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Arsenic

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Arsenic, Arsenic Poisoning, Arsenic Toxicity

  • See Also
  1. Unknown Ingestion
  2. Heavy Metal Poisoning
  • Pathophysiology
  1. Ingestion of Arsenic (found in Insect poisons)
  2. Arsenic blocks cellular respiration and gluconeogenesis at multiple sites
  • Symptoms
  1. Gastrointestinal Symptoms (within minutes to hours of ingestion)
    1. Nausea or Vomiting
    2. Abdominal Pain
    3. Diarrhea
  2. Cardiopulmonary symptoms and signs
    1. Cardiovascular collapse
    2. Acute Respiratory Distress Syndrome (ARDS)
    3. Dysrhythmia
    4. Paradoxically low Systemic Vascular Resistance (vasoplegia)
    5. Systemic Inflammatory Response Syndrome (SIRS)
  3. Neurologic Symptoms
    1. Headache
    2. Vertigo
    3. Fatigue
    4. Paresthesia
    5. Paralysis
    6. Encephalopathy with Delirium
  1. Mottled brown skin
  2. Hyperkeratosis of palms and soles
  3. Cutis edema
  4. Transverse striate Leukonychia
  5. Perforation of nasal septum
  6. Eyelid Edema
  7. Coryza
  8. Limb paralysis
  9. Reduced Deep Tendon Reflexes
  10. Carcinogenic with chronic exposure
  • Labs
  1. Urinalysis
    1. Oliguria
    2. Hematuria
    3. Hemoglobinuria
  2. Complete Blood Count and Peripheral Smear
    1. Macrocytic Anemia
  3. Tissue Exam reveals Arsenic deposits
    1. Urine
    2. Nails
    3. Hair
  • References
  1. Kinker and Glauser (2021) Crit Dec Emerg Med 35(9): 19-27