Toxicology

Question 1

What are the metal chelators?

Answer 1

EDTA, succimer

Question 2

Define LD50

Answer 2

Lethal dose needed to produce death in 50% of those treated

Question 3

Define LC50

Answer 3

Lethal concentration of a gas to produce death in 50% of patients

Question 4

Define NOAEL

Answer 4

No observed adverse effect level. Highest dose that does not produce significant toxic effect.

Question 5

Define RfD

Answer 5

Reference dose, estimate of daily exposure to an agent that is assumed tohave no adverse health impact

Question 6

What does anticholinergic toxicity (atropine) look like? What is the treatment?

Answer 6

Tachycardia, dry hot skin, elevate temp, urinary retention, agitated delirium.

Treatment with physostigmine

Question 7

What does sympathomimetic toxicity look like? What is the treatment?

Answer 7

Tachycardia, hypertension, elevated temp, diaphoresis, mydriasis, seizures, paranoia

Treatment IV benzodiazepine
Lidocaine for cocaine induced ventricular fib

Question 8

What does opiate toxicity look like? What is the treatment?

Answer 8

Hypotension, bradycardia, coma, respiratory depression, miosis, hyporeflexia

Treatment is naloxone

Question 9

What is the treatment for nonopiates?

Answer 9

Symptomatic treatment

Flumazenil for benzo

Question 10

What are the signs of cholinergic toxicity? How is it treated?

Answer 10

Confusion, muscle twitching, salivation, weakness, urination

Atropine
Pralidoxime for organophosphates, nerve agents

Question 11

This is a non specific chelator, limits drug absorption.

Answer 11

Activated charcoal

Question 12

This is a non specific antidote useful for drug poorly absorbed by charcoal such as lithium.

Answer 12

Whole bowel irrigation with PEG 3350

Question 13

Organophosphates act as what?

Answer 13

Acetylcholine esterase inhibitors

carbamates(physostigmine)

Question 14

What are the signs and symptoms of organophosphate toxicity?

Answer 14

headache, nausea, dizziness, SLUD= salivation, lacrimation, urination, defication

Question 15

What is the treatment for organophosphate toxicity?

Answer 15

Atropine.

2-PAM for non-carbmates

Question 16

Where is methanol found?

Answer 16

Windshield washer solvent

Question 17

What is the MoA of methanol?

Answer 17

metabolized to formaldehyde by ADH

cause blindness, metabolic acidosis

Question 18

What is the treatment for methanol poisoning?

Answer 18

Fomepizole

Question 19

Where is ethylene glycol found?

Answer 19

auto antifreeze

Question 20

What is the MoA of ethylene glycol?

Answer 20

Metabolized to oxalic acid that had high affinity for calcium causing hypocalcemia, tetany. Crystal formation leads to renal injury.

Question 21

What is the treatment for ethylene glycol poisoning?

Answer 21

Fomepizole

IV Ca, B vitamins

Question 22

Where is diethylene glycol found?

Answer 22

improper pharmaceutical products

Question 23

What are the signs of diethylene glycol poisoning?

Answer 23

Anuric renal failure, hepatitis, pancreatitis, nausea

Question 24

What protein in the body acts as a chelator?

Answer 24

Metallothionein

Question 25

What is the difference in halftimes for lead?

Answer 25

short in soft tissue long (years) in bone Inorganic common

Question 26

What is the source of lead?

Answer 26

consuming contaminated food prepared in lead cooking utensils or canned food Lead paint chips/dust inhalation, drinking water

Question 27

Hypochromic microcytic anemia, weak wrist/ankle, encephalopathy, colic are signs of?

Answer 27

Lead poisoning

Question 28

What does lead do in the body?

Answer 28

inhibits hemoglobin synthesis resulting in anemia.

Question 29

What is the treatment for lead poisoning?

Answer 29

Succimer, or EDTA | Dexamethasone for cerebral edema

Question 30

What is childhood lead exposure associated with?

Answer 30

lower IQ, ADHD, aggressive behavoir

Question 31

Which form of arsenic is more toxic? where is it found?

Answer 31

Inorganic forms. | Shrimp,shellfish, water supplies

Question 32

Violent nausea, laryngitis, bronchitis, hemorrhagic gastroenteritis, garlic breath are signs of?

Answer 32

Arsenic poisoning

Question 33

Hyperkeratosis, exfoliative dermatitis, vesicular lesions on feet are signs of chronic?

Answer 33

Arsenic poisoning

Question 34

Which form of methylmercury is more toxic?

Answer 34

Organic are highly absorbed from GI tract and pass BBB. | Contaminated fish and grain fungicides

Question 35

Cerebellar ataxia, movement disorders, deafness, loss of visual field are signs of?

Answer 35

Methylmercury poisoning

Question 36

When are metal chelators used?

Answer 36

Only used in patients with highly elevated metal levels or severe toxicity.

Question 37

This drug is given IV or IM for severe lead poisoning.

Answer 37

Calcium EDTA,

Question 38

This drug is toxic to kidney at high dose. It can cause flu-like symptomes.

Answer 38

Calcium EDTA

Question 39

This was the first orally effective metal chelator.

Answer 39

Succimer | more rapid than EDTA for lead and may also be used for mercury and arsenic

Question 40

This is a colorless, odorless, tasteless, nonirritating and ubiquitous gas.

Answer 40

Carbon monoxide

Question 41

What is the MoA of Carbon monoxide?

Answer 41

Out competes oxygen for binding sites on hemoglobin and forms carboxyhemoglobin.

Question 42

Where is cyanide found?

Answer 42

Present in smoke (plastics, wool, metal plating)

Question 43

Bitter almond breath, apnea, tachypnea, loss of consciousness are signs of?

Answer 43

Cyanide poisoning

Question 44

How is cyanide poisoning treated?

Answer 44

Hydroxocobalamin | or Na nitrite

Question 45

Where are PCBs and dioxin found?

Answer 45

Flame retardants, plasticizers, insulating material

Question 46

Dermal acne-like eruptions called chloracne, nausea, headache, vomiting are signs of?

Answer 46

Dioxin poisoning