Morbidities associated with smoking
Oral, laryngeal, esophageal, lung, pancreatic and bladder cancers. COPD, MI, peptic ulcers and atherosclerosis.
Morbidities associated with lead exposure
Low levels: decreased IQ, hearing, growth and peripheral nerve function. Medium levels: Decreased Hgb synthesis and Ca and Vitamin D homeostasis, increased protoporphyrins, increased nerve conduction velocity. High levels: Colic, frank anemia, nephropathy, encephalopathy and death. Note that GI symptoms are most common in adults.
X-ray indications of lead poisoning in children?
Lead lines at growth plates where the epiphyseal plates are supposed to close.
Peripheral blood findings in someone with lead poisoning?
Basophilic stippling due to accumulation of protoporphyrins.
What do you need to take into account when you see someone with an elevated carboxyhemaglobin level after a car accident?
Were they smokers? Smokers will have an elevated baseline of carboxyhemaglobin.
Treatment of carbon monoxide poisoning?
CO's half life is 4-5 hours. You put someone in hyperbaric O2 chamber.
Cause of 50% of acute liver failures
Acetaminophen. It causes hepatocellulary injury and centrilobular coagulative necrosis.
What causes the toxicity associated with aspirin overdose?
It stimulates respiratory centers and patients will become tachypneic. This results in a respiratory alkalosis and a compensatory metabolic acidosis. Most common symptoms are tinnitus and acute erosive gastritis.
What chemical are you looking for on autopsy if a patient overdosed on cocaine?
Cocaine is metabolized rapidly to benzoylecgonine (BE).
What is the common cause of death in patients that overdose on cocaine?
It blocks DA uptake which stimulates the sympathetic nervous system. This results in tachycardia, hypertension, vasoconstriction, platelet aggregation and very lethal arrhythmias.
What chemical are you looking for on autopsy if a patient overdosed on heroin?
Heroin, opiods, morphine and methadone are all metabolized to 6-monoacetylmorphine (6-MAM)
What is the common cause of death in patients that overdose on heroin?
Pulmonary edema and respiratory failure.