Cyanide poisoning

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Summary of Cyanide poisoning

Cyanide poisoning occurs when a living organism is exposed to a compound that produces cyanide ions when dissolved in water. Common poisonous cyanide compounds include hydrogen cyanide gas and the crystalline solids potassium cyanide and sodium cyanide. The cyanide ion halts cellular respiration by inhibiting an enzyme in the mitochondria called cytochrome c oxidase.

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Cyanide poisoning

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Cyanide poisoning

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USMLE® Step 1 style questions USMLE

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A 45-year-old man comes to the emergency department after being pulled from a burning upholstery factory in the city. He is very anxious when he is being interviewed and complains of headache, nausea, and a metallic taste in his mouth. His temperature is 37.1 ^oC pulse is 110/min, a respiratory rate of 24/min, and blood pressure of 148/70mmHg. He is put on pulse oximetry and it shows an oxygen saturation of 96% on room air. Physical examination shows a confused man with soot visible in the nares and mouth. He also has a breath odor of bitter almonds. Respiratory examination shows decreased air entry bilaterally with some diffuse wheezes. His arterial blood gas sample shows a serum lactate of 11mmol/L. Which of the following is the most likely explanation for the patient's physical findings?

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