Acute Poisoning Question And Answers

Acute Poisoning And Environmental Emergencies Important Notes

1. Different poisoning
2. Fluorosis
   • Dental fluorosis is caused by excessive intake of fluoride during tooth development
   • Features:
   • Dental fluorosis
     • Mottled enamel
     • Presence of hypoplastic areas
     • Mottled areas may stain yellow/ brown
     • Fluoride occurs symmetrically within dental areas, commonly affecting premolars
   • Skeletal Fluorosis
     • Severe pain in
       • Backbones
       • Joints
       • Hips
   • Stiffness in joints and spine
   • Knock-knee syndrome
     • Outward bending of legs and hands
     • Damage to fetus
     • Blocking and calcification of blood vessels
     • Cripping fluorosis
3. Effect On Kidney
   • May aggravate renal disease

Acute Poisoning And Environmental Emergencies Long Essays

Question 1. Describe the management of acute poisoning.

Answer:

Steps Of Management:

1. Resuscitation and initial stabilization
   • Maintain airway, breathing, and circulation
   • Blood sample collection for examination
   • Rectal temperature is obtained
   • Treatment of hypotension with crystalloids
   • Administration of a cocktail of 50% dextrose, naloxone, and thiamine
2. Diagnosis of various types of toxins
   • History
     • Reveals type of poison and amount of overdose taken
   • Examination
     • Helps to detect a syndrome associated with certain poisons
   • Investigations
     • Colour of urine
     • Colour of blood
     • Crystals in urine
     • Ketonuria
     • Anion gap
3. Nonspecific treatment
   • Reduces levels of toxin in the body
   • Gastric decontamination- includes
     • Removal of unabsorbed poison from the gut
     • Induction of emesis
     • Gastric lavage
     • Cathartics
     • Use of activated charcoal
     • Whole bowel irrigation
   • Enhancement of excretion of absorbed toxins from the body
     • Forced diuresis- alkaline diuresis
     • Use of multiple doses of activated charcoal
     • Peritoneal and hemodialysis
   • Dialysis
4. Specific therapy
   • A specific antidote is administered

Question 2. Describe the signs, symptoms, and management of fluorosis.

Answer:

Fluorosis

• Excessive intake of fluoride causes fluorosis

Fluorosis Types:

1. Dental Fluorosis
   • Caused by fluoride intake above 2 ppm
   • Its symptoms are:
   • Mottling of enamel
   • Discoloration of teeth
   • Teeth become weak and rough
   • Brown or yellow patches appear on their surfaces
2. Skeletal Fluorosis
   • Caused by fluoride intake above 20 ppm
   • It causes:
   • Pathological changes in the bone
   • Hypercalcification
   • Bone density of limbs, pelvis, and spine increases
   • Ligaments of the spine and collagen of bones get calcified
   • Neurological disturbances may also occur
3. Genu valgum
   • It is an advanced stage of Fluorosis
   • In it, individuals are unable to perform their routine work
   • Joints become stiff
   • Individuals are crippled

Read And Learn More: General Medicine Question and Answers

Fluorosis Management:

• Vomiting is induced wi a syrup of ipecac or digital or mechanical stimulation the of tongue or throat
• Decrease the absorption of fluoride by administering fluoride-binding liquids like warm water, calcium hydroxide, antacids containing aluminum or magnesium hydroxide, or milk
• The stomach should be thoroughly washed with additional lime water
• Calcium gluconate should be administered intravenously along with lime to prevent shock

Acute Poisoning And Environmental Emergencies Short Essays

Question 1. Atropine

Answer:

Atropine

• Atropine is a natural anticholinergic drug

Atropine Mechanism of Action:

• Bind to muscarinic receptors
• Blocks the effects of acetylcholine

Atropine Actions:

• Increases heart rate
• Vasodilation
• hypotension
• Reduces all secretions
• Muscle relaxation
• Bronchodilation
• Relaxes ureter
• Produces mydriasis
• CNS stimulant

Atropine Uses:

• Anti-spasmodic
• Mydriatric and cycloplegic
• Preanaesthetic medication
• Organophosphorous poisoning
• Bronchial asthma
• Peptic ulcer
• Parkinsonism
• Motion sickness
• During labor

Atropine Adverse Reactions:

• Blurring vision
• Dry mouth
• Dysphagia
• Dry skin
• Fever
• Constipation
• Urinary retention
• Skin rashes
• Palpitation
• Flushing
• Restlessness
• Delirium
• Hallucination
• Psychosis
• Convulsion
• Coma

Question 2. Arsenic poisoning

Answer:

Arsenic Poisoning Features:

• Gingivitis
• Stomatitis
• Painful mucosal ulceration
• Hyperpigmentation and hyperkeratosis
• Excessive salivation
• Vomiting
• Diarrhea
• Neurological disturbances

Question 3. Symptoms of lead poisoning

Answer:

Symptoms of lead poisoning Features:

• Excessive salivary secretions
• Metallic taste in the oral cavity
• Swelling of the salivary glands
• Development of the dark lead line along the gingival margin
• Convulsions
• GI upset
• Anaemia
• Neuritis
• Basophilic stippling of the RBC cells

Question 4. Fluorides in Health and Disease

Answer:

Importance of Fluoride in Health:

• The kidney excretes it
• It passes the placental barrier
• Fluoride prevents the development of dental caries
• It converts hydroxyapatite to fluorapatite
• It is mostly found in bones and teeth
• It is deposited in other calcified tissues also
• It is required for the proper development of bones
• It inhibits the activities of certain enzymes
• Sodium fluoride inhibits enolase in glycolysis
• Fluoroacetate inhibits aconitase in TCA cycle

Fluoride in Disease:

• Excess of fluoride causes fluorosis
• Drinking water containing less than 0.5 ppm of fluoride causes development of caries in children

Question 5. Dental care in mental retardation

Answer:

Dental care in mental retardation

• Familiarise the patient with the office and dental personnel to reduce his/her fear of the unknown before undertaking any treatment
• Speech must be slow and simple
• Only one instruction at a time should be given
• Tell, show, and do technique is used in mild cases and sedation in moderate cases
• Carefully listen to the patient
• Appointments should be short and scheduled during the early part of the day
• Children should be managed with a blend of kindness and firmness
• Generalanesthesiaa may be indicated in cases where adequate levels of cooperation cannot be achieved

VIVA VOCE

1. Atropine is used in organophosphorus poisoning
2. BAL is used for heavy metal poisoning
3. EDTA is used for metal poisoning
4. Dimercapto succinate is used for lead poisoning
5. Penicillamine is used for copper poisoning
6. Desferrioxamine is used for iron poisoning
7. Premolars are the most commonly affected teeth in fluorosis