

Question 29

What are 2 treatments for pesticide toxicity?

Answer 29

Atropine and Pralidoxime

Question 30

Which pesticide treatment is a muscarinic antagonist?

Answer 30

Atropine

Question 31

What is the number for poison control?

Answer 31

1-800-222-1222

Question 32

What drug classes in toxic levels can lead to mydriasis?

Answer 32

Adrengeric agonists | Anticholinergics

Question 33

What drug classes in toxic levels can lead to miosis?

Answer 33

Sympatholytics | Cholinergics

Question 34

With what type poisonings will the patient have an almond smell?

Answer 34

Cyanide Amygdalin Apricot pits

Question 35

With what type poisoning will the patient have a fishy odor?

Answer 35

Zinc/aluminum phosphide

Question 36

What what poisonings will a patient have an acetone smell?

Answer 36

Ketosis ethanol isopropyl alcohol salicylates