Acute Poisoning

Acute Poisoning And Environmental Emergencies Short Answers

Question 1. Fluorosis

Answer:

Fluorosis

Dental fluorosis is caused by excessive intake of fluoride during tooth development

Fluorosis Clinical Features

  • Lustreless, opaque white patches in the enamel which may become mottled, striated, or pitted
  • Mottled areas may become stained yellow or brown
  • Hypoplastic areas may also be present to such an extent in severe cases that normal tooth form is lost
  • Enamel fluorosis is a developmental phenomenon due to excessive fluoride ingestion during amelogenesis
  • Once crowns are formed no further fluorosis occurs
  • The hypocalcified areas of the mottled enamel are less soluble in acids
  • They have a greater permeability to dyes
  • They emit fluorescence of higher intensity then normal enamel
  • Fluorosis occurs symmetrically within arches
  • The premolars is usually first affected followed by second molar, maxillary incisor, canine, first molar, and mandibular incisors

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Question 2. Food poisoning

Answer:

Food poisoning Management:

  1. Resuscitation and initial stabilization
  2. Diagnosis of type of poison by
    • History
    • Examination
    • Laboratory investigations
    • Nonspecific therapy- to reduce the levels of toxin
  3. Specific therapy- to reduce toxic effects on the body
  4. Supportive care- to support functions of vital organs

Question 3. Arsenic poisoning

Answer:

Arsenic poisoning Features:

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

Question 4. Barbiturate poisoning

Answer:

Barbiturate Poisoning

  • Fatal dose of phenobarbitone is 6-10 gram

Barbiturate Poisoning Symptoms:

  • Respiratory depression with slow and shallow breathing
  • Hypotension
  • Skin eruptions
  • Cardiovascular collapse
  • Renal failure

Barbiturate Poisoning Treatment:

  • Gastric lavage followed by administration of activated charcoal
  • Maintain BP
  • Airway maintenance
  • Adequate ventilation
  • Oxygen administration
  • Forced alkaline diuresis with sodium bicarbonate, a diuretic, and 4 fluids
  • Hemodialysis

Question 5. Scorpion bite

Answer:

Types Of Scorpion Venom:

  1. Venom of the genera Hadrurus, Vejovis, and Uroctonus Effects:
      • Sharp burning
      • Swelling
      • Discoloration at the bite site
      • Rarely anaphylaxis
  2. Venom produced by genera of the poisonous varieties of centuries Effects
      • Block sodium channels
      • Spontaneous depolarization of parasympathetic and sympathetic nerves
      • Tachycardia
      • Hypertension
      • Sweating
      • Piloerection
      • Hyperglycemia
      • Pulmonary edema
      • Seizures
  3. Scorpion Venom Treatment:
    • Patient is hospitalised for at least 12 hours
    • Maintain airway maintenance
    • Administration of 1-2 vials of intravenous anti-venin

Question 6. Lead poisoning

Answer:

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 7. Adverse drug reactions

Answer:

Adverse Drug Reactions Definition:

  • It is defined as any response to a drug that is noxious and unintended and that occurs at the dose used in man for prevention, diagnosis, or therapy

Adverse Drug Reactions Types:

  1. Side effects
    • They are unwanted effects of a drug
  2. Toxic effects
    • They are seen with higher doses of the drug
  3. Intolerance
    • A person cannot tolerate a drug
  4. Idiosyncrasy
    • It is a genetically determined abnormal reaction to a drug
  5. Allergic reactions
    • They are immunologically mediated reactions
  6. Iatrogenic diseases
    • These are drug-induced diseases
  7. Drug dependence
    • It is a state of compulsive use of drugs despite the knowledge of the risks associated with its use
  8. Teratogenicity
    • A drug can cause fetal abnormalities when administered to a pregnant woman
  9. Teratogenicity and mutagenicity
    • Drugs causing cancers and genetic abnormalities

Acute Poisoning And Environmental Emergencies Medcial interview

Question 8. Organophosphorous poisoning

Answer:

Organophosphorous Poisoning

Acute Poisoning And Environmental Emergencies Organophosphorous Poisoning

Question 9. Thrush

Answer:

Thrush

  • Acute pseudomembranous oral candidiasis is also known as thrush

Thrush Common Sites Involved:

  • Buccal mucosa
  • Tongue
  • Palate

Thrush Etiology:

  • Causative organism- Candida albicans
  • Prolonged antibiotic therapy
  • Immuno-suppression

Thrush Predisposing Factors:

  • Infancy
  • Debilitating illness
  • Metabolic diseases
  • Diabetes
  • Hypothyroidism

Thrush Features:

  • Foul taste
  • This leads to inflammation, erythema, and eroded areas
  • Presence of adherent white plaques
  • It can be removed by scraping
  • It is more common in women

Thrush Treatment:

  1. Anti-fungal antibiotics
    • Nystatin
    • Amphotericin suspension or lozenges
  2. For AIDS patient
    • Oral fluconazole is used

Question 10. Halitosis

Answer:

Halitosis Definition:

  • Unpleasant odor exhaled in breathing is called halitosis

Halitosis Classification:

  1. Physiologic
  2. Pathologic
    • Oral
    • Extraoral

Halitosis Causes:

  1. Physiologic
    • Mouth breathing
    • Medication
    • Fasting
    • Aging
    • Tobacco
    • Food
  2. Pathologic
    • Periodontal infection
    • Tongue coating
    • Stomatitis
    • Xerostomia
    • Faulty restoration
    • Unclean denture
    • Ulcers
    • Abscess
    • Systemic diseases

Halitosis Treatment:

  • Scaling
  • Irrigation
  • Burning sensation
  • Tongue brushing
  • Use of mouth rinse
  • Use of Halita

Question 11. Macroglossia

Answer:

Macroglossia Definition:

  • Macroglossia is a relatively common condition characterized by an increase in the size of the tongue

Macroglossia Types And Causes

  1. Congenital macroglossia
    • Overdevelopment of the tongue musculature
    • Lysosomal storage diseases
    • Down’s syndrome
    • Multiple endocrine neoplasia syndrome
  2. Acquired macroglossia
    • Tumours in the tongue
    • Amyloidosis
    • Endocrine disorders
    • Lymphatic obstruction in the tongue
    • Cystic lesions in the tongue

Macroglossia Clinical Features:

  • Causes displacement of teeth and malocclusion
  • Disturbances in speech and feeding
  • Cosmetic deformity
  • Indentation or scalloping on the lateral margins of the tongue
  • Development of tongue-thrusting habits
  • Airway obstruction

Macroglossia Treatment:

  • Removal of the primary cause
  • Surgical reduction or trimming

Question 12. Ciprofloxacin

Answer:

Ciprofloxacin

  • Ciprofloxacin is the first generation of fluoroquinolone

Ciprofloxacin Uses:

  • Urinary tract infection
  • Typhoid
  • Diarrhea
  • Gonorrhea
  • Chancroid
  • Respiratory tract infection
  • Bone, joint, soft tissue, and intra-abdominal infections
  • Tuberculosis
  • Bacterial prostatitis and cervicitis
  • Eye infections
  • Anthrax
  • Orodental infections

Ciprofloxacin Adverse Reactions:

  • Nausea, vomiting, abdominal discomfort, diarrhea
  • Rashes
  • Tendinitis
  • Damages growing cartilage

Question 12. Phenobarbitone

Answer:

Phenobarbitone

  • Phenobarbitone is an anti-epileptic drug

Mechanism of Action:

  • Enhances inhibitory neurotransmission in the CNS
  • Enhances activation of GABA receptors
  • Facilitates GABA-mediated opening of chloride ion channels

Phenobarbitone Uses:

  • Generalized tonic-clonic seizures
  • Partial seizures

Phenobarbitone Adverse Reactions:

  • Sedation
  • Tolerance
  • Nystagmus
  • Ataxia
  • Megaloblastic anemia
  • Osteomalacia
  • Skin rashes
  • Hypersensitivity reactions

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