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R Notes > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Classification of poison?

A

CINCAM

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2
Q

Eschar is formed in acid / alkali?

A

Acid
Limit lateral spread

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3
Q

Coagulative necrosis is seen with…..

A

Acid
Alkali -liquefactive

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4
Q

Acid/ alkali which one is more dangerous?

A

Alkali
Cause deeper damage

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5
Q

2 types of acids? Examples of each?

A

Organic : carbolic, acetic, oxalic,formic
Inorg: sulphuric, nitric, hydrochloric.

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6
Q

Give examples of alkali

A

Ammonia
Sod/ pot hydroxide
Sod/ pot carbonate

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7
Q

The 4 things u shouldn’t do in a corrosive poisoning case?

A

Emesis
Gastric lavage
Charcoal
Neutralize

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8
Q

Properties of alkali vs acid

A

Xanthoporetic action.
Carbonisation
Hygroscopic property.

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9
Q

What are the Common features of corrosive consumption other than odynophagia, intense thirst, vomithing, (6)?

A

Abdominal pain
Chemical peritonitis
Resp distress.

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10
Q

Autopsy finding in sulphuric acid poisoning?

A

Black necrotic tongue
Black necrotic stomach mucosa
Gastric perforation
Chalky white teeth

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11
Q

Autopsy findings in nitric acid poisoning?

A

Yellowish discoloration of skin, teeth, stomach mucousa, brownish stomach mucosa

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12
Q

What is vitriolage? Commonly used corrosive for this? What all u can see while examining the victim?

A

Intentionally throwing corrosive for the disfigurement of a person.
Sulphuric
Nitric
Marking nut juice
Chemical burns, ulceration, contractures.
No blister, singeing of hair

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13
Q

How you can manage vitriolage??

A

Topical irrigation with water and ns
Apply Mgo paste
Eye= olive oil

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14
Q

Carbolic acid is also k/as…….
It has a…… Property.how cresol, lysol and dettol related to this acid.how this acid is produced?

A

Phenol.
Antiseptic
They are phenol derivatives
Phenol crystal on exposure to air forms pheenol liquid

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15
Q

Presentation of an acute phenol poisoning(carbolism) case??

A

Burning pain - tingling& numbness - anaesthesia.
Decrease emesis
Leathery stomach mucosa.
Blood= 1.pyrocatechol
2.hydroquinone
CNS:CNS depression, convulsion, constriction of pupil.
URINE: Olive green urine.
Kidney :oligouria, renal failure.

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16
Q

What is Phenolic marasmus??

A

Chronic phenol poisoning

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17
Q

How we clinically diagnose phenol poisoning?

A

Phenolic odour, dark urine
( gastric lavage possible due to lathery stomach mucosa)

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18
Q

Autopsy feature of phenol?

A

Resistant to putrefaction.

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19
Q

What kind of acid is hydrofluoric acid? And what effect does it have?

A

Inorganic acid
Local+ systemic effect
Causes : liquefactive necrosis.

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20
Q

Toxicity of hydrofluoric acid is due to?

A

Fluoride ion.
Which cause
LIQUEFACTIVE NECROSIS: affect skin/ deeper tissue/ bones.excruciating burning pain disproportionate to amount of exposure.
2. INSOLUBLE SALT with calcium, magnesium leads to
Hypocalcemia, hypomagnesemia, & hyperkalemia

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21
Q

How to manage a condition of hydrofluoric acid toxicity?

A

*Immediate icu admission.
*Continuous ecg monitoring
* Topical decontamination e water
*Calcium gluconate 2.5% topical, *injection of calcium gluconate.
*Correct electrolyte level

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22
Q

To whom hydrofluoric acid toxicity occur more?

A

Glass etching.

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23
Q

Oxalic acid is an……. Acidic. Also known as…………..! It visually resembles…….it was used for………

A

Organic
Acid of suga
Magnesium sulphate.
Ink/ rust removal

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24
Q

Source of oxalic acid?

A

Veg such as almond, corn,spinach,
Ladies finger

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25
Q

What happens if Oxalic acid comes in systemic circulation?

A

Calcium oxalate hypocalcemia
Crystals features of
Oxaluria tetany.
Needle/ evelope
Shaped cast.
Comes out of Urine.
Block tubule & renal
Failure.

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26
Q

How u treat oxalic acid poisoning?

A

GL e calcium lactate solution.
Antidote : calcium gluconate.
Hemodialysis.
Rx of renal toxicity.

27
Q

Boiled lobster appearance is seen?

A

Boric acid
Erythemic skin.
Peeling of skin
Skin is completely swollen.

28
Q

Most common acute heavy metal poisoning?

A

Arsenic

29
Q

Mc chronic heavy metal poisoning?

A

Lead

30
Q

3 forms of Arsenic?

A

Elemental
Org
Inorganic(toxic)

31
Q

Example for inorganic arsenic

A

Salt is there
* Arsenic trioxide which is colourless tasteless and order less and most toxic salt of arsenic.
*Sheele’s green
*Paris green.
Gas form arsine
Garlic odour
Most toxic form

32
Q

Types of Arsenic poisoning

A

*Fulminant which is massive intake (3g)
Acute large dose
Chronic small dose for a long period

33
Q

Fatal dose in acute Arsenic poisoning

A

100-200 mg

34
Q

Two forms of acute Arsenic poisoning

A

Gastroenteric form
Which include: profuse diarrhoea
Hemorrhagic gastritis
Narcotic form
Which include: affect CNS
Neurological manifestations.

35
Q

Differentiate acute Arsenic poisoning from cholera

A

Acute Arsenic poisoning
Throat pain vomiting loose stools.
tenesmus present .
On Autopsy : red velvety stomach mucosa.
Cholera
Ls- v- tp.
No tenes

36
Q

Chronic arsenic poisoning is K/as

A

Arsenicosis

37
Q

Contamination of groundwater e arsenic?

A

Hydroarsenicism

38
Q

Clinical features of chronic arsenic poisoning?

A

Skin2
Nail hair
Blood vessel
Nerve
Bm

39
Q

What is torokku arsenic ds?

A

Inhalation / drinking (contaminated e arsenic).
Lung ca
Skin ca
Bowen ds

40
Q

Black foot ds

A

Taiwan ( endemic ds )
Drinking
Peripheral vasospasm
Ischemia
Peripheral gang

41
Q

Most reliable sample used? Other samples?

A

Urine
Blood,hair, nail, bone.

42
Q

Tests for arsenic poisonig

A

Obsolete - marsh, reinsch.
Latest- neutron activation analysis
Atomic absorption
Spectrometry.

43
Q

Medicolegal imp

A

Accidental.
Homicidal
(Retard putrefaction
Decomposed bodies, ash)
Aphrodisiac.

44
Q

Chelating agent for arsenic

A

BAL, DMSA.

45
Q

Chronic poisoning by mercury is known as

A

Hydrargyrism

46
Q

Uses of Mercury

A

Photography
Fingerprinting
Thermometer
Dental amalgam
Sea food
Hat making
Glass bowling

47
Q

Order of toxicity of Mercury

A

Organic >mercuric >mercurous> element form

48
Q

Mercuria lentis?

A

Toxicity due to vapour
Anterior lens capsule
On slit lamp: malt brown reflex
Normal vision.

49
Q

Diseases caused by organic Mercury

A

1.minamata ds
Contaminated fish
Lipid soluble
Cross blood brain barrier
CNS symptoms
Ataxia, tremor convulsion
2. Hunter russel syndrome

50
Q

Ds caused by inorganic Mercury

A

Erethism
Pink ds

51
Q

Clinical features of erethism

A

Neuro psychiatric manifestations
Tremors
Writing- speech- ataxia- concussio mercurialis.
Hatters/ glass bowlers/ dandbury shakes.
Emotional instability
Emotional outburst
Most common in hat industry
Mad hatter syndrome.

52
Q

What is pink disease

A

Mercurous poisoning.
Hypersensitivity reaction in children
Painful peripheries
Feeling of skin
Pruritis
Puffy
Calomel/ acrodynia/ swift fear/selters
Ds
Chelating agent= BAL, DMSA.

53
Q

Why cadmium causes bone weakening bones softening & bone deformity

A

Because cadmium replaces Calcium from Bone

54
Q

Which poisoning couses itai itai disease or ouch ouch disease

A

Cd

55
Q

Clinical features of cadmium poisoning

A

Multiple pathological fractures
Severe bone pain

56
Q

This is an homicidal poison which is known as poisoner’s poison.
This cause butterfly Rash dermatitis,
Behaviour change, alopecia, madarosis, aldrich mees line &
Peripheral sensory motor neuropathy

A

Thallium ( th acetate& sulfate )

57
Q

Lead is used in

A

Paint, pipe, pottery, petrol, pencil, bullet

58
Q

Most toxic form of lead

A

Tetra ethyl lead
Organic form
Lipid soluble

59
Q

Inorganic forms of lead?

A

Lead carbonate
Acetate
Tetroxide
Sulfide.

60
Q

Which are the 2 anaemias sceen in lead poisoning

A

Normocytic normochromic.( bone marrow suppression )
Micro.hypochro(decreased hb production dt inhibition of ALA dehydratase, ferrochelates. )

61
Q

What is the manifestation of pbs?

A

Burtonian/ Burton’s line.
Blue colour deposit in gingivodental jun.
Upper teeth
1 w exposure.
Dental caries- bact h2s+pb =pbs.

62
Q

Importance of 5- pyramidine nucleotidase

A

It is required for removal of ribosomal particle from reticulocyte for formation of RBC.
It’s inhibition causes basophilic stippling.

63
Q

Manifestations in Bone

A

Bone line
RadioDens opacity in metaphysis of long bone.
Most common in children’s
Due to deposition of calcium

R Notes (10 decks)

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