Toxicology

Question 1

Which chemical can cause a Disulfuram-like reaction

Answer 1

Carbon disulfide

Question 2

What urinary metabolite would you expect to see in someone sniffing glue?

Answer 2

Hippuric Acid

Toluene is found in most glues as they are petroleum based

Question 3

What symptoms might you find in glue sniffers

Answer 3

insomnia and neuropsychiatric (due to brain damage)

Question 4

Describe how metabolism of Toluene affects the body

Answer 4

Toluene is broken down to hippuric acid in the liver by the cytochrome P450 system so elevated LFTs are seen. The hippuric acid is excreted by the kidneys which causes hematuria and proteinuria

Question 5

How to Hydrocarbons and CFCs (chlorofluorocarbons) affect the heart

Answer 5

Cause sensitization of the heart to catecholamines, sudden exposure of which can lead to fatal cardia arrhythmia. “scared to death” after huffing

Question 6

Which metal is likely to cause kidney stones and how?

Answer 6

Cadmium (NiCad batteries and metal alloys)

Cadmium accumulates in the liver and proximal tubules of the kidney causing damage. This Fanconi’s like syndrome causes increased secretion of glucose, phosphate and calcium leading to kidney stones.

Question 7

What is Itai-itai disease and which metal causes it?

Answer 7

Painful disease from psuedofractures from osteomalacia from Cadmium.

Question 8

Metals can cause either Pulmonary or Neurologic symptoms, but not both. Which metal is the EXCEPTION to this rule

Answer 8

Mercury (Hg)

Question 9

Which metal causes garlic breath with a dry mouth and no sweating

Answer 9

Tellurium

Question 10

Which chemical can cause permanent blindness if ingested?

List a couple of uses of this chemical

Answer 10

Methanol

• antifreeze
• solvent

Question 11

Polymer Fume fever is associated with what?

Answer 11

Exposure to teflon (fluorinated polymer products) that has been heated above 500 degrees
Its symptoms are similar to hypersensitivity pneumonitis

Question 12

Name 2 things that help to make a diagnosis of Metal Fume Fever?

Answer 12

• This flu-like illness improves over the weekend and return with return to work
• Chest X-ray is normal

Question 13

Polyvinyl Chloride (PVC) exposure is related to what syndrome

Answer 13

Acro-osteolysis. Resembles scleroderma

Question 14

Exposure to this substance is one of the most common causes of occupational allergic contact dermatitis

Answer 14

Epoxy resins

Question 15

2-PAM is contraindicated in the treatment of which type of insecticide toxicity?

Answer 15

Carbamate pesticide toxicity

atropine is used