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Questions and Answers
What is a severe symptom associated with toxic ingestion of acetone?
Which treatment is appropriate for symptoms resulting from acetone toxicity?
What is a potential long-term complication of phenol toxicity?
Why should topical preparations containing phenol not exceed 1% concentration?
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Which of the following is a symptom of phenol poisoning?
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What are the main categories of hydrocarbons?
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Which substance is likely to cause the most severe aspiration pneumonitis?
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Which of the following is NOT a route of exposure for hydrocarbons?
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What is the primary organ system affected by hydrocarbon toxicity following ingestion?
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How does CNS involvement occur following hydrocarbon ingestion?
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What is the significance of Saybolt seconds universal (SSU) in relation to hydrocarbons?
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Which of the following hydrocarbon products is associated with significant risk of aspiration pneumonitis due to its low viscosity?
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What is the most serious complication of hydrocarbon ingestion?
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How does the viscosity of hydrocarbons affect the risk of aspiration?
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What symptoms may young children exhibit after ingesting hydrocarbons?
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What is the recommended diagnostic procedure if respiratory failure is suspected after hydrocarbon ingestion?
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Which of the following properties of hydrocarbons is least associated with the increased incidence of aspiration?
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How long does nonfatal pneumonitis typically resolve after hydrocarbon ingestion?
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What might indicate hydrocarbon exposure if a patient cannot provide a history?
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What immediate behavior is associated with aspiration during hydrocarbon ingestion?
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What neurological symptom may develop with substantial systemic absorption of a halogenated hydrocarbon?
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What is the primary component found in most bleach products?
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What symptom is NOT typically associated with bleach ingestion?
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Why should acidic antidotes be avoided in the case of bleach toxicity?
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What is the primary reason for avoiding gastric emptying in cases of hydrocarbon toxicity?
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In cases of soap ingestion, what is the expected outcome for most patients?
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What gas can be released when bleach is mixed with strongly acidic cleaning agents?
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Which compound is found in modern mothballs, replacing naphthalene?
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Which substance is NOT considered to have significant toxicity when ingested?
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What is a potential risk for individuals with erythrocytic G6PD deficiency when ingesting naphthalene?
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Which treatment is NOT recommended for patients with hydrocarbon toxicity?
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What action should be taken if a patient presents with paint residue on their hands or mouth?
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What type of treatment is required for mothball toxicity caused by naphthalene?
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What is typically the most significant harm from ingestion of strong detergents?
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What is the primary health risk associated with exposure to high concentrations of acetone?
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What is the odor characteristic of acetone, commonly found in nail polish remover?
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Which of the following is a recommended treatment for severe vomiting or diarrhea caused by detergent ingestion?
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What concentration of acetone can cause irritation of the eyes, nose, and throat?
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What describes the primary action of soap as it relates to toxicity?
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What is a common misconception regarding the treatment of detergent ingestion?
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What characterizes the method of action for soaps in comparison to detergents in toxic ingestion scenarios?
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Study Notes
Hydrocarbons & Household Products Toxicity
- Hydrocarbons are the most basic type of organic molecules, consisting only of hydrogen and carbon atoms.
- They are categorized into alkanes, alkenes, alkynes, and aromatic hydrocarbons.
- Hydrocarbon poisons are mixtures of aliphatic and aromatic hydrocarbons.
- Properties like molecular weight, chemical, and physical properties vary among these compounds. Examples include gasoline, kerosene, mineral spirits, petroleum naphtha, petroleum ether, mineral seal oil, coal tar, benzene, toluene, xylene, and turpentine.
- Ingesting hydrocarbons can cause minimal systemic effects but often lead to severe aspiration pneumonia.
- The toxic potential of hydrocarbons is mainly dependent on viscosity, measured in Saybolt seconds universal (SSU).
- Liquids with low viscosity (SSU < 60), like gasoline and mineral oil, spread rapidly, increasing the risk of aspiration pneumonia.
- The two main routes of hydrocarbon exposure are inhalation and ingestion.
- Ingestion is a more common cause of acute hydrocarbon poisoning.
- Ingested hydrocarbons affect multiple organ systems, including the lungs, central nervous system (CNS), gastrointestinal tract, liver, and heart.
- Pulmonary system involvement, specifically aspiration pneumonia, is a significant cause of morbidity and mortality.
- CNS effects from hydrocarbon ingestion are secondary to hypoxic cerebral damage from chemical-induced pneumonia.
- The most serious complication from hydrocarbon ingestion is chemical pneumonia, usually resulting from aspiration during or after ingestion, or vomiting.
- Physiochemical properties like volatility and viscosity are important factors in the incidence of aspiration.
- Highly volatile hydrocarbons with low viscosity are more likely to be aspirated, causing damage.
- Hydrocarbons are gastric irritants, which can contribute to spontaneous vomiting and increase the risk of aspiration.
- Symptoms after ingestion can include coughing, choking, vomiting, cyanosis (in young children), persistent coughing, and burning in the stomach (in older children and adults).
- Aspiration pneumonitis causes hypoxia and respiratory distress, with symptoms appearing hours before they are visible on x-rays.
- Substantial systemic absorption of certain hydrocarbons, particularly halogenated ones, can lead to lethargy, coma, and seizures.
- Nonfatal pneumonitis typically resolves within a week, while mineral or lamp oil ingestion usually resolves in 5-6 weeks.
- Arrhythmias can occur before the presentation of the illness but recurrence is unusual unless the patient experiences agitation.
- Diagnosis usually involves obtaining chest x-rays and oximetry within 6 hours of ingestion, possibly sooner depending on the severity of symptoms. If respiratory failure is suspected, arterial blood gases are measured. CNS toxicity is diagnosed by a neurological exam and/or MRI.
Household Products Toxicity
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Soaps & Detergents: Soaps are fatty acid salts, often resulting from reacting fats or oils with alkalis like sodium or potassium hydroxide. Detergents are cleaning agents based on non-soap surfactants. Most soaps are relatively nontoxic and self-eliminating, with gastric upset as the main symptom. Strong detergents contain a wider variety of substances (inorganic and organic), including surfactants, whitening agents, fabric softeners and builders (e.g. carbonate, silicate, sulfate). The builder, due to its high alkalinity, can cause significant gastrointestinal damage.
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Bleach: Bleach is a 3-6% sodium hypochlorite solution in water with a high pH, approximately 11 (making it highly alkaline). Ingestion causes severe irritation and corrosion of mucous membranes, pain, and vomiting. In serious cases, there might be a drop in blood pressure and delirium/coma. Bleach solutions should not be mixed with acids or other alkalis as this can cause potentially hazardous reactions (releasing chlorine gas, for instance). Hypochlorous acid (formed when bleach interacts with stomach acid), is not toxic in small quantities but causes irritation of the mucous membranes of esophagus and the gastrointestinal tract. Treatment primarily focuses on demulcent therapy.
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Mothballs: Common mothballs consist of naphthalene or paradichlorobenzene. Naphthalene, due to its high potential toxicity, is less frequently used now in comparison to paradichlorobenzene; which might induce local irritation of the gastrointestinal tract. Naphthalene is a powerful, highly toxic substance requiring immediate medical treatment if ingested, especially by those with glucose-6-phosphate dehydrogenase (G6PD) deficiency (as it may also lead to erythrocyte membrane breakdown and hemolysis). Treatment is generally just supportive care and symptom management.
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Nail Polish Remover (Acetone): Acetone is a solvent found in nail polish removers. It's reasonably recognizable for its sharp, sweet odor. Acetone exposure, common in industry, may cause irritation to the eyes, nose, and throat, but ingestion cases in homes are less frequent. However, it does not present acute health issues (in terms of ingestion). Higher concentrations can lead to CNS depression, and the primary effect of ingestion is drying and irritation to the skin. Treatment is supportive care, though activated charcoal and saline catharsis can be useful in cases of coma.
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Disinfectants & Antiseptics:
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Phenol (Carbolic Acid): Phenol is an old disinfectant and deodorizer. It can cause intoxication through skin absorption or ingestion. Topical formulations should never exceed 1% concentration. Its main effect is cell damage to respiratory tract, gastrointestinal tract, cardiovascular system (CVS), skin, blood and CNS leading to acute poisoning/death. Immediate treatment involves gastric lavage, and use of supportive care, along with milk or gelatin followed by castor oil for quick evacuation of the poison..
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Iodine: Used as a topical disinfectant and water sterilizer (2% tincture). Direct protein precipitant; corrosive to mucous membranes. In the gut, it converts to iodide and deactivated by foodstuffs. Vomiting is a prominent symptom, helping to reduce the impact of the effects of ingested iodine. Treatment focuses on gastric lavage with soluble starch to absorb iodine followed by sodium thiosulfate to convert any residual iodine to iodide. Glucocorticosteroids should also be administered to reduce potential esophageal fibrosis.
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Quaternary Ammonium Compounds (QACs): QACs are cationic surfactants in various products like disinfectants, bactericides, deodorants, and sanitizers. Strong aqueous compounds cause superficial necrosis to mucous membranes they contact; internal effects include gastrointestinal tract damage, liver, and kidney damage. Soap serves as the best antidote for QAC poisoning, and following skin contamination/ingestion, the affected area should be thoroughly cleaned with a soap solution, to reduce the compound's toxicity.
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Additional safety notes:
Store kerosene and other potentially toxic chemicals using appropriate labeled containers. Keep out of reach of children, especially those under 5 years of age.
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Description
Test your knowledge on hydrocarbons and their toxicity found in household products. This quiz covers various types of hydrocarbons, their properties, and the health risks associated with their exposure. Understand how molecular weight and viscosity influence their toxicity levels.
