Monday, May 2, 2016

An Eye to Cyanide - Part 2

Hello awesome people :)

So, talking about differentials for the cyanide case.. (see previous post Here)
What all u can guess could be the case in such patient if not cyanide..?? Anyone? Think before you read it further..

Here it is...
It could be Carbon Monoxide poisoning. Reason? OK so you remember the patient had shown Cherry Red color of skin when she was brought to the emergency. Carbon monoxide also causes such discoloration of skin as well as blood. This is due to formation of carboxyhemoglobin, which causes decrease in oxygen carrying capacity of blood. So less supply of oxygen and essential nutrients to brain as well as other vitals of the patient, leading to neurological, cardiac as well as other systemic problems!!

Another one is Arsenic poisoning. An acute case of such toxicity causes CNS abnormalities and renal tubular necrosis, while chronic case presents with gastroenteropathy, peripheral neuropathy, and skin changes (thick areas of skin with increased pigmentation, also called Arsenic keratosis). Arsenic accumulates in hairs, and nails of fingers and toes,forming lines of discoloration called "Aldrich-Mees' lines" or leukonychia striata.

Carbon tetrachloride causes liver damage (steatohepatitis) while Ethylene glycol, used as an antifreeze, causes metabolic acidosis, and renal tubular necrosis . (It is converted to calcium oxalate, thus forming oxalate stones)

That's all!
Thanks :)

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