Toxicology

Question 1

Classification of poison?

Answer 1

CINCAM

Question 2

Eschar is formed in acid / alkali?

Answer 2

Acid
Limit lateral spread

Question 3

Coagulative necrosis is seen with…..

Answer 3

Acid
Alkali -liquefactive

Question 4

Acid/ alkali which one is more dangerous?

Answer 4

Alkali
Cause deeper damage

Question 5

2 types of acids? Examples of each?

Answer 5

Organic : carbolic, acetic, oxalic,formic
Inorg: sulphuric, nitric, hydrochloric.

Question 6

Give examples of alkali

Answer 6

Ammonia
Sod/ pot hydroxide
Sod/ pot carbonate

Question 7

The 4 things u shouldn’t do in a corrosive poisoning case?

Answer 7

Emesis
Gastric lavage
Charcoal
Neutralize

Question 8

Properties of alkali vs acid

Answer 8

Xanthoporetic action.
Carbonisation
Hygroscopic property.

Question 9

What are the Common features of corrosive consumption other than odynophagia, intense thirst, vomithing, (6)?

Answer 9

Abdominal pain
Chemical peritonitis
Resp distress.

Question 10

Autopsy finding in sulphuric acid poisoning?

Answer 10

Black necrotic tongue
Black necrotic stomach mucosa
Gastric perforation
Chalky white teeth

Question 11

Autopsy findings in nitric acid poisoning?

Answer 11

Yellowish discoloration of skin, teeth, stomach mucousa, brownish stomach mucosa

Question 12

What is vitriolage? Commonly used corrosive for this? What all u can see while examining the victim?

Answer 12

Intentionally throwing corrosive for the disfigurement of a person.
Sulphuric
Nitric
Marking nut juice
Chemical burns, ulceration, contractures.
No blister, singeing of hair

Question 13

How you can manage vitriolage??

Answer 13

Topical irrigation with water and ns
Apply Mgo paste
Eye= olive oil

Question 14

Carbolic acid is also k/as…….
It has a…… Property.how cresol, lysol and dettol related to this acid.how this acid is produced?

Answer 14

Phenol.
Antiseptic
They are phenol derivatives
Phenol crystal on exposure to air forms pheenol liquid

Question 15

Presentation of an acute phenol poisoning(carbolism) case??

Answer 15

Burning pain - tingling& numbness - anaesthesia.
Decrease emesis
Leathery stomach mucosa.
Blood= 1.pyrocatechol
2.hydroquinone
CNS:CNS depression, convulsion, constriction of pupil.
URINE: Olive green urine.
Kidney :oligouria, renal failure.

Question 16

What is Phenolic marasmus??

Answer 16

Chronic phenol poisoning

Question 17

How we clinically diagnose phenol poisoning?

Answer 17

Phenolic odour, dark urine
( gastric lavage possible due to lathery stomach mucosa)

Question 18

Autopsy feature of phenol?

Answer 18

Resistant to putrefaction.

Question 19

What kind of acid is hydrofluoric acid? And what effect does it have?

Answer 19

Inorganic acid
Local+ systemic effect
Causes : liquefactive necrosis.

Question 20

Toxicity of hydrofluoric acid is due to?

Answer 20

Fluoride ion.
Which cause
LIQUEFACTIVE NECROSIS: affect skin/ deeper tissue/ bones.excruciating burning pain disproportionate to amount of exposure.
2. INSOLUBLE SALT with calcium, magnesium leads to
Hypocalcemia, hypomagnesemia, & hyperkalemia

Question 21

How to manage a condition of hydrofluoric acid toxicity?

Answer 21

*Immediate icu admission.
*Continuous ecg monitoring
* Topical decontamination e water
*Calcium gluconate 2.5% topical, *injection of calcium gluconate.
*Correct electrolyte level

Question 22

To whom hydrofluoric acid toxicity occur more?

Answer 22

Glass etching.

Question 23

Oxalic acid is an……. Acidic. Also known as…………..! It visually resembles…….it was used for………

Answer 23

Organic
Acid of suga
Magnesium sulphate.
Ink/ rust removal

Question 24

Source of oxalic acid?

Answer 24

Veg such as almond, corn,spinach,
Ladies finger

Question 25

What happens if Oxalic acid comes in systemic circulation?

Answer 25

Calcium oxalate hypocalcemia Crystals features of Oxaluria tetany. Needle/ evelope Shaped cast. Comes out of Urine. Block tubule & renal Failure.

Question 26

How u treat oxalic acid poisoning?

Answer 26

GL e calcium lactate solution. Antidote : calcium gluconate. Hemodialysis. Rx of renal toxicity.

Question 27

Boiled lobster appearance is seen?

Answer 27

Boric acid Erythemic skin. Peeling of skin Skin is completely swollen.

Question 28

Most common acute heavy metal poisoning?

Answer 28

Arsenic

Question 29

Mc chronic heavy metal poisoning?

Answer 29

Lead

Question 30

3 forms of Arsenic?

Answer 30

Elemental Org Inorganic(toxic)

Question 31

Example for inorganic arsenic

Answer 31

Salt is there * Arsenic trioxide which is colourless tasteless and order less and most toxic salt of arsenic. *Sheele's green *Paris green. Gas form arsine Garlic odour Most toxic form

Question 32

Types of Arsenic poisoning

Answer 32

*Fulminant which is massive intake (3g) Acute large dose Chronic small dose for a long period

Question 33

Fatal dose in acute Arsenic poisoning

Answer 33

100-200 mg

Question 34

Two forms of acute Arsenic poisoning

Answer 34

Gastroenteric form Which include: profuse diarrhoea Hemorrhagic gastritis Narcotic form Which include: affect CNS Neurological manifestations.

Question 35

Differentiate acute Arsenic poisoning from cholera

Answer 35

Acute Arsenic poisoning Throat pain vomiting loose stools. tenesmus present . On Autopsy : red velvety stomach mucosa. Cholera Ls- v- tp. No tenes

Question 36

Chronic arsenic poisoning is K/as

Answer 36

Arsenicosis

Question 37

Contamination of groundwater e arsenic?

Answer 37

Hydroarsenicism

Question 38

Clinical features of chronic arsenic poisoning?

Answer 38

Skin2 Nail hair Blood vessel Nerve Bm

Question 39

What is torokku arsenic ds?

Answer 39

Inhalation / drinking (contaminated e arsenic). Lung ca Skin ca Bowen ds

Question 40

Black foot ds

Answer 40

Taiwan ( endemic ds ) Drinking Peripheral vasospasm Ischemia Peripheral gang

Question 41

Most reliable sample used? Other samples?

Answer 41

Urine Blood,hair, nail, bone.

Question 42

Tests for arsenic poisonig

Answer 42

Obsolete - marsh, reinsch. Latest- neutron activation analysis Atomic absorption Spectrometry.

Question 43

Medicolegal imp

Answer 43

Accidental. Homicidal (Retard putrefaction Decomposed bodies, ash) Aphrodisiac.

Question 44

Chelating agent for arsenic

Answer 44

BAL, DMSA.

Question 45

Chronic poisoning by mercury is known as

Answer 45

Hydrargyrism

Question 46

Uses of Mercury

Answer 46

Photography Fingerprinting Thermometer Dental amalgam Sea food Hat making Glass bowling

Question 47

Order of toxicity of Mercury

Answer 47

Organic >mercuric >mercurous> element form

Question 48

Mercuria lentis?

Answer 48

Toxicity due to vapour Anterior lens capsule On slit lamp: malt brown reflex Normal vision.

Question 49

Diseases caused by organic Mercury

Answer 49

1.minamata ds Contaminated fish Lipid soluble Cross blood brain barrier CNS symptoms Ataxia, tremor convulsion 2. Hunter russel syndrome

Question 50

Ds caused by inorganic Mercury

Answer 50

Erethism Pink ds

Question 51

Clinical features of erethism

Answer 51

Neuro psychiatric manifestations Tremors Writing- speech- ataxia- concussio mercurialis. Hatters/ glass bowlers/ dandbury shakes. Emotional instability Emotional outburst Most common in hat industry Mad hatter syndrome.

Question 52

What is pink disease

Answer 52

Mercurous poisoning. Hypersensitivity reaction in children Painful peripheries Feeling of skin Pruritis Puffy Calomel/ acrodynia/ swift fear/selters Ds Chelating agent= BAL, DMSA.

Question 53

Why cadmium causes bone weakening bones softening & bone deformity

Answer 53

Because cadmium replaces Calcium from Bone

Question 54

Which poisoning couses itai itai disease or ouch ouch disease

Answer 54

Cd

Question 55

Clinical features of cadmium poisoning

Answer 55

Multiple pathological fractures Severe bone pain

Question 56

This is an homicidal poison which is known as poisoner's poison. This cause butterfly Rash dermatitis, Behaviour change, alopecia, madarosis, aldrich mees line & Peripheral sensory motor neuropathy

Answer 56

Thallium ( th acetate& sulfate )

Question 57

Lead is used in

Answer 57

Paint, pipe, pottery, petrol, pencil, bullet

Question 58

Most toxic form of lead

Answer 58

Tetra ethyl lead Organic form Lipid soluble

Question 59

Inorganic forms of lead?

Answer 59

Lead carbonate Acetate Tetroxide Sulfide.

Question 60

Which are the 2 anaemias sceen in lead poisoning

Answer 60

Normocytic normochromic.( bone marrow suppression ) Micro.hypochro(decreased hb production dt inhibition of ALA dehydratase, ferrochelates. )

Question 61

What is the manifestation of pbs?

Answer 61

Burtonian/ Burton's line. Blue colour deposit in gingivodental jun. Upper teeth 1 w exposure. Dental caries- bact h2s+pb =pbs.

Question 62

Importance of 5- pyramidine nucleotidase

Answer 62

It is required for removal of ribosomal particle from reticulocyte for formation of RBC. It's inhibition causes basophilic stippling.

Question 63

Manifestations in Bone

Answer 63

Bone line RadioDens opacity in metaphysis of long bone. Most common in children's Due to deposition of calcium