Tenany is caused by which poisoning –
Correct Answer: Oxalic acid
Description: Oxalic Acid Synonyms: Salts of Sorrel, Acid of Sugar Mechanism of Action * Local: It acts as corrosive when used in concentrated form and act as irritants when used in dilute form * Systemic: After absorption, oxalic acid combines with calcium ion and causes hypocalcemia. It also causes tubular necrosis and renal failure. Clinical Features Local: Corrosion of mucosa with underlying congestion. The corroded area is referred as "scalded" in appearance. Systemic * Vomiting and diarrhea * Hypocalcemia (tetany) * Muscle irritability, tenderness, cramps * Convulsions * Accoucher's hand due to carpopedal spasm * Chavostek's sign positive. When tapping is done over facial nerve area, there is spasm of facial muscles. * Metabolic acidosis * Renal failure * Uremia. Management * Local exposure: Wash the affected skin with copious water * Gastric lavage with calcium gluconate or calcium lactate * Calcium gluconate intravenously * Symptomatic. Autopsy Findings * Scalded mucosa of GIT * Mucous membrane of mouth, tongue, pharynx, esophagus may be bleached and has scalded appearance * Kidneys show edema, congestion with oxalate crystals in renal tubules with necrosis of proximal convoluted tubule. Medicolegal Impoance 1. Accidental poisoning - common 2. Suicidal ingestion - rare 3. Homicide - not possible. REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO299
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