ACMT Board Review Course Buzzwords Flashcards
Pneumoconiosis with hilar adenopathy, clinically and pathologically identical to sarcoidosis except no eye involvement, lymphocyte transformation test
Berylliosis
Porphyria, pemba yara, spongiform encephalopathy, outbreak in turkey in 1956
Hexachlorobenzene
Isolated thrombocytopenia, “bathtub refinished lung” sensitizing agent, largest recognized cause of occupational asthma
Toluene di-isocyanate
Hepatic angiosarcoma
Vinyl chloride
Pesticide operator with sterility, altered sex ratio in offspring
Dibromochloropropane (DBCP)
Da balls can’t produce
Phossy jaw
Yellow phosphorus
Brown lung, Monday morning tightness, byssanosis
Cotton
Hypertension, saturnine gout, renal failure, microcytic anemia
Adult lead poisoning
Silver solderers, proximal RTA, Itai-itai disease in jintsu river basin, acute lung injury, renal failure
Cadmium
Perforated nasal septum, lung cancer, painless ulcers, “blackjack disease”, type 4 hypersensitivity dermatitis
Chromium
Hairdresser with hearing loss renal failure, methemoglobinemia
Bromate
A cute psychosis with elevated chloride level
Bromide
Solvent, epoxide metabolite, degreasers flush, trigeminal neuralgia
Trichloroethylene
Viscous rayon, increase rate of atherosclerosis, disulfiram and metam sodium metabolites, basal ganglia toxin, associated with spontaneous abortions, decreased spermatogenesis, craniofacial abnormalities, optic nerve and retinal degeneration
Carbon disulfide
The percentage of sick people who are identified as having the condition
Or
The likelihood of a test being positive if the condition is present
Sensitivity
A result of 100% means that the test recognizes all healthy people as healthy
Or
The likelihood of the unaffected individuals correcting having a negative test
Specificity
Solvent, acute can depression, arrhythmias, aml, Hodgkin’s lymphoma, paroxysmal nocturnal hemoglobinuria
Benzene
Wastewater treatment worker with sensory and motor distal axonal neuropathy , also has blue discoloration of hands and feet, desquamation and pulmonary irritation
Acrylamide
Ginger Jake, NTE inhibitor, sensory motor neuropathy, -1960 Morocco disaster
Triorthocresylphosphate
Mina mats bay
Methyl Mercury
Bhopal diasaster
Methyl isocyanate
Lung cancer, beer drinker with cardiomyopathy, classic tetrad
- Goiter
- Cardiomyopathy
- Metabolic acidosis
- Polycythemia
Inhibits oxidation of a-KG 59 succinyl-Co-A and pyruvate to acetyl-CoA
Cobalt
Pulmonary disease-anemia syndrome
Strong respiratory sensitizer
Trimellitic anhydride
Uranium mining, lung cancer
Radon
Firefighter with delayed pulmonary edema and smell of freshly mowed hay
Phosgene
Pest control operator with fishy odor, respiratory distress, refractory hypotension, delayed pulmonary edema
Phosphine AKA phosfish
Sewage worker with rapid collapse, mucous membranes irritation, blackened jewelry, sodium nitrite antidote
Hydrogen sulfide
Endoscopy technician with mucous membrane irritation, pulmonary edema, leukemia, sweet odor, N/V
Ethylene oxide
Epping jaundice
Methylenedianiline
Aromatic solvent, acute CNS depression, basal ganglia toxin, hypokalemia, pneumonitis, RTA/renal failure, myopathy, leukoencephalopathy
Toluene
Fungicide with pungent odor, skin and respiratory sensitizer, photoallergic dermatitis
Captafol
1937 sulfanilamide poisoning
Diethylene glycol
Neonatal gasping syndrome
Benzyl alcohol
1986 lake nyos disaster
Carbon dioxide
Eosinophilia myalgia syndrome
L-tryptophan
Koremlu poisoning
Thallium
Explosives/munitions production, spandex fibers, causes severe GI distress and vomits that smells like bitter almonds, retro ulnar and optic neuropathy, methemoglobinemia, hepatitis, aplastic anemia, yellowing of skin hair and dyes
1,3 dinitrobenzene
Oily liquid used in explosives and diisocyanate production, possible weight loss product, uncoupler, optic neuropathy, turns skin yellow
Dinitrotoluene
Sweet smelling irritant gas, insect fumigant and heat stabilizer for plastic production, delayed pulmonary toxicity
Epichlorohydrin
Textile finishing agent and used in the synthesis of malathion, vapors result in corneal edema, photophobia, and diplopia, chronic use associated with occupational asthma, hemolytic anemia and pulmonary hemorrhage
Maleic anhydride
Used as an odors t for natural gases, rotten cabbage odor, methemoglobin and hemolytic anemia
Mercaptans
Abdominal pain, hemolytic anemia, Paris green, hematuria, bronze skin
Arsine
Metals that produce non-fibrogenic benign pneumoconiosis (5)
- Tin (stannosis)
- Barium (baritosis)
- Iron (siderosis)
- Calcium (chalitosis)
- Melybdenun
Vineyard sprayers lung - interstitial pulmonary fibrosis, histiocytic grabulomas, adenocarcinoma
Copper sulfate - Bordeaux solution
Hard metal pneumoconiosis, pulmonary eosinophilia portends poor prognosis
Tungsten-carbide
Diamond polishers lung
Cobalt
Patient on dialysis who develops somnolence, peri oral numbness, abdominal pain and hyperamylasemia
Manganese sulfate
Worker with osteosclerosis with accompanying nerve root compression. Plain film X-ray reveals ligament calcification and lesions resembling osteoblasts metastasis
Fluorisis cryolite (NaAlFl)
Acroosteolysis (bone resorption at distal phalanx)
Vinyl chloride
Most common medication associated with hypersensitivity pneomonitis
Nitrofurantoin
Middle aged adult with chronic seizure disorder with X-rays demonstrating hilar lymphadenopathy. Biopsy reveals drug-induced lymphoid hyperplasia.
Phenytoin
Elderly male with hepatic angiocarcinoma and pneumococcal sepsisz abdominal X-ray reveals multiplied opacities in the liver and spleen
Thorotrast (thorium dioxide)
Zenobiotic induced aplastic anemia is most often associated with destruction of these progenitor cells
CD34+ progenitor cells
Lymphoma in a Dutch flower bulb worker using a nematode fumigant (also seen in fireman)
Dichloropropene (telon)
Cola colored infant with MRCP, abnormal skull calcification and hypo plastic nails
PCBS
PEPSI COLORED BABIES
Metabolite of disulfiram and used in the treatment of nickel carbonyl and platinoid poisoning
Diethylsithiocarbamate (DDC)
4 year old in an antineoplasric drug develops fever, SIADH, necrotic myocardial infarction, and loss of deep Tendon reflexes
Vincristine
Antineoplastic producing hilar adenopathy
MTX
Antineoplastic producing nodular bronchiolitis ollbliterans
Bleomycin
Antineoplastic associated with perforation of the GI tract
Paclitaxol
Antineoplastic associated with hemolytic uremic syndrome
Mitomycin
Metal that is radiolucent on plain film X-ray
Copper
Metal causing parasthesias (pins and needles), ataxia, dysarthria, constructed visual fields, deafness
Methyl Mercury
Pink disease - Mercury teething powders such as calomel
Mercury calomel (HgCl)
Hopewell epidemic, “Kepone shakes”, Chessapeake Bay contamination
Chlordecone
Stalinon poisoning, vomiting, transitory paralysis, photophobia, white matter edema
Triethyltin
Golfer with disulfiram reaction at the 18th hole
Thiuram Herbicide
Welder with early Parkinson’s Disease
Manganese
Paraket dies while family is cooking in the kitchen
Polymer fume fever
Welder dies after ingesting soldering flux
Zinc chloride
Black henna, black hair dye, angioedema, renal failure, methemoglobinemia, leukemia/bladder cancer
Para-phenylenediamides
Fumigant worker, peanut poisoning, fish odor
Zinc phosphide
Young male chimney sweeper with testicular cancer
Polyaromatic hydrocarbons
Middle aged male stripping paint that develops angina from delayed carbon monoxide poisoning
methylene chloride
Galvanized metal welder, “Monday morning fever”, “brass foundry workers argue”
Zinc oxide (metal fume fever)
Mill worker with allergic contact dermatitis, and respiratory sensitization (occupational asthma)
Plicatic acid (western red cedar)
Farmer’s lung
Thermophilic actinomycetes
irritant gas, warning agent in methylene chloride, component of papite (tear gas), cyclophosphamide metabolite
Acrolein
Urine metabolite of acrylamide used for testing worker exposure
carboxyethyl-cystine
Primary ingrediant in skin cement, skin sensitizer, elevated urine mercapturic acid, pediatric burns
methyl methacrylate
Spain 1981: rapeseed oil contaminated with aniline, diffuse pulmonary infiltrates on x-ray, methemoglobinemia
aniline
Airbag inflation, herbicide, cytochroma alpha-a3 inhibitor
sodium azide
Fumigant, fire extinguisher, lower extremity axonopathy, intoxication resemble’s Wernicke’s encephalopathy, inferior colliculi lesions, NAC may worsen syndrome
Methyl bromide
Irritant gas with gasoline-like odor, may cause hypotension and bradycardia with inhalation, associated with lymphohematopoetic cancer
1, 3, butadiene
Current pesticide/herbicide but once a mouthwash and toothpaste, methemoglobinemia and Gi distress 3-6 hours after ingestion
sodium chlorate
Hyperthyroid medication that was linked to aplastic anemia, now ground water contaminant
Perchlorates
Tar smarts, pitch warts and squamous cell carcinoma, chronic melanosis, UV phototoxicity, strong carcinogen of lung, bladder, skin, scrotal, oral, stomach
Coal tar products
Ammonia-like odor, rocket fuel and water treatment agent: toxicity tetrad: SLE (skin sensitizer), methemoglobinemia, seizures, hepatitis
Hydrazines
Paint remover and solvent with fishy or ammonia smell that cause severe hepatitis with jaundice and eventual liver failure
Dimethylacetamide
Solvent used in pharmaceutical industry, acrylic fiber production and recovery of CO2 in gasses that may result in skin irritation, severe hepatotoxicity, and disulfiram reactions
N,N-dimethylformamide
Riboflavin inhibition, painful peripheral neuropathy, neuropathy spares CN 1, 5, 8, slope is with sparing of the Axila facial hair and inner 1/3 of eyebrow, reverse sleep cycle
Thallium
Benzene monitoring
Total urine phenol
Toluene monitoring
Urine hippuric acid
Styrene monitoring
Urine mandelic and phenylglyoxylic acid
Lead monitoring
Blood ZPP/FEP
Methyl Mercury monitoring
Blood Mercury
Inorganic Mercury monitoring
Urine Mercury
Polyaromatic HC monitoring
Urine 1-hydroxypyrene
Pily liquor in cold sterilization, sensitizer and occupational asthma
Glutaraldehyde
Used in plastics and rubber, dental fillings and styrofoam. Causes flu-like symptoms and drunkenness activity, peripheral neuropathy and hearing loss chronically
Styrene - styrene syndrome
Chemical associated with highest incidence of lung cancer in the world
Polyaromatic HC
Dentist with vitamin b-12 like deficiency, bone marrow suppression, and pernicious anemia. Histochemistry reveals inactive cobalt and inhibition of methionine synthetase.
Nitrous oxide
Person exposed to a cloud of “red smoke” with delayed pulmonary edema and chemical burns with characteristic yellow discoloration
Nitric acid
Pyrophoric material causing severe thermal and chemical burns (submerge in CuSO4) and exposure may lead to hepatotoxicity and hypocalcemia and increase QT interval
White phosphorus
“Rush” fire in San Fran in 1983 leading to a number of firefighters with methemoglobinemia
Isobutyl nitrate
1978 Jonestown mass suicide
KCN
Only organic phosphorus pesticide that possesses a significant vapor hazard (high vapor pressure)
Dichlorvos (also very hydrophilic - amenable to HD maybe)
Patient presenting after herbicide ingestion with myotonia, myoclonus, hematuria/rhabdo, and cardiac disturbances
Chlorphenoxy herbicide
Fetal syndrome - 10-30%, 25% risk of spontaneous abortion, microcephaly/hydrocephaly, conventional heard disorders, microtia, cleft lip-palate
Fetal isotretinoin
Microcephaly, development delay, telecsnthus, short nose and flat nasal bridge, anteverted nares, long shallow fitrum, thin upper lip, nail displasia
Fetal hydantoin
Microcephaly, small palpebral fissure length, thin upper lip, smooth Phil trim, flattened cheeks and short nose. Risk of brain injury increases as eyes get smaller, philtrum get flatter, and lip gets thinner
Fetal alcohol
Small nose and markedly depressed nasal bridge, brachydactyl, hypoplasia of all distal phalanges, severe shortening of lower extremities, epiphyseal stippling of the sacrum, spine, proximal humeri, and femurs
Fetal warfarin
Parrot fish and tidal xanthid crabs
Inhibits Na/K ATPase, N/V/D, parasthesias, hypocalcemic tenany, CV collapse (second most potent toxin on earth)
Palytoxin
Paralytic shellfish poisoning, Na channel blocker, oysters/red tide, N/V, parasthesias, throat pain, descending paralysis
Saxitoxin
Neurotoxin shellfish poisoning, sodium channel opener, parasthesias, temperature reversal, N/V/D uncommon, tide aerosolized toxin causes conjunctivitis, rhinitis, bronchitis
Brevetoxin
Diarrhetic shellfish poisoning, inhibits protein phosphates disrupting cell metabolism, benign gastric tumors, N/V/D predominate
Okadaic acid
Amnestic shellfish poisoning, CNS glutamate receptor stimulation causing Na channel up regulation and Na/Ca influx g neuronal cell dementia, N/V/D, headaches, ataxia, seizures, associated with eating blue muscles
Domoic acid
Na and Ava channel opening, metallic taste, parasthesias, glove and stocking numbness, hot/cold reversal, sensation of loose teeth, symptoms worse with alcohol
Ciguatoxin
Bacteria-catalyzed decarboxylation of decomposition finfish muscle, sunburn like rash, urticaria, bronchospasm
Scombroid (histamine poisoning)
Sodium channel blocker, perioral parasthesias, numbensss tremor ataxia dysarthria dysphasia respiratory paralysis death 5th most potent toxin
Tetrodotoxin
Japanese vinyl sandal maker with peripheral sensorimotor neuropathy. Nerve biopsy reveals Axonal swelling.
N-hexane
Cicuta spp. Most fatal plant species in North America - 30-70% fatality rate
Water hemlock -
The only form of poisoning caused by bacterial contamination
Scombroid (decarboxylation of histadine in fish muscle to histamine)
St Anthony’s fire, ergotism
Claviceps purpurea
Structural similarity to the herbicide endothall, also known as Spanish fly, produced by the blister beetle
Cantharidin
Profound hypoglycemia, hepatitis with hyperbilirubinemia, acid emus and acidurea without Ketosis
Akee (hypoglycin)
The maximum concentration of a chemical to which a worker may be exposed continuously for up to 15 minutes without danger to health or work efficiency and safety
Stel - short term exposure limit
Sulfonylurea known to cause SIADH and disulfiram reactions
Chlorpropamide
Side chain of cephalosporins linked to disulfiram reactions
NMTT - n-methtltetrathiol
Antidysrhthmic with antimuscarnic properties and causes hypoglycemia
Disopyramide
Intoxicants that produce metaphyseal bands on plain fil x-ray
Lead
Yellow phosphorus
Bismuth
Hyper vitaminosis D
5 most common medications linked to lupus-like syndrome
CHIMP chlorpropamide Hydralazine INH Methyldopa Procainamide
Idiopathic intracranial hypertension (pseudo tumor cerebri)
Vitamin A
Chinese herbal remedy with bufadenalide cardiac steroid
Chan Su
Plant that is a cyp3A4 inducer
At John wort - hypericum perforatum
Pulegone -> methofuran -> hepatitis
Pennyroyal oil (mentha pelugium)
Aspiration pneumonitis, CNS depression, patients urine smells like violets
Terpentine (pine oil)
Essential oil, CNS depression, mild hepatitis, hemorrhagic pulmonary edema
Oil of cloves - eugenol - Eugenia aromatica
Most common cause of medication-induced contact dermatitis
Neomycin
Endocarditis and mistrial vale fibrosis, pulmonary hypertension
Fenfluramine
Disinfectant associated with neonatal vacuoles encephalopathy and cerebral edema
Hexachloraphene
Disinfectant ingestion causingetahilic acidemia due to a decreased renal clearance of H (patient has normal lactate)
Providine iodine
Disinfectant, hypopigmented skin, TD-like syndrome, bradycardia, hypotension, PEG decontamination
Phenol
Rose eye discoloration of eyelids, conjunctivitis, refractory hypotension, reddish discoloration of viscera post-Mortem
Acute selenium toxicity (selenious acid)
Peanut worker who develops liver cancer (hepatoma)
Alfatoxin
Bio marker for benzene exposure
Urine phenol
HIV medication associated with fatal hypersensitivity
Abacavir
Two P450s associated with development of cancer
1A2, 2E1
Enzyme linked to aromatic anticonvulsant hypersensitivity syndrome
Epoxide hydrolase
The only medication induced seizure that will likely respond to phenytoin
Aminopyridine
The only local anesthetic that causes vasoconstriction
Cocaine
Most cardio toxic amide local anesthetic (may cause cardio toxicity before CNS toxicity
Bupivacaine
Most extensively metabolized anesthetic, hepatitis, malignant hyperthermia, acute lung injury from abuse (PO/IV)
Halothane
The only IARC Group 4 drug - probably not carcinogenic to humans
Caprolactam
Patient with ventricular ectopy, blindness, NV, dishonored is tinnitus after drinking tonic water with Cinchona succirubra extract
Quinine
Biventricular tachycardia
Digoxin, aconitine, halogenated hydrocarbons
Patient with an aortic dissection and renal failure that develops altered mental status, seizures, and no metabolic acidosis
Thiocyanate toxicity
Opioid linked to serotonin syndrome, seizures, MPTP, and may not result in milieus in overdose
Meperidine
NSAID linked to aplastic anemia
Phenylbutazone
Patient with hiv with sulfa allergy who develops hemolysis and methemoglobinemia
Dapsone
Patient undergoing elective endoscopy that develops methemoglobinemia during pre-op
Benzocaine
Free radical induced cardiomyopathy with irreversible heart failure
Doxorubicin
Alkylation agent causing hemmhoragic cystitis, MESNA antidote
Cyclophosphamide
Allylating agent causing pulmonary fibrosis and skin hyperpigmentation
Busulfan
6 intoxicants for which urine alkalinizarion enhances drug elimination
Salicylate Phenobarbital chlorphenoxy herbicides Methotrexate Chlorpropamide Fluoride
Scleritis and uveitis in a patient being treated for hypercalcemia
Bisphosphanates
Peliosis hepatitis
Alkalated anabolic steroids
Black widow spider
Painful bite
Calcium channel opener
Causes release of NE ACH
Latrodectus mactans
Brown recluse Painless bite sphingomyelinase D Hyaluronidase Local wound (red white blue)
Loxosceles reclusa
Hobo spider
Painless bite
Local ulcer
Tegenaria agrestis
Box jellyfish
Most lethal cnideria
Rapid death in minutes
Acetic acid/Antivenom
Chironex fleckeri
Irukanji syndrome
Hypertension
Back spasms
Carukia barnesi
Portuguese man of war
Painful linear welts
Acetic acid
Physalia physallis
Crown of thorns
Pain, paralysis
Hot water immersion
Acanthaster planc
Lion fish
Pain possible blisters
Hot water immersion
Pterosis species
Stonefish
Cytotoxic, hemolytic, myotoxic
Severe pain, hypotension, hemolysis
Hot water, antivenin
Synanceja verrucosa
S. Horrida
Stingray
Local pain
Vibrio infections
Hot water, antibiotics
Dasyatis species
Funnel web spider
Massive release of ACH, NE, EPI
RAbbit igg antivenin
Death historically in peds under 4
Atrax robustus
Fire ant
Glucosaminidase, piperidines
Wheals, clear vesicles
Local care
Solenopsis invecta
Bark scorpion
Sodium channel opener
Pain, parenthesis, palsies
Centruroidea exilicauda
Colorado river toad
Bufadienolide cardiac steroid
Bufotenin tryptamines
Chan su herbal
Bufo alvarius
Body builder presenting with tachycardia, wide pulse pressure, hypokalemia
Clenbuterol
silo filers disease
Nitric oxides (No, No2)
Basal ganglia toxins
CO CArbon disulfide manganese MTPP+ Methanol
Remediation level for home radon
11 pc/L
Theee agents associated with perinatal death
ACE inhibitors
Cigarette smoking
Lead
Most common hydrocarbon used in dry cleaning
PERC
perchloroethylene
Cement worker with contact dermatitis
Chromium 6
OSHA PEL for benzene
1 ppm
OSHA PEL for CO
50 ppm
Azo dye and rubber manufacturing, HCN lab detection agent, methemoglobinemia, associated with bladder cancer (IARC 1)
Benzidine
Patient etching glass and wheel cleaning with delayed pain out of proportion to exam, hypocalcemia, hyperkalemia
HF
Vitamin B6 antidote for 4 toxins
INH
Gyromitra esculenta
Hydrazines
Ethylene glycol
The factor by which exposure is reduced by use of a respirator
Protection factor
Ambient/protection factor = exposure
Study design comparing an exposed group to an unexposed group either retro-or prospectively with results expressed as relative risk
Cohort study
Study design comparing an exposed group to an unexposed group at one point in time. Provides prevalence data, results expressed as relative risk
Cross-sectional study
Study design comparing individuals with a specific condition to those do not have the condition and compare exposures or risk factors. Results expressed as odds ratio.
Case control study
Federal agency responsible for conducting research and making recommendations for the prevention of work related injury and illness - has no legal authority
NIOSH
The main federal agency charged with enforcement of safety and health legislation
OSHA
Enacted by Congress in 1980 and created a tax on the chemical and petroleum industries and provided broad federal authority to respond directly to releases or threatened releases of hazardous substances that may endanger public health or the environment
CERCLA
comprehensive environmental response, compensation, and liability act
Federal public agency charged with the responsibility of evaluating the human health effects of exposure to hazardous substances
ATSDR
Characteristics of substances partitioning into breast milk
low molecular weight
Non-polar
Low protein binding
Risk factors for quinolone induced tendinopathy
Age over 60 Non-obese Steroid use Female Renal failure Diabetes
Hepatic zone where 2E1 is primarily present and active
Zone 3
Centeilobular necrosis
Primary toxicity associated with methoxyflurane
Nephrotoxicity
Tetrodotoxin MOA
NA channel blocker
Saxitoxin MOA
Blocks Na channel
Brevetoxin MOA
stimulates Na Channels
Domoic acid MOA
glutamate agonist, analog of glutamic and kainic acid
Okadoic acid MOA
Phosphates a1 and a1 inhibitor
Ciguatoxin MOA
Lowers threshold for opening Na channels
Toxins associated with peripheral neuropathy (5)
Acrylamide Methyl bromide Carbon disulfide Styrene Trichloroethylene
Occupational intoxicants associated with asthma (5)
Maleic acid Trimellitic anhydride Ethtlenediamine Toluene diisocyanate (#1) Diethtlhexyl phthalate
Rodenticide producing nausea vomiting bradycardia hyperkalemia
Red squill (digoxin)
Rodenticide producing CNS excitation, irritability, seizures, coma, ventricular dysrhythmias
Tetramine
Rodenticide producing orophyngeal and skin burns, smoking coming and stools, garlic odor, GI and hepatic injury
Phosphorus
Rodenticide producing tremors, myoclonus, depressed mental status
Bromethalin
Toxin used in hospital laundry. Toxicity resulted in 9 neonates ill, 2 deaths. Presented with fever sweating renal failure and acidosis, this agent was also used in various ways including in treating wood to function as preservative, also uncouples oxidative phosphorylation
Pentachlorophenol
Chemicals associated with causing chloracne
Chlorinated aromatic hydrocarbons
Hairdresser hand dermatitis
P-phenylenediamine
International treaty completed in 1987 by 24 nations to control the depletion of the ozone layer. Targeted the decrease of CFCs and halons used in fire extinguishers - halon 1211 and 1301
Montreal protocol
Shoemakers polyneuropathy
N-hexane… same as with methy-n-buyl ketone. All metabolized to 2,5-butanedione
Toluene toxicity (4 major)
Distal RTA
MEtabolic acidosis
Hypokalemia and associated symptoms
Leukoencephalopathy
The only hydrocarbon exposures associated with a chance in CV mortality
Carbon disulfide
Associated with accelerated atherosclerotic CAD
ALso peripheral neuropathy
Cement eczema
Chromium 6+
Type 4 hypersensitivity reaction
Wolf-chaikoff effect
Chronic iodine exposure leads to decreased hormone productions the inhibition of organic binding of iodide in the thyroid gland by excess iodide leading to decreased thyroid synthesis
