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Irrespirable Gases Flashcards

1
Q

Enumerate the irrespirable gases

A
  1. Carbon monoxide
  2. Carbon dioxide
  3. Hydrogen sulphide
  4. War gases
  5. Methyl isocyanate
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2
Q

Action of carbon monoxide

A

CO combines with Hb to COHb and cause anaemic hypoxia
Inhibits cytochrome A3 oxidase and cytochrome P450 and hinders intracellular respiration

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3
Q

Acute symptoms of CO poisoning

A

Headache
Dizziness
Nausea
Confusion

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4
Q

What is the result of CNS damage due to CO poisoning

A

Spastic paraplegia

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5
Q

Effect on liver due to CO poisoning

A

Enlarged and bleeding tendency

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6
Q

Effect on CNS due to CO poisoning

A

•spastic paralysis
•impairment of higher mental functions
•personality changes
•Parkinsonism

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7
Q

Effect on skin due to CO poisoning

A

Bullies lesions d/t skin hypoxia

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8
Q

How does a CO poisoning give a false impression of assault

A

Victim may move erratically in the room disturbing furniture and clothing

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9
Q

Diagnostic tests for CO poisoning

A
  1. Spectroscopy
  2. CT
  3. Kunkels test
  4. Hoppe-Seylers test
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10
Q

How is CO diagnosed

A

From 1. History , signs and symptoms
2. Lab findings

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11
Q

How is COHb analysed

A

By spectroscopy. Two absorption bands between Fraunhoffers lines D&E as in oxyhemoglobin

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12
Q

CT findings in CO poisoning

A

Symmetric low density areas in the region of globus pallidus, putamen and caudate nucleus

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13
Q

Kunkels test in CO poisoning

A

Diluted blood + few drops of tannic acid and shaken . Crimson red coagulum formed if COHb present

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14
Q

Hoppe-Seylers test in CO poisoning

A

Few drops of blood + NAOH
pink / red if COHb present otherwise greenish brown

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15
Q

Treatment of CO poisoning

A
  1. Remove patient to fresh air
  2. Patient blood COHb above 25% require hyperbaric Po2 of 2-3atm
  3. Blood transfusion
  4. Gastric lavage
  5. Cerebral edema - 20% mannitol solution 500ml IV
  6. Supportive measures
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16
Q

PM findings in CO poisoning

A

External
Cherry red colour hypostasis and mucous membranes
Fine froth at mouth and nostrils
Blisters on skin

Internal
Lungs and brain congested
Rhabdomyolysis
Heart shows petechial hemorrhage
Punctiform ring hemorrhage in white matter of brain

17
Q

Circumstances of CO poisoning

A

Suicidal
Starting car in neutral in shed or exhaust tube connected to interior of car

Accidental
Exposure to exhaust gas - during burning of house , gas mines , closed space after explosion

18
Q

Safety level of CO in air

A

0.1%

19
Q

Enumerate the war gases

A
  1. Vesicants or blistering gases
  2. Asphyxiants or lung irritants
  3. Lachrymators or tear gases
  4. Sternutators or nasal irritants
  5. Paralysants
  6. Nerve gases
20
Q

Name the vesicants

A
  1. Mustard gas
  2. Lewisite
21
Q

Treatment of vesicants

A
  1. Wash affected part with soap and water
  2. Eye wash with sodium bicarbonate
  3. BAL
22
Q

Asphyxiants or lung irritants

A

1.CO2
2. CO
3. Chlorine
4. Phosgene
5. Diphosgene

23
Q

Green cross gases

A

Phosgene and diphosgene

24
Q

Treatment of Asphyxiants

A
  1. Eye wash with saline
  2. Oxygen
  3. Antibiotics to prevent infection
25
Q

Lacrimators

A
  1. Chloracetophenone
  2. Ethyliodoacetate
  3. Bromobenzyl cyanide
26
Q

Signs and symptoms of lacrimators

A

Severe irritation of eyes with watering , spasm of eyelids and temporary blindness

27
Q

Treatment of lacrimators

A
  1. Patient removed to fresh air
  2. Eyes washed with normal saline
  3. Antibiotics to prevent infection
28
Q

Sternutators or nasal irritants

A
  1. Diphenyl chlorarsine
  2. Diphenylamine chlorarsine
  3. Diphenylcyanoarsine
29
Q

Treatment of Sternutators

A
  1. Removal of patient to fresh air
  2. Nose irrigated with sodium bicarbonate
  3. Antibiotics to prevent infection
30
Q

Paralysants

A
  1. Hydrogen sulphide
  2. CO
  3. Methylisocyanate
31
Q

Gas involved in Bhopal gas tragedy

A

Methylisocyanate

32
Q

Nerve gases

A
  1. Tabun
  2. Sarin
  3. Cyclosarin
  4. Soman

Forensic (5 decks)

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