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Questions and Answers
What is the primary antidote used in gastric lavage for treating thickening of the gastric mucosa?
What is the primary antidote used in gastric lavage for treating thickening of the gastric mucosa?
Which treatment is indicated for impaired renal function following a snake bite?
Which treatment is indicated for impaired renal function following a snake bite?
Which statement about snake bites in the U.S. is true?
Which statement about snake bites in the U.S. is true?
What is one of the primary general measures taken for patients in a coma?
What is one of the primary general measures taken for patients in a coma?
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Why is the snake often used as a symbol for medicine?
Why is the snake often used as a symbol for medicine?
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What primarily determines the flow of snake venom?
What primarily determines the flow of snake venom?
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What is considered a benefit of snake venom extraction?
What is considered a benefit of snake venom extraction?
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Which statement accurately describes snake venom?
Which statement accurately describes snake venom?
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How do snakes help control rodent populations effectively?
How do snakes help control rodent populations effectively?
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Where is the modified parotid salivary gland, responsible for venom production, located?
Where is the modified parotid salivary gland, responsible for venom production, located?
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What is the primary antidote used for alkali poisoning?
What is the primary antidote used for alkali poisoning?
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Which symptom is NOT associated with phenol poisoning?
Which symptom is NOT associated with phenol poisoning?
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What is a possible long-term effect of phenol exposure?
What is a possible long-term effect of phenol exposure?
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Which of the following is a characteristic symptom associated with carbolic acid (phenol) poisoning?
Which of the following is a characteristic symptom associated with carbolic acid (phenol) poisoning?
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Why are corticosteroids used in the treatment of certain corrosive poisonings?
Why are corticosteroids used in the treatment of certain corrosive poisonings?
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What is an immediate visible effect of phenol on the skin upon exposure?
What is an immediate visible effect of phenol on the skin upon exposure?
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What is a common route of accidental poisoning in children involving phenol?
What is a common route of accidental poisoning in children involving phenol?
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What type of necrosis is primarily caused by phenol exposure upon local application?
What type of necrosis is primarily caused by phenol exposure upon local application?
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What percentage of snake venom is composed of protein by dry weight?
What percentage of snake venom is composed of protein by dry weight?
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Which type of damage does hemotoxic venom primarily cause?
Which type of damage does hemotoxic venom primarily cause?
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Which of the following is NOT a common side effect of snake venom?
Which of the following is NOT a common side effect of snake venom?
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In the synaptic action of venoms, what is the primary effect of neurotoxic enzymes?
In the synaptic action of venoms, what is the primary effect of neurotoxic enzymes?
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What is the oral fatal dose of concentrated inorganic acids?
What is the oral fatal dose of concentrated inorganic acids?
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When corrosive poisons are ingested, what is a common clinical sign observed?
When corrosive poisons are ingested, what is a common clinical sign observed?
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What is the purpose of injecting horses with toxins to produce antivenin?
What is the purpose of injecting horses with toxins to produce antivenin?
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What is the recommended initial treatment for someone who has ingested a corrosive acid?
What is the recommended initial treatment for someone who has ingested a corrosive acid?
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What does lymphangitis indicate in a patient bitten by a snake?
What does lymphangitis indicate in a patient bitten by a snake?
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Which of the following best describes snake venom's composition?
Which of the following best describes snake venom's composition?
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Which of the following is a common outcome of inhaling acid fumes?
Which of the following is a common outcome of inhaling acid fumes?
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What is the most serious potential outcome of untreated snake bites?
What is the most serious potential outcome of untreated snake bites?
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What differentiates the oral effect of corrosive alkalies from corrosive acids?
What differentiates the oral effect of corrosive alkalies from corrosive acids?
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What is a potential serious consequence if a patient survives corrosive poison ingestion?
What is a potential serious consequence if a patient survives corrosive poison ingestion?
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In cases of poisoning with corrosive acids, what is the immediate risk associated with gastric lavage?
In cases of poisoning with corrosive acids, what is the immediate risk associated with gastric lavage?
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Which of the following treatments is recommended to neutralize corrosive acids?
Which of the following treatments is recommended to neutralize corrosive acids?
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Study Notes
Corrosive Poisons
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Corrosive poisons cause local tissue damage, with severe oral burns.
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Inorganic acids such as concentrated sulfuric, nitric, and hydrochloric acid are common culprits.
- A fatal oral dose of these acids is only 4 ml.
- Poisoning can come from skin contact or inhalation of fumes, or via intentional attack
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Oral exposure causes severe burning pain from the mouth to the stomach.
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Vomiting often contains bloody, acidic pieces of gastric mucosa.
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The colour of vomit can vary -Dark vomit due to acid haemation in sulfuric acid -Black charring in sulfuric acid, and yellow in nitric acid
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The effects also include dehydration and thirst.
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Other symptoms involve oliguria (low urine production) and constipation, shock, weak pulse, hypotension, and evidence of corrosion on lips and mouth.
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Swelling of the glottis (larynx) may cause stridor (wheezing) and cyanosis (bluish discoloration)
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Death can occur in a few hours due to shock and dehydration or after a few days due to perforation and peritonitis.
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If the patient survives, esophageal stricture may occur, causing dysphagia (difficulty swallowing).
Corrosive Acid Inhalation
- Inhalation of acid fumes causes burning pain in the chest, severe coughing, and shortness of breath.
- Swelling of the glottis can also happen resulting in stridor and pulmonary edema – further leading to cyanosis (bluish discoloration of the skin) and death from asphyxia - suffocation
- Bronchopneumonia (lung infection) can also occur
Corrosive Acid Treatment
- Emetics and gastric lavage are often contraindicated due to the possible risk of gastric perforation.
- Diluting the acid by giving water is a recommended action.
- Neutralizing the acid with weak alkalines like magnesium oxide, lime water, or soap solution is also beneficial.
- Milk, egg albumin, olive oil, or butter are alternative options to mitigate the acidic effects, and prevent further damage.
Corrosive Alkalis (Potassium hydroxide and Sodium hydroxide)
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Caustic potash (potassium hydroxide) and sodium hydroxide are used in homes for cleaning purposes and are accidental poison hazards for children.
- A fatal dose is 3-5 grams of the solid or the corresponding amount of solution.
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Similar to inorganic acids in terms of symptoms, but the mouth mucosa is white.
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Vomis is whitish, slimy (soapy), alkaline, and contains blood.
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The attack period is more delayed than in acid poisoning.
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Stricture of the esophagus is common.
Corrosive Alkalis Treatment
- Treatment involves the same principles as for corrosive acids, avoiding emetics and lavage.
- Neutralizing the alkali with a weak acid, such as lemon or orange juice, dilute vinegar (3-5% acetic acid) in water.
- Further treatment methods include corticosteroids.
Organic Acids (Acetic Acid)
- Glacial acetic acid is highly corrosive.
- Exposure can be via oral ingestion or inhalation of fumes and produces the same picture of acid corrosions accompanied by vinegar-like smell
- The treatment method is the same as that of corrosive acids.
Carbolic Acid (Phenol)
- Phenol is a white crystalline solid, characterized by a strong odor.
- A common form is toilet disinfectant, and other forms like Lysol and Dettol share similar properties.
- Acute exposure causes local tissue necrosis, superficial ulcers, and numbness due to the neurotoxic effect for extended time.
- Sensory nerve endings can be damaged resulting in gangrene, if exposed for long periods
- Systemic absorption from the site of contact can cause central nervous system depression and respiratory distress.
- Fatal dose is 2-4 grams (solid).
- Symptoms include temporary burning pain, colic, vomiting, whitish buccal mucosa, and brownish carbolic eschars (scabs).
- Possible later complications include coma, difficulty breathing, and edema
- Other severe effects include pupils contracted but dilating before death.
- Urine turns green if left in air due to the oxidation of phenol byproducts.
Carbolic Acid Treatment
- Gastric lavage is performed, combined with magnesium sulphate and water given to precipitate the poison.
- To minimize absorption, topical applications should be used, such as 10% ethanol or glycerin as neutralizing agents.
- General supportive care including measures for managing respiratory issues and edema are implemented
- Contaminated skin should be washed with soap and water and then with 10% alcohol
Snake Bites
- There are over 3,000 snake species; only 15% are dangerous.
- Venom is a varied form of saliva secreted through a modified parotid gland.
- Venoms contain enzymes and proteins, causing a variety effects, unlike a single toxin.
- It is produced through a pumping mechanism from an alveolar sac that stores the venom.
- Commonly, venom flows down a tubular fang.
- Though dangerous, it cannot be considered a poison since it isn't inhaled.
- Snake bites are a major hazard for farmers in Africa.
- Some snakes' venomous bites can have benefits for farmers, to combat rodents.
- Antivenoms are produced by injecting horses with venom, monitoring their survival, and collecting their blood for antivenin processing.
- Symptoms include respiratory paralysis, fever, rapid pulse, thirst, dizziness, local tissue damage, blurred vision, nausea, vomiting, diarrhea, coma, and death. (Case Study)
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Description
This quiz covers the critical aspects of corrosive poisons, particularly focusing on the dangers of inorganic acids like sulfuric and nitric acid. Understand the symptoms, effects, and potential outcomes of poisoning, including how exposure occurs and the implications for treatment. Test your knowledge about proper protocols for handling these hazardous substances.
