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Clin Lab > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Small amounts of substances that produce injury

A

Toxins or poisons

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2
Q

What are 2 things that lab assays analyze?

A
  • Qualitative (detect their presence)

- Quantitative (detect their amounts)

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3
Q

Is the typical blood screen quantitative or qualitative?

A

Qualitative- most people want to see if the drug is present- they dont really care how much is present

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4
Q

What is something that is important to determine before ordering a drug screen?

A

What is included in that specific ‘drug screen’

-this is different depending on which lab you are ordering from

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5
Q

Does timing matter when you are checking levels of toxins

A

Yes- certain toxins are only present for a short time, or they are only found in the blood, urine, or gastric acid

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6
Q

What is the most reliable source for determining the presence of toxins within a few hours of ingestion?

A

Gastric fluid

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7
Q

Describe levels of heroin and cocaine

A

Blood levels are only elevated for a short period of time

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8
Q

How do you test if ingestion occured more than a few hours before presentation

A

Urine levels

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9
Q

What compounds are better tested in blood because the urine excretion is minimal

A

-Lead or carbon monoxide

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10
Q

When quantitative results are needed, _____ is the only suitable fluid

A

BLOOD

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11
Q

What types of patient are usually given tox screens?

A

Patients that present with…

  • coma
  • confusion
  • delirium
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12
Q

Can you overdose on acetaminophen?

A

Yes- when you take them in amounts that exceed metabolic capabilities

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13
Q

What effects does overdosing on acetaminophen have on the body?

A
  • Causes renal toxicity

- Can produce acute tubular necrosis along with hepatic toxicity

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14
Q

When should levels be drawn if acetaminophen poisoning is suspected?

A

4 hours after ingestion- and levels should be more than 150 ug/mL to indicate toxicity

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15
Q

HOw should levels be drawn for people with acetaminphen toxicity?

A

-Should have levels drawn several times in the first few hours of observation

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16
Q

What is the most common type of toxicity?

A

Ethanol alcohol

17
Q

T/F- Blood alcohol levels correlate with patterns of toxicity

A

True

18
Q

How can chronic alcohol abuse be detected?

A
  • Increased MCV
  • Increased GGT
  • Along with a positive drug screen
19
Q

This is an odorless colorless gas that is produced from the incomplete combustion of hydrocarbons

A

Carbon monoxide

20
Q

What percentage of deaths due to toxins does carbon monoxide cause?

A

50%- and 1/3 are accidental

21
Q

How does carbon monoxide poison people

A

It binds to hemoglobin and prevents oxygen transport

22
Q

Are the symptoms related to the amount of exposure in carbon monoxide?

A

Yes- they start with fatigue and headache and can progress to neurological deficit and cardiac & cerebral ischemia, and lactic acidosis

23
Q

What are other S&S that someone has carbon monoxide poisoning?

A

-Other family members are involved

24
Q

What is the most common cause of fatal poisoning in children?

A

Accidental ingestion of excess IRON

25
Q

What is the pathogenesis of iron poisoning

A

Iron is absorbed by the intestine and stored in the liver- so too much iron can damage the liver and causes mucosal injury
-Leads to vomiting, GI bleeding, and abdominal pain

26
Q

When does the amount of iron begin to effect the body?

A
  • When the amount of iron ingested exceeds the binding capacity of transferrin
  • Free iron causes damage to many cells
  • This causes shock and lactic acidosis
27
Q

What levels of iron produce toxicity?

A

When levels are over 100 ug/dL

28
Q

What is the major source of lead

A

Lead paint in houses or on toys

29
Q

What are S&S of lead poisoning

A
  • Lowered intelligence
  • Developmental delay
  • Abdominal pain
  • Neuropathy
  • Anemia
30
Q

What levels of lead produce toxicity?

A

over 40 ug/dL

31
Q

When were tricyclic antidepressants prescribed?

A

-To patients that are prone to suicide attempts

32
Q

What is amoung the most common encountered toxic agents?

A

Tricyclic Antidepressants

33
Q

How is overdose on TCAs seen clinically?

A

-Overdose results in an anticholinergic pattern is seen and cardiac arrythmia is possible

34
Q

What is the most typical methodology for testing drugs

A

-Immunoassays

35
Q

Causes of False Positives…

A
  • Occur with compounds that are chemically similar to the abused drug in question
  • Poppy seeds
  • Cocoa tea
  • Sympathomimetic drugs are chemically similar to amphetamines
36
Q

False negatives

A
  • Urine sample from another person
  • Water added to the sample to dilute the urine
  • Chlorine bleaches added to denature the proteins after collection

Clin Lab (23 decks)

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