Disease Information for Cyanide CBW (Cyanogen chloride) exposure

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Clinical Manifestations
Signs & Symptoms
Cyanosis
Loss of bowel control/incontinence acute
Paresthesias
Seizures
Bloodshot eyes/Conjunctival injection
Red Eyes Bilateral
Scleral Injection
Clinical Presentation & Variations
Presentation/Collapse Seizure Acidosis Anaerobic
Disease Progression
Course/Acute
Course/Acute only
Demographics & Risk Factors
Exposure Factors
Exposure/Terrorist Chemical weapon agent
Exposure/Terrorist/Chemical-biological weapon (CBW)
Occupational Factors
Occupation/Soldier/officer military
Event, Activity, Behavioral & Seasonal Factors
Event/Mass exposure/community illness/death
Laboratory Tests
Abnormal Lab Findings - Decreased
PCO2, arterial blood (Lab)
pH, arterial blood (Lab)
Abnormal Lab Findings - Increased
Anion gap (Lab)
Lactic acid/Lactate (Lab)
RBC Cyanide levels
Associated Diseases & Rule outs
Associated Disease & Complications
Acidosis
Acidosis, metabolic
Asphyxia/suffocation
Chemical Tracheobronchitis
Convulsions (grand mal)
Hypochloremic metabolic alkalosis
Lactic acidosis
Laryngeal edema
Metabolic Acidosis with High Anion Gap
Tracheal edema
Disease Mechanism & Classification
Process
PROCESS/Poison/specific (category)
Toxin
TOXIN/Aerosolized Terror/Weapon chemical
TOXIN/CBRNE (Chemical/Biologic Weapons All) potential
TOXIN/Chemical Weapon/Terrorist/Military
TOXIN/Fruity odor/bitter almonds odor
TOXIN/Increases Respiratory Rate
TOXIN/Poison/Inorganic (category)
TOXIN/Weapon/anti-personnel agent/poison (ex)
Treatment
Drug Therapy - Indication
RX/Hydroxocobalamine injection
Definition

Cyanide poisoning by aerosol gaseous state , HCN, or cyanogen chloride as CBW terror attack or military exposure;

While liquid cyanide can be absorbed through the skin or eyes, the primary route of exposure is by inhalation or ingestion; Following absorption, cyanide is distributed rapidly to all organs and tissues in the body; Cyanide combines with ferric iron in cytochrome a3 (a component of the cytochrome oxidase complex in mitochondria) and inhibits this enzyme; This prevents intracellular oxygen use and results in imbalance between ATP hydrolysis and production; Metabolic acidosis is a hallmark of cyanide toxicity; It develops as cells are forced to use anaerobic metabolism and accumulate hydrogen ions and lactate; clinically seizures followed by respiratory arrest then

circulatory collapse; color good by global hypoxia effects

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External Links Related to Cyanide CBW (Cyanogen chloride) exposure
Google
Wikipedia
Merck
Images
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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