Bites, Stings Toxicology (473-476)

Question 1

How to tx bee sting?

Answer 1

scrape out stinger if still present

• Airway IVF and O2
• Epinephrine
• Diphenhydramine/methylprednisone

Question 2

Pt has red hourglass on abdomen with deep burning, aching pain, HA, vomiting, HTN and rigid abd muscles and back spasms

Answer 2

Black widow bite

Question 3

Tx for black widow bit

Answer 3

Antivenin is curative … also tentanus prophylaxix and pain relief

Question 4

Pt with brown yellow violin on thorax. Also Nausea, myalgias, fever,chills, rash and necrosis at bite site.Dx? Tx?

Answer 4

Brown Recluse Spider bite - Wound care, dapsone, consult surg if significant necrosis

Question 5

Snake bite tx?

Answer 5

Antivenin, tentanus prophylaxis, coagulopathy, and check for compartment syndrome

Question 6

Tender regional lymphadenopathy and decreased ROM (tenosynovitis) caused by what cat organism?

Answer 6

Pasturella

Question 7

Dog bite provoked vs unprovoked

Answer 7

not rabies vs rabies

Question 8

How to tx human bite?

Answer 8

Treat with copious irrigation, augmentin PO and IV abx for unresolving. Treat all knuckle injuries in a fight as a human bite.

Question 9

Acetaminophen antidote

Answer 9

N-acetylcysteine

Question 10

alkali agents antidote

Answer 10

NPO

Question 11

Anticholinergic antidote

Answer 11

Physostigmine

Question 12

Arsenic antiode

Answer 12

Dimercaprol

Question 13

Aspirin antidote

Answer 13

Bicarbonate, dialysis

Question 14

Benzodiazepine antidote

Answer 14

Flumazenil if iatrogenic overdose

Question 15

B blocker antidote

Answer 15

Glucagon, IV calcium

Question 16

Carbon Monoxide antidote

Answer 16

100% O2 or hyperbaric O2

Question 17

Cyanide antidote

Answer 17

Sodium nitrate, sodium thiosulfate, hydroxocobalamine

Question 18

Digoxin antidote

Answer 18

Antidigoxin, Fab antibodies

Question 19

Ethylene glycol antidote

Answer 19

Fomepizole

Question 20

Heparin antidote

Answer 20

Protamine

Question 21

Iron antidote

Answer 21

Deferoxamine

Question 22

Isoniazid antidote

Answer 22

Pyridoxine

Question 23

Lead antidote

Answer 23

EDTA, Dimercaperol

Question 24

Mercury antidote

Answer 24

Dimercaperol

Question 25

Methanol antidote

Answer 25

Bicarbonate, Fomepizole

Question 26

Opioids antidote

Answer 26

Naloxone

Question 27

Organophosphate antidote

Answer 27

Atropine, pralidoxime

Question 28

Phenobarbital antidote

Answer 28

supportive

Question 29

Qunidine antidote

Answer 29

IV magnesium

Question 30

Theophylline antidote

Answer 30

Charcoal, cardiac monitor

Question 31

TCA antidote

Answer 31

Bicarbonate bolus

Question 32

Warfarin antidote

Answer 32

Vitamin K

Question 33

Most common fish-borne illness worldwide caused by this fish toxin

Answer 33

Ciguatera

Question 34

MOA of ciguatera

Answer 34

inhibits calcium regulated cell membrane sodium channels

Question 35

Parasthesias of lips and extremeties, hot-cold, “loose” painful teeth, starts in 6 hrs and can persist for months. Cause of sx?

Answer 35

Ciguatoxic fish ie: barracuda, grouper, snapper and sea bass

Question 36

Histamine-like reaction associated with marine tuna, mackeral, jacks, dolphin mahi mahi, and bluefish

Answer 36

Scombroid

Question 37

How is scombotoxin formed?

Answer 37

When proteus and klebsiella on fish secrete enzyme histadine decarboxylase and convert histidine in the fish flesh to histamine

Question 38

What is the name of the toxin that causes paralysis when ingested. Found in mollusks..

Answer 38

Saxitoxin

Question 39

What is the name of the neuro toxin found in mollusks

Answer 39

Brevitoxin

Question 40

What is the MOA of tetrodotoxin and what’s it’s chemically related counterpart?

Answer 40

Blocks sodium channels in nerve terminals causing ascending paralysis

Counterpart is Saxitoxin

Question 41

What can you tx tetrodotoxin poisoning with?

Answer 41

Edrophonium - anticholinesterase