Toxicology Flashcards
1
Q
Describe the grocery store system
A
16oz = 1lb
1lb = 1pt
2pt = 1qt
4qt = 1gal
2
Q
How much does 1 mL weigh?
A
1 gram
3
Q
1% =
A
1g OR 1mL/100g or mL
4
Q
1:1000 =
A
1g/1000mL
5
Q
1ppm =
A
1:1,000,000 or 1mg/kg or 0.0001%
6
Q
Ppm in feed x %BW eaten per day =
A
Mg/kg dose
7
Q
What is the general organ target system of insecticides?
A
Nervous system
8
Q
Organophosphate, carbamate, and neonicotinoid insecticides increase action at ________ receptors
A
Acetylcholine
9
Q
If caught early, how can you treat carbamate/OP toxicity?
A
0.01 - 0.04 mg/kg IV atropine
10
Q
After giving atropine, you can confirm whether or not patient actually had OP/carbamate toxicity. How?
A
If eyes dilated, HR increases, and/or salivation stops in 5-10 minutes, patient does NOT have OP or carbamate toxicity
11
Q
You gave a first dose of atropine to a suspected OP toxicity. There was no change in the patient. What do you do next?
A
Give antidotal dose of atropine (0.02mg/kg)
12
Q
How does atropine treat OP/carbamate toxicity?
A
OP and carbamate act as cholinesterase inhibitors, so if we give atropine, a parasympatholytic (muscarinic receptor antagonist), we can decrease Ach action at the receptor
13
Q
What other drug can be use in in small animals for the treatment of OP/carbamate toxicity?
A
2-PAM
14
Q
If there is a known high dose exposure to OP/carbamate, what dose of atropine should be given and how?
A
0.1-0.5mg/kg
give first 1/4IV and the rest IM or SC
15
Q
T/F: An antidote exists for bromethalin toxicity, it just needs to be purchased from Europe.
A
False - the only treatment for Bromethalin toxicity is to decontaminate
16
Q
What is the toxic dose of bromethalin?
A
0.25 - 1.5 mg/kg
17
Q
Vitamin K antagonists target what body system?
A
Hematopoietic
18
Q
Cholecalciferol is a ___________
A
Vitamin D
19
Q
What is the target organ of cholecalciferol?
A
Kidneys
20
Q
T/F: Strychnine targets the nervous system, causing profound dullness and depression
A
False - causes tetanic seizures
21
Q
What body systems does lead affect?
A
GI
CNS
Kidney
22
Q
What is the treatment for lead toxicosis?
A
Calcium EDTA 75mg/kg
23
Q
What crop does aflatoxin have an affinity for?
A
Corn
24
Q
What body system does aflatoxin affect?
A
GI (liver)
25
Normal serum sodium is __________
110-160mEq/L
26
What are normal blood lead values?
<0.2ppm
27
Normal serum iron levels
1-3ppm
28
Normal serum zinc levels
0.7-2ppm
29
Whole blood selenium levels should be
80-300ppb
30
When feeding cool, wet season grains, what toxin should you be aware of?
Vomitoxin
31
Zealenone is besties with what other toxin
Vomitoxin
32
Slaframine is produced in _________
Clover
33
Where can penitrem A be found?
Rotting dairy, garbage
34
Like penitrem A, _________ can also be found in garbage and is neurotoxic
Roquefortine
35
Fumonisin is a neurotoxin that can be found in _______
Moldy corn products
36
Name some toxic bulbs
Daffodils
Tulips
Iris
Hyacinths
Crocus
Amaryllis
Gladiolas
37
CS associated with bulb ingestion
Onset time <1h
Salivation, vomiting, diarrhea
Usually not lethal
38
How can you treat bulb ingestions?
Decontamination
Activated charcoal
Cerenia
39
In addition to being a GI irritant, Narcissus sp. are also associated with __________
Dermatitis
40
Toxic dose of onions and garlic
0.5% BW or 5g/kg
41
What is the target body system of onions and garlic?
Hematopoietic - oxidative injury to RBCs
42
How can you treat onion toxicity?
Decontamination
Symptomatically
43
Name some common toxic holiday plants
Mistletoe
Holly
Poinsettia
Christmas trees
44
Christmas plants typically act on the _____ system
GI
45
Christmas trees are extra special in that in addition to gastroenteritis the phenols and pine oils present can cause…
Hepatic necrosis
Nephrosis
46
Who is more susceptible to onion/garlic toxicity?
Cats
47
Which is/are recognized as more toxic to cats?
A) Tulip bulbs
B) Onions
C) Mistletoe
D) Pine
B and D
48
What is the toxic component of cardiotoxic plants?
Digoxin
Oleander
Others exist
49
Name some cardiotoxic plants
Foxglove
Lily of the Valley
Oleander
50
T/F: only dried cardiotoxic plants are toxic
False - can be fresh or dry
51
Who is susceptible to cardiotoxic plants?
All animals
52
Mechanism of action of cardiotoxic plants
Inhibition of Na/K/ATPase pump leads to increased intracellular Na and Ca
Slows HR and causes dysrhythmias
53
What clinicopathologic changes might you see with cardiotoxic plant ingestion?
Hyperkalemia d/t the impaired Na/K/ATPase pump
54
Treatment for cardiotoxic plant intoxication
Aggressive decontamination
Atropine for bradycardia
Lidocaine for arrhythmias
SA - Digibind (binds digitalis and other glycosides)
55
Dogbane and common milkweed target the heart and most exposures are from _______
Contaminated hay
56
Diagnosing milkweed/dogbane toxicosis
GI, cardiac abnormalities
presence of plant in GIT
Hyperkalemia
ECG abnormalities
57
The toxic principle in tobacco is _________
Nicotine
58
Who is more frequently affected by tobacco?
Puppies
59
T/F: cardiotoxic plants can be found in home gardens and in fields
True
60
T/F: Many cardiotoxic plants are similar to the cardiac drug digoxin
True
61
T/F: HR increases when animals ingest typical cardiotoxic plants
False - bradycardia common finding
62
What is the toxic principle in Yew?
Taxine
63
T/F: All parts of yew are toxic
F - all parts except for the flesh red aril
64
What does Yew affect?
The heart - depression of AV conduction, bradycardia, hypotension
Can lead to diastolic cardiac arrest
65
Prognosis for yew intoxication is
Guarded
66
Rhododendron, Azalea, and Mt. Laurel contain __________
Grayanotoxins
67
Who is most likely to be affected by grayanotoxins?
Sheep and goats
68
Mechanism of action of rhododendron toxicity
Stimulates the vagal nerve and vomiting center in the brain - bradycardia and persistent, projectile vomiting
69
Toxic principle in buckeyes
Aesculin
70
Clinical signs of buckeye toxicity
Ataxia, muscle tremors, lateral recumbency, paralysis, incoordination w/ hypermetria, hyperesthesia, nystagmus/strabismus, prostration, clonic-tonic seizures, coma
71
Treatment for buckeye toxicity
Sedatives (Acepromazine)
72
Who is most commonly affected by black walnut?
Horses
73
What does black walnut cause in horses?
Laminitis - enhanced constriction of the blood vessels in the hoof wall thought to be the cause of
74
T/F: the most ideal bedding for horse stalls is black walnut
False
75
Treatment for black walnut toxicosis in horses
Remove shavings and wash legs
Activated charcoal, cathartic, mineral oil
Acepromazine, DMSO
Prazosin (Alpha1 adrenergic blocker)
Pain meds
Mechanical support
76
Toxic principle in acorns
Gallotannin
77
What systems do acorns affect?
Renal
GI
Cardiovascular
78
Differential for acorn toxicosis
Red root pigweed
79
Toxin associated with Acer spp. (maples)
Aceritannin
80
CS of maple toxicity
Weak, tachypnea, pyrexia, methemoglobinemia, Heinz body anemia, cyanosis, tachycardia, hemoglobinuria, icterus, colic
81
Plants that have cyanide glycosides (Sorghum sp. and Prunus sp.) are most hazardous during the ____________
Wilting stage
82
Mechanism of action of cyanide
O2 stuck to Hgb
Cherry red colored blood
83
CS of cyanide toxicosis
<1h onset
Bright red mucus membranes
Bitter almond or bleach smell
Staggering
Polypnea, severe dyspnea
Coma
Sudden death
84
Treatment for cyanide toxicosis
Thiosulfate, nitrite, vitamin B12a
85
T/F: Extreme case morbidities and mortalities (<30% and >70%) are more helpful than moderate morbidities/mortalities (30-70%) for differential diagnosis lists
True
86
Four major points to help guide your differential list for toxicosis
1. Systemic classification (GI, CNS, Renal)
2. Onset time classification
3. Morbidity
4. Mortality
87
Risk =
Hazard + Exposure
88
When are emetics/gastric lavage contraindicated?
Volatile compounds, solvents, corrosives, convulsing patients
89
When shouldn’t you use activated charcoal?
Metals, alcohols
90
T/F: Three important items on a differential diagnosis are systems involved, onset time, and patients age.
False - Systems involved, onset time, morbidity and mortality
91
T/F: Toxicological sampling and analysis is necessary for diagnosis of all cases of poisoning
F
92
In most cases, what is the most reasonable approach to a toxicant exposed patient?
Decontamination
93
T/F: A client calls to tell your their dog got into the cabinets under the kitchen sink where they kept a bunch of cleaning supplies. The best thing you can do for this patient would be to have them wait it out at home and see if anything happens.
False - Household chemicals range from extremely toxic to practically nontoxic, so it’s best to bring the patient to the clinic.
Probably would also be helpful to take pictures of what was under the sink or bring the products idk
94
The _____ makes the _______
The dose makes the poison
95
You look at a bottle of chemicals from under the kitchen sink. The label says “CAUTION.”
What category would this be? What might you expect the oral LD50 to be?
Category 3
0.5-5g/kg
96
T/F: Category 1 and 2 products typically don’t have a signal word/label
True
97
The oral LD50 for category 1 products is _________, while the oral LD50 for category 2 products is __________.
Category 1: >15g/kg
Category 2: 5-15g/kg
98
You look at a bottle of chemicals from under the kitchen sink. The label says “Warning.”
What category would this be? What might you expect the oral LD50 to be?
Category 4
50-500mg/kg
99
You look at a bottle of chemicals from under the kitchen sink. The label says “Danger: Poison.”
What category would this be? What might you expect the oral LD50 to be?
Could be either category 5 or 6
Category 5: 5-50mg/kg
Category 6: <5mg/kg
100
T/F: Of all the detergents and surfactants we discussed, cationics are the least toxic
False - Cationics are the MOST toxic type; Nonionics have the lowest toxicity
101
Non-phosphate, low suds laundry products, shampoos, and dishwashing detergents can be categorized as……
Nonionic!
Anionics also can be found in dishwashing soap, many laundry detergents, shampoo
102
Where might you run into cationic products?
Disinfectants (Roccal), algicides, applicator tank mixes, fabric softeners
103
When considering how toxic a cationic product is, what must you take into account?
The dose
104
Amphoteric products are a combination of _________ and __________; however, amphoteric products aren’t as common around the home.
Anionic and cationic
105
What is an example of a cationic ingredient that Dr. Ehrich mentioned a whole lot?
Quaternary ammonium derivatives
“Quat”
106
What clinical signs can you expect to see with most detergents/surfactants?
GI irritation - vomiting and diarrhea
107
T/F: Anionic products are associated with hemolysis
True
108
T/F: Cationic products are limited to the GI system
False - GI and nervous system (muscle tremors, paresis, seizures, bladder atony)
109
What’s scary about alkali substances?
More lipophilic than acids and penetrate deeper into tissues causing liquefactive necrosis
110
T/F: If you suspect a patient has gotten into a alkali substance like oven cleaner, you should immediately induce emesis
False - Emesis, activated charcoal, lavage, and catharsis are CONTRAINDICATED
Should dilute & protect to treat
111
What lesions might you expect with cationic surfactant toxicosis?
GI, dermal, and corneal ulcers possible
112
Acids like toilet bowl cleaner have _______ labels
Danger
113
Oxidizer like bleach have ________ labels
Warning
114
Hydrocarbon solvents like furniture polishes, paint thinners, and spot removers have a _________ label
Caution
115
What are the three major types of disinfectants?
Cationic surfactants (Ex. Lysol Basin, Tub & Tile, Roccal)
Phenolic compounds (Ex. Lysol)
Pine-oil based (Ex. Pine-Sol)
116
What are the signs of disinfectant toxicity?
GI irritation, pain
117
What species doesn’t handle phenols well?
Cats
118
Treatment for disinfectant toxicity
Symptomatic
Irrigate exposed surface (milk/water)
119
_________ and _________ are bad for cats
Pine oil and phenol
120
T/F: Acids cause liquefactive penetrating necrosis
False - Acids cause coagulative surface necrosis
121
What products can be inhaled?
Solvents and bleach
122
T/F: You should never use emetics with caustics, corrosives, or solvents
True - stomach wall weakened and may burst, potential aspiration problems
123
What alcohols are FDA approved for antiseptic use?
Ethanol, isopropyl
124
What alcohol is a big no no and can cause vomiting, CNS depression, hypothermia, and acidosis?
Methanol
125
T/F: Despite containing K, plant and lawn fertilizers typically don’t have enough to cause cardiac problems
True
126
Who is most often affected by fertilizer toxicity?
Dogs
127
What’s special about rose fertilizers?
Iron toxicosis with hepatic damage
128
What system do fertilizers target?
GI
129
How do you treat fertilizer toxicity?
Symptomatic
Dilution
Demulcents
130
What is the best way to deal with corrosive (caustic, acid) ingestion?
Irrigation with water or milk
131
Soaps, detergents, and surfactants for household use are usually not considered particularly dangerous, why?
Active ingredient is in low concentration
Labeling and/or packaging
132
What is an important method of treatment in cases of exposure?
Dilution
133
T/F: Pesticides encapsulate a large variety of pest-killers (herbicides, fungicides, insecticides, etc)
True
134
>____% of all pesticides used are herbicides
50
135
Name the most noteworthy herbicides
Glyphosphate
2,4-D, Dicamba
Paraquat, Diquat
Atrazine
136
T/F: Glyphosphate has low mammalian toxicity d/t poor dermal and oral absorption
True
137
GI clinical signs associated with glyphosphate toxicity typically resolve within ________
24 hr
138
Treatment for glyphosphate toxicity
Symptomatic
Dilution
139
Glufosinate irriversibly inhibits _____ synthesis, leading to ______
Glutamine
Hyperammonemia
140
Glufosinate acts on what systems?
CNS, Respiratory
141
How do we treat Glufosinate toxicity?
Diazepam for seizures
IV fluids to increase excretion
Respiratory support as needed
142
What is the mechanism of action of 2,4-D and Dicamba?
Analogues of auxin (plant growth hormone)
Cause abnormal plant growth
143
Why do dogs have a greater sensitivity to phenoxyacetic acid herbicides compared to cattle? (Dicamba, 2-4D)
Decreased ability to excrete in urine
144
What systems do phenoxyacetic acid herbicides affect?
GI - V, D, anorexia
Neuromuscular - Myotonia, paresis
Neural
Renal
145
Treatment for 2,4-D toxicity
Decontamination!
Excreted thru urine, provide fluids with NaHCO3- to prevent ion trapping in the urine
Activated charcoal
Good prognosis
146
Name the two bipyridil herbicides we discussed
Paraquat
Diquat
147
Where does Paraquat accumulate? What is the result of this accumulation?
Lungs - severe fibrosis
Kidney - direct damage to glomerulus and tubules
148
T/F: Unlike Paraquat, Diquat doesn’t result in lung toxicity
True
149
What unique lesion may be found in dogs with chronic diquat toxicity?
Cataracts!
150
What systems does diquat effects?
GI - Anorexia, ulceration of mouth and esophagus, vomiting, diarrhea, colic
Renal - Renal impairment
Eye - cataracts in dogs
151
What is one way we can diagnose Paraquat/diquat toxicity?
Lab analysis of stomach contents, plasma, urine, lung, kidney using sodium dithionite test (blue or green color) in plasma and urine <24h
152
Treatment for animals that present <6 hours after ingestion of Paraquat/diquat
Decontamination (emesis, activated charcoal, food)
Forced diuresis to maintain renal perfusion and increase elimination
Scavenger defense mechanism (N-acetylcysteine)
Anti-inflammatories
Salicylates
153
T/F: prognosis following Paraquat/Diquat ingestion is extremely good.
False - extremely guarded
154
What is the mechanism of action of triazine herbicides?
Unknown; can cause direct arteriolar vasodilation
155
CS of triazine herbicide toxicity
Anorexia, salivation
Ataxia
Prostration (lying stretched out)
Hyperesthesia
Muscle tremors (hind end)
156
T/F: 2,4-D is linked with lymphoma in dogs
False - probably not a cause of lymphoma in dogs
157
T/F: glyphosate and 2,4-D are popular herbicides with low toxicities
True
158
What are common factors that contribute to glyphosate and 2,4-D toxicities?
Inappropriate dilution of concentrations
Species sensitivities
Additives and/or contaminants
Use of structural relatives
159
T/F: Atrazine is more available for use than Paraquat
True
160
Who has a lower acute LD50 - Paraquat or atrazine?
Paraquat
161
T/F: the target organ of atrazine is the lung, causing severe fibrosis
False - that would be Paraquat
