tox test 3

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coal
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247712
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tox test 3
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2013-11-19 18:26:48
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tox test 3
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  1. RDI of Se
    55 ug/day
  2. max tolerated dose of Se
    400 ug/day
  3. S/S of acute Se poisoning
    • GI
    • Heart
    • circulatory (shock)
  4. s/s chronic Se poisoning
    alopecia
  5. diagnosis of acute Se poisoning
    severe gastroenteritis with garlic breath ododr and HoTN
  6. inorganic forms of arsenic
    • -3 arsenide
    • +3 arsenite
    • + 5 arsenate
  7. organic forms of arsenic
    seafood
  8. inorganic forms of arsenic
    juices, small grains, red meat, poultry
  9. arsenic distribution
    • highly protein bound - rapid distribution thru central compartment
    • biphasic distribution - 90% removed from blood w/I 2 hrs
  10. arsenic longer term stores are where
    keratin
  11. toxixity of arsenic
    AsIII arsenite >> AsV arsenate
  12. arsenites react with
    sulfhydryls
  13. arsenates substitute for
    phosphate
  14. arsenite inhibits the regeneration of
    • lipoic acid
    • no conversion of pyruvate to acety-CoA
    • alpha-ketoglutarate dehydrogenase
  15. what happens with arsenate substituition for phosphate
    • no ATP produced
    • in hydroxyapatite of bone
  16. clinical acute arsenic signs
    hemorrhagic gastroenteritis
  17. chronic arsenic signs
    • hyperkeratosis
    • hyper & hypo pigmentation
    • peripheral vascular disease "blackfoot"
  18. normal arsenic blood levels
    < 1 ug/dL
  19. best index of chronic arsenic exposure
    hair, nail samples
  20. Tx of acute arsenic poisoning
    • vasopressors
    • IV fluids to maintain renal function
  21. how long do you treat acute arsenic poisoning
    24 hr urine As < 25 ug or < 90% of urine As is "organic"
  22. 3 forms of mercury
    • elemental
    • inorganic
    • organic
  23. where does inorganic Hg concentrate
    kidneys
  24. where does organic Hg concentrate
    CNS
  25. where does elemental Hg concentrate
    lungs
  26. clinical signs of acute inorganic Hg
    • GI hemorrhage, necrosis
    • colic, diarrhea, shock
  27. clinical signs of chronic inorganic Hg
    • kidney - proximal tubule necrosis
    • acrodynia "pink disease"
  28. clinical signs of acute metallic Hg overdose
    • corrosive bronchitis
    • pneumonitis
  29. clinical signs of chronic metallic Hg
    • intention tremor
    • mad hatters
  30. clinical signs of organic Hg triad
    • dysarthria
    • ataxia
    • constricted visual fields
  31. normal Hg blood & urine levels
    • < 2 ug/dL
    • < 10 ug/L
  32. Tx of metallic Hg
    • ingestion - no specific Tx
    • inhalation - pneumonitis, ARDS
    • respiratory support
  33. Tx of inorganic salts
    careful decontamination
  34. Tx of organic Hg (methyl)
    • neuro exam
    • resistant to chelation
  35. acute Cu intoxication
    • emesis
    • gastroenteritis
    • kidney failure
    • hemolytic anemia
  36. chronic Cu poisoning
    • Wilson's disease
    • menke's disease
    • active hepatitis - dogs
  37. hallmark sign of chronic poisoning
    kayser-fleischer rings
  38. Tx of Cu poisoning
    • chelation
    •   penicillamine
    •   BAL
    •   Zn acetate
  39. normal metabolism of Cu
    chaperoned to Golgi - secreted into portal circulation

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