Carbon Monoxide Poisoning

CARBON MONOXIDE POISONING

Q. 1

In CO poisoning all of the following clinical features are seen, EXCEPT:

 A

Cyanosis

 B

Cerebral edema

 C

Convulsions

 D

Bradycardia

Q. 1

In CO poisoning all of the following clinical features are seen, EXCEPT:

 A

Cyanosis

 B

Cerebral edema

 C

Convulsions

 D

Bradycardia

Ans. A

Explanation:

Carbon monoxide (CO) is a colourless, odorless, tasteless, and non irritating gas produced by the incomplete combustion of any carbon-containing material.

CO binds to hemoglobin with an affinity 250 times that of oxygen, resulting in reduced oxyhemoglobin saturation and decreased blood oxygen-carrying capacity.

CO may also directly inhibit cytochrome oxidase, further disrupting cellular function, and it is known to bind to myoglobin, possibly contributing to impaired myocardial contractility.

Symptoms of intoxication are predominantly in organs with high oxygen consumption, such as the brain and heart.

The majority of patients describe headache, dizziness, and nausea.
Patients with coronary disease may experience angina or myocardial infarction.
With more severe exposures, impaired thinking, syncope, coma, convulsions, cardiac arrhythmias, hypotension, and death may occur.
 
Cerebral edema (swelling of the brain) is also a common result of severe carbon monoxide poisoning.
Survivors of serious poisoning may experience numerous overt neurologic sequelae consistent with a hypoxic-ischemic insult, ranging from gross deficits such as parkinsonism and a persistent vegetative state to subtler personality and memory disorders.
Cyanosis is not seen in CO poisoning.
Ref: Olson K.R. (2012). Chapter 44. Carbon Monoxide. In K.R. Olson (Ed), Poisoning & Drug Overdose, 6e.

Q. 2

A child was dead in an fire accident department following CO poisoning. Which of the following is a feature of death due to CO poisoning?
 A

Cherry red colour

 B

Cyanosis

 C

Petechial haemorrhage over conjunctiva

 D

Frothing at the mouth

Q. 2

A child was dead in an fire accident department following CO poisoning. Which of the following is a feature of death due to CO poisoning?
 A

Cherry red colour

 B

Cyanosis

 C

Petechial haemorrhage over conjunctiva

 D

Frothing at the mouth

Ans. A

Explanation:

  • Above 80% of COHb% causes rapid death from respiratory arrest.
  • A cherry-red colouration of the skin, mucous membranes, conjunctiva, nail beds, areas of hypostasis, blood, tissues, and internal organs is seen in CO poisoning.
  • This colour changes to dark-green, then to brown with the onset of decomposition.
 
Ref: The Essentials of Forensic Medicine and Toxicology by Dr K. S.Narayan Reddy, 27th edition, Page 555.

Q. 3

Condition where severe hypoxaemia occurs without cyanosis

 A

CO poisoning

 B

High altitude

 C

Anaemia

 D

A & C

Q. 3

Condition where severe hypoxaemia occurs without cyanosis

 A

CO poisoning

 B

High altitude

 C

Anaemia

 D

A & C

Ans. D

Explanation:

A i.e. CO poisoning C i.e Anemia


Q. 4

Which of the following statements about Carbon Monoxide poisoning is not true:

 A

Carboxy haemoglobin (COHb) causes left shift of oxyhaemoglobin dissociation curve

 B

Partial pressuresas low as 0.6 mm Hg can be lethal

 C

Tissue toxicity plays an important role in clinical CO poisoning

 D

Hyperbaric oxygen is used for treatment

Q. 4

Which of the following statements about Carbon Monoxide poisoning is not true:

 A

Carboxy haemoglobin (COHb) causes left shift of oxyhaemoglobin dissociation curve

 B

Partial pressuresas low as 0.6 mm Hg can be lethal

 C

Tissue toxicity plays an important role in clinical CO poisoning

 D

Hyperbaric oxygen is used for treatment

Ans. C

Explanation:

C i.e. Tissue toxicity plays an important role in clinical CO poisoning


Q. 5

Diagnosis of CO poisoning post mortem

 A

Blood thin and red coloured

 B

Congestion of all organs

 C

Cyanosis

 D

a and b

Q. 5

Diagnosis of CO poisoning post mortem

 A

Blood thin and red coloured

 B

Congestion of all organs

 C

Cyanosis

 D

a and b

Ans. D

Explanation:

A i.e. Blood is thin & red coloured; B i.e. Congestion of all organs;


Q. 6

Orthobaric oxygen is used in:-

 A

CO poisoning

 B

Ventilation failure

 C

Anerobic infection

 D

Gangrene

Q. 6

Orthobaric oxygen is used in:-

 A

CO poisoning

 B

Ventilation failure

 C

Anerobic infection

 D

Gangrene

Ans. A

Explanation:

Ans is ‘a’ i.e., CO Poisoning 

  • Orthobaric Oxygen – 100% oxygen at atmospheric pressure.
  • Orthobaric oxygen is used in CO poisoning. It reduces the half life of carboxyhemoglobin complex.
  • About use of hyperbaric oxygen in CO poisoning.

Although hyperbaric oxygen therapy is often recommended for patients with coma, syncope, seizures, and cardiovascular instability, for those who do not respond to orthobaric oxygen therapy, recent data suggest that it is no more effective than orthobaric oxygen therapy – [Harrison 15/e p 2660; CMDT 2005, p1572]


Q. 7

Anemic hypoxia is seen   

CMC (Vellore) 14

 A

CO poisoning

 B

CO2 poisoning

 C

HCN poisoning

 D

Nerve gas

Q. 7

Anemic hypoxia is seen   

CMC (Vellore) 14

 A

CO poisoning

 B

CO2 poisoning

 C

HCN poisoning

 D

Nerve gas

Ans. A

Explanation:

Ans. CO poisoning


Q. 8

Symptoms of CO poisoning starts when the concentration is:

 A

< 10%

 B

> 10%

 C

> 20 %

 D

> 40 %

Q. 8

Symptoms of CO poisoning starts when the concentration is:

 A

< 10%

 B

> 10%

 C

> 20 %

 D

> 40 %

Ans. B

Explanation:

Ans. > 10%


Q. 9

In CO poisoning, immediate emergency treatment:

Jharkhand 10

 A

5% CO2 inhalation

 B

10% CO2 inhalation

 C

High flow O2

 D

Nitroglycerine

Q. 9

In CO poisoning, immediate emergency treatment:

Jharkhand 10

 A

5% CO2 inhalation

 B

10% CO2 inhalation

 C

High flow O2

 D

Nitroglycerine

Ans. C

Explanation:

Ans. High flow O2


Q. 10

Hyperbaric oxygen is given in the treatment of:

Bihar 12

 A

Nerve gas

 B

CO2 poisoning

 C

HCN poisoning

 D

CO poisoning

Q. 10

Hyperbaric oxygen is given in the treatment of:

Bihar 12

 A

Nerve gas

 B

CO2 poisoning

 C

HCN poisoning

 D

CO poisoning

Ans. D

Explanation:

Ans. CO poisoning


Q. 11

Postmortem finding in CO poisoning is:

UP 09; PGI 10

 A

Cherry red hypostasis

 B

Intense cyanosis

 C

Excessive salivation

 D

Pin-point pupil

Q. 11

Postmortem finding in CO poisoning is:

UP 09; PGI 10

 A

Cherry red hypostasis

 B

Intense cyanosis

 C

Excessive salivation

 D

Pin-point pupil

Ans. A

Explanation:

Ans. Cherry red hypostasis



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