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Toxicology Booklet part 1 (kuzco's poison) Flashcards | StudBud
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Toxicology Booklet part 1 (kuzco's poison)
Toxicology Booklet part 1 (kuzco's poison)
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1
CS of Amphetamine ingestion
circling, head bobbing, apprehension
mydriasis
hypertension often with reflex bradycardia
seizures
hyperactivity, tremors, and agitation
tachycardia and tachyarrhythmia
2
What is the general prognosis for Amphetamine ingestion?
poor
grave
good
guarded
3
What is the second phase of CS for amantia phalloides?
diarrhea
anorexia
lethargy
abdominal pain
seizures
severe vomiting and nausea
4
What is the primary cause of death for bromethalin?
dehydration
seizures
suicide
respiratory paralysis
5
Are lab findings specific for amphetamine? Which ones would be abnormal?
increased alanine aminotransferase (ALT)
no
yes
hypoglycemia
hyperglycemia
increased alkaline phosphatase (ALP)
6
What is the treatment for cantharidin?
supportive treatment of symptoms
diuretics
fluids
enhancing fecal and urinary elemination
decontamination (NG admin. of mineral oil) and AC
gastric levage
7
If ventilation isn't required & the animal doesn't have concurrent aspiration penumonia, what's avermectin recovery time
weeks
no more than 5 days
days to weeks
weeks to months
8
What is the specific treatment for avermectins?
digoxin
benzodiazepines if needed
phenobarbital/levetiracetam for seizures
possible ventilation
supportive care
IV lipids (lipophilic compound)
9
What are the clinical signs for Allium SPP?
vomiting
anemia
abdominal pain
depression
loss of appetite
diarrhea
10
Lab findings for Anticoagulant Rodenticide
anemia with watching hypoalbuminemia (PCV low, matching TS)
Reticulocytosis/polychromasia
thrombocytopenia
prolonged PT, PTT, ACT
11
Definitive diagnosis of Amantia Phalloides ingestion requires examination of fresh liver or kidney tissue
True
False
12
What are the clinical signs for bromethalin?
severe musle tremors and seizures
hyperexcitability
respiratory paralysis
hyperesthesia
hyperglycemia
hyperthermia
13
What are the remaining CS of amlodipine ingestion?
constipation
noncardiogenic pulmonary edema
Digestive upset
hypothermia (most likely caused by hypotenison)
14
What do you expect after a mild bromethalin poisoning has been treated?
CS resolve within several weeks of ingestion
CS resolve within several days of ingestion
no need to monitor neurologcial signs
subtle signs of neurologic dysfunction may persist
15
ran out of room... what are the other CS of Amphetamine?
GI upset
depression
coma
mellow attitude
lethargy
hypotension
16
Important aspects of Allium SPP
severe neurological disturbances
GI tract disturbances
heinz body formation
hemolytic anemia
17
What are the confirmatory techniques to dx Amantia Phalloides ingestion?
fecal examination
direct identification of the mushroom
detection of alfa amanitin via ELISA
PCR analysis of gastric content containing mushrooms
18
treatment for Allium SPP
induce vomiting then AC
blood transfusion if necessary
do not induce vomiting due to the common neurological CS
admin antioxidant vitamins C&E or n-acetyl-cysteine (not proven to work)
give the antidote
supportive care
19
What test is used for anticoagulant rodenticide that shows the accumulation of inactivated vit. K dependent cofactors?
urine drug screen
PIVKA test
ELISA
gas chromatopgrahy
20
The best form of gastric decontamination is inducing emesis no matter if there are neurological CS
False
True
21
Based on the supportive care treatments you just selected for Amantia Phalloides, what should you be concerned about?
hyperglycemia
hepatic failure leading to coagulopathy
GI disturbances - vomiting/diarrhea
renal failure
hypoglycemia
dehydration
22
What are the CS for the 4th phase of Amantia Phalloides?
severe hepatic dysfunction with icterus
encephalopathy
fulminant hepatic failure
Coagulopathies
severe renal dysfunction
Coma
23
What are the CNS CS for Avermectins?
ataxia
central blindness
coma
tremors/seizures
paddling and head pressing
weakness
24
What should be included with sportive care for Amantia Phalloides ingestions?
IV Crstalloids and possibly FFP
broad-spectrum parenteral ABX to reduce risk of sepsis
Vit. K1
GI and liver protectants (SAM-e, Silymarin, n-acetylcystein)
parenteral dextrose
macropitant as antiemetic
25
What testing is available for Cantharidin?
endoscopy
blister beetles seen in feed
LC/MS analyses of GI contents or urine for cantharindin
rapid elimination of cantharidin with urine (EARLY SAMPLE IS ESSENTIAL)
26
Treament for Anticoagulant Rodenticide
if no bleeding, vit. K1 for 3-4 weeks (SQ then PO)
GI decontamination (emesis and then AC) intially
if bleeding than FFP
may need pRBC, IV fluids
can give vit. K1 IV if severe
oxygen PRN
27
While there is no specific lab test for bufo toad, what lab findings can you see?
increased BUN
decreased sodium and phosphorus
increased PCV
moderate increases to hemoglobin concentrations
increased glucose, AP, and potassium
decrease in total protein and WBCs
28
What should you monitor with box elder tree?
changes in behavior
reluctance to walk
specific CS of toxicity
CK levels for the rest of the herd
29
If a horse survives for 48 hours, recovery is more likey
True
False
30
While the prognosis depends on quanitity of toxin & speed of therapy, what is the prognosis of cantharidin in most cases
poor
grave
good
guarded
31
How do you diagnosis Allium SPP?
Clinical signs
microscopic confirmation of a heinz body hemolytic anemia
History
fecal sample testing
blood test
nasal swab
32
About how many hours after exposure to Amantia Phalloides would you see the second phase of CS?
2-4 hours
6-24 hours
3-6 hours
24-48 hours
33
Where can you test for a chemical detection of bromethalin (analytical methods)?
liver
fat
brain
kidney
34
There is a specific blood test to determine the presence of Allium SPP
False
True
35
important facts of bromethalin
uncouples oxidatvie phosphorylation
myelin edema
only found in horses
neurotoxin via interference with cell membrane pumps
36
What is the treatment for box elder tree?
decontamination with IV fluid administration
selenium/vit. E supplementation
insulin
correct electrolyte balance
supportive care and analgesia
oxygen therapy
37
What supportive treatments should be considered with Cantharidin?
Calcium supplements
analgesics
Magnesium supplements
Potassium supplements
electrolytes
blood transfusion
38
When an animal develops anemia because of Allium SPP, what would you see?
weakness
pale mucous membranes
jaundice
dark urine = hemoglobinuria
rapid RR and HR
increased appetite
39
What is the treatment for Amphetamine ingestion?
treat seizures (Barbiturates, gas anesthesia, levetiracetam, or propofol)
phenothiazines to control stim. effects on CNS
acidifcation of urine
propanolol or esmolol for cardiac arrhythmias
gastric decontamination (emesis/gastric lavage) with AC
euthanasia
40
Important facts about Amantia Phalloides
renal toxicosis
gastro-intestinal disturbances
hepatotoxicity
4 distinct phases of CS
41
What are the GI and Respiratory CS for Avermectins?
hyperventilation
gastric ulcers
hypoventilation
respiratory failure
vomiting
diarrhea
42
What tests can be run for diagnosis of Arsenic ingestion?
urine values that show 2-100 PPM arsenic
liver tissue concentrations of >3 PPM arsenic
kidney tissue concentrations of >3 PPM arsenic
stomach contents within 24-48 hours
43
What should you monitor after amlodipine ingestion?
CVS
blood chemistries for AT LEAST 12-24 hours
urinary system
electrolytes
Resp. system
nervous system
44
If a dog comes in with recent know arsenic poisoning and but is not showing clincal signs, what is the prognosis?
poor
guarded
good
grave
45
What kind of specimens can you used to detect alfa amanitin via ELISA when testing for Amantia Phalloides?
urine
renal tissue
saliva
serum
feces
hepatic tissue
46
What is the way to have a definitive diagnosis for Box elder tree ingestion?
measurement of toxic metabolities in blood
measurement of toxic metabolities in urine
there isn't one
type 1 muscle biopsy
47
What are the CS for box elder tree
cardiomyopathy with arrhythmias
reddish/brown colored urine
hypothermia
possible respiratory failure
trouble breathing
weakness, stiffness, pain, difficulty walking
48
treaments for Amlodipine ingestion
euthanesia
emesis/gastric lavage with repeated AC (INITIAL)
atropine
vasopressors
calcium
insulin-glucose
49
After initial/time sensitive treatment is complete with anticoagulant rodenticide, what should you do next?
repeat coagulation panel 48 hours after last nose of vit. k1
monitor PT and if becomes elevated than start vit. K1 treatment
PT should remain normal for 72 hours after all treatments
send the animal home
50
Ingestion of a large amount of Amantia Phalloides can lead to death
True
False
51
Important facts about Amphetamine
gastro-intestinal upset
depression of the CNS, CV, and respiratory system
stimulation of the CNS, CV, and respiratory system
hepatotoxicity
52
What CS can be seen in the most severe cases of bufo toad poisoning?
blindness
cardiac dysrhythmias
acidosis
status epilepticus
53
Major aspects to monitor for a cantharidin ingestion
pain level
calcium and magnesium levels
vomiting/diarrhea
CK abnormalities
54
What is the initial treatment for avermectins?
gastric lavage & AC under anesthesia depending on neurological signs
repeated doses of AC due to enterohepatic recirculation
fluid therapy/blood transfusion
Decontamination (emesis)
intubation
Activated charcoal
55
important facts about box elder tree
most common in autumn
most common in summer
seasonal myopathies in horses when seeds are consumed
the seeds from teh box elder tree contain hypoglycin A
most common in spring
most common in winter
56
You should avoid benzodiazepines when treating avermectin ingestion
True
False
57
A dog with avermectin ingestion has been intubated due to respiratory failure. What is the prognosis?
poor
grave
guarded
good
58
Bufo toad posioning important facts
hypothermia
CVS effects similar to digoxin
hyperthermia
hallucinogens
59
What is the inital treatment for bufo toad?
emesis/AC are not recommended
warm blankets
decontamination through emesis and AC
rinse the mouth with water, repeatedly
immediate tx of hyperthermia (cool bath/fan)
if toad was swallowed, emesis/endoscopic removal
60
What are the lab findings for box elder tree?
elevated AST
erythrocytosis, neutrophilia, azotemia
elevated levels of cardiac troponin 1
elevated creatinine kinase
elevated dehydrogenase and lactate
hyperkalemia
61
important facts about Arsenic
causes disruption of cellular metabolism
affects mainly tissues with high oxidative energy requirements
binds to RBCs
interacts with sulfhydrl enzymes
62
What is the general prognosis for box elder tree?
good
poor
guarded
grave
63
What Lab findings are espcially seen during the
4th phase
of Amantia Phalloides?
metabolic alkalosis
metabolic acidosis
elevation of serum hepatic enzyme activites
hypoglycemia
azotemia
elevation of bilirubin
64
important information about anticoagulant rodenticide
no fators 2,7,9,10 are made
affects the integumentary system
clinical bleeding for 24-72 hours post ingestion
GI upset
vitamin K antagonist
cardiotoxicity
65
What are ways to prevent cantharidin/blister beetles?
scout fields for beetles
feed smaller bales of hay that have been hand inspected
cut hay early, before bloom
have LOTS of barn cats to scare of the beetles
66
What are the lab findings for Cantharidin?
elevated PCV
Acantholysis
CK elevation
marked hypocalcemia and hypomagnesemia
USG <1.010 (even if dehydrated)
hypoproteinemia after the first 24 hours
67
What is the initial treatment of Arsenic ingestion?
decontaimination via emesis
if no CS - just monitor
blood transfusion if needed
GI protectants (kaolin-pectin)
aggresive fluid therapy
AC with a cathartic though the efficacy is questionable
68
While treating cantharidin, in the lab findings a prolonged increase in the CK elevation is noted. What's the prognosis?
guarded
poor
grave
good
69
A dog comes in with a known arsenic cutaneous contact. what CS could you see?
cracking
bleeding
edema
blistering
70
MDR-1 is the same as ABCB-1 mutation in dogs and causes problems with avermectins
False
True
71
A dog comes in with a known arsenic oral ingestion. what CS could you see?
staggering gait/weakness/collapse
prostration
rapid/weak pulse
death
v/d and abdominal pain; salivation
subnormal temps
72
After treating for amlodine with everthing in the previous question, you notice it remains refractory.. now what?
glucagon
temporary pacemaker
IV lipid emulsion
imamrinone
73
What are the CVS CS of amlodipine ingestion?
sinus tachycardia
all degrees of heart block, QT interval, prolongation or junctional rhythms
atrial fibulation
bradyarrhythmias
sinus bradycardia
ventricular fibulation
74
While the lab findings are not specific for Arsenic, the renal damange can show what value changes?
increased BUN
proteinuria
urinary casts
increased PCV
decreased creatinine
increased urine SG
75
After dx an animal with bromethalin ingestion, it becomes paralized and then slips into a coma. prognosis?
grave
poor
guarded
euthanize
76
important parts of care for amphetamine ingestion
monitor CNS stimulation signs/hyperactivity
no monitoring needed
ECG in all pets with noted tachycardia
ECG in all pets with noted reflex bradycardia
monitor HR
monitor BP
77
Avermectins in MDR-1 dog important facts
CNS clinical signs
inhibits depolarization
bind GABA channels
p-glycoprotein deletion avermectins in CNS and GI tract
78
Treatment for Amantia Phalloides exposure
aggressive emergency measures
supportive care
gastric decontamination (emesis or gastic lavage)
given the antidote
79
If the animal is having decreased O2 sat in serial samples of aterial blood, what would the prognosis be for box elder?
good
poor
guarded
grave
80
What are the tissues with high oxidative energy requirements?
liver
kidney
lung
interstital epithelium
epidermis
81
What are the CNS CS of amlodipine ingestion?
depression
stimulatory signs - seizures, agitation, temors
82
What medications can be given to help treat Arsenic ingestion?
clindamycin
d-penicillamine - serves as a chelator
dimercaprol (BAL) though questionable benefit in large animals
sodium thiosulfate
83
You can use a human urine multidrug test to test for amphetamine ingestion
False
True
84
Which animal usually dies within 3-18 hours from onset with cantharidin?
horse
goat
dog
cow
85
If a dog comes in with recent know arsenic poisoning and is already showing clincal signs, what is the prognosis?
good
poor
grave
guarded
86
Important facts about blister beetles (cantharidin)
streaks of ventricular myocardial necrosis
gross lesions throughout GI tract(ulcerations and erosions)
gross lesions throughout urinary tract (ulcerations and erosions)
commonly affects the terminal portions of esophagus, stomach, and intestine
87
What are the CS of bufo toad?
altered mentation and abnormal gate
hypersalivation and hyperemic mucus membranes
hyperactivity and hyperthermia
mydriasis
nystagmus
vomiting
88
What are the clinical signs for Cantharidin?
death
severe shock
occult blood
hematuria sometimes
depression/discomfort caused by severe colic
horses might submerge muzzles in the water
89
What are the CS of Anticoagulant Rodenticide
hemoptysis
petechiae
respiratory distress
hematuria
Shock
90
Lab findings of Amlodipine ingestion
hypernatremia
increased lactate production
hyponatremia
hypokalemia
metabolic acidosis
hyperglycemia
91
It is good practice to given vitamin K1 via IV when bleeding is severe
True
False
92
While specific testing is not available for avermectins, what tests can you do?
EEG of the brain
fundic exam looking for retinal edema
genetic testing
serum levels for drug levels
93
If no fatal bleeding happens with anticoagulant rodenticide, what is the prognosis?
okay
poor
great!
guarded
94
You can also search from bromethalin's metabolite desmethyl bromethalin (DMB) to diagnosis
True
False
95
What should you monitor with an Arsenic ingestion?
urinary color
amount of salivation
GI signs (mobility and pain)
kidney values (BUN)
96
What is the specific treatment for bufo toad?
digoxin-specific Fab fragments if severe
diazepam for seizures
euthanize
atropine to reduce salivation and treat any bradyarrhythmia
esmolol, propanolol, lidocaine for tachyarrhythmias
perform regular ECG to assess cardiac rhythm
97
What are the important facts about amlodipine?
Cardiotoxic effects
can cause scondary CNS effects due to hypotension
GI disturbances
98
What is the treatment for Bromethalin?
treat seizures with diazepam or phenobarbital
monitor for cerebral edema
EARLY decontamination (emesis): 1-5 hours after ingestion
use osmotic diuretics if necessary
AC repeatedly because of enterohepatic recirculation
cathartic - no magnesium sulphate
