Monday, 25 October 2010

MRCP revision battle 34.7: Cyanide poisoning

Cyanide is used in insecticides, photography and found in some metals.

It's toxicity comes from inhibition of oxidising enzymes, which happily is reversible.

The classical features of cyanide poisoning are:
  • brick red skin
  • smell of bitter almonds

Acute signs of cyanide poisoning include:
  • hypotension
  • hypoxia
  • headache
  • confusion

Chronic signs of cyanide poisoning include:
  • ataxia
  • peripheral neuropathy
  • dermatitis

Treatment is with 100% oxygen and IV dicolbalt edetate

Onwards for a very brief final battle of the day: phentolamine