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Toxicology > snake bite > Flashcards

snake bite Flashcards

1
Q

snake bite that doesnt have bite mark

A

krait

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2
Q

Scientific name of hump nosed viper

A

Hypnale hypnale

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3
Q

Low back pain in viper bite

A

ARF

Retroperitoneal bleeding

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4
Q

Acute abdominal tenderness in viper bite

A

GI or retroperitoneal bleeding

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5
Q

stomach pain in krait poisoning

A

submucosal hemorrhages in stomach

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6
Q

Type of paralysis induced by elapids

A

descending paralysis

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7
Q

Presentation of krait bite

A

Early morning with paralysis that may be mistaken for stroke

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8
Q

Late onset envenomation is common with

A

Juvenile snakes
krait
hump nosed viper

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9
Q

Viper that can present with neurotoxic features

A

Russell viper

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10
Q

signs of local envenomation

A 
PONDS
 Pain
 Oozing
 Node
 Discoloration
 Swelling
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11
Q

Why 20WBCT is done every 6 hrly

A

liver cannot synthesize clotting factors in under 6 hours

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12
Q

Frequency of 20WBCT in suspected poisonous snake bite cases

A

Every 30min for first 3 hours,then hourly

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13
Q

RIGHT approach to snake bite

A

Reassure
Immobilise
Get to Hospital
Tell the doctor of any symptoms

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14
Q

Half life of ASV

A

90 minutes

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15
Q

Average amount of venom injected by russell viper

A

63mg

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16
Q

One vial of ASV neutralises how much mg of russell viper venom

A

6 mg

17
Q

Pathogenesis of ASV reaction

A

complement mediated not IgE mediated

18
Q

Duration of administration of ASV

A

1 hour

19
Q

amount of isotonic saline in ASV infusate

A

5-10ml/kg

20
Q

Onset of action of im adrenaline

A

8 min

21
Q

Onset of action of S.C adrenaline

A

34 min

22
Q

Dilution of adrenaline available in wards

A

1:1000

23
Q

Rate of adrenaline infusion

A

0.25 ug/kg/min

24
Q

Dose of dexa and hydrocortisone in ASV reaction

A

Dexa: 0.1-0.4 mg/kg
Hydrocort: 2-6 mg/kg

25
Q

Treatment of late serum sickness reaction due to ASV

A

Prednisolone 5mg qid

26
Q

onset of late serum sickness reaction

A

1 to 2 wks after administration of ASV

27
Q

Max dose of ASV to be given in a neurotoxic snake bite patient

A

20 vials

28
Q

Max venom yield from a russell viper

A

147 mg

29
Q

Mech of neurotoxicity of elapids

A

Cobra- post synaptic

krait- pre synaptic

30
Q

Recovery after ASV: spontaneous systemic bleeding

A

15-30 min

31
Q

Recovery after ASV: blood hypocoagulability

A

6 hrs

32
Q

Recovery after ASV: neurotoxicity

A

Cobra: as early as 30 min
krait: delayed

33
Q

Recovery after ASV: BP

A

30 min

34
Q

Refractory hypotension in russell viper bite

A

pitutary or adrenal necrosis

35
Q

Normal intracompartmental pressure

A

<20 mm Hg

36
Q

Fasciotomy is indicated if intracompartmental pressure is more than

A

30-40 mm Hg

37
Q

role of heparin in viper bites

A

contraindicated

venom induced thrombin is resistant to heparin

Toxicology (4 decks)

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