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ACVIM General Boards - 2022 > Toxicology > Flashcards

Toxicology Flashcards

1
Q

What are the toxic properties of hydrogen peroxide?

A

Corrosive damage - Gastric ulceration
Gas production - Bloat, gas emboli
Oxidative damage - lipid membranes

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2
Q

What is intralipid emulsion used for?

A

Lipophilic drug intoxication

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3
Q

What are side-effects to intralipid therapy?

A

Corneal lipidosis (reversible)

hypertriglyceridemia

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4
Q

What are autonomic clinical signs of serotonin syndrome?

A

CV: Tachycardia, hypertension (BP fluctuating widely)

GI: abdominal pain, hypersalivation, nausea, vomiting

Others: Hyperthermia (can be life-threatening), tachypnea, mydriasis

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5
Q

What is the antidote for serotonin syndrome?

A

Cyproheptadine - non-selective serotonin (5-HT2) receptor antagonist

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6
Q

What is the toxic mechanism for inocybe mushrooms?

A

Muscarine contained within the mushroom - Competes with Ach for receptor

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7
Q

What is the treatment for inocybe mushroom toxicity?

A

Atropine

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8
Q

What is the MOA for chocolate toxicity?

A

Theobromine - Competitive inhibitor of cellular adenosine receptors

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9
Q

Which canabinoid receptor is associated with marijuana toxicity?

A

CB-1

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10
Q

What is the main system affected with bromethalin toxicity?

A

CNS - cerebral and spinal cord edema and increased lipid peroxidation

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11
Q

What is the toxic mechanism for bromethalin?

A

Uncouple oxidative phosphorylation - decreased cellular ATP and failure of Na+/K+ ATPase - Neurons lose osmotic control, retain sodium

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12
Q

What is the treatment for bromethalin toxicity?

A

Decontamination

Intralipid therapy

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13
Q

What is the prognosis for bromethalin toxicity?

A

Poor/grave if neurologic symptoms are present

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14
Q

Why are cats more sensitive to pyrethrin toxicity?

A

More sensitive to toxicity due to the lack of substantial glucuronide conjugation

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15
Q

What is the mechanism of action of organophosphates?

A

Inhibit acetylcholinesterase - Ach accumulates

Some bind irreversibly - Carbamate is reversible

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16
Q

What are treatments for organophosphate toxicity?

A

Atropine - Competitive antagnosit of Ach receptors

2-PAM (Pralidoxime chloride) - Reactivates inactivated cholinesterase

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17
Q

Are dogs or cats more susceptible to ethylene glycol toxicity?

A

Cats

Reported lethal dose (min) = cats 1.4 mL/kg vs dogs 4.4 mL/kg

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18
Q

What is the mechanism of toxicity of ethylene glycol?

A

Ethylene glycol is converted to glycoaldehyde by alcohol dehydrogenase (ADH)

Glycoaldehyde is further metabolized to glycolate, glyoxalate, and oxalate (toxic metabolites)

Calcium oxalate crystals in tubule

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19
Q

What causes the acidosis in ethylene glycol toxicity?

A

Glycolic acid

20
Q

How is ethylene glycol diagnosed?

A

Wood’s lamp - urine, vomit, muzzle (exposure)

Ethylene glycol test - 1 hour post exposure. Most accurate within 12-24 hours after exposure

Blood test

21
Q

What are medical therapies for ethylene glycol toxicity?

A

Ethanol - competes with alcohol dehydrogenase

4‐Methylpyrazole, 5% (fomepizole)

22
Q

What are toxins produced by cyanobacteria (general systems)?

A

Hepatotoxins

Neurotoxins

23
Q

What species is affected with xylotol?

A

Dogs

Cats not reported

24
Q

How does xylotol cause hypoglycemia?

A

Causes an increase in blood insulin concentrations

25
Q

What are xylotol’s effects on the liver?

A

Acute hepatic necrosis (unknown mechanism)

26
Q

What is the toxic metabolite of acetaminophen?

A

NAPQI - Inactivated by gluthatione conjugation

27
Q

How do cats metabolize acetaminophen?

A

Alternative pathway – deacetylation via hepatic carboxyesterases to produce paraaminophenol
(toxic metabolite, RBC oxidative damage)

Methemoglobinemia

28
Q

What is the treatment for acetaminophen toxicity in cats?

A

NAC (cysteine and sulfate source, direct antioxidant effect)

Ascorbic acid (30 mg/kg IV Q6 hr.) until resolution of methemoglobinemia

29
Q

Are ibuprofen and naproxen COX selective or non selective?

A

Non-selective (use both COX 1 and 2)

30
Q

What is the mechanism of toxicity of lead?

A

Lead competes with calcium ions - substitutes for Ca++ in bone, alters nerve and muscle
transmission, displaces Ca++ from calcium binding proteins.

Inhibits thiol (‐SH) containing enzymes, interfering with heme synthesis

31
Q

What are clinical signs of lead toxicity?

A

Anemia with nucleated RBC

Gastrointestinal signs

CNS - cerebral edema

32
Q

How does calcium EDTA work in the treatment of lead toxicity?

A

Chelation through displacement Ca++ forming a divalent or trivalent metal complex that is
non‐ionic and soluble

33
Q

What are side effects of calcium EDTA?

A

Nephrotoxic, GI irritant

34
Q

Is penicillamine indicated for GI lead toxicosis?

A

NO - penicillamine enhances absorption of lead

35
Q

Which pennies can cause zinc toxicity?

A

Pennies minted after 1982

36
Q

What are the clinical signs of zinc toxicity?

A

Hemolytic anemia

Acute kidney injury

37
Q

What is the toxic principle of pyrethrin?

A

Binds to sodium channels and prolong conductance

38
Q

What is the mechanism of toxicity of strychnine?

A

Inhibits glycine - No inhibition

39
Q

What are the clinical signs of strychnine toxicity?

A

Stiff, tense, tonic extensor rigidity, death-opisthotonos because of paralysis of respiratory muscles

40
Q

What is the toxic principle of cyanide?

A

Inhibits cytochrome C oxidase - Prevents mitochondrial respiration.

41
Q

What is the antidote for cyanide toxicity?

A

hydroxycobalamin

Nitrates

Sodium thiosulfate

42
Q

5-FU toxicity in cats vs dogs

A

Cats are extremely sensitive to 5-FU - only a few licks can cause life-threatening toxicity (Fatal CNS signs)

43
Q

What is the toxic principle behind 5-FU?

A

5-FU’s metabolite causes failure of the urea cycle - leads to severe ammonia build-up

44
Q

What is a specific therapy for Strychnine?

A

Acidify the urine - Hastens urinary excretion

45
Q

Ethylene glycol (increases/decreases) osmolarity?

A

Increases

46
Q

What is a side effect of potassium bromide in cats?

A

Pneumonitis

47
Q

How do fluoroquinolones affect theophylline metabolism?

A

Fluoroquinolones inhibit metabolism of theophylline - NEED to decrease the dose of theophylline

ACVIM General Boards - 2022 (16 decks)

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