Toxicology

Question 1

What causes pesticide poisoning

Answer 1

ACHE I poisoning happen due to organophosphates - seen in farmers

Question 2

Pesticides poisoning symptoms

Answer 2

DUMBBELSS
Diarrhea
Urination 
Miosis 
Bronchospasm
Bradycardia 
Emesis
Lacrimation
Sweating 
Salivation

Question 3

What are the nicotinic and CNS symptoms of pesticides poisoning

Answer 3

Nicotinic-> weakness paralysis and fasiculations

CNS—> seizures, respiratory depression and coma

Question 4

Pesticides poisoning treatment

Answer 4

Atropine -> reverses muscarinic and crosses bbb to reverse CMS
Pralidoxime—> reactivates aches reversing muscarinic and nicotinic symptoms but doesn’t cross BBB

Question 5

Where is methanol found

Answer 5

In cleaning products

Question 6

What happens to methanol when it’s ingested

Answer 6

It’s metabolised to formaldehyde and fromic acid

Question 7

What does methanol metabolites do

Answer 7

They are toxic to the eye and cause blindness, CNS depression-> coma

Question 8

How does poisoning with ethylene glycol present

Answer 8

Presents with acute renal failure

Question 9

Where is ethylene glycol found

Answer 9

Automobile antifreeze and engine coolant

Question 10

What happens to ethylene glycol after it enters the body

Answer 10

It is metabolised to glycolic acid which is toxic to the renal tubules and OXALIC ACID can precipitate with calcium forming calcium oxylate score in the renal tubule

Question 11

What does calcium oxylate do to the renal tubules

Answer 11

Causes metabolic acidosis and renal failure

Question 12

What’s the antidote to methanol and ethylene glycol

Answer 12

Fomepizole blocking ADH

Question 13

Usual case of lead poisoning

Answer 13

Child injesting lead containing paint chips or adult inhale in lead mines or frequent contact with batteries and bullets

Question 14

What does lead do in the body

Answer 14

Lead inhibits two enzymes in HEME SYNTHESIS -> leading to anemia
-enzymes are
ALA dehydratase
Ferrochelatase

Question 15

Lead positioning symptoms

Answer 15

Congenitive delays and behavioural changes in children drop in IQ
Short term memory loss, lead palsy(foot drop and wrist drop) in adults

Question 16

Effect of lead on pregnant women

Answer 16

Can cause miscarriage, prematurity and can get excreted in breast milk

Question 17

Lead poisoning treatment

Answer 17

Chelating agents
succimer for children
Dimercaprol or EDTA for adults

Question 18

Effect of mercury poisoning on pregnant women

Answer 18

It’s Teratogenic so we should avoid it in pregnant women

Question 19

How does mercury poisoning happen usually

Answer 19

Occurs from eating sea food and emissions from coal fired planets

Question 20

Mercury poisoning symptoms

Answer 20

It’s neurotoxic so leads to anxiety, irritablity and tremors
Causes acrodynia pink disease -> pink hands and feet

Question 21

Mercury poisoning treatment

Answer 21

Chelating agents like

EDTA and dimercaprol

Question 22

How do we get cadmium poisoning

Answer 22

Ingestion of contaminated sea food
Cadmium uptake from plants
Inhalation of smoke cigs

Question 23

What happens when cadmium is invested

Answer 23

Can lead to kidney failure, liver damage, osteoporosis and itai itai disease

Question 24

What happens when cadmium is inhaled

Answer 24

It causes renal failure and decrease in lung function it can also lead to cancer cells as it produces reactive oxygen species

Question 25

Cyunide and CO poisoning how do they affect the body

Answer 25

They bind and inhibit enzymes containing iron ( cytochrome C oxidase complex IV of ETC) -> inhibiting ATP production—> so anaerobic glycolysis takes over causing increase level of lactic acid and metabolic acidosis

Question 26

How does cyanide poisoning happen

Answer 26

Inhaling of smoke from burning synthetic product or ingesting of amygdalin (apricot seed)

Question 27

Cyanide poisoning characteristic

Answer 27

Bitter almond breath odor, mydriasis, seizures and cardiac arrest

Question 28

Cyanide poisoning treatment

Answer 28

- Activated charchol - Sodium thiosulfate inducing methemoglobin production which binds is to cyanide - hydroxocobalamin which binds to cyanide

Question 29

What is CO called and why

Answer 29

Silent killer- colourless odourless and tasteless

Question 30

How does CO poisoning happen

Answer 30

Inhalation of too much CO, close to the fire inhaling smoke (fireplace) -> multiple individuals may develop symptoms at the same time

Question 31

What does CO do in the blood

Answer 31

It binds to Hb displacing O2 as it has higher affinity

Question 32

Co poisoning symptoms

Answer 32

Headache, nausea, seizures, coma and cherry red rash

Question 33

CO poisoning treatment

Answer 33

High flow 100% O2 ASAP

Question 34

What are Benzene and toluene

Answer 34

Aromatic hydrocarbons

Question 35

What can aromatic hydrocarbons do

Answer 35

They are volatile, can cross BBB so cause CNS toxicity

Question 36

How can toluene and benzene by obtained

Answer 36

From solvent vapours

Question 37

What can benzene cause

Answer 37

Acute myeloid leukaemia | Anaplastic anemia

Question 38

What can toluene cause

Answer 38

CNS depression

Question 39

What are the characteristics of halogenated hydro carbons

Answer 39

Same as aromatic hydrocarbons They are volatile, can cross BBB so cause CNS toxicity

Question 40

Where are halogenated hydrocarbons found

Answer 40

They are found in refrigerants, propellants and cleaning products

Question 41

What does chloroform do

Answer 41

Depletes glutathione (antioxidant) causing necrosis of renal cells and hepatocytes

Question 42

What substitutes glutathione

Answer 42

Nacetylcysteine substitutes glutathione

Question 43

What can carbon tetracholride do

Answer 43

Generation of ROS. Causing necrosis

Question 44

What is chloroform and carbon tetrachloride

Answer 44

Halogenated hydrocarbons

Question 45

What happens when asbestos is inhaled

Answer 45

Leads to asbestosis -> fibrosis and calcification of the lung

Question 46

What type of cancer can asbestos cause

Answer 46

Lung and mesothelioma

Question 47

What happens when inhaling silica

Answer 47

Silicosis

Question 48

Where does silica exposure happen

Answer 48

Mines and stone cuttings - prolonged exposure in to silica industries

Question 49

Silicosis

Answer 49

Progressive irreversible fibrotic lung disease - COPD

Question 50

When do we use chelators

Answer 50

Only use when needed as they have serious side effects and only used with metal poisoning

Question 51

Side effects of EDTA

Answer 51

Given IV or IM can cause reversible renal damage

Question 52

What is dimercaprol used for

Answer 52

Used to chelate mercury

Question 53

Dimercaprol + EDTA uses

Answer 53

For lead

Question 54

Dimercaprol die effects

Answer 54

Increase blood pressure and heart rate ohhh

Question 55

What is DMPS (unithiol)

Answer 55

Dimercaprol derivative- less toxic

Question 56

What is succimer

Answer 56

Derivative of dimercaprol - less toxic given orally - doesn’t cause increase in BP and HR

Question 57

What doesn’t succimer chelate

Answer 57

Zinc copper and iron