Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CLINICAL TOXICOLOGY > ENVENOMATION > Flashcards

ENVENOMATION Flashcards

1
Q

Snakebite envonoming is a …… disease

A

Neglected tropical disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Snakebite envenomation is a ————- medical emergency

A

Life threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which regions of the world experience snakebites the most

A

Tropical and Subtropical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vast majority of deaths due to snakebites occur in ………

A

Sub Saharan Africa and south east Asia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Country with the highest snakebite mortality

A

India

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why do children suffer more severe effects from snakebites than adults

A

Due to their smaller body mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why do children suffer more severe effects from snakebites than adults

A

Due to their smaller body mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Epidemiology of snakebites

A

Males are bitten more than females
Agricultural workers and children are most affected
Elderly are at a greater risk of mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Number of snake species considered venomous

A

600 out of the 3500 species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Classification of snakes to their suborder

A

Class Reptilian
Order Squamata
Suborder Serpentes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Venomous snakes are in ——- families

A

Five

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Largest and second largest venomous snake families

A

Viperidae and Elapidae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Five families of venomous snakes

A

Colubridae
Atractaspididae
Elapidae
Viperdae- Viperinae
Crotalidae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Examples of Colubridae

A

Boomslang
Bird snake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examples of atractaspididae

A

Burrowing asps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Examples of elapidae

A

Cobras, kraits, coral snakes , mambas, death adder, tiger snake, most Australian snakes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examples of Hydrophiidae

A

Hydrophiidae are in the family Elapidae
Examples are Sea snakes and Sea kraits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Examples of Viperinae ( True/Pitless vipers)

A

Vipers
Adders
Asps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Examples of Crotalidae or pit vipers

A

Rattlesnakes
Bushmaster
Copperhead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Types of snake fangs

A

fangless (aglyphous),
rear-fanged (opisthoglyphous),
front fanged and fixed maxilla (proteroglyphous),
Front fanged and mobile maxilla (solenoglyphous)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Anatomical classifications of snakes based on fangs

A

Colubridae- Opisthoglyphous
Elapidae- Proteroglyphous
Viperidae- Solenoglyphous
Atractaspididae- All types of fangs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which family of snakes contain species capable of spraying their venom

A

Elapidae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Two examples of cobras

A

Common cobra- Naja naja
King cobra- Ophiophagus hannah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Examples of kraits

A

Common krait: Bangarus caeruleus

Banded krait: Bangarus fasciatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Most venomous snake based on the murine LD50

A

Western or Inland taipan from the family Elapidae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Examples of true cobras (Najas)

A

Common cobra - Naja naja
Black necked spitting cobra- Naja nigricollis
Egyptian cobra- Naja heje

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Key identification feature of the common cobra

A

Well marked hood
Monocellate or Binocellate spectacle mark

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Key identification feature of the common krait

A

Paired white bands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Two examples of mambas

A

Green mamba - Dendroaspis angusticeps
Black mamba - Dendroaspis polyplepis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Features of pit vipers

A

Pit between eye and nostril
Flat triangular shaped head
Vertical pupils
Curved fangs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Examples of true or pitless vipers

A

Russell’s Viper - Daboia russelii
African saw scaled viper or carpet viper - Echis ocellatus
African puff adder - Bitis arietans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Examples of pit vipers /Crotalidae

A

Rattlesnakes
Cottonmouth or Water moccasin
Copperhead
Bushmaster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Key identification feature of the Russell’s viper

A

Black edged almond or chain shaped marks on the back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Examples of rattlesnakes

A

Sidewinder
Diamondback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Key venomous snakes in Ghana

A

West African saw scaled / carpet viper - Echis ocellatus
Puff adders- Bitis arietans
Black necked spitting cobra- Naja nigricolis
Senegales cobra - Naja senegalensis
Western green mamba -Dendroaspis viridis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Identification features of venous and nonvenomous snakes

A

Venomous
Triangular head or arrowhead head
Elliptical pupil
Fangs
Single row of subcaudal anal plates

Harmless
Oval head or egg shaped head
Round pupil
Double row of subcaudal anal plates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Difference between poison and venom

A

Venom must be injected into the body by mechanical means however poisons must be ingested inhaled or absorbed

Venoms are generally nontoxic if swallowed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Functions of snake venom

A

Prey immobilization
Assist in or start the digestive process
Self defense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Causes of difference in snake venom composition

A

Geographical distribution
Seasons of the year
Age or ontogenic variation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Two main classes of snake venoms

A

Proteins and Peptides
Non enzyme and Enzymes

Non proteinaceous components

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Effect of 3FTX neurotoxin

A

Selective inhibition of nAchR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Effect of 3FTX cardiotoxin

A

Membrane perturbation by electrostatic and hydrophobic interactions with the cell membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Effect of Disintegrin peptide components

A

Inhibit platelet aggregation
.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Effect of kurnitz type inhibitors

A

Inhibition of serine proteases (e.g., plasmin, kallikrein, trypsin).
Interferes with the blood coagulation cascade and fibrinolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Effect of natriuretic peptide components

A

Vasodilation
Hypotension
Increase NO production
Cardiprotective action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Effect of BPP( Bradykinin potentiating peptides) protein components

A

Inhibit the function of ACE and raise the level of bradykinin.
Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Effects of Crotamine peptide components

A

Interacts electrostatically with DNA.
Penetrates membranes via heparan sulphate proteoglycans binding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Effects of safarotoxin

A

Vasoconstriction via endothelin receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Effect of waglerin

A

nAChR antagonist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Effect of CRISPs

A

Inhibit high K induced contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Effects of PLA2

A

Hypotension
Vasorelaxation
Antiatgetogenic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Effects of 3FTXs

A

Hopotension
Vasorelaxation
Inhibition of platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Effect of fibrinolytic enzymes

A

Inhibit platelet aggregation
Fibrinolytic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Which snakes produce neurotoxic venoms

A

Elapidae- cobras, kraits, coral snake
Hydrophiidae
Small Bitis vipers
Russell’s viper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Which snakes produce cytotoxic venoms

A

Black necked spitting cobra
Bothrops asper
Saw scaled/ Carpet viper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Snakes that produce haemotoxic venoms

A

Viperidae, spitting cobra, certain Colubridae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Snakes that produce myotoxic venoms

A

Hydrophiidae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Snakes that can produce venoms with combined toxicities

A

Spitting cobra
Saw scaled or carpet viper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Signs of neurotoxic venoms

A

Descending muscular paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Predominant neurotoxic toxins

A

PLA2
3FTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Sign of cytotoxic venoms

A

Swelling at the bite site which can develop into blistering and bruising and hypovolaemic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Predominant cytotoxic toxins

A

Hydrolytic enzymes eg: Snake Venom Metalloproteinases (SVMPs)

PLA2s
Non enzymatic cytotoxic 3FTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Signs of myotoxic envenoming

A

Negligible local swelling
Myalgia
Associated features of neurotoxic venoms and progressive descending paralysis
Rhabdonyolysis and renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Examples of myotoxic toxins

A

Myotoxic single chain peptides (42-44amino acid residues)
Myotoxic PLA2s

65
Q

Signs of haemotoxic venoms

A

Cardiovascular effects- Hypotension leading to shock

Haemostatic effects- local and systemic hemorrhage

66
Q

What is VICC

A

Venom-induced consumption coagulopathy (VICC) is a disseminated intravascular coagulation(DIC)-likesyndrome, characterized by low or undetectable levels of fibrinogen, resulting in incoagulable blood

67
Q

Examples of haemotoxic venoms

A

Snake venom serine proteases
Snake venom metalloproteinases
Bradykinin potentiating peptides
C-type lectins
PLA2
Disintegrins
Factor Va toxin
Factor Xa toxin
Kurnitz type serine protease inhibitors

68
Q

Factors determining risk of the human envenomation by different snakes

A

Venom toxicity/potency
Size of snake
Effectives of the bite
Innate aggressiveness of snake
Likelihood of human contact

69
Q

Clinical features of snake bites

A

Increasing Local pain at site
Local swelling that extends oroximall
Tender painful enlargement of regional lumpen nodes

70
Q

Examples of snakes with painless bites

A

Kraits
Sea snakes

71
Q

Local signs and symptoms at the site of a snake bite

A

Fung marks *
Local pain
Local bleeding *
Brushing
Lymphangitis *
Lymph node enlargement
Inflammation
Blistering *
Local infection
Abscess formation
Necrosis

72
Q

Systemic signs of snake bites

A

Malaise
Nausea
Vomiting
Abdominal pain
Weakness
Drowsiness
Prostration

73
Q

Cardiovascular signs of snake bites

A

Hypotension
Shock , Blurred vision , Syncope, Dizziness, Collapse

Pulmonary edema
Cardiac arrhythmias
Cardiac arrest

74
Q

Bleeding and clotting disorders associated with snake bites

A

Bleeding from recent wounds and partly healed wounds
Spontaneous systemic bleeding

75
Q

Signs of spontaneous systemic bleeding in snakebites

A

Bleeding from gums
Epixtasis
Haemoptysis
Haematemesis
Rectal bleeding
Meleana
Haematuria
Vaginal bleeding
Bleeding into skin and mucosal
Intracranial hemorrhage
Antepartum haemorrhage

76
Q

Examples of skin bleeding

A

Purpura
Petechiae
Ecchymoses

77
Q

Signs of neurological snake venoms

A

Drowsiness
Paraesthesiae
Abnormalities of taste and smell
Heavy eyelids
Progressive descending paralysis

78
Q

Which venoms cause broken neck sign and respiratory or flaccid paralysis

A

Neurotoxic venoms

79
Q

Signs of skeletal muscle breakdown in snake envenoming

A

Généralised pain
Stiffness and tenderness of muscles
Lock jaw or trismus
Myoglobinuria
Hyperkalemia
Cardiac arrest

80
Q

Which snakes produce venoms that cause skeletal muscle breakdown

A

Sea snakes
Russell’s viper

81
Q

Signs or renal failure in snake envenoming

A

Loi or lower back pain
Haematuria
Haemoglobinuria
Myoglobinuria
Oliguria/Anuria
Uraemia signs and symptoms

82
Q

Examples of snakes that release venoms that cause renal failure

A

Viperidae
Sea snakes

83
Q

Signs and symptoms of uraemia

A

Acidotic breathing
Hiccups
Nausea
Pleuritic chest pain

84
Q

Four initial questions in assessing snake bites

A

Which part of body was bitten
When were you bitten
Where is the snake that but you or what did it look like
How are you feeling now

85
Q

Parameters to be examined

A

Tooth marks
Local signs
Bleeding
Shock
Neurotoxicity or paralysis

86
Q

Earliest signs of snake envenoming

A

Local swelling , enlargement and tenderness of regional lymph nodes

87
Q

First site of spontaneous systemic bleeding in snake envenoming

A

Gums (Gingival sulci)

88
Q

Snake responsible for most deaths in northern Ghana

A

Echis ocellatus

89
Q

Earliest symptoms of neurotoxity or paralysis in snake envenoming

A

Blurred vision
Heaviness of the eyelids
Apparent drowsiness
Contracted frontalis muscle

90
Q

Haematological investigations in snake envenoming

A

FBC
Neutrophil leukocytosis
Thrombocytopenia

20WBCT

PT as INT or activated Partial Thromboplastin Test (aPTT)

91
Q

Which snakes cause thrombocytopenia

A

Vipers
Colubrids

92
Q

How is 20WBCT performed

A

Leave 2-5 ml of blood in dried test tube
Failure to clot after 20 minutes implies incoagulable blood

93
Q

Biochemistry investigations in snake envenoming

A

BUE and Creatinine - renal dysfunction and acid base imbalance
LFT- increased bile
Serum electrolytes : CK, AST - muscle damage

94
Q

Other investigations

A

Urine examination
Arterial oxygen saturation
ECG
Chest radiography

95
Q

Duration to death for snake bites

A

Hours for Elapidae bites
Days for Viper bites

96
Q

Contraindicated potentially harmful treatments in snake envenoming

A

Torniquet
Wash, rub, massage, tamper with bite wound
Suction of bite site
Incision of bite site
Cryotherapy
Electric shock
Excision of bite site
Cauterization
Instillation of chemicals like KMnO4

97
Q

Thé Do it RIGHT mnemonic of snake envenoming first aid

A

R- Reassure patient
I- Immobilize
GH- Get to Hospital
T - Tell

98
Q

Early Treatment of local pain

A

Oral paracetamol
Opiates for sever pain

99
Q

Why are NSAIDS avoided in snake envenoming

A

Avoid NSAIDS due to risk of gastric bleeding in pts with incoagulable blood

100
Q

Early treatment of vomiting

A

Lay patient in recovery position( on left side), head down to avoid aspiration

IM Chlorpromazine 25-50mg in adults, 1mg/kg in children
OR
IM Prochlorperazine 12.5mg in adults

101
Q

What drug is used for mild sedation in snake envenoming

A

Diazepam oral 5-10mg stat

102
Q

Treatment of pain in snake envenoming

A

Paracetamol oral
Morphine IV/IM/SC

103
Q

Dose for polyvalent anti-snake serum

A

50-100ml (5-10ampoules)
by IV drip in 0.9%N/S or 5%Dextrose over 2-4 hours

104
Q

Treatment for hypovolaemic shock in snake envenoming

A

Crystalloids
Colloids
Blood

105
Q

Treatments for defects of hémostasis in snake envenoming

A

Clotting factors
Fresh frozen plasma
Platelets

106
Q

Treatments for respiratory distress in snake envenoming

A

Oxygen
Intubate
Ventilate

107
Q

Indication for antivenin in snake envenoming

A

Presence of symptoms and signs of systemic or severe local manifestations of envenomation

108
Q

Complications of antivenin use

A

Anaphylaxis
Pyrogenic reactions
Later immune complex disease ( Serum sickness)

109
Q

Storage of liquid antivenin

A

Stored at 2-8 degrees Celsius and not frozen

110
Q

Animals used in producing antivenins

A

Horses
Donkeys
Sheep

111
Q

Which has a longer shelf life, lyophiliséd or liquid antivenin

A

Lyophilised has a longer shelf life but is more expensive

112
Q

Types of antivenom

A

Monovalent or Monospecific
Polyvalent or Polyspecific

113
Q

Disadvantages of polyvalent antivenin

A

Larger doses required
Higher risk of adverse reactions
Increased cost of treatment

114
Q

Advantages of polyvalent antivenom

A

Neutralisons antibodies agains a wider pool of antigens
No need to identity snake that has bitten the patient

115
Q

Disadvantage of monospecific antivenom

A

Limited cross efficacy, often restricted to snake genus

116
Q

Why do children and adults require same dose of antivenom

A

Antivenom neutralizes a fixed amount of venom

117
Q

Patients with increase risk of severe actions to antivenom

A

Atopic history ( severe asthma, hay fever etc)
History of reactions to equine antisera(anti-tetanus serum)

118
Q

Pretreatment for diminishing reaction to antivenom

A

Subcutaneous adrenaline and IV antihistamine and hydrocortisone

119
Q

Why are tests with diluted antivenom not predictive of anaphylaxis or late serum sickness reactions

A

Large majority of antivenom reactions are not IgE based Type 1 hypersensitivity reactions but rather due to direct complement activation by aggregates of IgG or its fragments

120
Q

Antivenom is best given IV, why is IM not ideal

A

Absorption is very slow

121
Q

How is antivenom given

A

IV injection at a rate of about 5ml/min
Or
Diluted in isotonic fluid and infused over 30-60min

122
Q

Response to antivenom treatment on the various systemic and local effects of snake envenoming

A

Neurotoxic signs - change slowly after several hours

Cytotoxic - limit further damage but not reverse damage

Cardiovascular effects - respond within 10-20min

Spontaneous bleeding - stops within 15-30 min

Blood coagulability - restored within 6 hours

123
Q

If blood is still incoagulable 6hours after the first dose of antivenom, what should be done

A

Repeat dose and so on every 6h until blood coaguability is restored

124
Q

Which brand of antivenom is a solution

A

ASNA Antivenom C and
ASNA Antivenom D

125
Q

Symptoms of early antivenom reactions

A

Cough
Tachycardia
Itching
Urticaria
Fever
Nausea
Vomiting
Headache

126
Q

Symptoms of systemic anaphylaxis

A

Hypotension
Bronchospasm
Angioedema

127
Q

Treatment of early antivenom reactions

A

Adrenaline 0.5-1ml for adults, 0.01mg/kg for children

Followed by IV H1 antagonist

128
Q

Dose for IV H1 antagonists in treating early antivenom reaction

A

Chlorphenamine - 10mg for adults. 0.2mg/kg for children

Promethazine - 25mg IM in adults

129
Q

Signs of pyrogenic reactions to snake antivenom

A

Chill
Cutaneous vasoconstriction
Gooseflesh and shivering
Myalgia
Headache
Tachycardia
Fever
Intense vasodilation and hypotension
Febrile convulsions in children

130
Q

Treatment for pyrogenic reactions to snake antiserum

A

Reduce temperature by fanning, tepid spongin and antipyretics
IV adrenaline for severe cases with hypotension

131
Q

Symptoms of late reactions ( serum sickness) to snake antivenom

A

Itching
Urticaria
Lymphadenopathy
Arthralgia
Periarticular swellings
Proteinuria
Neurological symptoms

132
Q

Treatment of serum sickness

A

Antihistamine Chlorphenamine 2mg/6h adult 0.25mg/kg/day in divided doses for children: 5 days

Prednisolone for severe cases and failure of antihistamines within 24 hours

133
Q

Timelines for the different reactions to snake antivenom

A

Early and anaphylactic reactions - 3-60min
Pyrogenic reactions - 1-2 hours
Late reactions or serum sickness- 5-24 hours, averagely 7 hours

134
Q

Antibiotic prophylaxis in local envenoming

A

Amoxicillin/ Clavulanate

135
Q

Treatment of coagulopathy if not reversed by ASV therapy

A

Fresh frozen plasma
Cryoprecipitate ( Fibrinogen, Factor VIII)
Fresh whole blood
Platelet concentrate

136
Q

Treatment of bulbar paralysis and respiratory failure in snake envenoming

A

Tracheotomy
Endotracheal intubation
Mechanical ventilation

IV Neostigmine 50-100mcg/kg/4hours infusion
Glycopyrrolate 0.25mg before neostigmine in place of atropine

137
Q

Which snakes cause snake venom ophthalmia

A

Spitting elapid species

138
Q

Taxonomy of order Hymenoptera

A

Phylum Arthropoda
Class Insecta
Order Hymenoptera

139
Q

The three families under Hymenoptera

A

Vespidae ( True Wasps)
Apidea (bees)
Formicidae(Wasps)

140
Q

Subfamily and family of genus solenopsis (fire ants)

A

Subfamily - Myrmicinae
Family- Formicidae

141
Q

Examples of insects in subfamily aspinae

A

Honeybees
Bumblebees

142
Q

Genus of honeybees

A

Genus apis

143
Q

Insects under subfamily Vespinae

A

Hornet
Yellowjackets

144
Q

Which insects causes most all allergic reactions

145
Q

Difference between apids and vespids in relation to stinging

A

Female apids sting once
Vespids sting multiple times, both males and females

146
Q

Composition of Vespids venoms

A

Proteins
PLA
Hyaluronidase
Acid Phosphatase
Antigen 5

Peptides
Mast cell degranulating peptide
Kinins

147
Q

Components of Formicids venoms

A

Proteins
PLA
Hyaluronidase
Unidentified third protein

Alkaloids
Piperidiones

148
Q

Components of Aphid venom

A

Proteins
PLA
Hyaluronidase
Acid Phosphatase

Peptides
Melittin
Apamin
Mast cell degranulating peptide

149
Q

Effects of melittin

A

Pain
Destruction of tissues
Basophils and mast cell degranulation

150
Q

Which insect mostly causes local infections from its stings

A

Yellow jacket

151
Q

Management of airway in anaphylactic reactions due to Hymenoptera

A

High flow oxygen

152
Q

Treatment of hypotension in anaphylactic reactions due to Hymenoptera

A

Lactated ringers

153
Q

Treatment of severe shock in anaphylactic reactions due to Hymenoptera

A

SC epinephrine 0.01mg/kg (0.3mg in adults
IV epinephrine 0.1mg

154
Q

Antihistamines used in anaphylactic reactions due to Hymenoptera

A

IV diphenhydramine 1mg/kg (50mg in adults )
IV cimetidine 300mg in adults
IV steroids (100-250’mg hydrocortisone or methyl prednisolone)

155
Q

Treatment of wheezing in anaphylactic reactions due to Hymenoptera

A

Orciprenaline 0.3cc or
Salbutamol 2.5cc in 3cc NS

156
Q

Management of hypotension despite IV fluids in anaphylactic reactions due to Hymenoptera

A

IV dopamine or Epinephrine drip

157
Q

If sting site of insect is red and swollen but mainly pruritic

A

Treat with oral antihistamines

158
Q

If sting site is red and swollen but mainly painful

A

Treat with oral antibiotic

159
Q

If sting site is red and swollen and pruritic and painful

A

Treat with oral antibiotic and antihistamines

CLINICAL TOXICOLOGY (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions