Module 11: CO, CN, and Heavy Metals

Question 1

too much or too little of essential trace elements

Answer 1

Hormesis

Question 2

Analysis technique

Introduce sample into argon plasma; aerosol droplets added to argon plasma; plasma dries aerosol and disassociates molecules and moves electrons forming a single charged ion which is then directed into mass filter (MS)

Answer 2

Inductively Coupled Plasma-Mass Spec (ICP-MS)

Question 3

Analysis technique

Sample into small graphite tube; then heated; allowed to vaporize and atomize; amount of light absorbed is proportional to amount of # of atoms

Answer 3

Graphite Furnace Atomic Absorption Spectrometry (GFAAS):

Question 4

Analysis technique

Uses intensity of light emitted from excitation of elemental atoms (from flame/spark) at a specific wavelength to determine quantity of an element in sample

Answer 4

Atomic Emission Spectroscopy: (or Optical Emission Spectroscopy; AES or OES)

Question 5

Heavy metal associated with Mee’s lines (white lines on nails)

Answer 5

Arsenic

Question 6

How is Barium toxicity caused?

Answer 6

Hypokalemia (low potassium) - agonist of potassium channels

Question 7

Beryllium primarily affects what organ system?

Answer 7

Lungs

Question 8

Heavy metal that has a long detection time in bone

Answer 8

Lead

Question 9

Heavy metal associated with pink disease (acrodynia)

Answer 9

Mercury

Question 10

Heavy metal poisoning that may be confused with Guillain-Barre Syndrome

Also a byproduct of other heavy metal production

Answer 10

Thallium

Question 11

protein in red blood cells that carries O2; four protein subunits each with a heme group with an iron atom

Answer 11

Hemoglobin

Question 12

Approximate affinity of CO for hemoglobin compared to oxygen

Answer 12

200-270x

Question 13

Best/worst tissues for CO testing

Answer 13

Best: spleen, bone marrow
worst: liver

*Needs to contain hemoglobin so no urine, serum

Question 14

Microdiffusion/Conway result for CO

Answer 14

silver

*Uses palladium chloride + acid

Question 15

This can be present in blood via B12 metabolism

Answer 15

CN

*Highly distributed in blood compared to plasma (think Hemoglobin)

Question 16

Microdiffusion/Conway result for CN

Answer 16

Violet

Question 17

Distinctive post-mortem finding of CO

Answer 17

Cherry red discoloration

Question 18

Distinctive post-mortem finding of CN

Answer 18

Bitter almond smell, sometimes bright red color of blood

Question 19

Distinctive post-mortem finding of Hydrogen Sulfide (H2S)

Answer 19

green discoloration of grey matter, bronchial
egg smell

Question 20

Which of the following does the Reinsch test not cover?

Arsenic
Antimony
Lead
Bismuth
Mercury

Answer 20

Lead

*Tests for antimony, arsenic, bismuth, selenium, thallium and mercury

Question 21

The addition of _____ reduces oxyhemoglobin and methemoglobin to Hb while leaving COHb unaffected.

Answer 21

Sodium hydrosulfite

Question 22

%COHb saturations of _____ are considered normal for smokers.

Answer 22

10%

Question 23

CN causes:
Hypoxia, Metabolic alkalosis, Metabolic acidosis, A and B, A and C

Answer 23

A and C

Question 24

The primary target organ of CN is the _____:

Answer 24

Brain

Question 25

CN levels less than _____ are generally considered to be normal levels.

Answer 25

< 0.26 mg/L

Question 26

True or False: The liver can detoxify a significant amount of orally ingested CN.

Answer 26

True

Question 27

Cyanide metabolite:

Answer 27

Thiocyanate

Question 28

Blood CN concentrations above ___ are consistent with death.

Answer 28

3 mg/L

Question 29

99% of Pb that is absorbed is bound to:

Answer 29

Hb in red blood cells

Question 30

Rhodanese is involved in _____ metabolism.

Answer 30

CN

Question 31

Pb causes increased _____ in the blood.

Answer 31

Zinc protoporphyrin

Urine = Delta-ALA

Question 32

The most toxic form of arsenic:

Answer 32

Arsine

Question 33

Formation of _____ is an antidote for CN poisoning.

Answer 33

Methemoglobin

Question 34

Major arsenic metabolite:

Answer 34

DMA

Question 35

Potassium CN may be used in the manufacture of:

Answer 35

PCP

Question 36

Stopping of the Kreb’s cycle leads to accumulation of:

Answer 36

Pyruvic Acid

Question 37

Heavy metal that causes black or gray line along the gums:

Answer 37

Lead

Question 38

CN antidote:

Answer 38

Nitrite/Thiosulfate

Question 39

Arsenic antidote:

Answer 39

BAL

Question 40

Removes metal contamination from collection containers and devices:

Answer 40

10% nitric acid

Question 41

Pb causes increased _____ in the urine.

Answer 41

Delta-ALA