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Organic Phosphate Poisoning Lab Results

Organic Phosphate Poisoning Lab Results. Lab Results Hematology. Patient Results. Normal Range. 14 – 18 g/dl 40 – 54% 4.5 – 6.0x10 6 4500 – 11,000 mm 3 0 – 3% 55 – 70% 20 – 40% 2 – 8% 1 – 4%. Hb 15.9 g/dl Hct 49% RBC 5.6x10 6 WBC 30,500 mm 3 Differential: 12% Band form

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Organic Phosphate Poisoning Lab Results

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  1. Organic Phosphate Poisoning Lab Results

  2. Lab Results Hematology Patient Results Normal Range 14 – 18 g/dl 40 – 54% 4.5 – 6.0x106 4500 – 11,000 mm3 0 – 3% 55 – 70% 20 – 40% 2 – 8% 1 – 4% • Hb 15.9 g/dl • Hct 49% • RBC 5.6x106 • WBC30,500 mm3 • Differential: 12% Band form 75% Segmented Neutrophil 12% Lymphocyte 1% Monocyte 0% Eosinophils

  3. Lab Results Serum Data Patient Results Normal Range 80 – 120 mg/dl 3.5 – 5.0 g/dl 6.0 – 8.0 g/dl 10 – 20 mg/dl 0.7 – 1.5 mg/dl 133 – 145 mEq/l 3.3 – 5.3 mEq/l 96 – 106 mEq/l 1.3 – 2.1 mEq/l 8.4 – 10.6 mg/dl 7.35 – 7.45 • Glucose160 mg/dl • Albumin 4.1 g/dl • Total Protein 6.9 g/dl • BUN 17 mg/dl • Creatinine 1.5 mg/dl • Na 145 mEq/l • K 4.3 mEq/l • Cl 100 mEq/l • Mg 1.7 mEq/l • Total Ca 9.2 mg/dl • pH 7.36

  4. Lab Results Urine Patient Results Additional Lab Tests BarbituratesNegative Glucose Negative Protein Negative Acetone Negative

  5. Blood Serum Test WBC Elevated: Neutrophilic Leukocytosis Glucose Elevated: In Sympathetic response which inhibits insulin and stimulates glycogenolysis in liver Producing RBC/WBC's

  6. Barbiturate Test Results: Negative Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia.

  7. Other Possible Lab results Hypomagnesemia (1.7 mEq/l) Cofactor in many enzyme regulated reactions. Hypokalemia (4.3 mEq/l) Decreased Extracellular K+ causes the cell to become hyperpolarized – can lead to paralysis/suffocation Abnormal Liver Function values Increased demand from leukocytosis Increased demand for glucose (muscle firing) Increased glycogenolysis/Epinephrine signal Detoxification of Organophosphates from blood

  8. Cont’d Metabolic/Respiratory Acidosis (7.36) Possibilities: Increased Ach in synapse leading to overstimulation of Muscles causing lactic acid build up Decreased respirations causing decreased exchange of O2/CO2 leading to lowered blood pH Elevated Hematocrit (49%) RBCs have cholinesterase and are more easily affected by metabolic changes AcH E enzyme

  9. Serum CholinesteraseRBC AcH E Test Serum/Plasma Cholinesterase Liver acute phase protein Easier to test, more available It is affected by infection, pregnancy and general illness RBC Cholinesterase Better representation of neuronal levels of AchE RBCs have receptors for Ach and this alters the shape Test is more accurate than plasma levels

  10. Neuromuscular Junction • Action Potential travels down axon • Depolarizes and brings in Calcium • Release of Ach Vesicles • Ach binds chemically gated channel on post-synaptic membrane • Channel opens and allows Sodium in (large) and Potassium out (small) • Depolarization signal spread through out muscle fiber and it contracts • Ach is broken down by AchE (Choline is recylced and Acetate is degraded)

  11. Effects on NMJ • Function of Ach E: • Normally: • breakdown Ach in NMJ into choline and actetate • Inhibition via Organophosphates: • Increases duration of Ach in synaptic cleft and increases the firing of muscles – leads to muscle fasciculations • Later, sodium channels accommodate and you can no longer get an action potential (inactivation gates close) and is shown in muscle weakness

  12. References 1. Katz, Kenneth D., and Daniel E. Brooks. "Toxicity, Organophosphate." EMedicine. 30 May 2008. WedMD. 11 Dec. 2008 <http://emedicine.medscape.com/article/167726-overview>. 2. Lindsey, Marti. "Description of Laboratory Test." Description of Laboratory Test. 2002. University of Arizona College of Pharmacy. 11 Dec. 2008 <http://coep.pharmacy.arizona.edu/curriculum/clusterbusters/ohio/labtests.html>. 3. Gilboa-Garber, Nechama, and Lea Mizrahi. "Effect of acetylcholine on the osmotic fragility of papain-treated and untreated human red blood cells." Cellular and Molecular Life Sciences jan 28 (1972): 78-79.

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