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Toxico - Bobo > Intoxicatii cu metale grele > Flashcards

Intoxicatii cu metale grele Flashcards

1
Q

Cum se manifestă efectul toxic al arsenicului?

A

Prin similitudinea cu compusii de tip P, influenteaza sinteza ATP

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2
Q

Cum se manifesta efecteul toxic al pb?

A

Prin inhibarea eliberarii de ach din terminatiile nervoase

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3
Q

Ce doze de fe sunt considerate a fi toxice?

A

Peste 20 mg/kgc

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4
Q

Ce doze de fe sunt considerate a fi foarte toxice?

A

Peste 60 mg/kgc
=intoxicatie foarte severă

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5
Q

Ce doza de fe este considerata a fi letala?

A

180-300 mg/khc

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6
Q

Ce se intampla in cazul unui exces de fe?

A

Transportorii feritina-tranefritina sunt suprasaturati
fe se depune in avse = elib de his si ser
creste permeabilitatea vasc + hemoragie + ulceratii

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7
Q

Ce sisteme sunt afecatat in intoxicatia cu fe?

A

Dig: hepatotoxicitate, IH, hipoprotrombinemie, tulb de coag + hemoragii
SNC: convulsii, coma, edem cerebral
CV: tahicardie, hipoTA

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8
Q

In cazul intoxicatiei cu fe, ca urmare a ce apare edemul cerebral?

A

Acidoza metabolica
Lezare vasculara

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9
Q

Faza de debut - intoxicatia cu fe

A

Primele 1-2 h
Afecatre hemoragica+dig + SNC + CV

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10
Q

Faza de stabilizare - intoxicatia cu fe

A

12 h

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11
Q

Faza recurenta - intoxicatia cu fe

A

12-24h

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12
Q

Faza tardiva - intoxicatia cu fe

A

dupa 4-6W, stenoza pilorica ac urmare a cicatricilor formate

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13
Q

Sideremie - fe doza letala

A

1000microg%

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14
Q

Sideremie - fe doza intoxicatie marcata

A

599-1000microg%

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15
Q

Intoxicatia cu fe - decontaminare interna

A

Spalaturi gastrice
Carbuna activ = NU absoarbe Fe, dar abs fe-defroxina
DEFEROXINA - pe sonda nazo-gastrica

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16
Q

Care este antidotul pentru intoxicatia cu fe?

A

Deferoxina IM 40-90 mg/kgc, max 6g/zi

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17
Q

Cum este utina in cazul eliminarii d efe?

A

neagra

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18
Q

Cume ste urina pacientilor carora li s-a adm deferoxina?

A

rosu-roz

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19
Q

Care este doza letala de pb din organism?

A

15g oxid de plumb

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20
Q

Surse ale intoxicatiei cu plumb

A

fabrici de cabluri, armamment
vopsitorii
tipogrfii

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21
Q

De ce sunt copiii mult mai vulnerabili la intox cu pb?

A

abd mult mai mare (40% dig fata de 5% la adult)
excretie redusa

22
Q

Cum se poate abdorbi pb?

A

digestiv
inhalator
transdermic

23
Q

Unde se poate distribui pb in organism?

A

oase
tesuturi moi
hematii

24
Q

Unde constituie pb depozite in organism si de ce?

A

ÎN OASE - t1/2 de 20-30 de ani!!

25
Q

Cum se elimina pb?

A

Urinar: secretie+filtrare
Transpiratie
Dig

26
Q

Ce efecte are intoxicatia cu pb asupra organismului?

A
  1. anemie: prin blocarea biosintezei hemului
  2. scade viteza de conducere nervoasa la nivelul terminatiilor = neuropatie periferica + encefalopatie saturniana (copii)
  3. Renal = sdr. Fanconi: aminacidurie, glicozuie, fosfaturie și acidoza tubulara
27
Q

Ce leziuni renale sunt mai frecvente in intoxicatia cu pb?

A

cele interstitiale fata de glomerulare!!!

28
Q

Cum se manifesta encefalopatia saturniana la copii?

A

varsaturi in jet
cefalee atroce

29
Q

Ce manifestari digestive pot fi intalnite in intoxicatia cu pb?

A

dureri abd
colici
constipatie
voma
salivatie

30
Q

Ce manifestari sistemice pot fi intalnite in intoxicatia cu pb?

A

anemie
artralgii
slabiciune
agitatie

31
Q

Ce manifestari SNC pot fi intalnite in intoxicatia cu pb?

A

tulburari de comportament
iritabilitate
convulsii
coma
neuropatie motorie+perif
encefalopatie
IR

32
Q

Care este triada pt intoxciatia cu pb?

A

anemie
apatie
anorexie

33
Q

Care este antidotul pt intoxicatia cu pb?

A

dimercaprol
EDTA Na2Ca
D-penicilamina
Acidul dimercaptosuccinic

34
Q

Doza dimercaprol

A

5 mg/kgc IM = pb IC și EC

35
Q

La cine e contraindicat dimercaprolul?

A

la cei cu IH

36
Q

Doza EDTA Na2Ca

A

1,5g/zi IM, in 2 prize = pb EC

37
Q

Doza D-penicilamina

A

20-40 mg/kgc/zi oral in 4 prize = pb oase!!

38
Q

De unde poate proveni intox cu arsenic?

A

pesticide
ierbicide
vopseluri
hidrogen arseniat

39
Q

Care este cel mai toxic compus cu arsenic?

A

hidrogen arseniat

40
Q

Care este cea mai toxica forma a arsenicului?

A

Cea trivalenat = poate forma hidrogen arseniat

41
Q

Sub ce forme se poate găsi arsenicul?

A

Trivalent
Pentavalent

42
Q

Proprietati arsenic

A

fara miros
fara gust

43
Q

Care este doza letala de arsenic?

A

200-300 mg

44
Q

Unde se depoziteaza o cantitate mare de arsenic?

A

ficat = degenerescventa grasa a ficatului

45
Q

Care sunt cele mai pregnanate manifestari ale intox cu arsenic?

A

Cele digestive!!
greata, varsaturi
diaree sanghinolenta
dureri abd intense
respiratie si saliva cu miros de usturoi

46
Q

Care este cea mai severa manifestare a intox cu arsenic?

A

gastroenterita hemoragica

47
Q

D+ intox cu arsenic

A

diaree sanghinolenta
dureri abd severe
albuminurie
miros de usturoi saliva si respiratie

48
Q

Antidotism intox cu arseni

A

Dimercaprol: 3-5 mg/kgc IM la 4 ore
Penicilamina: 500 mg x 4/zi, oral

49
Q

Distributie arsenic

A

IN SANGE LEGAT DE GLOBULINA, SE REDISTRIBUIE
IN ORGANE LEGAT DE -SH PROTEICE

50
Q

Unde se poate depozita arsenicul?

A

OASE SI IN PAR

51
Q

Cum se face eliminarea arsenicului?

A

Urinar, in 4 zile, aproape complet

Toxico - Bobo (11 decks)

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