Question

a cold fall morning, a group of about 40 people attending a tailgating party for the Mean Green suddenly started complaining of being dizzy and feeling sick to their stomach.  Upon arrival of the ambulance, assessment of the patients affected revealed the following:

They were all aged 18 – 25 years old  (18 females: 22 males)

Ten (10) of the 40 people requiring treatment were clearly disoriented and could not provide the medics with background information; 2 people had actually lost consciousness (passed out).

Thirty (30) of the 40 people requiring treatment had vomited at least once in the past 30 minutes; all 40 people complained of abdominal pain

All had been in the “party tent” (a large heated outdoor tent with food/beverages) prior to feeling ill

About 60% of the patients presented with an elevated blood pressure (hypertension); while 30% showed low blood pressure levels (hypotension) and about 10% had normal blood pressure readings.

Once taken to the hospital, a full patient history was acquired on each patient.  The following was learned (and generalized) across patients:

All 40 people had been in the tent for at least 1 hour; 15 of them reported being in the tent for closer to 2 hours.

26 of the 40 people had consumed 2 or more cups of beer from the keg in the party tent; the other 14 had brought their own drinks.

32 of the 40 people had consumed food provided in the party tent:

15 had a hot dog

17 had a burger

22 had nachos

29 had cookies

By the time all the patients were in-processed, 26 of them felt better, only reporting a persistent “headache” and light nausea. 

The other 14 patients continued to vomit, complained of headaches, and were disoriented.  The following information was collected on these 14 patients: 

Average O2 saturation:  95% 

Average heart rate:  89 bpm (range: 79-100 bpm; “normal values”:  60-80 bpm)

Average blood pressure:  108/71 (range: 100/65 – 116/75; “normal” values:  120/80)

1 patient had a seizure within 15 minutes of arriving at the hospital 

Rapid cultures did not show the presence of any common pathogens (i.e. E coli, 

Salmonella, Shigella dysenteriae, Vibrio cholera, Cryptosporidium parvum, Listeriosis); 
but blood, urine, and fecal samples were sent for more indepth diagnosis.

1.  Provide a hypothesis as to what you think the xenobiotic (pick 1) might be for this exposure scenario:

2.  What was the route of exposure for this xenobiotic and what location in the body was it absorbed?

3.  Based on what we have discussed so far, what might determine how much of this xenobiotic is 
     absorbed into the body in these patients?  

4.  What would be the likely mechanism of transport of the xenobiotic into the cells of the target tissue?  

     What would be the effects of this xenobiotic on the cells of the target tissue?  

5.  How would this xenobiotic most likely be eliminated from the body?

Answer 1

1. The other drink was the probable xenobiotic. Cause the 14 who had the other drink were still disoriented.

2. Route of exposure was ingestion. It was absorbed in the liver.

3. Factors which will determine xenobiotic absorption-

a. Species i.e human

b. Age

c. Diet

4. Mechanism of transport is diffusion or carrier mediated transport.