Toxicity of Corrosive Substances

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Questions and Answers

Why are emetics contraindicated in cases of corrosive ingestion?

They reduce the effectiveness of activated charcoal.

They induce a false sense of safety.

They enhance the absorption of the corrosive agent.

They cause re-exposure to corrosives, leading to further injury. (correct)

What effect does neutralization have in cases of corrosive ingestion?

It decreases the acidity of the corrosive agent.

It improves endoscopic visualization.

It generates heat, worsening thermal injury. (correct)

It facilitates faster recovery from chemical burns.

What symptoms might indicate corrosive injury in a patient?

Vision changes and headaches.

Drooling and difficulty swallowing. (correct)

High fever and rash.

Increased appetite and fatigue.

What are the potential complications of using cathartics in a child with corrosive ingestion?

Damage to the colon, rectum, and anus. Signup and view all the answers

What would be the priority treatment approach for a child with second-degree burns in the oropharynx?

Providing supportive care and pain management. Signup and view all the answers

What is the primary definition of a corrosive substance?

A substance that damages and erodes surfaces with which it comes in contact. Signup and view all the answers

Which of the following categories does not belong to the types of corrosives?

Base Signup and view all the answers

What factor does not influence the severity of corrosive effects?

Type of food consumed prior to exposure Signup and view all the answers

What type of necrosis is primarily associated with acid ingestion?

Coagulative necrosis Signup and view all the answers

Which mechanism of toxicity involves the hydrolysis of amide bonds?

Acid ingestion leading to protein denaturation Signup and view all the answers

What is a characteristic outcome of liquefactive necrosis?

Formation of a viscous liquid mass Signup and view all the answers

Which part of the body is most affected during acid ingestion?

The stomach Signup and view all the answers

What type of necrosis is characterized by the formation of a coagulum in dead tissues?

Coagulative necrosis Signup and view all the answers

What is the main type of necrosis caused by alkali ingestion?

Liquefactive necrosis Signup and view all the answers

Which symptom is NOT associated with corrosive ingestion?

Severe headache Signup and view all the answers

What procedure is indicated for the management of esophageal stricture caused by alkali?

Bougienage Signup and view all the answers

What is the recommended management for pain relief in patients with corrosive toxicity?

Analgesics Signup and view all the answers

Which of the following is a potential complication of alkali ingestion?

Thrombus formation Signup and view all the answers

What is the primary goal of using TPN (Total Parenteral Nutrition) in patients with corrosive injury?

To provide nutrition Signup and view all the answers

Which of the following management strategies should be avoided in corrosive toxicity?

Performing gastric lavage Signup and view all the answers

What role do corticosteroids play in managing corrosive toxicity?

Decrease inflammation Signup and view all the answers

Study Notes

Toxicity of Corrosive Substances

Corrosive substances damage, destroy, and erode surfaces like metals or living tissues (skin, eyes, etc.).
Corrosive substances are categorized by their pH: acids (pH < 7), alkalis (pH > 7), and oxidizing agents.
Examples of strong acids include sulfuric, hydrochloric, nitric, phosphoric, and oxalic acids.
Examples of strong alkalis include sodium hydroxide, potassium hydroxide, ammonia, sodium carbonate, and calcium oxide.
Oxidizing agents, such as hydrogen peroxide, bleach, and potassium permanganate, can also be corrosive.

Mechanism of Toxicity

The effect of corrosives on living tissues is known as caustic.
Strong acids cause protein denaturation through amide bond hydrolysis.
Strong alkalis cause lipid saponification through ester bond hydrolysis.
The outcome of the corrosive substances' reaction might result in the formation of coagulative necrosis (acid) or liquefactive necrosis (alkali) in the tissues.

Types of Necrosis

Coagulative necrosis: The tissue architecture remains maintained, with the formation of gelatinous substances.
Liquefactive necrosis: Tissue architecture is lost via the formation of a viscous liquid mass.

Severity of Corrosive Substances

The severity depends on the concentration and volume of the ingested corrosive, the duration of contact with the tissues, and the percentage of body surface area exposed.
Low concentrations can cause irritation; high concentrations can cause chemical burns.

Management of Corrosive Toxicity

Treatment focuses on supportive care, with the goal of limiting further damage.
Management for corrosive acid frequently involves use of analgesics, diluents and demulcents, antiemetic drugs, and TPN, antibiotics, systemic corticosteroids. Then, considering gastric resection in case of severe injury.
Management for corrosive alkali often entails analgesics, diluents and demulcents, antiemetic drugs, and TPN. In severe cases, antibiotics, systemic corticosteroids, and bougienage are used, and rarely gastric resection is needed.

Important Considerations

Gastric lavage and emesis are contraindicated as these can worsen tissue damage and lead to further exposure to corrosive substances.
Activated charcoal is also contraindicated due to its potential to obscure endoscopic visualization. Also, neutralization is not advisable as it causes additional thermal injuries and heat.
Cathartics are harmful as they can damage the colon, rectum, and anus.

Case Study (Example)

A three-year-old ingested Clinitest tablets.
Symptoms included drooling, difficulty swallowing, vomiting, and red/white spots on the mouth.
Examination revealed second-degree esophageal burns.
Endoscopy confirmed esophageal ulceration.

Questions Raised from Case Study

Should gastric lavage be performed?
Should steroids be used?
What's the mechanism of the corrosive substance toxicity?
Does antibiotic use play a role in treating corrosive cases?

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Description

Explore the harmful effects of corrosive substances, including their categorization by pH and examples of acids and alkalis. Understand the mechanisms of toxicity, such as protein denaturation and lipid saponification, and their impact on living tissues. This quiz delves into the critical aspects of chemical safety and biology.