2. (7 pts) A young mother contacted the poison control center because her 2 year
ID: 3165923 • Letter: 2
Question
2. (7 pts) A young mother contacted the poison control center because her 2 year old daughter ingested some acetonitrile based nail polish remover and then vomited 15 minutes later. No treatment was recommended because it was confused with acetone based nail polish remover. The child was put to bed about 2 hours after ingestion. Respiratory distress developed sometime after the child was put to bed and she was found dead the next moming. ??_c Accone A. 4 pts Explain why metabolism of acetonitrile caused respiratory distress and based on the cause, what could have been done to prevent death (ie what should her treatment have been). B. 3 pts Explain why metabolism of a small amount of acetone would not require treatment.Explanation / Answer
1. Acetonitrile when metabolized produces hydrogen cyanide. This cyanide binds to the cytochrome c oxydase( one of the electron carrier in mitochondria in Electron transport chain) which prevents the reduction of oxygen to water or prevents the use of available oxygen to form ATP. This causes a shortness of breath, slow pulse rate, nausea, vomiting and in serious case coma and death may also occur due to failure in respiration.
The treatment should have included Oxygen, nitrate and thiosulphate to prevent the binding of cyanide to the electron carrier.
2. Acetone in small quantity can be metabolised by human body to produce lactate/pyruvate and ultimately energy. So treatment is not required in small amount ingestion. But in larger amount it can render to be toxic.
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