Question Of The Day

What common oxidizing component used in rocket fuel, implicated in occupational disasters with the Apollo-Soyuz and Titan II missile explosions, can cause upper airway corrosion, pneumonitis and potentially methemoglobinemia? Dinitrogen tetroxide https://wwwn.cdc.gov/TSP/MMG/MMGDetails.aspx?mmgid=394&toxid=69 Contributed by Mason Jackson, MD

Historical QOD 3/17/2009: What drugs have been associated with the development of progressive multifocal leukoencephalopathy (PML)? Classic cytotoxics and immunosuppressants (e.g., cyclophosphamide, methotrexate, and mycophenolate mofetil) as well as more recently introduced drugs, such as the B-cell-depleting monoclonal anti-CD20 antibody rituximab, the T-cell-depleting monoclonal anti-CD52…

Which is plant has higher potency, Abrus pecatorious or Ricin communis Abrin is more potent/lethal with toxic dose of 0.1-1mcg/kg while ricin is 1-20mg/kg Audi J, Belson M, Patel M, Schier J, Osterloh J. Ricin Poisoning: A Comprehensive Review. JAMA. 2005;294(18):2342–2351. doi:10.1001/jama.294.18.2342, https://www.poison.org/articles/are-rosary-peas-poisonous-194, https://www.poison.org/articles/what-happens-if-i-eat-castor-beans-222 Contributed…

What toxin is produced by this plant? Ricinus communis/castor beans contain ricin. Audi J, Belson M, Patel M, Schier J, Osterloh J. Ricin Poisoning: A Comprehensive Review. JAMA. 2005;294(18):2342–2351. doi:10.1001/jama.294.18.2342, https://www.poison.org/articles/are-rosary-peas-poisonous-194, https://www.poison.org/articles/what-happens-if-i-eat-castor-beans-222 Contributed by Mason Jackson, MD

What toxin is produced by this plant? Abrus precatorious/rosary pea contains abrin Audi J, Belson M, Patel M, Schier J, Osterloh J. Ricin Poisoning: A Comprehensive Review. JAMA. 2005;294(18):2342–2351. doi:10.1001/jama.294.18.2342, https://www.poison.org/articles/are-rosary-peas-poisonous-194, https://www.poison.org/articles/what-happens-if-i-eat-castor-beans-222 Contributed by Mason Jackson, MD

What feared occupational pulmonary complication can be seen in “fire-eaters” and those who lubricate machinery or spray pesticides/paints? Lipoid Pneumonia due to chronic inhalation of mineral oils and hydrocarbons “Betancourt SL, Martinez-Jimenez S, Rossi SE, Truong MT, Carrillo J, Erasmus JJ. Lipoid pneumonia: spectrum of…

Historical QOD 3/17/2009: True or False:  In building fires, the vertical and horizontal dispersion of toxic gases has been found to be relatively uniform. False.  Concentrations of toxic gasses in fires are indeed relatively constant at a given height over surprisingly long distances from the…

Correction to QOD 4/30/24: The original question should have read the following- In a secondary analysis examining the association of QRS prolongation with serious adverse effects:  1) Amongst xeniobiotics studied, which of the following adverse effects was the negative predictive value the worst? A. seizures…

To what familiar drug is orphenadrine most closely related? Diphenhydramine. Orphenadrine is ortho-methyl diphenhydramine (adding one methyl group to one of the benzene rings Dhaliwal N, Roberts DM. Clinical outcomes associated with orphenadrine deliberate self-poisoning: a retrospective poisons centre study. Clin Toxicol 2024 (online ahead…

What are the typical clinical findings after orphenadrine overdose? In a review of 46 patients with orphenadrine overdose, most patients had antimuscarinic symptoms. At lower doses, patients often had drowsiness (22) and sinus tachycardia (15). At progressively higher doses, patients had delirium (13) and urinary…