Toxicology 2

Question 1

3 C &D In lead poisoning??

Answer 1

Colic
Constipation
Cobots ring
Wrist, foot drop

Question 2

How the tetra ethyl lead causes irreversible damage in brain

Answer 2

Encephalopathy
Learning disability
Irritability

Question 3

Most consistent sign of lead poisoning

Answer 3

Facial pallor
Perioral pallor

Question 4

G in chronic lead poisoning is

Answer 4

Gout

Question 5

Lab findings, blood, urine, radiology,
Blood picture

Question 6

Antidote for lead

Answer 6

Ca disodium EDTA
BAL+ EDTA/ DMSA+ EDTA. (Serve )

Question 7

Iron poisoning is mc in………
(Accidental)

Answer 7

Children

Question 8

Forms of iron

Answer 8

Ferrous sulphate
“ Fumerate
“ Gluconate

Question 9

A person present to the OPD with history of iron poisoning 7 hours before and had episode of nausea and vomiting. Now everything is subsided so the doctor send him back 3 weeks later he presented with severe jaundice and bowel obstruction.
Explain the stages duration and clinical features of iron poisoning and how would have been u managed this patient?

Answer 9

Stage one
< 6 hr gastroenteric phase nausea vomiting.
Stage 2
6 to 24 hour asymptomatic
Stage 3
1-2 days multi organ involvement
Hepatic failure- jaundice
Stage 4
2 to 6 week Bowel obstruction
Dt stenosis / strictures
Decontamination,
Chelating agent, hemodialysis.

Question 10

Chelating agent in iron poisoning

Answer 10

Desferrioxamine

Question 11

Properties of white phosphorus

Answer 11

Toxic
Garlic odour
Glow in dark
EMIT fumes
Pyrophoric( spontaneous combustion )
Stored in water

Question 12

Mechanism of action of white phosphorus

Answer 12

Protoplasmic poison.
( necrobiosis of liver cell)

Question 13

Exposure to phosphorus through skin will cause………… & it is treated by…………….

Answer 13

Burns
Cuso4,Agno3

Question 14

How acute Phosphorus poisoning occur in children and adult

Answer 14

Children accidental Firework
Adult rat poison consumption

Question 15

A person presented to the OPD with burning pain vomiting and loose stools
Within 3 days he became normal and patient got discharged within one week the person died. According to 304 IPC The doctor got arrested and imprisonment for 2 years with fine. Explain the cause of death & the leading point he missed during the first stage.

Answer 15

Acute Phosphorus poisoning
Stage one gastroenteritis with the burning pain,vomiting,loose tools.
He missed-Garlic order,Luminous, EMIT fumes, smoky stool syndrome
Stage2 1-4 days asymptomatic.
stage 3 multi organ involvement,
Liver failure, kidney failure,
coagulapady, death due to multi organ failure.

Question 16

Fatal dose of phosphorus

Answer 16

1 mg/ kgbwt

Question 17

How will you treat a person with acute Phosphorus poisoning

Answer 17

Decontamination
Gastric lavage with KMnO4
If liver failure NAC, vitamin K liver transplantation.
Dialysis

Question 18

Even though phosphorus delay oncet of death,mimic natural disease, difficult to trace. They are not commonly used for homicidal purpose why?

Answer 18

Due to Garlic order and its smell

Question 19

What is Lucifer match stick/ phossy jaw/ glass jaw?

Answer 19

Inhalation of white phosphorus vapour by the combustion of Lucifer match stick causes osteomyelitis of mandible.

Question 20

A person presented to the OPD with intense tooth ache, swelling over the cheek and garlic odour pus discharge from sinuses what’s your probable diagnosis.

Answer 20

Osteomayelitis, osteonecrosis of mandible, (phossy jaw)