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ZUKU NAVLE PREP > Cross Species - Top 20 Toxicosis Part 2 > Flashcards

Cross Species - Top 20 Toxicosis Part 2 Flashcards

1
Q

what companion animals are most often affected by raisin, grape, chocolate, & xylitol toxicosis?

A

dogs

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2
Q

what organs are affected by grapes/raisin toxicosis?

A

kidneys

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3
Q

what clinical signs are seen with raisin/grape toxicosis?

A

vomiting, diarrhea, abdominal pain, weakness, tremors, polydipsia, & anuria

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4
Q

what organs are affected by chocolate toxicosis?

A

gi, heart, & CNS

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5
Q

what clinical signs are seen with chcocolate toxicosis?

A

cardiac arrhythmias, cns dysfunction (restlessness, ataxia, tremors, seizures), pu/pd, vomiting, diarrhea, & abdominal distension

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6
Q

what organs/body systems are affected by xylitol toxicosis?

A

endocrine & liver

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7
Q

what clinical signs are seen with xylitol toxicosis?

A

vomiting, weakness, depression, ataxia, seizures, coma, icterus, & potentially coagulopathy

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8
Q

what is the toxic principle of raisins/grapes? how is it diagnosed?

A

unknown - history, clinical signs, & azotemia

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9
Q

what is the toxic principle of chocolate? how is it diagnosed?

A

methylxanthines (theobromine & caffeine)

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10
Q

what is the toxic principle of xylitol? how is it diagnosed?

A

essentially acts as a huge dose of insulin - profound hypoglycemia (monitor every 1-2 hours), bilirubinemia, thrombocytopenia, & hyperphosphatemia

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11
Q

how is raisin/grape toxicosis treated?

A

decontamination, IV fluid diuresis, & promote urination with dopamine or furosemide

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12
Q

how is chocolate toxicosis treated?

A

decontamination (gastric emesis/lavage, activated charcoal), methocarbamol, diazepam, & barbiturates, treat arrthymias, & other supportive care

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13
Q

how is xylitol toxicosis treated?

A

emesis at a hospital, IV dextrose, & liver support with SAMe & n-acetylcsteine

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14
Q

why does activated charcoal not work for xylitol toxicosis?

A

it won’t bind to it

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15
Q

what is the prognosis of raisin/grape toxicosis?

A

guarded

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16
Q

how are the kidneys damaged by raisins/grapes?

A

toxin damages proximal renal tubular epithelium

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17
Q

T/F: for dogs, some are resistant to raisin/grape toxicosis while others develop acute renal failure after just a few raisins or grapes

A

TRUE

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18
Q

how is chocolate toxicity characterized by severity?

A

higher cocoa percentage - white chocolate is the least toxic while dark chocolate/baker’s chocolate is most toxic

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19
Q

what is the pathophysiology of how methylxanthines damage the body?

A

inhibit cellular adenosine receptors, increase intracellular calcium, & increase cyclic AMP levels

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20
Q

how long can signs persist from chocolate toxicosis?

A

72 hours

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21
Q

why do dogs typically die from chocolate toxicosis?

A

cardiac arrhythmias, hyperthermia, & respiartory failure

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22
Q

T/F: chocolate toxicosis rarely affects cats

A

TRUE

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23
Q

what is xylitol?

A

sugar free sweetener

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24
Q

what is the pathophysiology of xylitol? what are poor prognostic indicators?

A

stimulates a profound, rapid, dose-dependent insulin release - liver disease & hyperphosphatemia usually mean a poor prognosis

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25
Q

what human medications are often implicated in companion animal toxicity cases?

A

acetaminophen, SSRIs, methylphenidate, & sleep aids

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26
Q

what does acetaminophen affect in the body?

A

affects erythropoiesis, liver, & kidneys

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27
Q

what clinical signs are seen with acetaminophen toxicity?

A

muddy mucus membranes, hyperpnea, tachycardia, weakness/depression, & death

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28
Q

what in the body is affected by SSRI toxicity?

A

CNS & heart

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29
Q

what clinical signs are seen with SSRI toxicosis?

A

mydriasis, vomiting/diarrhea, lethargy, fever, ataxia, seizures, hyperactivity, vocalization, & increased or decreased heart rate

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30
Q

what body system does methylphenidate affect?

A

CNS only

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31
Q

what clinical signs are seen with methylphenidate toxicity?

A

hyperactivity, aggression, hyperthermia, tremors/ataxia/circling, tachycardia, hypertension, mydriasis, & death

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32
Q

how do sleep aids affect the body in toxicity cases?

A

affect the CNS

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33
Q

what clinical signs are seen in sleep aid toxicosis?

A

marked sedation & paradoxical excitement

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34
Q

how is acetaminophen toxicosis diagnosed?

A

methemoglobinemia & then heinz bodies & abnormal liver values

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35
Q

how is methylphenidate toxicosis diagnosed?

A

measure levels in gastric contents/urine - can use over the counter test kits

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36
Q

how is acetaminophen toxicosis treated?

A

decontamination, n-acetylcysteine slowly iv, ascorbic acid, iv fluids, & blood transfusions

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37
Q

how is SSRI toxicosis treated?

A

decontamination, cyproheptadine, phenothiazines, diazepam, & beta blockers - DO NOT USE ATROPINE

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38
Q

how is methylphenidate toxicosis treated?

A

phenothiazines & acidify urine to increase excretion

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39
Q

how is sleep aid toxicosis treated? what drug is contraindicated for use in these cases?

A

if mild, keep animal quiet, decontamination, phenothiazines, flumazenil if severe - NO DIAZEPAM

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40
Q

what is the pathophysiology of acetaminophen toxicosis?

A

oxidizing toxic metabolites lead to methemoglobin formation with heinz bodies

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41
Q

why are cats uniquely sensitize to acetaminophen toxicosis?

A

they lack glucuronyl transferase

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42
Q

what other condition may dogs develop with acetaminophen toxicosis?

A

KCS

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43
Q

what is the pathophysiology of SSRI toxicosis?

A

block the presynaptic serotonin receptors

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44
Q

T/F: serotonin syndrome can occur with any drug that increases free serotonin levels

A

TRUE

45
Q

what is the pathophysiology of methylphenidate toxicosis?

A

amphetamiens cause release of norepinephrine & other catecholamines

46
Q

methylphenidate toxicosis is difficult to differentiate from what other toxicosis?

A

cocaine

47
Q

what is the pathophysiology of sleep aid toxicosis?

A

binds to GABA receptors

48
Q

what household hazards are most often implicated in toxicity cases?

A

alcohol, chlorine bleach, & dish washer packets

49
Q

what animals are most often affected by household hazards? why?

A

dogs - indiscriminate eating habits

50
Q

what body systems are affected by alcohol toxicosis?

A

gi & CNS

51
Q

what clinical signs are seen with alcohol toxicosis?

A

vomiting, diarrhea, ataxia, disorientation, tremors, dyspnea/respiratory failure, hypothermia, & death

52
Q

what body systems are affected by chlorine bleach toxicosis?

A

gi, eyes, skin, & respiratory

53
Q

what clinical signs are seen with chlorine bleach toxicosis due to ingestion?

A

vomiting, diarrhea, & hypersalivation

54
Q

what clinical signs are seen with chlorine bleach toxicosis due to inhalation?

A

caged birds at highest risk of respiratory exposure due to unique respiratory anatomy - gogging, coughing, & sneezing

55
Q

what clinical signs are seen with chlorine bleach toxicosis due to ocular contact?

A

epiphora & ulceration

56
Q

what clinical signs are seen with chlorine bleach toxicosis due to dermal contact?

A

ulceration

57
Q

what body system is affected by dishwasher packets?

A

gi tract

58
Q

what clinical signs are seen with dishwasher packet toxicity?

A

vocalization, hypersalivation, vomiting (bloody), & gi pain

59
Q

how is alcohol toxicosis diagnosed?

A

blood alcohol level, hypoglycemia, & metabolic acidosis

60
Q

how is chlorine bleach toxicosis diagnosed?

A

metabolic acidosis & pulmonary edema if inhalation exposure seen on rads

61
Q

how is dishwasher packet toxicosis diagnosed?

A

endoscopy to determine degree of necrosis

62
Q

T/F: activated charcoal does not work for treating alcohol toxicosis

A

TRUE

63
Q

how is alcohol toxicosis treated?

A

induce emesis, treat CV & acid base status, diazepam, & yohimbine

64
Q

how is chlorine bleach toxicosis treated for all of the different exposures?

A

treat metabolic acidosis - treat inhalation/pulmonary edema, treat dermal exposure by bathing, & treat ocular with irrigation

65
Q

what should not be done for dishwasher packet toxicosis?

A

do NOT induce emesis or activated charcoal

66
Q

what treatment is used for dishwasher packet toxicosis?

A

dilute with milk/water, supportive care, & potentially an esophagostomy tube

67
Q

what is the pathophysiology of alcohol toxicosis?

A

gi irritation, cns depressant, stimulates catecholamine release, & metabolic acidosis

68
Q

what alcohols are most often involved in toxicity cases?

A

ethanol, methanol, isopropanol

69
Q

what is the pathophysiology of chlorine bleach toxicosis?

A

irritant - if pH is greater than 11 or less than 3.5, can cause corrosive injury - risk depends on concentration pH - bleach and ammonia produce a toxic gas that causes pulmonary edema

70
Q

what is the pathophysiology of dishwasher packet toxicosis?

A

alkaline corrosive (pH is higher than 11) - causes liquefactive penetrating necrosis

71
Q

what are the common rodenticides involved in toxicity cases?

A

anticoagulant, bromethalin, cholecalciferol, & zinc phosphide

72
Q

when do clinical signs start in anticoagulant toxicosis cases?

A

5-7 days after ingestion

73
Q

what clinical signs are seen in anticoagulant toxicosis cases?

A

hemorrhage (affects coagulation cascade) anemia, weakness, lameness if hemorrhage in a joint, hematomas, melena, hematuria, etc

74
Q

what acute clinical signs are seen with bromethalin toxicosis?

A

hyperexcitability, muscle tremors, seizures, hyperthermia, & death

75
Q

what subacute/chronic clinical signs are seen with bromethalin toxicosis?

A

pelvic limb weakness, paralysis, & ataxia

76
Q

what body systems are affected by cholecalciferol toxicity?

A

affects kidneys, CV, & CNS

77
Q

what clinical signs are seen with cholecalciferol toxicity?

A

depression, anorexia, pu/pd, vomiting, hematemesis, & hypertension

78
Q

what body systems are affected by zinc phosphide toxicity?

A

affects respiratory system, liver, & kidneys

79
Q

what clinical signs are seen with zinc phosphide toxicity?

A

vomiting, tachypnea, ataxia, trembling, collapse, seizures, & death

80
Q

how is anticoagulant rodenticide toxicity diagnosed?

A

measure in serum/plasma/stomach contents - prolonged PT, aPTT, & ACT

81
Q

how is bromethalin toxicity diagnosed?

A

measure levels in liver, kidney, fat, & brain

82
Q

how is cholecalciferol toxicity diagnosed?

A

hypercalcemia then hyperphosphatemia

83
Q

how is anticoagulant rodenticide toxicity treated?

A

vitamin k PO for 3-4 weeks until PT is normal 72 hours after last dose, plasma/whole blood transfusion, & oxygen

84
Q

how is bromethalin toxicity treated?

A

decontamination & diazepam

85
Q

how is cholecalciferol toxicity treated?

A

decontamination, cholestyramine, calciuresis (normal saline, furosemide, & prednisolone), aluminum hydroxyide, & pamidronate

86
Q

how is zinc phosphide toxicity treated?

A

decontamination, decrease gastric acid, n-acetylcysteine, SAMe, & diazepam

87
Q

what is the pathophysiology of anticoagulant toxicity?

A

vitamin k antagonist by inhibiting vitamin k epoxide reductase causing abnormal coagulation

88
Q

what are the vitamin k dependent clotting factors?

A

I, II, VII, IX, & X

89
Q

what are the 1st & 2nd generations anticoagulants? how are they different?

A

1st: warfarin & 2nd: brodifacoum - warfarin needs multiple doses for toxicity & brodifacoum only needs one

90
Q

what is the pathophysiology of bromethalin toxicity?

A

uncouples oxidative phosphorylation causing demyelination & cerebral edema

91
Q

what animals are especially sensitive to bromethalin toxicity?

A

cats & young dogs

92
Q

T/F: subacute/chronic toxicity can be seen from bromethalin up to 7 days after exposure

A

TRUE

93
Q

what is the pathophysiology of cholecalciferol toxicity?

A

vitamin d3 causes increased calcium & phosphorus

94
Q

why does calciuresis initiated prior to hypercalcemia worsen disease?

A

stimulates osteoclasts

95
Q

what products have zinc phosphide?

A

gopher/mole/ground squirrel bait

96
Q

what is the pathophysiology of zinc phosphide toxicity?

A

phosphide + low gastric ph produces a toxic phosphine gas (careful with emesis as personnel can inhale this toxic gas which causes noncardiogenic pulmonary edema) & after absorption, blocks cytochrome c oxidase producing reactive oxygen compounds which cause tissue damage

97
Q

T/F: zinc phosphide toxicity is worse in animals that can’t vomit

A

TRUE

98
Q

T/F: phosphine gas is a public health hazard that smells like fish or garlic

A

TRUE

99
Q

what animals are most often affected by ethylene glycol toxicity?

A

dogs & cats

100
Q

what clinical signs are seen with ethylene glycol toxicosis?

A

kidneys & neuro signs - stupor, ataxia, knuckling, poor withdrawal & righting reflexes

101
Q

what is seen in phase 1 of ethylene glycol toxicosis?

A

vomiting & pu/pd

102
Q

what is seen in phase 2 of ethylene glycol toxicosis?

A

oliguric renal failure

103
Q

how is ethylene glycol toxicosis diagnosed?

A

normochloremic metabolic acidosis with increased anion gap & osmolar gap, calcium oxalate crystalluria, & commercial ethylene glycol tests

104
Q

T/F: it is best to treat dogs within 8-12 hours & cats within 2 hours for ethylene glycol toxicosis

A

TRUE

105
Q

how is ethylene glycol toxicosis treated?

A

if no neuro signs - induce vomiting & gastric lavage, 4-MP, fomipizole, or ethanol to inactivate alcohol dehydrogenase, & sodium bicarbonate for acidosis

106
Q

what is the pathophysiology of ethylene glycol toxicosis?

A

toxic metabolites of ethylene glycol that cause renal tubular damage & lead to a metabolic acidosis

107
Q

T/F: the prognosis becomes poor for ethylene glycol toxicosis once the animal is in acute renal failure

A

TRUE

108
Q

T/F: ethylene glycol (anti-freeze) is always dyed a bright color like yellow-green and has a sweet flavor, so it has a small lethal dose

A

TRUE

109
Q

what type of urinary crystals are seen with ethylene glycol toxicosis?

A

calcium oxalate monohydrate crystals - dumb bell shaped

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