FINAL Flashcards Preview

clinical toxicology > FINAL > Flashcards

Flashcards in FINAL Deck (42)
Loading flashcards...
1
Q

“Cherry red cyanosis”

A

Carbon monoxide poisoning

2
Q

Oxidizing agents - Nitrogen oxide poisoning

A

“Chocolate cyanosis”

3
Q

Carbon monoxide competes with O2 in heme binding site to form

A

Carboxy-hemoglobin

4
Q

Nitrogen oxides oxidize Heme Fe2+ to Heme Fe3+, AKA

A

Methemoglobin

5
Q

Strong acids interacting with flesh results in

A

Precipitative necrosis (coagulative necrosis)

6
Q

Strong bases interacting with flesh results in

A

Dissolution necrosis (liquefactive necrosis)

7
Q

Salicylates inhibit

A

COX enzymes;

causes decreased Prostaglandin synthesis

8
Q

Salicylate toxicity can cause acid-base imbalance by

A

stimulating medullary respiratory nuclei -> hyperventilation -> Respiratory Alkalosis and
Metabolic Acidosis

9
Q

Hydrocortisone

A

Steroidal Anti-inflammatory meds

10
Q

SAIDs inhibit

A

Phospholipase A2 enzyme -> prevent formation of arachidonic acid -> decrease Prostaglandin synthesis

11
Q

Adverse effects of SAIDs

A

Hyperglycemia
Cushing’s disease (thin extremities, trunk obesity, moon face, buffalo hump)
Immunosuppression
Increase protein catabolism (for GNG)- muscle wasting and poor wound healing
Decreased ACTH secretion

12
Q

Narcotic analgesics cause

A

CNS depression;
Medullary depression -> CV and resp nuclei depression;
Cheyne-Stokes breathing;
overactive Vagus -> spastic GI tract - vomiting and constipation, sinus bradycardia, stim E-W nucleus - pupillary constriction (miosis)

13
Q

Narcotic analgesics include

A

morphine, codeine, oxycontin

14
Q

Non-narcotic analgesics include

A

acetaminophen/Tylenol

15
Q

Non-narcotic analgesics cause

A

Inhibition of PG synthesis in brain

16
Q

Chronic overdose of NNAs can cause

A

kidney failure

17
Q

Acute overdose of NNAs can cause

A

Centrilobar hepatic necrosis

18
Q

MAO inhibitors include

A

Tranylcypromine

19
Q

MAO inhibitors cause

A

Increased activity at aminergic synapses- NE, serotonin;

used as an anti-depressant

20
Q

Tricyclic antidepressants include

A

Imipramine

21
Q

Tricyclic antidepressants cause

A

Prolonged QT interval on ECG;
Block muscarinic ACh receptors on smooth m.s, exocrine glands, and SA node -> intestinal stasis, pupillary dilation, decreased secretions- dry mucous membranes

22
Q

SSRIs include

A

Prozac and Zoloft

23
Q

(Di-)Ethylene glycol is the main component of

A

antifreeze

24
Q

Ethylene glycol causes

A

CNS depression; hypocalcemia - tetany, decreased myocardial contractility and peristalsis

25
Q

Ethylene glycol forms

A

Oxalic acid in the liver and

Calcium Oxalate stones in soft tissue**

26
Q

The preferred substrate for Alcohol Dehydrogenase is

A

Ethyl alcohol

27
Q

Hypocalcemia from ethylene glycol poisoning causes tetany by acting on the

A

Axon Hillock

28
Q

Methanol consumption will result in

A

Metabolic acidosis and an

Increase in Anion Gap acidosis

29
Q

Metabolism of ALL lower alcohols (few carbons) can result in

A

ATP synthesis

30
Q

Alcohol is oxidized by the enzyme

A

Alcohol Dehydrogenase

31
Q

alchohol dehydrogenase removes a H+ via the coenzyme

A

NAD+

32
Q

Alcohol is oxidized to form an

A

aldehyde

33
Q

Aldehyde is oxidized to form

A

a weak acid (proton donor)

34
Q

The weak acid resulting from alcohol metabolism

A

ionizes to form an Anion and H+

35
Q

Chronic alcoholism can cause

A

Fatty liver, cirrhosis, portal hypertension, and esophageal varices

36
Q

Acute overdose of alcohol can cause

A

CNS depression, Hypoglycemia, and Metabolic acidosis

37
Q

Subacute overdose of alcohol can cause

A
Decreased LES (cardiac sphincter) tone -> heartburn -> GERD;
Increased HCl secretions -> gastritis
38
Q

The most common type of metabolic acidosis

A

Lactate acidosis (forms acetic acid and acetate)

39
Q

Management of alcohol overdose

A

D5W infusion (5% dextrose/water) and Thiamine (vitamin B1)

40
Q

Alcohol Aversion Therapy (Disulfiran)

A

Increases blood concentration of Acetaldehyde (by inhibiting Aldehyde dehydrogenase)

41
Q

Formate anion is the product of methanol metabolism, which causes

A

Destruction of ganglion cells at the retina, leading to blindness

42
Q

Methanol and ethylene glycol poisoning are treated by

A

Titrated doses of Ethyl alcohol/Ethanol, the preferred substrate for Alcohol DH - gives the kidneys time to filter out MetOH/EG