Lec 3 Flashcards
What is Carbon Monoxide (CO) poisoning known as?
Silent Killer
What are the common household sources of CO poisoning?
- Charcoal grills
- Gas heaters
- Stoves
What is the mechanism of action of Carbon Monoxide?
CO binds to hemoglobin, forming carboxyhemoglobin (COHb), reducing oxygen carrying capacity and leading to anemic anoxia.
What are the clinical presentations of mild CO poisoning (COHb < 15-20%)?
- Headache
- Dizziness
- Blurred vision
- Nausea
- Vomiting
What are the severe clinical presentations of CO poisoning (COHb > 40-60%)?
- Palpitations
- Dysrhythmias
- Hypotension
- Myocardial ischemia
- Cardiac arrest
- Pulmonary edema
- Respiratory arrest
- Seizures
- Coma
What investigations are used to detect COHb levels in blood?
- Spectroscopic Examination
- CO-oximeter
- Gas chromatography
What is the treatment for COHb levels greater than 15%?
100% O2
What is the primary use of Hydrocyanic Acid (Prussic Acid)?
- Industrial uses
- Agricultural insecticide and rodenticide
- Medical uses (Na nitroprusside)
What is the mechanism of action of Prussic Acid?
Blocks cytochrome oxidase enzymes, leading to cellular asphyxia and histotoxic anoxia.
What are the clinical symptoms of large dose Prussic Acid poisoning?
Sudden death within 1-2 minutes.
What is the treatment for Prussic Acid poisoning?
- Amyl nitrite
- Sodium nitrite
- Sodium thiosulfate
- Reducing agents (Vitamin C, methylene blue)
What is the mechanism of action of Ethanol?
Depresses the central nervous system and causes peripheral vasodilatation.
What are the clinical signs of mild ethanol intoxication?
- Alcoholic euphoria
- Abnormal behavior
- Sexual crimes
What are the signs of severe ethanol intoxication?
- Weak rapid pulse
- Low blood pressure
- Slow shallow respiration
- Inhibited reflexes
- Convulsions
What is the legal evidence of drunkenness based on blood ethanol concentration?
Higher than 150 mg %
What are the supportive measures for ethanol poisoning?
- ABC
- Gastric lavage
- Forced alkaline diuresis
- Hemodialysis if blood alcohol level > 350 mg %
What are the primary effects of Methyl Alcohol (Methanol) poisoning?
- CNS depression
- G.I.T. irritation
- Metabolic acidosis
- Ocular toxicity
What is the treatment for Methanol poisoning?
- Supportive measures
- Gastric lavage
- Forced alkaline diuresis
- Hemodialysis if blood level > 50 mg/dl
What antidote is used for Methanol poisoning?
- Ethanol
- 4-methyl pyrazole (fomepizole)
What are the common types of animal envenomation?
- Snake bites
- Scorpion stings
- Jellyfish stings
- Spider bites
What is the clinical picture of snake bites?
- Local swelling, pain, and bruising
- Systemic symptoms include paralysis and cardiac arrest
What is the treatment for snake bites before reaching the hospital?
- Reassurance
- Immobilization of the limb
What is the treatment for snake bites after arrival at the hospital?
- Supportive measures
- Tetanus toxoid
- Specific antivenin
- Antibiotics
- Analgesics
What are the systemic effects of scorpion stings?
- CNS agitation
- Tachycardia
- Hypertension
- Cardiac arrest
What is the clinical picture of scorpion stings in terms of local symptoms?
One punctured wound, local pain that becomes generalized, no swelling, ecchymosis, or erythema.
Local symptoms are characterized by pain without significant swelling or discoloration.
What are the systemic central nervous system symptoms associated with severe scorpion stings?
Agitation, tremors, fasciculations, cranial nerve dysfunction, coma, convulsions, malignant hyperthermia, hypertensive encephalopathy.
These symptoms indicate serious neurological involvement following a scorpion sting.
What cardiovascular symptoms may occur due to scorpion stings?
Tachycardia, hypertension, shock, cardiac arrest.
Cardiovascular complications can be life-threatening and require immediate medical attention.
What respiratory symptoms are observed in scorpion sting cases?
Tachypnea, stridor, respiratory distress, acute pulmonary edema (cardiogenic or non-cardiogenic).
Respiratory complications can lead to severe breathing difficulties.
What gastrointestinal symptoms can result from scorpion stings?
Vomiting, diarrhea, acute gastric erosions, hematemesis, melena.
These symptoms reflect the systemic impact of the venom on the gastrointestinal system.
What metabolic disturbances are associated with scorpion stings?
Acidosis, hyperkalemia, hyperglycemia.
Metabolic changes can complicate the clinical picture and require monitoring.
What is the initial treatment for scorpion stings before hospital arrival?
Similar to snake bite treatment.
Immediate first aid measures can be crucial in managing symptoms.
What supportive measures should be taken after arrival at the hospital for scorpion stings?
ABC (Airway, Breathing, Circulation).
These are critical first steps in emergency medical care.
What is the specific anti-scorpion antivenin treatment protocol?
Can reverse neurologic symptoms within minutes to hours, given after intradermal sensitivity test, dose is 1 ampoule (2ml) IM.
Antivenin is a key treatment in reversing the effects of the venom.
What symptomatic treatments are recommended for pain management in scorpion sting cases?
Non-SAID (avoid narcotics to prevent respiratory arrest).
Pain management should be carefully considered due to potential respiratory complications.
What is the treatment for stridor and non-cardiogenic pulmonary edema following a scorpion sting?
Corticosteroids.
Corticosteroids can help reduce inflammation and improve breathing.
What is the treatment for acidosis caused by scorpion stings?
NaHCO3.
Sodium bicarbonate can help correct metabolic acidosis.
What is the treatment for convulsions resulting from scorpion stings?
Diazepam.
Diazepam is effective in managing seizures.
What should be administered for shock in scorpion sting cases?
I.V. fluid and inotropic agents.
These are essential for stabilizing the patient’s condition.
What is the causative agent of botulism?
Exotoxin produced by Clostridium Botulinum.
The toxin is responsible for the paralysis associated with botulism.
What is the source of botulism?
Improperly processed canned food.
Food safety is crucial to prevent botulism.
How does the botulism toxin affect the body?
Binds to presynaptic receptors, blocking acetylcholine release, leading to progressive descending paralysis.
This mechanism explains the characteristic paralysis seen in botulism.
What are the initial gastrointestinal symptoms of botulism?
Nausea, vomiting, abdominal distension, pain, diarrhea (negative in 1/3 of patients).
Gastrointestinal symptoms may not appear in all cases.
What ocular symptoms are associated with botulism?
Blurred vision, diplopia, photophobia, dilated fixed pupil.
Ocular involvement is a significant indicator of botulism severity.
What are the main components of botulism treatment?
Supportive measures, GIT decontamination (gastric lavage, activated charcoal), antitoxin (trivalent A, B, & E).
Early treatment is crucial for effective management of botulism.
What is the recommended prophylactic measure to prevent botulism?
Proper preservation of canned food (acidifying to a pH < 4.5).
Ensuring food safety can prevent the growth of Clostridium Botulinum.
When should the antitoxin for botulism be administered?
As early as possible (≤ 2 days after onset of symptoms).
Timely administration improves outcomes in botulism cases.
