False about acute aluminum phosphide poisoning
**Core Concept**
Acute aluminum phosphide (AlP) poisoning is a severe form of organophosphate poisoning, characterized by the release of phosphine gas, which is highly toxic to the body. The toxic effects of AlP are mediated through the inhibition of mitochondrial cytochrome c oxidase, leading to cellular hypoxia and ultimately cell death.
**Why the Correct Answer is Right**
The correct answer is related to the mechanism of AlP toxicity. Phosphine gas, generated from the reaction of AlP with moisture, binds to the heme group of cytochrome c oxidase in the mitochondrial electron transport chain. This binding inhibits the enzyme's activity, disrupting cellular respiration and leading to cell death. The inhibition of cytochrome c oxidase is responsible for the characteristic symptoms and signs of AlP poisoning, including metabolic acidosis, hypotension, and multi-organ failure.
**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect, as AlP poisoning does not primarily involve the inhibition of acetylcholinesterase, which is the target of organophosphate compounds like parathion and malathion.
**Option B:** Incorrect, as the primary mechanism of AlP toxicity is not the release of free radicals, although oxidative stress may contribute to tissue damage.
**Option C:** Incorrect, as AlP poisoning does not primarily involve the inhibition of the enzyme succinate dehydrogenase, which is a component of the mitochondrial electron transport chain.
**Clinical Pearl / High-Yield Fact**
In cases of suspected AlP poisoning, prompt gastric lavage and administration of activated charcoal may be beneficial in reducing absorption of the toxin. However, these measures should be initiated as soon as possible, as the window for effective treatment is narrow.
**Correct Answer:** D