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Forensic Significance Pt. 2 > Chemical Trauma > Flashcards

Chemical Trauma Flashcards

1
Q

Define toxicology.

A

Field of science that helps us understand the harmful effects that chemicals, substances, or situations can have on people, animals and the environment.

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2
Q

Define forensic toxicology.

A

The application of toxicological principles, theory, and methods to cases before the court.

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3
Q

What is a chemical?

A

Any substance that is produced or purified in a reaction that involves changes to atoms and molecules.

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4
Q

List the 6 different classifications of chemicals as outlined in class.

A

Organic, inorganic
Benign, healthy
Legal, illegal

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5
Q

What is a benign chemical?

A

Chemical that produces no effects

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6
Q

Give examples of sources of healthy chemicals.

A

Food, nutrients, prescription drugs

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7
Q

Give four examples of poisons/environmental chemicals.

A

Hydrogen sulfide
Hydrogen cyanide
CO
Cyanide

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8
Q

Give examples of chemicals of abuse.

A

Depressants
Stimulants
Hallucinogens

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9
Q

What is chemical trauma?

A

Trauma caused either directly or indirectly by the application of chemical agents to tissues

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10
Q

Give examples of direct chemical trauma.

A

Tissue destruction (e.g., burns)

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11
Q

Give examples of indirect chemical trauma.

A

Asphyxia, long-term structural changes, infection

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12
Q

What causes direct destruction of tissues?

A

Application of strong bases, strong acids, elemental metals, phenol…

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13
Q

What type of chemical causes the most damage?

A

bases

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14
Q

What are 5 mechanisms of direct chemical trauma?

A

Red/ox
Corrosion
Protoplasmic disruption
Vesicants
Desiccants

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15
Q

What do vesicants do? What can this eventually lead to?

A

Bring fluid where it doesn’t belong
Blistering, ischemia –> necrosis

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16
Q

What do desiccants do?

A

Pull fluid out of cells

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17
Q

What is an injury typically associated with stimulants?

A

Holes in tissue, specifically roof of mouth

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18
Q

How can chemicals lead to infection?

A

via introduction route (needle, inhalation) due to tissue destruction or disruption

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19
Q

Other than via introduction route, how else can chemicals lead to infection? Give an example.

A

Introduction of a pathogen via the agent.
Ex: aspergillosis infection from inhaled cocaine

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20
Q

What is asphyxia?

A

loss of oxygen to tissues either because body cannot take in oxygen or cannot make use of the oxygen it does have.

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21
Q

What causes asphyxia? 6

A

Tissue destruction
Metabolic derangement
Oxygen sequestration
Congestion
Inflammation
Action on respiration centres of the brain

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22
Q

What part of the brain houses the respiration centres?

A

brainstem - medulla oblongata

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23
Q

Describe this image of alveoli.

A

Cocaine entered the lungs.
Red = bleeding due to hemorrhage
pink = hemosiderosis, release of chemicals into extracellular space.

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24
Q

Describe what is seen in this image of alveoli.

A

scar tissue due to prolonged exposure to cocaine.

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25
Q

Why is scar tissue in the lungs harmful?

A

Limits expansion of lungs, oxygen intake

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26
Q

Is aortic dissection direct or indirect chemical trauma?

A

Indirect

27
Q

What is aortic dissection?

A

Separation of vessel layers causing cell walls to be weakened

28
Q

What types of drugs can cause aortic dissection? Give examples.

A

Stimulants
Cocaine, amphetamine

29
Q

Other than chemical, what is another type of trauma that can cause aortic dissection? Give examples.

A

Blunt force trauma
MVA, physical assault

30
Q

What does asbestos exposure lead to?

A

Pleural plaques

31
Q

What are pleural plaques?

A

Chemical itself lays on pleura

32
Q

What do pleural plaques do to pleural cells? What can this cause?

A

Changes in DNA, leading to mesothelioma

33
Q

What are the 5 factors affecting the severity of chemical trauma?

A

Chemical agent
Time of exposure
Tissue exposed/penetrated
Deliivery method
Quantity and concentration

34
Q

What is crack lung?

A

Heavily scarred lung tissue due to cocaine use

35
Q

When can crack lung become fatal?

A

Can lead to death in the long term or as little as 48 hours after crack use

36
Q

What does the lethality of crack lung depend on?

A

Susceptibility and dose

37
Q

Why is crack lung an issue?

A

Lung tissue affected cannot exchange oxygen.

38
Q

What is the issue if asbestos enters the lung?

A

It cannot be cleared over time.

39
Q

What are the two types of developmental windows identified in class?

A

Acute and chronic

40
Q

What does acute chemical use indicate?

A

Overdose

41
Q

What can an overdose lead to?

A

Depression of function, specifically of brainstem

42
Q

What are the consequences of brainstem function depression?

A

Heart rate, respiration, balance

43
Q

Give an example of drug that can be overdosed on.

A

Fentanyl, can cause lots of damage at low concentrations

44
Q

What does chronic chemiical use refer to?

A

Long-term

45
Q

what can chronic chemical use lead to? What can this cause?

A

Receptor sensitivity changes (tolerance)
Leading to cell death

46
Q

What types of loss can lead to cell death?

A

Structural loss (i.e., chemical damaging cell wall)
Loss of function

47
Q

Give an example of a condition leading to cell death.

A

Alcoholic neuropathy

48
Q

Describe the identifiable effects on imaging of alcoholic neuropathy

A

Loss of white matter, massive ventricle expansion

49
Q

What affects of medium-term alcohol abuse can occur on the liver?

A

fatty liver disease (reversible)

50
Q

What affects on the liver can long term alcohol abuse lead to?

A

cirrhotic liver

51
Q

What is the developmental window that alcohol use is most likely to lead to fetal alcohol syndrome.

A

0-8 weeks

52
Q

Why are fetuses so susceptible to FAS during the first 8 weeks of development?

A

Rapid development and organ formation during this time, susceptible to birth defects.

53
Q

Describe the effects of alcohol on the fetus following the first 8 weeks.

A

Neurological impairment is possible
By third trimester fetus can redirect blood supply and spare brain

54
Q

Describe the discriminating features of FAS.

A

Narrowed eyelids/sockets
Flat midface
Short nose
Indistinct philtrum
Thin upper lip

55
Q

Describe the associated features of FAS.

A

Low nasal bridge
Epicanthal folds
Minor ear anomalies
Small chin

56
Q

List the 9 learning disorders associated with FAS.

A

Dyslexia
Dyscalculia
Dysgraphia
Dyspraxia
Spelling problems
Auditory processing disorder
Visual processing disorder
Verbal processing disorder
ADHD

57
Q

what are potential issues with delivery method in chronic use ?

A

infection risk
collapsed vessels

58
Q

What is pharmacokinetics?

A

dose - concentration vs. time

59
Q

what is pharmacodynamics?

A

effect vs. concentration

60
Q

What is an effective dose?

A

Desired therapeutic/recreational effect
Act on desired tissue with desired effect

61
Q

What are two pharmacodynamic complications associated with overdoses?

A

Effect is too strong
Effect is on the wrong tissue

62
Q

Using SSRIs, give an example of what would occur at an effective dose.

A

Act on desired tissue (brain)
Desired effect = serotonin reuptake

63
Q

Using SSRIs, give an example of what would occur at an overdose.

A

Too strong: respiratory depression
Wrong tissue: cardiac events

Forensic Significance Pt. 2 (7 decks)

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