Environmental Toxins

Question 1

___ is a non-specific chelator that limits drug absorption while ___ is good for recent ingestion of caustic liquids (not pills)

Answer 1

Activated charcoal; gastric lavage

Question 2

Carbamates, VX Nerve agent and methyl parthinon belong to which drug class (most toxic!!)

Answer 2

Organophosphates - type of insecticide

Question 3

True or False: Headache and SLUD symptoms are typical symptoms that are seen in OP poisoning

Answer 3

True

Question 4

Organophosphates inhibit ____, an enzyme

Answer 4

AchE

Question 5

Carbamates bind ____ while OP are ____. Therefore, carbamates are treated with ___ while OP are treated with ___/____

Answer 5

Carbamates = reversible binding; atropine

OP = irreversible; 2 PAM/atropine

Question 6

Which class of insecticides paralyzes the diaphragm, leading to respiratory failure, and depresses CNS centers?

Answer 6

Organophosphates

Question 7

Which class of insecticides inhibits VG sodium channels?

Answer 7

Chlorinated Insecticides (DDT)

Question 8

What two drugs can treat chlorinated insecticide (DDT) poisoning?

Answer 8

1) Phenobarbital
2) Diazepam

Question 9

Patient presents with seizure and weakness. What insecticide have they most likely been exposed to?
A. Chlorinated
B. Pyrethrins
C. OP

Answer 9

B. Pyrethrins

Question 10

Activated charcoal and bronchodilators can be used to treat least toxic class of insecticides, which is ____

Answer 10

Pyrethrins

Question 11

Chloracne is a result of ___ exposure

___ exposure can lead to mesothelioma

Answer 11

Dioxin

Asbestos

Question 12

What two products result from methanol metabolism?

What product results from ethylene glycol metabolism?

Answer 12

1) ADH
2) Aldehyde Dehydrogenase

1) Oxalic acid

Question 13

Three ways to treat methanol poisoning?

Answer 13

1) Fomepizole
2) NaHCO3 - met acidosis
3) Folic B - formate

Question 14

___ can be used to treat both methanol and ethylene glycol poisoning

Answer 14

Fomepizole

Question 15

Hypocalemic tetany and oxalicacidurea crystals are characteristic of ____ poisoning

Answer 15

ethylene glycol

Question 16

Microcytic hypochromic anemia is characteristic of ____ poisoning

Answer 16

Pb (inhibits Hb synthesis)

Question 17

First line drug for Pb poisoning?

Answer 17

Succimer
(2nd is EDTA)

Question 18

True or False: Methylmercury deteriorates BBB while Pb passes into BBB

Answer 18

False - Methylmercury enters into BBB while Pb deteriorates BBB

Question 19

True or False: Chelation therapy is only temporarily effective

Answer 19

True (blood metal levels rebound after therapy)

Question 20

Which form of methylmercury is more toxic: organic or elemental form?

Which form of arsenic is more toxic: organic or elemental form?

Answer 20

Methylmercury - organic

Arsenic - elemental

Question 21

Hyperkeratinosis and Exfoliative Dermatitis are symptoms of chronic exposure to which metal?
A. Arsenic
B. Iron
C. Methylmercury
D. Pn

Answer 21

A. Arsenic

Question 22

____ is a symptom of acute arsenic exposure

Answer 22

Hemorrhagic gastroenteritis

Question 23

Contaminated fish is source of ___ while water is source of ___

Answer 23

methylmercury; arsenic

Question 24

Irreversible deafness and ataxia can result from exposure to which metal?

Answer 24

Methylmercury

Question 25

___ is the drug used to treat arsenic poisoning

Answer 25

Dimercaprol

Question 26

___ is used to treat methylmercury

Answer 26

Penicillamine

Question 27

True or False: Headache suggests CN- exposure

Answer 27

False - suggest CO exposure

Question 28

Treatment for CO exposure?

Answer 28

Hyperbaric O2

Question 29

True or False: CO outcompetes O2 binding and form carboxyHb

Answer 29

True

Question 30

True or False: CN- binds to cytochrome oxidase and inhibits ETC

Answer 30

True

Question 31

Tachy and hot dry skin are symptoms most closely associated with which toxic syndrome? A. Sympathomimetic B. Cholinergic C. Anti-cholinergic Treatment?

Answer 31

C. Anti-cholinergic Neostigmine

Question 32

Both heroin (opioid) and ETOH produce hypotension, miosis, and brady. However, the cause of the prior is ___ while the cause of the latter is ____

Answer 32

opiod = narcoitcs ETOH = barbituates, benzos

Question 33

___ are a class a drugs that could lead to cholinergic syndromes

Answer 33

Insecticides (OP)

Question 34

IV saline and flumazenil treat which toxic syndrome?

Answer 34

Non-opioids

Question 35

Benzodiazepines and Lidocaine can treat seizure and tachy, respectively, both of which are commonly seen in which toxic syndrome?

Answer 35

Sympathomimetic

Question 36

True or False: Tachy, HTN, myriasis, and sweating are symptoms of sympathomimetics (e.g cocaine)

Answer 36

True