WITH SOLUTIONS GRADED A+
◉ Bleach toxicity. Answer: - dilute stomach w/ MILK
- DO NOT induce emesis
- GI protectants
◉ Black widow spiders. Answer: - latrodectus mactans, L. Hesperus
- ACh is the toxin that binds to Ca channels = ascending motor paralysis
and destruction of peripheral nerves
- signs = recumbent, vocalizing, pain, rigidity w/ muscle spasms
- death from resp/cardio failure
◉ Warfarin toxicity. Answer: - ANTICOAGULANT = clotting factors
II, VII, IX, X
,- signs = 12-16 hrs, slowly developing; PT prolonged soonest after
ingestion
- give vit. K1 for 3-4 wks (if chronic give plasma too) = do NOT give
vit. K1 to horses (nephrotoxic; only plasma)
- most common site of hemorrhage = thoracic cavity
- spontaneous bleeding below 45 (or 25K) platelets
- platelets < 10,000 = IMTP, DIC
- diagnosis = PIVKA
◉ Brodifacoum toxicity. Answer: - D-con rodenticide
- inhibits epoxide reductase (loss of Vit. K)
- give vit. K and monitor PT
◉ Bromethalin toxicity. Answer: - seizures
,- low dose = paralysis
- high dose = convulsions
◉ Cholecalciferol toxicity. Answer: - converted to active Vit. D =
increased resorption of calcium and gut absorption
- can lead to fatal hypercalcemia + hyperphosphatemia = tissue
mineralization
- tx = phosphate binders (aluminum hydroxide, bisphosphonates, fluids
(NaCl)), prednisone/prednisolone (decrease osteoclastic activity)
- DO NOT give sulfa drugs = potentiate toxicity
- human Vit. D supplements are high in Ca and P!
◉ Strychnine toxicity. Answer: tetanic seizures
◉ Zinc oxide. Answer: - gas
- decontaminate = don't breathe in!
, ◉ Ethylene glycol. Answer: - always isosthenuric in stage 1/2 = ethanol
(osmotic diuretic)
- crystals don't tell you about stage = present all the time
- stage 1 = ethanol, acidosis (CNS depression, V/D, ataxia, severe
metabolic acidosis)
- stage 2 = less depression, still acidotic, tachypnea
- stage 3 = azotemia, casts, protein in urine --> treat renal dz
- dx = high anion gap, azotemia, calcium oxalate crystalluria, metabolic
acidosis, hyperglycemia, PU/PD or oliguria, hypocalcemia
- tx = aimed at alcohol dehydrogenase - give 4-methylpyrazole (4-MP,
fomepazole) --> effective 6-8 hrs post ingestion (best within 3); DOES
NOT WORK ON CATS; ethanol competes
◉ Organophosphate toxicity. Answer: - inhibit acetylcholinesterase =
muscarinic signs
- DUMBSLED