16. Acid and base poisonings, oxalic acid

Question 1

??

Answer 1

• Alkaline substances damage tissue by accepting a Proton - Acidic substances donating a proton in an aqueous solution. - The injury determined: Duration The amount and state (liquid, solid) Physical properties (pH, concentration, ability to penetrate tissue, and its titration) - Acid: vingar, oxalic, sulfuric, nitic - Alkaline: ammonium, custic soda, slaked lime

Question 2

Alkaline

Answer 2

• Liquefactive necrosis saponification of fats solubilization of proteins - Alkaline agent reacts with tissue collagen –> swell and shorten –> Small vessel thrombosis and heat production.

Question 3

alkaline

Answer 3

• Destruction of Squamous epithelial cells of the pharynx and esophagus. - (The esophagus is most commonly involved with the stomach much less frequently involved after alkaline ingestions.) - Tissue edema - May progress to an airway obstruction - Enough, necrotic tissue is replaced by granulation tissue  perforation treatment Alkaline - Same as acid, except alkalization. - Administration of calcium.

Question 4

acid

Answer 4

• coagulation necrosis –> eschar or coagulum - stomach is the most involved –> due to some natural protection of the esophageal squamous epithelium - Early symptoms: pyloric- and antral spasm, emesis and hemorrhage - Late symptoms: Perforation and gastrointestinal hemorrhage. treatment Acid - NO induction of emesis - NO gastric lavage - exothermic reaction, emesisre-exposing tissue to harm - NO neutralization!! - Oral local anestheticsmorphine, atropine, glucocorticoids, - Drop infusion of 5% NaHCO3 or Na-Lactate Dilution of the acid content of the stomach by milk, eggs

Question 5

oxalic acid

Answer 5

• Naturally occurring in many plant foods –> spinach - Used in industry for rust removal - In high amount appear acidic and have chelating properties. - Symptoms: - Ulcerations of the mouth, - Vomiting of blood, shock - Convulsions - Twitching - Tetany Oxalic acid bind calcium –> form calcium oxalate which is insoluble at physiological pH –> precipitate in the kidney tubules and the brain. Hypocalcemiasecondarytocalciumoxalate- - - disturb of heart and nerve - skin ulcers - corneal injury If inhaled it can cause respiratory tract injury Chronic exposure thyroid problems and weight loss can occur. - Oral/IV CaCl2 Oxalic acid Treatment - Or IV calcium gluconate, forced diuresis with excessive fluid infusion.