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Toxicology scs RUSVM > Boots Final stuff > Flashcards

Boots Final stuff Flashcards

1
Q

What are the vitamin K dependent coag factors?

A

X, IX, VII, II (1972)

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2
Q

Which of the following are 1st generation (before 1970) anticoagulant rodenticides? Which are second generation?

Chlorphacinone
Brodifacoum
Bromodialone
Warfarin 
Diphacinone
Pindone
A

1st gen: Warfarin, Pindone (W-P pre ‘70)

2nd: Brodifacoum, Bromdialone (B’s are 2nd)

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3
Q

Arftoo-D2 has ingested anticoagulant rodenticide, his PCV is 18%, he is bleeding, but otherwise stable. How do you treat?

A

Start vit K therapy and monitor closely

Give FFP +/- FWB

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4
Q

Which rodenticide causes cerebral edema and diffuse white matter vacuolization throughout the CNS?

A

Bromethalin

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5
Q

T/F Anticoagulant rodenticides have a pungent smell and degrade in the environment over about 1 week.

A

False, they are odorless and tasteless and resistant in the environment for weeks.

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6
Q

Your patient, Captain Sniffy, ingests a small amount (less than 1g) of an anticoagulant rodenticide. His owner is not sure whether what he ingested is Warfarin or Brodifacoum, but she is certain it is one of these. Do you treat Captain Sniffy either way or do you need to try to figure out which of these he ate? Why?

A

Need to investigate further - Warfarin is 1st gen and a single dose (especially as low as 1 gram) may not cause any symptoms.
Brodifacoum is 2nd gen and is toxic after a single dose. The LD50 for a dog is 0.2-4mg/kg so depending on how much the Captain weighs it might kill him.

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7
Q

What is the mechanism of action for bromethalin?

A

Uncoupling of oxidative phosphorylation (leading to inadequate ATP to power Na+/K+ pump)

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8
Q

T/F Administering phenobarbitol reduces the metabolism of warfarin because it is an enzyme inhibitor. This enhances the toxicity.

A

False
Phenobarb is an enzyme INDUCER and would DECREASE toxicity

Cimetidine is an enzyme inhibitor

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9
Q

Which of the following enhance the toxicity anticoagulant rodenticides?

Cimetidine 
Estrogen
Certain sulfonamides
Enzyme inducers
Vitamin K
Hemorrhage
Phenylbutazone
Corticosteroids 
Salicylates
A

Cimetidine (also other enzyme inhibitors, like grapefruit juice)

Certain sulfonamides (antibiotics)

Hemorrhage (all things that cause blood loss, anemia, or hemolysis)

Phenylbutazone
Corticosteroids
Salicylates

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10
Q

T/F Blood levels of anticoagulant rodenticides reflect clinical signs. Peak levels in blood coincide with the most severe clinical signs.

A

False, peak blood levels occur in 6-12 hours but it can take days for clinical signs to develop

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11
Q

What are the targets for bromethalin that rely heavily on oxidative phosphorylation?

A

Brain

Spinal cord

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12
Q

The plasma half-life for ___generation anticoagulant rodenticides is several hours, the half life for ___generation is several days.

A

1st
(Warfarin=19hrs)

2nd
(Brodifacoum=6 days)

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13
Q

What enzyme do anticoagulant rodenticides inhibit? What does that enzyme do?

A

Vitamin K epoxide reductase

It converts vit K epoxide to its reduced form which is needed for the formation of clotting factors.

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14
Q

Which vitamin K-dependent coagulation factor has the shortest half-life? Which pathway is this factor in?

A

VII

Extrinsic

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15
Q

T/F All animals poisoned with anticoagulant rodenticides will show external evidence of bleeding, especially if they are going to succumb.

A

False in all ways, if the bleeding was in the brain or heart the animal will probably die but may not bleed externally.

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16
Q

A cattle farmer found out that he the hay he just fed his cows was contaminated with brodifacoum. Why may his pregnant cows abort?

A

Placental hemorrhage

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17
Q 
Which of the following clotting tests reflect the extrinsic pathway?
aPTT
PIVKA
PT
ACT
A

PT

PIVKA

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18
Q

Which clotting test is not available cage-side, is not highly specific, but will become abnormal first in case of anticoagulant rodenticide toxicity?

A

PIVKA

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19
Q

Which form of vitamin K is used to treat anticoagulant rodenticide toxicity? How is it administered?

A

Vitmine K1 (phytonadione)

Given orally

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20
Q 
Which of the following may reduce the effectiveness of vitamin K therapy?
Kidney failure
Liver failure 
Pneumonia
Fatty meals
A

Liver failure

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21
Q

You have given activated charcoal to a dog that has very recently ingested an anticoagulant rodenticide. The coag factors are in the normal range but on the low end so you want to give vitamin K. Which of these is the best course of action?

Start oral vitamin K1 supplementation immediately.

Give IV vitamin K now and send home oral vitamin K1.

Send the patient home with vitamin K1 and recheck coags in 72 hours.

Give FFP and IV fluids that contain potassium.

A

Send the patient home with vitamin K1 and recheck coags in 72 hours.

You cannot start oral vit K immediately, must wait for the charcoal to wear off

IV vit K is counter-indicated

Potassium (K) is not the same thing as vitamin K

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22
Q 
Which of the following species are most susceptible to anticoagulant rodenticides? Which is most sensitive? 
Pig
Cat
Dog
Ruminant
Horse
Chicken
A

Dogs are most susceptible

Pigs are most sensitive

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23
Q

Obi Wag Kenobi has ingested anticoagulant rodenticide, his PCV is 13%, he is bleeding and very weak. How do you treat?

A

Give FWB or FFP + packed RBCs

Give IVF and provide other supportive care

Start vitamin K and monitor closely

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24
Q

Treatment for warfin ingestion is indicated for ____, while treatment for brodifacoum ingestion is indicated for _____. If the rodenticide is unknown, treat for ____.

A

1 week

4 weeks

3-4 weeks

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25
Q

Quintox, Rampage, Ortho Mouse-B-Gone or Rat-B-Gone, and Muritan cause vitamin D toxicosis. What type of rodenticide are these?

A

Cholecalciferol

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26
Q

What do Cestrum diurnum (day-blooming jasmine) and Solanum torvum (turkey berry) both contain?

A

Vitamin D analogs

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27
Q

Some rodenticides when consumed by the target animal in sublethal doses can cause the animal to learn to avoid the poison. This does not occur with cholecalciferol. What property am I describing?

A

Bait shyness

No bait shyness with cholecalicerol or bromethalin rodenticides.

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28
Q

T/F Swine, dogs and cats can be poisoned by relay toxicosis by anticoagulant rodenticides.

A

True

This means they (a non-target species) eat a mouse or other target animal that has been poisoned

29
Q

What organ will you find the highest concentration of anticoagulant rodenticides?

A

Liver

30
Q

T/F Cats are more susceptible to cholecalciferol rodenticides than dogs.

A

True

31
Q

Which is correct in terms of the order of potency (most to least):
Ergocalciferol»Dihydrotachysterol»Calcitriol

Calcitriol»Dihydrotachysterol»Ergocalciferol

Dihydrotachysterol»Ergocalciferol» Calcitriol

A

Calcitriol»Dihydrotachysterol»Ergocalciferol

32
Q 
Cholecalciferol is absorbed from which of the following:
Liver
GIT
Blood
Kidney
A

GIT

33
Q

Which 2 conditions can predispose an animal to cholecalciferol toxicity?

A

Renal disease

Hyperparathyroidism

34
Q

T/F The more bioavailable forms of cholecalciferol rodenticides are toxic are much lower doses.

A

True

35
Q

A diet high in ___ / ___ may predispose to cholecalciferol toxicity.

A

Calcium

Phosphorous

36
Q

Cholecalciferol is metabolized to calcidiol in the ____ and to calcitriol in the ____.
_____ is the main form in circulation.

A

Liver
Kidney

Calcidiol

37
Q

Cholecalciferol rodenticide toxicity causes ____calcemia and ____phosphatemia. It causes ___ PTH levels.

A

Hyper

Hyper

Low

38
Q

Which rodenticide can be excreted in high levels in milk?

A

Cholecalciferol

39
Q

Name one gastrointestinal, one renal, one cardiovascular and one neurological clinical sign that can occur with cholecalciferol toxicity.

A

GI: anorexia, vomiting (+/- hematemesis), abdominal pain, constipation (+/- melena)

Renal: PU, PD, hyposthenuria

CV: arrhythmia, hypertension

Neuro: depression, weakness, muscle twitching, seizures, coma/death in days

40
Q

What does “GUP” stand for?

A

General Use Pesticide

41
Q

What methylxanthine alkaloid is found in cacao beans?

A

Theobromine

42
Q

T/F Cats are more sensitive than dogs to bromathalin.

A

True

43
Q

Bromathalin is metabolized by N-demethylation in the liver to the metabolite desmethylbromethalin, which is more toxic. What is this term describes this process?

A

Lethal synthesis

44
Q

T/F: Acute signs such, as CNS excitation, occur with supralethal doses of bromethalin.
Subacute signs, such as CNS depression, are more common.

A

True

45
Q

Anticoagulant rodenticides from which generation take over a week to act?

A

1st generation

46
Q

For which rodenticide is Ginko biloba used?

A

Bromethalin

47
Q

Why must we be cautious when using human oral hygiene products extra-label in canines?

A

It may contain xylitol, which may not be listed as an active ingredient

48
Q

T/F Cats are most susceptible to xylitol toxicity.

A

False, dogs

49
Q

Xylitol is absorbed readily but incompletely from the GIT. Approximately how long after ingestion do plasma levels peak?

A

30 minutes

50
Q

T/F Dogs who develop hypoglycemia due to xylitol ingestion will eventually develop liver failure.

A

False.

51
Q

What are the three main methylxanthine alkaloids causing toxicity in dogs and cats?

A

Caffeine
Theobromine
Theophylline

52
Q

T/F Decontamination by inducing vomiting is counterindicated with xylitol ingestion, activated charcoal is a better option.

A

False, it is indicated and activated charcoal is ineffective because it is an alcohol

53
Q

Which organ is responsible for most of the metabolization of xylitol?

A

Liver (80%)

54
Q

What methylxanthine alkaloid can be found in tea and asthma medications?

A

Theophylline

55
Q

Xylitol is a potent promoter of the release of which substance in some species. What does this cause?

A

Insulin
Hypoglycemia
In large doses, liver failure

56
Q

Oral feeding of a diet high in what is indicated for xylitol toxicity treatment?

A

Carbohydrates

57
Q

Which animals are resistant to bromathalin toxicity?

A

Guinea pigs

58
Q

Which liver enzyme should be monitored with xylitol toxicity?

A

ALT

59
Q

T/F Dogs are most susceptible to methylxanthine toxicity?

A

True

60
Q

Methylxanthines inhibit which enzyme and antagonize which receptor?.

A

Phophodiesterases

Adenosine receptors

61
Q

Which causes greater cardiac stimulation: caffeine, theobromine or theophylline?

A

Theobromine

62
Q

Which causes GI symptoms including nausea, vomiting and abdominal pain: caffeine, theobromine or theophylline?

A

Theophylline

63
Q

How long to clinical signs of methylxanthine toxicity generally last?

A

12-72 hours, depending on the dose ingested

64
Q

T/F: The LD50 for caffeine is higher than that for theobromine in cats and dogs.

A

False, caffeine has a lower LD50 in both species.

65
Q

T/F Activated charcoal is indicated in the treatment of methylxanthine toxicosis.

A

True

Also, repeat for up to 36-72 hours

66
Q

Which causes catecholamine release: caffeine, theobromine or theophylline?

A

Caffeine

67
Q

T/F Methylxanthine undergoes lethal synthesis in the liver.

A

False, it does undergo enterohepatic recycling though

68
Q

T/F Seizures and arrhythmias are common with methylxanthine toxicosis and do not factor into prognosis.

A

False, they indicate a poor prognosis

Toxicology scs RUSVM (4 decks)

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