Question

Mr Jims, 68 year-old man presented to the Emergency Department following a house fire. The flat below his had caught fire during the night, and the smoke rose through the floors and windows, and the patient was exposed to significant smoke inhalation. He is suspected to have carbon monoxide poisoning. Answer the following questions based on the scenario. 6.1) What might be the pathophysiological changes brought about by carbon monoxide in his body? 6.2) Enlist the seven (7) possible signs and symptoms that the patient may manifest?

Answer 1

Pathological changes in Jim carbon monoxide poisoning...

carbon monoxide gas is absorbed by lungs

90% of it binds with hemoglobin and 10% with myoglobin and cytochrome c -oxidase 1%is dissolved in plasma ,1%is oxidised to carbon dioxide. Cardiac injury is associated with hypoxia there can be neurological and perivascular injuries due to hypoxia as a result of oxidative stress secondary to carbon monoxide exposure. Damages CNS as a result of hypoxia may lead to cardiovascular insufficiency. Carbon monoxide poisoning can cause muscular hypotension. Carbon monoxide at cellular Injury it impairs oxygen carrying capacity of blood and oxygen diffusion resulting in carbon monoxide diffusion into hemoglobin carbon monoxide has stronger affinity for hemoglobin compared to oxygen . Prevents delivery of oxygen to tissue through hemoglobin since carbon monoxide binds with hemoglobin giving rise to oxygen hemoglobin dissociative curve. Carbon monoxide direct effect of causing tissue injury it impairs respiratory function of cells .it binds to hemeproteins which carry oxygen within the cells leading to cellular respiratory dysfunction which in turn leads to mitochondrial deterioration in CNS and heart cells causing tissue damage. Carbon monoxide cause myocardial injury by myoglobin leading to cardiac dysfunction which aggrevates tissue hypoxia. Carbon monoxide induced reoxygenation injury in CNS promotes oxygen free radicals leading to demyelination in brain .

Symptoms and signs:-

1) dyspnoea and tachypnoea

2) Nausea

3) fatigue

4) confusion

5) headache

6) Angina

7)visual impairment

8) muscular weakness

9) loss of sensory perception

10) tachycardia

11)seizures

12) coma

13) severe acidosis leading to death.