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Lab Med > Forensic Toxicology > Flashcards

Forensic Toxicology Flashcards

1
Q

what are 2 things that are required in forensic toxicology?

A

patient consent
chain of custody

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1
Q

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

A

forensic toxicology

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2
Q

what is the most widely used screening in forensic toxicology?

A

urine drug screen

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3
Q

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

A

urine drug screen

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4
Q

what do urine drug screens detect?

A

class of the drug

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5
Q

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

A

high sensitivity
low specificity

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6
Q

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

A

gas chromatography with mass spectrometry (GC-MS)

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7
Q

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

A

high sensitivity
high specificity

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8
Q

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

A

lab cannot report as positive or get a confirmatory test

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9
Q

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

A

cannot be reported as positive

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10
Q

what is the most expensive and most intrusive biological specimen?

A

blood

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11
Q

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

A

blood

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12
Q

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

A

blood

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13
Q

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

A

serum
plasma

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14
Q

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

A

whole blood

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15
Q

what is the specimen of choice for most tests?

A

urine

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16
Q

how do analytes in urine remain stable?

A

if frozen

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17
Q

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

A

saliva

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18
Q

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

A

saliva

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19
Q

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

A

only parent drug may be found

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20
Q

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

A

hair

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21
Q

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

A

3cm above scalp in 3 months

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22
Q

stool collected through an amniocentesis

A

meconium

23
Q

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

A

meconium

24
Q

what kind of drugs is meconium sensitive for?

A

basic and neutral drugs

25
Q

what is the advantage of meconium specimen?

A

provides drug exposure info over 4-5 months of gestation

26
Q

what are 2 limitations of testing meconium?

A

cannot detect acidic drugs
usually immunoassays (for specific compounds)

27
Q

what are 2 specimen used in postmortem?

A

vitreous humor
stomach contents

28
Q

biological sample that measures electrolytes, glucose, and alcohol postmortem

A

vitreous humor

29
Q

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

A

schedule I

30
Q

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

A

schedule II

31
Q

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

A

schedule III

32
Q

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

A

schedule IV

33
Q

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

A

schedule V

34
Q

what is the metabolite that is tested in marijuana?

A

carboxytetrahydrocannabinol

35
Q

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

A

3-5 days

36
Q

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

A

14 days

37
Q

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

A

30 days

38
Q

what is the metabolite that is tested in cocaine?

A

benzolecgonine

39
Q

methamphetamine is a derivative of endogenous _____

A

phenylethylamine (PEA)

40
Q

where is methamphetamine present in? (2)

A

OTC inhaler
diet pills

41
Q

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

A

7-14 hours

42
Q

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

A

18-34 hours

43
Q

what is the half-life of heroin in blood?

A

< 20 mins

44
Q

heroin has high _____ liability and high _____ solubility

A

addiction
lipid

45
Q

what accounts for the activity of heroin?

A

morphine

46
Q

what is the #1 cause of high toxicity levels?

A

polypharmacy

47
Q

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

A

toxidromes

48
Q

what happens to pupil size with anti-cholinergics?

A

mydriasis (dilation)

49
Q

what are 3 vitals with anti-cholinergics?

A

tachycardia
fever
hypertension

50
Q

what is the mental status with anti-cholinergics?

A

mad as a hatter

51
Q

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

A

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

52
Q

what happens to pupil size with a cholinergic?

A

miosis (constriction)

53
Q

what are 3 vitals with a cholinergic?

A

bradycardia
hypothermia
tachypnea

54
Q

what is the mental status with a cholinergic?

A

altered mental status (confusion)

55
Q

what does the physical exam look like with a cholinergic?

A

Salivation
Lacrimation
Urination
GI distress
Defecation
Emesis

Lab Med (19 decks)

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