Toxicology - Hydrocarbon

Question 1

refers to the general “thickness” of a liquid

Answer 1

Viscosity

lower viscosity flow more easily than ones with high viscosity

measured in Saybolt universal seconds (SUS)

Question 2

low viscosity

Answer 2

gasoline, kerosene, mineral seal oil, and turpentine

Question 3

high viscosity (>100 SUS)

Answer 3

diesel fuel, grease, mineral oil, paraffin wax, and petroleum jelly

Question 4

refers to the property where liquid molecules tend to cohere to each other

Answer 4

Surface tension

Question 5

refers to the ability of the liquid or solid to vaporize and is inversely related to the boiling point

Answer 5

Volatility

highly volatile liquids have a low boiling point.

Ingestion of liquids with low viscosity and surface tension and high volatility increases the risk for aspiration because these substances flow easily, spreading out widely on the oral mucosa, and vaporize at body temperature.

Question 6

Pulmonary effects

Answer 6

Tachypnea, grunting respirations, wheezing, retractions

Necrotizing pneumonitis and hemorrhagic pulmonary edema may develop within minutes to hours

With less severe d age, symptoms usually subside within 2 to 5 days, except in the case of pneumatoceles and lipoid pneumonias

Question 7

Cardiac effects

Answer 7

Ventricular dysrhythmias (may occur after exposure to halogenated hydrocarbons and aromatic hydrocarbons)

Question 8

Central nervous

Answer 8

Slurred speech, ataxia, lethargy, coma

(1) direct toxic response to the systemic absorption of the hydrocarbon,
(2) indirect result of severe hypoxia secondary to aspiration, (3) simple asphyxiation due to the displacement of oxygen by the volatile hydrocarbon, or
(4) volatile substance abuse with a plastic bag that prevents adequate oxygenation

Question 9

Peripheral nervous

Answer 9

Numbness and paresthesias in the extremities

Question 10

GI AND HEPATIC EFFECTS

Answer 10

Nausea, vomiting, abdominal pain, hepatotoxicity, loss of appetite (mostly with halogenated hydrocarbons)

Question 11

Renal and metabolic

Answer 11

Muscle weakness or paralysis secondary to hypokalemia in patients who abuse toluene

metabolic profile of renal tubular acidosis is a normal anion gap hyperchloremic acidosis with hypokalemia and a urine pH of >5.5.

Question 12

Hematologic effects

Answer 12

Lethargy (anemia), shortness of breath (anemia), neurologic depression/syncope (carbon monoxide from methylene chloride), cyanosis (methemoglobinemia from aminecontaining hydrocarbons)

aplastic anemia, acute myelogenous leukemia, and multiple myeloma

Naphthalene exposure is associated with hemolytic anemia

Question 13

Dermal

Answer 13

Local erythema, papules, vesicles, generalized scarlatiniform eruption, exfoliative dermatitis, “huffer’s rash,” cellulitis

Question 14

most common radiologic finding

Answer 14

bilateral infiltrates at the bases.

Multilobar involvement is more c mon than single-lobe involvement, and right-sided involvement is more common than left-sided involvement

Question 15

Changes may be seen on radiology

Answer 15

early as 30 minutes after aspiration, but the initial radiograph in a symptomatic patient may be deceptively clear. Conversely, an asymptomatic patient can still have abnormal chest radiographic findings.

usually appear by 2 to 6 hours;

almost always present by 24 hours

Question 16

The most worrisome acute complication found in solvent abusers

Answer 16

sudden sniffing death syndrome

catecholamine sensitization of the heart by hydrocarbons

simple asphyxia, respiratory depression, and vagal inhibition

Question 17

Peripheral toxicity

Answer 17

metabolite, 2,5-hexanedione

inhibit glutaraldehyde-3-phosphate dehydrogenase,