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Flashcards in Toxicology I Deck (76):
1

What are most poisons produced by?

medication

2

What type of medications produce the greets number of poisons?

OTC analgesics

3

What do street drugs rank on the poisons list?

10th

4

What are the most common non-medication toxicities from?

household cleaning products

5

Are people actually worried more about lower risks than higher ones?

yes

6

What are the 2 main goals of toxicology?

1. protection of humans and the environment
2. development of better selective toxicants.

7

What was paracelsus major statement in terms of toxicology?

All substances are poison, there is none which is not a poison. The right dose differentiates a poison from a remedy.
[1. tried to experiment with toxins
2. tried to distinguish dose ranges
3. requested that active ingredients be extracted to have better and stronger effect]

8

Is poison a quantatative or qualitative concept?

Quant.

9

What is the most lethal toxin?

Botulinus Toxin

10

What is the most lethal manmade toxin?

TCDD dioxin

11

How many children die each year of unintentional poisoning? leading cause of death?

More than 45,000 (5-17 age) 5th leading cause of injury death

12

How man unintentional poisoning deaths in the US. in 2014

36,280
11.6 per 100,000

13

T-F--trends of deaths by poison has been falling? motor vehicle accidents?

False
True

14

When does rates of poisoning deaths jump up according to age?

late teens, 20

drops off at 60

highest at 50

15

Poisoning in young children <5 is most likely caused by what? 2nd cause? 3rd?

Parents medications (over half)
Cosmetics
Cleaning supplies

16

How many of adolescent poisonings are intentional, either as a suicide or substance abuse?

Over half

17

In adults what poisons far outnumber street drugs?

prescriptions

18

What is the percentage of unintentional poisoning in hospitals by drugs?

79%

19

What is risk in terms of toxicology?

The probability or likelihood of adverse effects occurring

20

Is smoke plum or alcohol exposure voluntary? under own control? known risks? common risks? immediate adverse effects? consequences reversible?

1.alcohol
2. alcohol
3. Alcohol
4. Alcohol
5. Alcohol but both can be or not be
6. Alcohol, but both can be or not be.

21

IS poisoning a growing problem?

Yes

22

What is the 3 step approach to risk prevention?

1. Hazrd Identification and analysis
2. Risk Assessment
3. Risk Management

23

T-F- inhalation exposure is easy to avoid?

False

24

4 key air pollutants?

CO, SOx, NOx, Ozone

25

Air pollution is a risk factor for what 2 things?

cardiac death and pulmonary conditions

26

How many US people live in areas with pollutant concentrations deemed unsafe?

1/3

27

What two air pollutants are asphyxiants?

CO
cyanide

28

What air pollutants are irritants?

SO2
NO2
SMOG-OZONE, aldehydes, particles, hydrocarbons

29

What are the 6 criteria pollutants?

CO
SO2
NO2
OZone
PM
Lead

30

Where does SOx come from?

fossil fuel power plants>>>industry

31

Where does NOx come from?

Fossil fuel power plants>vehicles

32

Where does CO come from?

vehicle>>fires, smoking

33

Where does PM come from?

Fires, fossil power plants, industry

34

Order the air pollutants that cause more severe Acute respiratory health effects

SOx > PM >NOx > CO

35

Is CO irritanting?

No- there is really no way of knowing

36

What is CO a result of ?

incomplete combustion with too little oxygen

37

What is the most abundant pollutant in the lower atmosphere

Carbon Monoxide

38

Death rates of CO are higher in what populations?

Men, blacks, 15-24, and elderly

39

What states is CO poisoning higher in?

N. and Midwest

40

T-F-- most CO deaths in garages occur even with doors or windows open?

True

41

Is CO hemoglobin reversible?

Yes, but affinity is 220 times greater

42

If you add .1% if CO in the air, what would be the carboxylhemoglobin percentage?

50%

43

Obviously in CO poisoning hypoxia is a problem, but what occurs when there is altered dissociation characteristics of oxyhemoglobin?

decreased oxygen release in tissues= cellular asphyxia

44

Where are the 1st effects of CO?

brain and heart where the demand is high

45

What binds CO more avidly than hemoglobin A? Why?

Fetal hemoglobin, maternal shift of O2 to the left

46

What are the main symptoms of mild and medium CO exposure?

Headaches that get worse and then unconsciousness etc.

47

Why do we get severe headache in CO poisoning?

edema and up intracranial pressure

48

We know we get heart damage with CO, but do we get congestion and hemorrhages elsewhere?

Yes, in all organs

49

T-F--CO poisoning is marked by delayed neuropsych impairment?

true

50

review the pathology of acute CO poisoning

severe headache
heart damage
congestion and hemorrhaging all over
delayed neuropsych impairment
ischemic anoxia
delayed encephalopathy due to autoimmune

51

What are the symptoms of chronic exposure of CO?

headache- everyone in family
[may be misdiagnosed as influenza, other tips, morning headache in multiple members of family.

52

What are the CO effects on ST changes?

earlier and longer lasting ST changes

53

With CO is there a lower threshold for arrhythmias?

yes

54

Can pulseox detect HbCO?

Not really

55

What lab diagnosis do we usually do for CO? 2

Expired CO
Carboxyhemoglobin- co-oximeter/blood sampling. be aware of time of exposure and measurement

56

What is Tx for CO?

fresh air, O2 100%, hyperbaric, correct hypotension and acidosis

57

Do many victims of CO have subtle memory problems after recovery?

yes about 1/3

11% have long term neurpsych problems

58

Is tobacco smoke a major cause of CO poisoning?

yes

59

What is a major problem of sulfur dioxide with moisture?

conversion to acids--> acid rain, pH change of soil, metal leaching

60

IS SO2 water soluble? what does this mean

Yes-->damage in upper airways

heavy breathing may lead to damage in lower airways

61

Air SO2 levels are in strong association with what?

Asthma episodes

62

At 3ppm of SO2, what happens

You can smell it!

50-100 max tolerable dose for 30-60 min

63

What are the 6 acute affects of SO2?

irritation, cough, burning, lacrimation, difficulty, swallowing

64

What are the long-term effects of SO2?

Aggravation of chronic cardiopulmonary disease

children- reduced lung function and up respiratory infections

65

What is the pathophysiology of SO2? leads to what?

sulfur dioxide+moisture--> sulfurous acid (irritation, inhibition of mucociliary transport, vagal stim, constriction)

66

What is a major treatment of SO2?

Removal from source (no jogging on bad days)

support airway and breathing

decontaminate

67

What color is NO2?

brownish and highly reactive

68

What is NO2 a major source of?

OZONE

NO2+ O2 + light--> NO + O3

O3+NO+dark-->O2+NO2

69

Is NO2 water soluble? what does this mean?

Not really, penetrates deep into the lung

70

What is a very potent respiratory tract toxin? features?

NOx
brinchitis, pneumonia, hemorrhagic pulmonary edema, alvolar damage

71

What is the pathophys of NOx?

lipid peroxidation, decreased ciliary movement, bronchoconstriction, enzyme inhibition

72

What color is ozone?

bluish, slightly pungent odor

73

Is ozone soluble? What does this mean?

penetrate deep into the lung

74

What is the pathophys problem of O3?

forms hydroxy radical--> per oxidation of lipids and oxidation of thiols, amines, proteins

75

In the stratosphere, ozone problems due to decrease halogenated hydrocarbons leads to what?

UV exposure, skin cancer

76

In the troposphere problems due to increase cars on the ozone lead to what?

Acute high dose= pulmonary edema and hemorrhage
Acute low= asthma, irritation
Chronic= bronchitis, emphysema, fibrosis