Forensic Toxicology

Question 1

what are 2 things that are required in forensic toxicology?

Answer 1

patient consent
chain of custody

Question 1

the application of chemical analytical procedures to isolate, extract, identify, and quantitate drugs and chemical in biological samples

Answer 1

forensic toxicology

Question 2

what is the most widely used screening in forensic toxicology?

Answer 2

urine drug screen

Question 3

what provides a qualitative result indicating the presence of a specific substance?

Answer 3

urine drug screen

Question 4

what do urine drug screens detect?

Answer 4

class of the drug

Question 5

what type of sensitivity and specificity does the initial urine drug screen show?

Answer 5

high sensitivity
low specificity

Question 6

what is the gold standard for a urine drug confirmatory test?

Answer 6

gas chromatography with mass spectrometry (GC-MS)

Question 7

what kind of sensitivity and specificity does the confirmatory urine drug test show?

Answer 7

high sensitivity
high specificity

Question 8

what happens if you test below the drug cutoff levels on the initial urine drug screen?

Answer 8

lab cannot report as positive or get a confirmatory test

Question 9

what happens if you test above the drug cutoff levels on the initial urine drug screen, but below them on the confirmatory test?

Answer 9

cannot be reported as positive

Question 10

what is the most expensive and most intrusive biological specimen?

Answer 10

blood

Question 11

what is the most accurate biological specimen for relating drug concentrations to clinical effects?

Answer 11

blood

Question 12

what is the least common biological specimen of testing in forensic toxicology?

Answer 12

blood

Question 13

what kind of blood specimen should be used in medical toxicology?

Answer 13

serum
plasma

Question 14

what kind of blood specimen should be used in forensic toxicology?

Answer 14

whole blood

Question 15

what is the specimen of choice for most tests?

Answer 15

urine

Question 16

how do analytes in urine remain stable?

Answer 16

if frozen

Question 17

what biological specimen is easy to administer but requires lab processing to ensure accuracy?

Answer 17

saliva

Question 18

which biological specimen is useful for drugs that were used within the past few days?

Answer 18

saliva

Question 19

what is the limitation in using saliva as a biological specimen for testing drugs?

Answer 19

only parent drug may be found

Question 20

what is the stable biological specimen that measure long-term drug use, but does not detect recent drug use?

Answer 20

hair

Question 21

how will a drug ingested today, appear on the scalp?

Answer 21

3cm above scalp in 3 months

Question 22

stool collected through an amniocentesis

Answer 22

meconium

Question 23

specimen that is sensitive for identifying infants who have been exposed to drugs in utero

Answer 23

meconium

Question 24

what kind of drugs is meconium sensitive for?

Answer 24

basic and neutral drugs

Question 25

what is the advantage of meconium specimen?

Answer 25

provides drug exposure info over 4-5 months of gestation

Question 26

what are 2 limitations of testing meconium?

Answer 26

cannot detect acidic drugs usually immunoassays (for specific compounds)

Question 27

what are 2 specimen used in postmortem?

Answer 27

vitreous humor stomach contents

Question 28

biological sample that measures electrolytes, glucose, and alcohol postmortem

Answer 28

vitreous humor

Question 29

substances that have a high potential for abuse and no accepted medical used and are not safe to use under medical supervision

Answer 29

schedule I

Question 30

substances that have a high potential for abuse, despite having an accepted medicinal use in the US

Answer 30

schedule II

Question 31

substances that have less potential for abuse but abuse can lead to moderate physical dependence or high psychological dependence

Answer 31

schedule III

Question 32

substances than have less abuse potential and has accepted medical use in the US. Abuse may lead to limited physical or psychological dependence.

Answer 32

schedule IV

Question 33

substances with limited quantities of certain narcotics that have less potential for abuse and and have accepted medical use in the US with limited risk of physical and psychological dependency

Answer 33

schedule V

Question 34

what is the metabolite that is tested in marijuana?

Answer 34

carboxytetrahydrocannabinol

Question 35

what is the detection time of marijuana in an occasional user?

Answer 35

3-5 days

Question 36

what is the detection time of marijuana in a chronic user?

Answer 36

14 days

Question 37

what is the detection time of marijuana in a "large" user?

Answer 37

30 days

Question 38

what is the metabolite that is tested in cocaine?

Answer 38

benzolecgonine

Question 39

methamphetamine is a derivative of endogenous _____

Answer 39

phenylethylamine (PEA)

Question 40

where is methamphetamine present in? (2)

Answer 40

OTC inhaler diet pills

Question 41

what is the half-life of methamphetamine in acidic urine?

Answer 41

7-14 hours

Question 42

what is the half-life of methamphetamine in alkaline urine?

Answer 42

18-34 hours

Question 43

what is the half-life of heroin in blood?

Answer 43

< 20 mins

Question 44

heroin has high _____ liability and high _____ solubility

Answer 44

addiction lipid

Question 45

what accounts for the activity of heroin?

Answer 45

morphine

Question 46

what is the #1 cause of high toxicity levels?

Answer 46

polypharmacy

Question 47

clinical signs and symptoms suggestive of a toxic reaction and indicates a medical emergency

Answer 47

toxidromes

Question 48

what happens to pupil size with anti-cholinergics?

Answer 48

mydriasis (dilation)

Question 49

what are 3 vitals with anti-cholinergics?

Answer 49

tachycardia fever hypertension

Question 50

what is the mental status with anti-cholinergics?

Answer 50

mad as a hatter

Question 51

what does the physical exam look like with anti-cholinergics?

Answer 51

dry as a bone red as a beet hot as a hare urinary retention

Question 52

what happens to pupil size with a cholinergic?

Answer 52

miosis (constriction)

Question 53

what are 3 vitals with a cholinergic?

Answer 53

bradycardia hypothermia tachypnea

Question 54

what is the mental status with a cholinergic?

Answer 54

altered mental status (confusion)

Question 55

what does the physical exam look like with a cholinergic?

Answer 55

Salivation Lacrimation Urination GI distress Defecation Emesis