Posions

Question 1

sources of carbon monoxide

Answer 1

endogenous
incomplete conbustion of fossil fuels, old cars
exposure to methylene chloride
some drugs - phenytoin, phenobarb

Question 2

is carbon monoxide a routine analysis

Answer 2

no

Question 3

elimination of carbon monoxide

Answer 3

unchanged by the lungs

Question 4

mechanism of carbon monoxide poisoning

Answer 4

binds to hemoglobin causing tissue hypoxia

Question 5

CO level 30-40% sx

Answer 5

sever headache, weakness, dizziness, nv, collapse

Question 6

CO level 40-50% sx

Answer 6

retinal hemorrhage

increased respiration

Question 7

over 50% CO sx

Answer 7

convulsions
coma
death

Question 8

who is most susceptible to CO poisoning

Answer 8

infants
those with lung disease
CV disease
elderly 
anemia

Question 9

treatment of CO poisoning

Answer 9

remove person from source of CO

hyperbaric oxygen

Question 10

problems with interpretation in CO poisoning

Answer 10

whole blood - has to be whole blood bc binds to RBC
putrefaction - byproducts given off that interfere with analysis bc same UV spectrum
fire victims may have to use liver or kidney tissues bc blood coagulated

Question 11

forms of cyanide

Answer 11

hydrogen - cololess gas or blue white liquid

salts - white crystalline powder

Question 12

sources of cyanide

Answer 12

normal metabolism
cigarette smoking
insecticides
electroplating industry
dyeing, printing, photgraphy
combustion of N containing compounds - synthetic furniture
cyanogenic glycosides

Question 13

mechanism of cyanide toxicity

Answer 13

enzymatic poison attacks the cytochrome system
prevents oxygen utilization at the cellular level
results in metabolic asphyxiation (no oxygen)

Question 14

acute cyanide toxicity sx

Answer 14

giddiness
stiff lower jaw
rapid slow breathing
muscle twitching
palpitation
cyanosis
convulsion
coma
death due to resp arrest 
*brain and heart most sensitive

Question 15

chronic cyanide toxicity sx

Answer 15

dizzy
weak
congestion of lungs
conjunctivitis
loss of appetite
weight loss
mental deterioration

Question 16

deathly concentrations of cyanide

Answer 16

> 270ppm immediately fatal
180 - 10min
135 - 30min
110 - 1 hr

Question 17

treatment of cyanide poisoning

Answer 17

body can detoxify on its via rhodanese enzyme

but can be sped up by adding an exogenous source of sulfur

Question 18

agents used in cyanide poisoning

Answer 18

amyl nitrite - given at scene
sodium nitrite
sodiom thiosulfate - best one

Question 19

how does sodium nitrite work

Answer 19

turns hemoglobin into methemoglobin which combines with iron cyanide to form cyanomethemoglobin so cyanide is tied up not causign damage

Question 20

how does sodium thiosulfate work

Answer 20

combines with cyanide to form thiocyanate

Question 21

interpretation of cyanide

Answer 21

whole blood

Question 22

problems with postmortem cyanide detection

Answer 22

enzymes and bacteria produce cyanide

Question 23

what are inhalants

Answer 23

breathable chemical vapors that producs psychoactive effects

volatile solvents, aerosols, anaesthetics, volatile nitrites

Question 24

reason for widespread use of inhalents

Answer 24

low cost
ready available
legal

Question 25

methods of inhalant exposure

Answer 25

inhalation oral ingestion skin contact

Question 26

what is sniffing

Answer 26

directly inhaling from container or heated pan or from a piece of clothing soaked with solvent

Question 27

what is huffing

Answer 27

holding solvent soaked rag over face and breathing in through mouth

Question 28

what is bagging

Answer 28

spraying or pouring the solvent into a plastic bag holding over mouth and nose and inhaling from the bag

Question 29

typical abuser of inhalants

Answer 29

young male underpriveleged unstable home poor student with high rate of absenteeism

Question 30

ppl likely exposed to inhalants

Answer 30

``` doctors nurses dentist hair stylist painter dry cleaners ```

Question 31

stimulant phase of sniffing

Answer 31

``` euphoria excitement release of inhibitions floating sensation delusions of grandeur and invincibility lasts 15-30min ```

Question 32

depressant phase of sniffing

Answer 32

``` drowsy slowed reflex stupor bizarre thoughts hallucination similar to alcohol intoxication lasts 1-2hrs ```

Question 33

indicators of inhalant use

Answer 33

``` pungent chemical odor excessive nasal secretion red watery eyes, dilated pupil, rapid involuntary eye movement double vision ringing in ears vivid dreams hallucination slow slurred speech white powdery ring of dried glue around mouth and nose paint stains on body or clothing drooling, sores aroudn mouth paraphenalia with traces of paint/glue ```

Question 34

inhalant absorption

Answer 34

vapors enter bloodstream directly from lungs | stored in fat tisssues and slowly released back into the blood

Question 35

inhalant distribution

Answer 35

rapidly distributed to brain and liver

Question 36

inhalant metabolism

Answer 36

some metabolized and excreted by kidneys | other eliminated unchanged via lungs

Question 37

long term effects of sniffing

Answer 37

``` fatigue chronic headache dizzy depression irritable loss of concentraion loss of appetite tremor liver kidney and brain damage ```

Question 38

dependence associated with inhalant use

Answer 38

psychological dependece tolerance no physiological dependence but some develop tremors

Question 39

what is sudden sniffing death

Answer 39

follows strenuous exercise or stress after several deep inhalations of sniff caused b yheart failure resulting from severely irregular heartbeat (arrythmia) associated with halogenated hydrocarbons