Poisoning Flashcards
Black button spider bite pain treatment?
Iv calcium gluconate for muscle cramps, but only last 20-30 min.
NOT CNS depressants!
Is black or brown butter spider bite worse?
Black
Name 2 spiders with cytotoxic venom
• Sac spider!
• violin spider!
. Six eyed sand spiders
Which spider responsible for most cytotoxic spider bites?
Sac spider: cheiracanthium furculatum
“Aggressive”
Presentation sac spider bite?
- Initially not painful, resemble mosquito bite
- later typical bull’s eye lesion
- Center necrosis and ulcerations
- systemic symptoms rare but may be experienced after 2 days.
No antivenom.
Violin spider bite presentation?
- Initially painless and unnoticed
- 2 hours later red and swollen, purple centre
- day 1-2 bleeding into site: blackened
- day 4: swelling and inflammation subside, cutaneous necrosis spread slowly
- necrotic tissue slough off leaving deep ulcerating wound - slow healing and scarring
No antivenom.
Which family scorpions most venomous?
Buthidae eg parabuthus! (Most venomous)
Cause scorpionism
What type of toxicity scorpion venom?
Most neurotoxic
Parabathus sting presentation
- Immediate, excruciating local burning pain
- spread through body as cramps, numb, pins and needles.
- hyperesthesia
- tremors, drool, loss pharyngeal reflexes, sweating, stiff gait.
- respiratory failure primary cause of death.
- children unique form restlessness with uncontrollable jerking, chaotic thrashing movements, flail and writhe, screaming
Treatment parabuthus stings?
• Symptomatic and supportive - listen to patient hyperesthesia
• antivenom: if systemic symptoms, take 2-6 hours
. Pain: inject local anaesthesia
What type venom do button spiders have?
Neurotoxic
Button spider bite presentation?
- Neurotransmitter ach and noradrenaline release responsible for clinical picture latrodectism
- first hypersensitive, generalised stimulation somatic and autonomic nerve endings
- relative paralysis next due to neurotransmitter depletion.
Moa carbon monoxide poisoning?
• CO displace oxygen from haemoglobin, 300 times greater affinity
Cyanide poisoning moa?
Prevent up take oxygen by inhibition cytochrome oxidase, and local erosion.
Arsenic poisoning acute symptoms? (4)
- Haemorrhagic gastritis
- Subendocardial haemorrhage
- tubular necrosis
- intravascular hemolysis
Arsenic poisoning chronic symptoms? (3)
- Hyperkeratosis
- skin thick
- hair loss
Organophosphate and carbamate poisoning moa?
Inhibit choline esterase. Toxic effects begin when drop below 30%. Rapid death in large doses.
Organophosphate and carbamate poisoning smaller doses presentation? (5)
- Nv
- blurred vision
- pinpoint pupils
- hypersalivation, increased bronchial secretions
- twitching and fits precede death.
How is bulb of sekanama or drimia sanguinea poisonous?
Contains cardiac glycosides
How is tuberous roots impila ( ox eye daisy) or callilepis laureola poisonous? (4)
- Contain carboxyatractylocide
- hypoglycaemia
- hepatotoxic
- nephrotoxic
How are seeds of thornapple or moonflower (datura) poisonous?
Contain different parasympatholytic alkaloids eg atropine, hyoscine.
How is Nerium oleander (garden) poisonous?
Contain cardiac glycosides
How are chinkerinchee (ornithogalum) plants in garden poisonous?
Severe diarrhoea
How are arum lilies (araceae) garden plant stems poisonous?
Cause stomatitis and salivation
Clinical effects amanita phalloides (death cap mushrooms) poisoning?
- Initial git signs
* then severe hepato-and nephrotoxicity
Clinical effects aflatoxicosis by aspergillus flavus?
Severe hepatotoxicity.
