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Clinical Chemistry > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Study of Poisons

A

Toxicology

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2
Q

EXOGENOUS agents produced by has effect on LIVING ORGANISM from chemical esposure, antibiotics and antidepressants

A

XENOBIOTICS

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3
Q

EXOGENOUS agents with effects on the BIOLOGICAL SYSTEM

A

POISON

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4
Q

ENDOGENOUS agents synthesized by the acquired biological agent which have effect on the BODY/INSIDE THE CELL.

A

TOXINS

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5
Q

Substances that are NOT produced by living cells but more commonly by ENVIRONMENTAL CHEMICALS

A

Toxicant

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6
Q

True or False. ABSORPTION of toxins is NEEDED to reach GI tract first to produce SYSTEMIC EFFECT

A

True.

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7
Q

True or False. Toxins preferred IONIZED species because they can diffuse passively

A

False. Toxins preferred NON-IONIZED species because they can diffuse passively.

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8
Q

True or False (Morse). The faster the gastrointestinal motility, the faster the passage of the toxin. The SLOWER the motility, LESSER/FEWER the toxin is absorbed which is less dangerous.

A

1st statement: TRUE
2nd statement: FALSE

A: SLOWER the motility, the MORE the toxin is absorbed which is MORE DANGEROUS.

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9
Q

Implies to the relationship with an INCREASE TOXICITY response as the DOSE IS INCREASED

A

Dose-response relationship

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10
Q

Predicted dose to produce a TOXIC RESPONSE in 50% population

A

TD50 (Toxic Dose)

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11
Q

Predicted dose to result in DEATH/KILL of 50% population

A

LD50 (Lethal Dose)

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12
Q

Predicted dose that can TREAT/EFFECTIVE at 50% population

A

ED50 (Therapeutic Dose)

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13
Q

Specimen tube for Toxicology and Trace Element testing

A

Royal Blue Top Tube

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14
Q

Tube for Lead Testing Determination

A

Tan/Light Brown Tube

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15
Q

Reference Method for Toxicology in detecting Organic compounds

A

Gas Chromatography - Mass Spectrophotometry (GC-MS)

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16
Q

Analytical process which sgould be seprated by GC that would involve FRAGMENTATION and IONIZATION OF MOLECULES

A

Mass Spectrophotometry

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17
Q

This SEPARATE sample into its INDIVIDUAL chemical components, usually with volatile compounds and steroids

A

Gas Chromatography

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18
Q

A common CNS depressants, causing disorientation, euphoria and confusion

A

Alcohol

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19
Q

Toxic Metabolite of ETHANOL

A

Acetaldehyde

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20
Q

Toxic Substance of METHANOL

A

Formic Acid

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21
Q

Unique signs and symptoms of Methanol due to formation of Formic acid

A

METABOLIC ACIDOSIS

OPTIC NEUROPATHY

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22
Q

Rubbing Alcohol

A

Isopropanol

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23
Q

Toxic Substance of ISOPROPANOL

A

Acetone

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24
Q

Unique signs and symptoms of ETHYLENE GLYCOL

A

Deposition of Calcium Oxalate Crystals

Renal Tubular Acidosis and Stones

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25
Q

Production of Oxalic Acid that further result to Calcium Oxalate

A

Ethylene Glycol

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26
Q

Disinfectant used in Alcohol Testing

A

Benzaldehyde/Benzalkonium chloride

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27
Q

Anticoagulant of choice for storage of alcohol

A

Sodium Fluoride

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28
Q

Reference Method of ETHANOL determination

A

Gas Chromatography (GC)

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29
Q

Carbon monoxide intoxication produces what Hb variant?

A

Carboxyhemoglobin

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30
Q

Unique characteristic of Carbon monoxide poisoning

A

Cherry Red appearance

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31
Q

It produces cyanide toxicity once it binds to what Hb structure and substances?

A

Cyanide binds to HEME IRON and IRON-BINDING substance

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32
Q

A SUPER TOXIC substance from insecticides, rodenticides

A

Cyanide

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33
Q

Unique effect of Cyanide toxicity

A

ODOR OF BITTER ALMONDS/GARLIC BREAD ODOR

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34
Q

Identify:
Common homicide and suicide agent
High affinity to KERATIN

A

Arsenic

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35
Q

True or False. INGESTION of Arsine gas demonstrates MOST ACUTE toxicity

A

False. INHALATION of arsine gas demonstrates the most acute

toxicity.

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36
Q

Unique effect of Arsenic in long term exposure

A

MEE’S LINES

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37
Q

True or False. ALL Metal detection is evaluated by ION SPECIFIC ELECTRODE

A

False. ALL Metal detection is evaluated by ATOMIC ABSORPTION SPECTROPHOTOMETRY (AAS)

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38
Q

Cadmium Characteristics

A

Used in:
Electroplating and Galvanizing
Pigment found in Paints and Plastics
Significant environmental pollutant

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39
Q

Unique effect of Cadmium toxicity

A

ITAI-ITAI

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40
Q

Disease characterized by severe OSTEOMALACIA and OSTEOPOROSIS from long term CADMIUM-CONTAMINATED RICE

A

Itai-Itai

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41
Q

Lead bind to what ION making it mostly found in BONES and Soft tissues

42
Q

Associated signs and symptoms in Higher concentration of Lead

A
  1. Neurological (motor function - decrease movement) Symptoms due to decrease nerve conduction and demyelination of nerves.

Rationale: Leads binds to Ca2+ and thus inhibit nerve signaling pathways.

43
Q

Normal threshold for blood lead levels (BLL)

44
Q

Associate based on CDCs Blood Lead levels:
o For >10 ug/dL
o For >20 ug/dL
o For < 10 ug/dL

A

For >10 ug/dL - Growth deficits
For >20 ug/dL - Anemia
For < 10 ug/dL - permanent IQ and hearing deficits

45
Q

True or False.
Forms of Mercury

Elemental - Brain and Nerves
Organic Compounds - Nephrotoxic

A

False.

Elemental - No significant Effect; Nephrotoxic
Organic Compounds - Brain and Nerves

46
Q

Common toxic route of Mercury

A

Consumption of contaminated foods

47
Q

Most abundant and are

responsible for about one–third of all pesticide poisonings

A

Organophosphates

48
Q

Most common pesticides

49
Q

An enzyme that degrades or binds to acetylcholine

to stop the signaling process or to stop the activation of the muscle which is being inhibited by organophosphates.

A

Acetylcholinesterase

50
Q

Analysis in Pesticide poisoning

A

Measure: Serum pseudocholinesterase (SChE) activity

51
Q

a.k.a Acetylsalicylic acid

52
Q

Enzyme inhibited by Aspirin

A

Cyclooxygenase

53
Q

Mechanism of Action of Aspirin

A

Decreasing thromboxane and prostaglandin formation (causes pain) through the inhibition of cyclooxygenase

54
Q

Condition associated with excessive intake of aspirin in CHILDREN

A

Reye’s Syndrome

55
Q

Trinder reaction

A

Salicylate reacts with ferric nitrate to form a colored complex that is then measured spectrophotometrically.

56
Q

Reference Method in ACETAMINOPHEN/PARACETAMOL

57
Q

Phase affected when Acetaminophen Toxicity or with overdose.

A

Phase II metabolic Pathway

58
Q

REACTIVE INTERMEDIATE converted from drugs by P450 dependent system

A

N-acetyl-p-benzoquinoneimine

59
Q

Therapeutic drugs used for NARCOLEPSY and Attention Deficit Disorder.

A

AMPHETAMINES

60
Q

Toxic effects of Amphetamine and methamphetamine

A

Hypertension
Cardiac arrhythmias Convulsions
Pancytopenia

61
Q

a.k.a Methylenedioxymethamphetamine (MDMA)

62
Q

True or False. Onset of effect of Ecstacy is 30 to 60 minutes, and duration is about 3.5 hours

63
Q

Associated with male sex hormone testosterone that increase muscle mass

A

ANABOLIC STEROIDS

64
Q

Psychoactive compound and most potent component of Marijuana.

A

Tetrahydrocannabinoids (THC)

65
Q

Major urinary metabolite for testing Marijuana and is detected in screening tests for Drug testing.

A

11-nor-tetrahydrocannabinol-9-carboxylic acid (THC–COOH)

66
Q

After a single use of marijuana, how many days which it can be detected.

67
Q

In heavy users of marijuana, how many days or weeks which THC -COOH can be detected.

68
Q

Urinary Metabolite of Cocaine and is primary product of Hepatic metabolism

A

Benzoylecgonine

69
Q

Half-life of Benzoylecgonine

70
Q

A plant/flower which Opiates are derived from.

A

Opium poppy (papaver somniferum)

71
Q

Naturally Occurring Opiates

A

Opium
Morphine
Codeine

72
Q

Chemically modified Opiates

A

Heroin
Hydromorphone (Dilaudid)
Oxycodone (Percodan)

73
Q

Opioid overdose

A

Pupillary constriction
Comatose
Respiratory depression

74
Q

Naloxone

A

Treatment for Opioid Overdose

75
Q

CNS depressants

A

SEDATIVES-HYPNOTICS

76
Q

Most common

types of sedative–hypnotics abused.

A

Barbiturates Benzodiazepines

77
Q

Abused BARBITURATES

A

Secobarbital
Pentobarbital
Phenobarbital

78
Q

Most commonly abused

BENZODIAPINES

A

Diazepam (Valium)
Chlordiazepoxide (Librium)
Lorazepam (Ativan)

79
Q

Used to control Seizure activity

80
Q

Most serious toxic effect of Sedatives-Hypnotics

A

Respiratory depression

81
Q

Give Values in Toxicity Rating System

Super Toxic
Extremely Toxic
Very Toxic
Moderately Toxic
Slightly Toxic
Practically Toxic
A 
Super Toxic (<5 mg/kg)
Extremely Toxic (5-50 mg/kg)
Very Toxic (50-500 mg/kg)
Moderately Toxic (0.5-5 g/kg)
Slightly Toxic (5-15 g/kg)
Practically Toxic (>15 g/kg)
82
Q

Therapeutic Index

A

TD50 (or LD50) / ED50

83
Q

Ethanol

Other Name:
Toxic Metabolite;
Toxicity:
Fatal Dose:
Preferred Test:
Treatment:
A

Ethanol

Other Name: Grain alcohol
Toxic Metabolite; Acetaldehyde
Toxicity: Hangover, CNS Depression
Fatal Dose: 300 - 400
Preferred Test: Enzymatic - Aldehyde Dehydrogenase
Treatment: Diazepam
84
Q

Alcohol Critical Values

Symptoms of Alcohol Intoxication: _________
Legally Intoxicated: __________
Presumptive Evidence of driving under influence: ________

A

Alcohol Critical Values

Symptoms of Alcohol Intoxication: >/+ 0.05% w/v
Legally Intoxicated: _>100 mg/dl
Presumptive Evidence of driving under influence: >/= 0.10% w/v

85
Q

Methanol

Other Name:
Toxic Metabolite;
Toxicity:
Fatal Dose:
Screening Test:
Preferred Test:
A

Methanol

Other Name: Wood Alcohol
Toxic Metabolite: Formic Acid
Toxicity: Optic Neuropathy, Metabolic Acidosis
Fatal Dose: 60- 250 mL
Screening Test: Computation of Osmolality Gap
Preferred Test: GC-MS

86
Q

Isopropanol

Other Name:
Toxic Metabolite;
Toxicity:
Fatal Dose:
Preferred Test:
Antidote:
A

Isopropanol

Other Name: Rubbing alcohol
Toxic Metabolite: Acetone
Toxicity: Fruity Breath, CNS Depression, 
Fatal Dose: 250 mL
Preferred Test: Gas Chromatography
Antidote: Activated Charcoal
87
Q

Ethylene Glycol

Source:
Toxic Metabolite;
Toxicity:
Fatal Dose:
Preferred Test:
A

Ethylene Glycol

Source: Hydraulic fluid, Anti-freeze
Toxic Metabolite: Oxalic Acid
Toxicity: CaOx, Renal Tubular Acidosis, Stones
Fatal Dose:100 grams
Preferred Test: HPLC
88
Q

Carbon Monoxide

Affinity:
Indicator:
Toxic Dose:
Definitive method:

A

Carbon Monoxide

Affinity: 220x
Indicator: Cherry Red appearance
Toxic Dose: 20% w/v
Definitive method: Carbon Monoxide Oximetry

89
Q

Cyanide

Mechanism:
Indicator:
Toxic Dose:
Definitive method:

A

Cyanide

Mechanism: Binds to iron binding substances
Indicator: Odor of Bitter Almond
Toxic Dose: >2 ug/mL
Definitive method: Gas diffusion Amperometry

90
Q

Arsenic

Mechanism:
Indicator:
Toxic Dose:
Definitive method:

A

Arsenic

Mechanism: High affinity to Keratin
Indicator: Garlic Bread Odor/ Mees Lines
Toxic Dose: 120 mg/mL
Definitive method: AAS

91
Q

Cadmium

Mechanism:
Indicator:
Definitive method:

A

Cadmium

Mechanism: Inhibits Type 1 epithelial cells of lungs
Indicator: GGT in Urine
Definitive method: AAS

92
Q

Lead

Mechanism: 
Indicator: 
Toxic Dose:
Fatal Dose:
Screening Test:
A

Lead

Mechanism: Potent Enzyme Inhibitor of D-ALA, 5’ nucleotidase
Indicator: Microcytic Anemia, Basophilic Stippling, Increase D-ALA/Protoporphyrin
Toxic Dose: > 0.5 mg/day
Fatal Dose: 0.5 g
Screening Test: Zinc Protoporphyrin Test, D-ALA dehydratase test

93
Q

Mercury

Mechanism:
Indicator:
Toxic Dose:
Definitive method:

A

Mercury

Mechanism: Bind to sulfhydryl proteins which inhibit catecholamine enzymes
Indicator: 
 Elemental Mercury - Pink Disease
 Alkyl Mercury - Minimata Disease
Toxic Dose: >50 ug/dl
Definitive method: AAS
94
Q

Amphetamines

Use:
Popular Designer Drug:

A

Amphetamines

Use: Treatment for Narcolepsy and Attention deficit
Drug: Methylenedioxyamphetamines (MDMA)

95
Q

Other Names - Amphetamines

A

Shabu
Poorman’s Coccaine
Lid Popper/Pep pills/Hearts

96
Q

Cannabinoids

Treatment:
Common Name:
Most Potent Component:
Urinary Metabolite:
Detected:
A

Cannabinoids

Use: Stimulant and Depressant
Common Name: Marijuana
Most Potent Component: Tetrahydrocannabinoid
Urinary Metabolite: 11-nor-deltatetrahydrocannabinoid (THC)
Detected: 3-5 days up to 4 weeks

97
Q

Other Names - Cannabinoids

A

Harshish
Mary Jane
Flower
Pampapogi

98
Q

Cocaine

Use:
Common Name:
Inhibitor:
urinary Metabolite:
Detected:
A

Cocaine

Use: Local anesthetic for nasopharyngeal surgery
Common Name:
Inhibitor: Prozac
Urinary Metabolite: Benzolecgonine
Detected: Up to 3 days
99
Q

Other Names - Coccaine

A 
Gold dust
Star dust
Heaven dust
White girl 
Speed Ball
100
Q

Opiates

Use:
Antagonist:
Toxic Effect:

A

Opiates

Use: Depressant - Sedative, Analgesic, Anesthetic
Antagonist: Naloxone
Toxic Effect: Pinpoint pupils

101
Q

Sedative Hypnotics

Use:
Cause:
Toxicity Initiated by:
Major Metabolite:

A

Sedative Hypnotics

Use: CNS Depressants
Cause: Respiratory Depression
Toxicity Initiated by: Alcohol
Major Metabolite: Secobarbital

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