Bites and Stings

Question 1

Bite characteristics of the black widow:

What does their venom contain and what is its MOA??

Answer 1

Venom has latrotoxins which are neutrotoxin proteins that increase presynaptic intracellular Ca and promote neureotrans release. Prevents Ach reuptake and a single bite can be lethal

Question 2

TX of black widow bites:

Answer 2

Supportive care, relief of muscle pain (morphine and benzos), antivenom (Acalatro which is horse serum based, can cause anaphylaxis, slow infusion req. to decrease infusion related allergic rxns)

Question 3

Brown recluse bites contain what type of venom? What is its MOA?

Answer 3

Phospholipases, proteases, esterases, collagenases, hyaluronase, dermonecrosis factors, and sphigomyelinase D

Question 4

Brown recluse bites TX:

Answer 4

No antivenom available in US, wound care, experimental methods like Dapsone (an anti-inflammation and immunomodulatory via myeloperoxidase inhibition), steroids can be used but their use is controversial

Question 5

What are the two families of poisonous snakes in the US?

Answer 5

Crotalidae (rattlesnake, copperhead, cottonmouth), Elapidae (coral snake)

Question 6

___ ____ are the largest group of venomous snakes in the US

Answer 6

Pit vipers

Question 7

What snake is responsible for the majority of bites?

Answer 7

Copperheads

Question 8

Crotalinae venom (pit vipers) Lethality of their bite includes what three characteristics?

Answer 8

• endoth. damage
• fibrinogenolysis
• platelet aggregation

Question 9

T/F cats are more resistant to snake bites than dogs but usually present in worse condition.

Answer 9

True!!

Question 10

a 1-2 fang mark bite with pain, edema and systemic clinical signs with progression being spreading edema, ecchymosis, vesiculation, bullae, and necrosis is likely due to a bite from what snake family??

Answer 10

Crotalinae snakes

Question 11

Systemic effects of pit viper envenomation–>

Answer 11

Hemolysis, thrombocytopenia, decreased clotting factors, DIC like syndromes, SHOCK***, end stage organ dysfunction

Question 12

Shock= what sp. of snake bit this p?

Answer 12

Pit viper

Question 13

Snake bites severity scoring. 0= WNL, 3/4 = severe, list then per bodily system:

Answer 13

Pulm system, CV system, GI system, and CNS 0-3, local wounds, hematological system 0-4

Question 14

When should you reeval. the snake bite severity scoring while p is in your care?

Answer 14

Q 6 hrs, 12 hrs, and 24 hrs post initial hospitalization

Question 15

Should you extract the venom for first aid care of a snakebite?

Answer 15

HELL NAH.

Question 16

What are the two types of antivenom?

Answer 16

Wyeth Polyvalent (horse serum IgG) and Crofab (sheep FaB antibody, lower incidence of allergic rxns/serum sickness)

Question 17

What the name of the pit viper venom vax

Answer 17

Crotalus Atrox Toxcoid (rattlesnake vaccine)

Question 18

What is unique of the elapidae venom (coral snake) venom?

Answer 18

It causes neurotoxicity and is an Ach receptor blockade with fewww local symptoms

Question 19

Hymenoptera stings include which 3?

Answer 19

Bees, wasps/hornets, fire ants

Question 20

What is different about the fire ant venom than bee venom for stings?

Answer 20

They are mostly composed if alkaloids rather than proteins and peptides

Question 21

Wasps venoms contain ______ which causes immediate pain, increased vasc. perm. and edema

Answer 21

Waspkinins

Question 22

Bee venom contains ____ ____, histamine, ____, mast cell degranulation, peptides, sugars, and ____

Answer 22

Cytotoxic enzymes, dopamine, lipids

Question 23

TX of hymenoptera stings:

Answer 23

Removal of stinger if present (honeybees leave stinger whereas wasps and hornets do not). Cold compress, pain management PRN, Antihistamines for acute swelling and watch for any signs of anaphylaxis (seek med. care if so)