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Toxinology > Tox > Flashcards

Tox Flashcards

1
Q

Clinical pathology of Brown snake bites

A

1.VICC always present with significant envenomation 2.MAHA + Thrombocytopenia 3Neurotoxicity (pre synaptic - rare) 4.Renal failure - uncommon

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2
Q

Clinical features of Brown snake

A

Asymptomatic Non specific symptoms - Headache/N &V/Abdominal pain Systemic envenomation- Presyncope/sudden collapse Early death _Direct cardio toxicity VICC-bleeding from gums/Venesection site/ICH MAHA- renal failure rhabdomyolysis and near toxicity is rare

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3
Q

diagnosis of envenomation in brown snake bite

A

History of collapse

Objective evidence VICC

Laboratory evidence of VICC

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4
Q

What are the features of VICC

A

elevated INR>3 -usually unrecordable undetectable fibrinogen Elevated D dimer and FDP

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5
Q

What type of Toxin in Death adder ?

A

Post synaptic neurotoxin

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6
Q

What are the clinical features of Death adder

A

Pain or stinging at the bite site is common

Systemic envenomation - Progressive symmetrical descending flaccide paralysis-withing 6 hours

Early Signs -Ptosis /Blurred vision/Diplopia/Diffuclty in swallowing

Symptoms resolve in 1-2 days

Coagulopathy/Rhabdomyolysis,renal filure not a feature of death adder.

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7
Q

What is characterstic to death adder

A

painful bite

symetrical descening paralysis

normal blood tests

In the absence of antivenoum - Neurotoxicity may be reversed by neostigmine

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8
Q

Tiger snakes envenomation

A
  1. pre and post psynatic neurotoxin
  2. procoagulants
  3. myolysins

VICC

Rhabdomyolysis

Gradual onset paralysis

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9
Q

what are the clinial features of envenomation of tiger snake?

A
  1. Local pain -50%
  2. Non specific -Headache/N&V/Abdominal pai
  3. Sudden collapse/cardiac arrest
  4. VICC
  5. Paralysis starts 1-2 hours but slow in onset - progress over many hours- diplopia& ptosis
  6. Rhabdomyolysis- late and can be massive
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10
Q

What are the clinial features of FWS

A
  1. Pain -Severe ,Immediately
  2. Paresthesia - Local/Distal extremity/Peri oral
  3. Fasiculation-Local/Tongue
  4. Non specfic symtpoms-N/V/headcahe/Abdopain
  5. Autonomic features
    1. Hypersalivation
    2. Lacrimation
    3. Generalised sweating
    4. Miosis
    5. Mydriasis
    6. tachy/Brady
    7. agiated /anxious
    8. Reduced LOC
    9. Non cardiogenic pulmonary odema
    10. severe Hypertension
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11
Q

what are the clinical features of Red back spider

A
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12
Q

What is the treatment for FWS

A
  1. Supportive - PIB/IVF
  2. Airway /NGT- to prevent Gastric dilatation
  3. Antivenom -2 vials -1:10 dilution -repeat 15-30minutes

Reaction <2% (less than RBS)

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13
Q

What are clinical features of Box jelly fish(Chironex Fleckeri)

Rapid rise in cytosolic ca in myocardium

A
  1. severe pain upto 8 hours
  2. Liner Welts -Crosshatched pattern
  3. sudden death /collpase within few minutes
  4. CVS-hypertension/Hypotension/Tachycardia/Arrythmia
  5. Delayed Hypersensitvity reactions
    1. 50 % of patients
    2. pruritic erythema at bite site
    3. can last 7-14 days
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14
Q

What is the treatment for Box Jelly fish?

A
  1. immediate and prolonged CPR/Reassurance
  2. Generous amount of vinegar
  3. NO PIB
  4. IV antivenom
    1. Cardiac arrest -6 vials push
    2. Collapse/hypotension/arrthymia-3vials
    3. refractory pain - 1 vial(1:10)
  5. IV magnisum 10mmol over 15 minutes
  6. IV analgesia
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15
Q

Irukandji syndrome clinial features

Caruka Barnesi

A
  • characterstic 60minutes delay
  • usually sting not felt
  • Massive catecholamine release
    • from 30minutes-120 minutes
    • sense of impending doom
    • agitation
    • dysphoria
    • vomiting
    • generalied sweating
    • severe pain in back/limbs/abdomen
    • hypertension/tachycardia
    • usually settles in 12 hours
  • Severe envenomation -
    • toxic cardiomyopathy
    • cardiogenic shock
    • pulmonary odema
    • ICH
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16
Q

What is the treatment for Irukandji syndrome

A
  1. Vinegar
  2. NO PIB
  3. IV fentanyl
  4. IV GTN
  5. IV Mg- pain control & catecholamine symptom
    1. No antivenom

Toxinology (1 decks)

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