Term
Grayanotoxins:
a. Are found in plants of the Eriaceae family (Kalmia, Rhododendron)
b. Are found in plants of the Nightshade family (Datura--Jimson Weed)
c. Are found in the Macadamia nut
d. Are found in the Nerium family (oleander)
e. None of the above |
|
Definition
A. Are found in the Eriaceae family--Kalmia (laurel, lambkill, calfkill) and Rhododendron
These plands are found in the woods/mountains of SE Appalachia to mid-Atlantic coast |
|
|
Term
| T/F: all parts of the Rhododendron are toxic. |
|
Definition
|
|
Term
___________________ affects sodium channels, binding and blocking inactivation of sodium channels in cell membranes, leading to prolonged depolarization and excitation.
a. Andromedotoxin of the Rhododendron
b. Tropane Alkaloids of the Jimson weed
c. Cardiac glycosides of the Foxglove
d. Taxine Alkaloids of the Yew
e. Ricin |
|
Definition
| a. Andromedotoxin of the Rhododendron |
|
|
Term
| T/F: most toxicoses of Rhododendron occur in the late summer/early fall, and only two or three leaves (approximately 0.2% of BW) is toxic. |
|
Definition
False: toxicoses in winter or early spring, when other forage is unavailable
Toxic at 2-3 leaves though (0.2% of BW) |
|
|
Term
Rhododendron toxicity presents as:
a. Salivation, oral irritation, vomiting, and diarrhea
b. Muscle weakness, incoordination, and paralysis
c. Impaired vision and a lack of a pupillary response
d. Bradycardia, hypotension due to vasodilation, and varying degrees of heart block.
e. All of the above |
|
Definition
e. All of the above
Also see dyspnea, depression, and prostration
Death occurs within 12-24 hours of onset |
|
|
Term
| T/F: atropine is indicated for toxicity with Grayanotoxins. |
|
Definition
True: Grayanotoxins = Eriaceae family = Rhododendron
Also to treat: emesis early, activated charcoal, lavage followed by cathartic, other supportive therapy |
|
|
Term
Jimson:
a. Is part of the Nightshade family (Datura stramonium)
b. Is a tropane alkaloid that has anticholinergic effects at muscarinic receptors in the CNS
c. Is a nicotinic alkaloid that mimics acetylcholine at nicotinic receptors.
d. A and B
e. A and C |
|
Definition
d. A and B
Datura (Jimson), Mandragora, and Atropa belladonna all are tropane alkaloids
Nicotiana is a nicotinic alkaloid, which has the opposite effects of the tropane alkaloids |
|
|
Term
| __________ and _____________ are the species most affected by the Solanaceae family of plants. |
|
Definition
|
|
Term
| T/F: toxicity with the Jimson weed appears as an atropine overdose, with animals exhibiting reduced secretions, blindness, mydriasis, paralytic ileus, bloat, colic, and urine retention. |
|
Definition
True--the Mandrake and the deadly nightshade would also cause these symptoms
Nicotine would cause the opposite effect |
|
|
Term
| T/F: Macadamia nuts were once indigenous to Madagascar and Australian rainforests, but are now grown in California and Hawaii. |
|
Definition
|
|
Term
Toxicosis with macadamia nuts have only been reported in:
a. Cats
b. Dogs
c. Cows
d. Horses
e. Pigs |
|
Definition
|
|
Term
| T/F: even a few macadamia nuts can be potentially lethal for a dog. |
|
Definition
| False: macadamia toxicosis does not kill animals; they recover |
|
|
Term
You are vacationing in a remote part of Hawaii and your dog wanders off and returns after an hour or so. The next morning, approximately 14 hours after your dog wandered away, he appears to be unable to move his hind limbs and demonstrates some small tremors. You are unable to get your dog to a clinic due to mudslides, so you wait it out. Two days later, your dog recovers without receiving any treatment. What could have caused these random clinical signs?
a. The dog was faking it for attention
b. The dog ingested digitalis
c. The dog ingested strychnine
d. The dog ingested macadamia nuts
e. The dog was munching on Jimson weed |
|
Definition
d. The dog ingested macadamia nuts
Non-fatal, reversible paresis and paralysis with hind limbs most often affected
If you were to draw blood, triglycerides would be increased at 4-6 hours, lipase would peak at 24 hours, and amylase would not be affected.
Dogs usually recover within 48 hours regardless of treatment. |
|
|
Term
Cardiac glycosides:
a. Include plants in the Nerium, Digitalis, Convallaria, and Apocynum genuses
b. Inhibit the Na/K ATPase pump, leading to increased intracellular sodium and hyperkalemia
c. Can be highly toxic, depending on the plant species involved
d. All of the above
e. None of the above |
|
Definition
|
|
Term
| The __________ of the stems, leaves, and flowers of the Nerium oleander are toxic when dry. |
|
Definition
|
|
Term
| T/F: digitalis toxins are toxic when dried, but is also water soluble. |
|
Definition
True
Toxins: digitoxin, digoxin, others |
|
|
Term
_______________ is a cardiac glycoside that presents as acute gastroenteritis, vomiting, and bradycardia followed by tachycardia, weakness, and death; several ounces are capable of killing a horse.
a. Digitalis purpurea
b. Convallaria majalis
c. Nerium oleander
d. Apocynum canibinum
e. Datura stramonium |
|
Definition
c. Nerium oleander
Supportive therapy and removal of the offending material is about all you can do to help these animals. |
|
|
Term
___________________ is a cardiac glycoside-containing plant that causes clinical signs 2-4 hours post-ingestion; Clinical signs involve abdominal pain, local irritation of the mouth and stomach, nausea, vomiting, bradycardia followed by tachycardia and arrhythmias, peripheral vasoconstriction leading to cold extremities, mydriasis, dizziness, ataxia, respiratory paralysis, coma, and death; the possibility of epicardial hemorrhage exists.
a. Digitalis purpurea
b. Convallaria majalis
c. Nerium oleander
d. Apocynum canibinum
e. Datura stramonium |
|
Definition
a. Digitalis purpurea
Note: signs can persist for up to 24 hours after the GI system clears |
|
|
Term
_____________________ have taxine alkaloids, which are present in the bark, leaves, and seeds of the plant.
a. Onions
b. Yew
c. Castor beans
d. Rhododendrons
e. Foxglove |
|
Definition
|
|
Term
| All parts of the yew are toxic except the _________, which is the red covering of the seeds. |
|
Definition
|
|
Term
| T/F: the Taxus (yew) spp. are cardiac glycosides. |
|
Definition
|
|
Term
The Yew plant:
a. Causes bradycardia, dyspnea, fatigue, collapse, coma, diarrhea, vomiting, and possible acute death from circulatory failure
b. Contains the toxic aril, which is responsible for the manifestation of clinical signs
c. Can sometimes be diagnosed postmortem by finding leaves in the GI tract
d. A and B
e. A and C |
|
Definition
e. A and C
The aril is the only non-toxic part |
|
|
Term
n-propyl disulfide is present in ________________, leading to increased free-radical formation, direct erythrocyte membrane damage and denatured hemoglobin, causing Heinz body formation and acute hemolysis.
a. Onion
b. Garlic
c. Leek
d. Chive
e. All of the above |
|
Definition
|
|
Term
| T/F: Akitas and Shiba Inus are more resistant to Allium spp. toxicity due to their high concentration of reduced GSH in their red blood cells. |
|
Definition
False: more susceptible because of high concentration of reduces GSH in their RBCs
Dogs are most often affected by the Allium spp. but cats are also susceptible |
|
|
Term
You are a super awesome garlic lover and cooked a fantastic feast last night for dinner. Today, your Akita seems weak, is breathing rapidly, and appears to have "yellow" gums. You rush her to the vet, who explains that there is a high probability she has:
a. Yew toxicity, likely from ingesting a decorative plant
b. Grayanotoxin exposure from the garlic you used in cooking
c. Allium spp. toxicity from your cooking ingredients
d. Nerium oleander toxicity from the garlic in your meal
e. Internal bleeding due to some unforseen trauma in the backyard |
|
Definition
c. Allium spp. toxicity from your cooking ingredients
Allium spp (onion, garlic, leek, chive) = free radical formation = erythrocyte membrane damage = Heinz body formation/eccentrocytes = acute hemolytic crisis = clinical signs |
|
|
Term
| T/F: eccentrocytes appear as red blood cells with a ragged fringe of cytoplasm along one side of the cell and frequently occur secondary to oxidative stress; membrane damage leads to cross-linking of opposing RBC membranes. |
|
Definition
|
|
Term
| T/F: all lillies come from the family Araceae. |
|
Definition
| False! Many lillies are not in the lily family (example is Convallaria majalis--lily of the valley, which is a cardiac glycoside...not sure what family though) |
|
|
Term
| T/F: all parts of the plants in the Araceae family are poisonous. |
|
Definition
| True--the leaves are often less poisonous than other parts of the plant though. |
|
|
Term
The major problem with Araceae toxicity is:
a. Preformed calcium oxalate crystals
b. Heinz body formation
c. The presence of eccentrocytes
d. The presence of phytotoxins
e. None of the above |
|
Definition
a. Preformed calcium oxalate crystals
Several proteolytic enzymes also trigger the release of kinins and histamines.
Local reactions are from the kinins, which may be aggravated by the calcium oxalate crystals to damage cells in mouth. |
|
|
Term
__________________ has contractile cells (idioblasts) that contain oxalate crystals (raphides) in a gel matrix. These idiolasts are broken during mechanical digestion, causing individual oxalate crystals to be propelled into adjacent tissue.
a. Philodendron
b. Elephant's ear
c. Calla lily
d. Dumbcane
e. All of the above |
|
Definition
|
|
Term
| Araceae plants typically cause local/systemic clinical signs. |
|
Definition
Local
Immediate pain and irritation upon chewing
Headshaking, intense salivation
Swelling of mucous mumbranes of pharynx and tongue--change in phonation
Severe dyspnea, but rarely obstruction
Nausea, vomiting, diarrhea, secondary dehydration, electrolyte imbalance, shock
Very rarely see arrhythmia, mydriasis, coma, and death |
|
|
Term
When treating animals with Araceae toxicity:
a. Signs will usually abate within 2-4 hours after treatment, but have the potential to persist for several days
b. Oral calcium (milk,yogurt) may aid precipitation of any soluble oxalates
c. Antihistamines, activated charcoal, and IV fluids are indicated
d. A and B
e. A, B, and C |
|
Definition
|
|
Term
Ricinus communis and Euphorbia pulcherrima come from the ______________ family.
a. Allium
b. Euphorbiaceae
c. Viscaceae
d. Liliaceae
e. Araceae |
|
Definition
b. Euphorbiaceae
Ricinus communis = castor bean
Euphorbia pulcherrima = poinsetta |
|
|
Term
| _________________ is one of the most toxic compounds of plant origin, containing two glycoprotein chains, A and B. The B chain is responsible for binding to galactoside containing proteins on the cell surface, facilitating internalization, while the A chain enters the ER and depurinates 28S RNA and causing inhibition of protein synthesis and subsequent cell death. |
|
Definition
Ricin
The actual toxin is toxalbumin/lectin |
|
|
Term
_______________ contains diterpenoid phorbol esters, which are directly irritating/blistering to the GIT and skin.
a. Castor bean
b. Poinsetta
c. Macadamia nut
d. Elephant's ear
e. Dumbcane |
|
Definition
|
|
Term
_______________ belongs to the Viscaceae family.
a. Yew
b. Calla lily
c. Mistletoe
d. Castor bean
e. Onion |
|
Definition
c. Mistletoe
Variable toxicity when growing on various host plants
Exact agent/mechanism unknown |
|
|
Term
All of the following are clinical signs consistent with mistletoe toxicity except:
a. Acute GI upset--vomiting, nausea, diarrhea
b. Periocular and perioral swelling
c. Hypothermia and mydriasis
d. Polyuria
e. Dyspnea and bradycardia, leading to CV collapse with asystole |
|
Definition
| b. periocular and perioral swelling--more consistent with poinsetta toxicity |
|
|
Term
All of the following are consistent with ricin toxicity except:
a. Acute clinical signs within minutes of ingestion
b. Vomiting with blood; diarrhea
c. Catarrhal to hemorrhagic gastroenteritis
d. Petechial hemorrhages on serosal surfaces
e. Edematous mesenteric lymph nodes |
|
Definition
a. Acute signs
Ricin has a characteristic lag period of a few hours to days |
|
|
Term
| T/F: poinsetta toxicity usually causes severe irritation of the GIT and mouth, with just occasional hemorrhage/diarrhea; blistering, periocular and perioral swelling, excessive salivation, and emesis are more common. |
|
Definition
True
The sap can cause a contact dermatitis as well. |
|
|
Term
| T/F: no specific antidote exists for ricin toxicity. |
|
Definition
True: treat with supportive care.
The same is true for poinsettas--can try to dilute toxins orally with water or milk |
|
|
Term
| T/F: the castor bean must be crushed or broken to release the toxin. |
|
Definition
| True--a swallowed bean will not cause toxicity |
|
|
Term
| T/F: castor oil contains ricin. |
|
Definition
|
|
Term
| T/F: moist heat can destroy ricin. |
|
Definition
|
|
Term
| T/F: members of the family Liliaceae are rapidly absorbed and excreted. |
|
Definition
|
|
Term
| ___________ are uniquely sensitive to lily toxicity. |
|
Definition
Cats
One of the 5 most commonly reported toxin exposure for cats
Exposure is generally following introduction of new plants indoors |
|
|
Term
Which of the following does not describe liliaceae toxicity?
a. Vomiting and salivation lasting 4-6 hours
b. Depression and anorexia
c. Polyuria for 12-24 hours leading to dehydration at 48 hours
d. Weakness, recumbency, and death in 3-7 days
e. Swelling of the mucous membranes of the pharynx and tongue |
|
Definition
| e. Swelling of mucous membranes of pharynx and tongue--this is caused by Araceae plants |
|
|
Term
All of the following are useful in diagnosis of liliaceae toxicity except:
a. Proteinuria, glucosuria, and isosthenuria eventually progressing to anuria
b. Incraseases in BUN, Creatinine, Phosphorous, Potassium, ALT, and ALP
c. Pulmonary and hepatic congestion, as well as perirenal edema and swollen kidneys
d. Diffuse acute renal tubular necrosis of the proximal tubules of the kindey with an intact basement membrane and evidence of regeneration
e. All of the above are consistent with liliaceae toxicity. |
|
Definition
e. All of the above
Also see a stress leukogram, granular and hyaline casts in the collecting ducts of the kidney, and a disproportionate increase in creatinine vs. BUN |
|
|
Term
Treatment for lily toxicity:
a. usually carries a good prognosis, even if started late
b. Requires intense fluid therapy prior to anuria at 2-3x the maintenance and may require peritoneal or hemodialysis following anuria
c. Does not involve emesis or activated charcoal
d. A and B
e. A, B, and C |
|
Definition
b. want fluid therapy and hemodialysis/peritoneal dialysis
Prognosis is grave if treatment is delayed
GI decontamination should be attempted: emesis, activated charcoal, cathartics |
|
|
Term
| Grapes and raisins are members of the ____________ spp. |
|
Definition
|
|
Term
| T/F: grape/raisin toxicity is limited to cats. |
|
Definition
False: limited to dogs
Raisins > grapes |
|
|
Term
| Raisins/grapes primarily attack the _________________ (body system). |
|
Definition
GI/renal
Vomiting/diarrhea within a few hours of ingestion.
Polydipsia reduced to no urine production in advanced cases--die from renal failure once anuric.
See degeneration and necrosis of PCT epithelia with intact basement membranes +/- regeneration and mineralization. |
|
|
Term
Which of the following is not a consistent diagnostic finding with grape/raisin toxicity?
a. Hypercalcemia
b. Hypophosphatemia
c. Increased BUN
d. Increased Creatinine
e. Degeneration and necrosis of the proximal convoluted tubules with an intact basement membrane. |
|
Definition
b. Hypophosphatemia
Should be hyperphosphatemia because kidney function stinks. |
|
|
Term
| T/F: Urticaceae, Poaceae, and Cactaceae cause more physical damage than internal damage to animals. |
|
Definition
True
Urticaceae = nettles
Poaceae = grasses
Cactaceae = cactus--ouch! |
|
|
Term
| T/F: hunting dogs are most commonly affected by nettles and cactaceae plants. |
|
Definition
|
|
Term
Which of the following is not a clinical sign seen by plants causing physical damage?
a. Otitis, laminitis, fistulous tracts, stomatitis, and conjunctivitis
b. Suppurative arthritis and pleuritis
c. Salivation, pawing at the mouth, and emesis
d. Respiratory distress, bradycardia/arrhythmias, and muscle weakness
e. All of the above are seen in plants that cause physical damage. |
|
Definition
e. All of the above
Suppurative pleuritis comes from soil organisms (Nocardia, Actinomyces) |
|
|
Term
| The Yellow Star Thistle (Centaurea spp.) contains the lactones ________________ and _________________, which cause the clinical signs. |
|
Definition
|
|
Term
_______________ are the species affected by Centaurea spp.
a. Cats
b. Dogs
c. Horses
d. Cows
e. Pigs |
|
Definition
c. horses
An extended period of consumption is necessary--high intake for 30+ days for toxicosis |
|
|
Term
| T/F: horses with yellow star thistle toxicity usually die from respiratory failure. |
|
Definition
False: die from starvation
C/S: involuntary chewing movements, twitching of lips, mouth held open, unable to eat
See nigropalladial encephalomalacia
Euthanasia is recommended--no treatment |
|
|
Term
| T/F: locoweeds are part of the legume family (Astragalus, Oxytropis) |
|
Definition
|
|
Term
__________________ contains an indolizidine alkaloid called swainsonine in all parts of the plant; swainsonine inhibits alpha-mannosidase with accumulation of oligosaccharides in lysosomes of cells in the brain and other tissues, leading to generalized lysosomal storage disease.
a. Datura stramonium
b. Yew
c. Ricinus communis
d. Locoweeds
e. Garlic |
|
Definition
|
|
Term
| With regard to locoweed toxicity, _____________ (species) have CNS signs with proprioceptive deficits, circling, ataxia, and falling over backwards; ____________ appear blind and have stargazing behavior; ______________ and ____________ have reproductive problems (abortions, fetal resorption, skeletal malformations, testicular atrophy, sperm defects); lesions include vacuolation of neurons, renal tubular epithelia, and macrophages. |
|
Definition
Horses = CNS
Sheep = blind/stargaze
Cattle/sheep = repro failure |
|
|
Term
| Quinolizidine alkaloids, from the _________________ plants, have ________________, which binds nicotinic and muscarinic receptors, and ______________, which is a teratogenic alkaloid in cattle, but not sheep. |
|
Definition
Lupinus spp (lupine, bluebonnet)
Toxins:
lupanine = binds nicotinic/muscarinic receptors
anagyrine = teratogenic in cattle but not sheep |
|
|
Term
Lupinus toxicity:
a. Is manifested as a labored breathing pattern, salivation, ataxia, clonic spasms, followed by coma and death
b. Has a toxin that causes teratogenic effects in cattle, but not sheep
c. Is caused by ingestion of the Bluebonnet plant
d. A and B
e. A, B, and C |
|
Definition
e. A, B, and C
Death may only be preceded by coma and no other signs |
|
|
Term
Lupinus toxicity in cattle:
a. Is caused by ingestion at 20-30 days gestation
b. Usually results in stillborn calves
c. Manifests as arthrogryphosis and "crooked calf disease"
d. A and B
e. A, B, and C |
|
Definition
c. Arthrogryphosis and "crooked calf" disease
May also see cleft palate/involvement of neck and back
Usually affects cattle that ingest the plant at 40-70 days gestation
Malformed calves are usually alive at full term |
|
|
Term
| Eupatorium rugosum is known to normal people as ______________________. |
|
Definition
|
|
Term
| T/F: Yews are a high molecular weight alcohol and produce trematone, which is toxic when dried; it is secreted in the milk and induces myonecrosis. |
|
Definition
| False: white snakeroot (Eupatorium rugosum) is a high molecular weight alcohol that produces trematome; it is toxic when dried, secreted in the milk, and induces myonecrosis (cardiac > skeletal) |
|
|
Term
Which of the following is secreted in the milk?
a. Grayanotoxin
b. Cardiac glycosides
c. Tropane alkaloids
d. Tremetones
e. Andromedotoxin |
|
Definition
| d. Tremetones from the white snakeroot (Eupatorium rugosum) |
|
|
Term
| T/F: the toxic effects of white snakeroot are cumulative. |
|
Definition
|
|
Term
| T/F: since tremetone is secreted in milk, suckling offspring may show clinical signs first. |
|
Definition
|
|
Term
A horse presents to you for excessive sweating. Upon examination, you note jugular pulsations and an arrhythmia upon auscultation. Capillary refill is >3 seconds and dark urine is noted upon collection. An acetone odor is discernable on the horse's breath. Which of the following would be a plausible differential?
a. White snakeroot toxicity
b. Red maple toxicity
c. Nail polish remover toxicity
d. Yew toxicity
e. Onion toxicity |
|
Definition
a. White snakeroot toxicity
On clinical pathology: myoglobinuria, elevated CK, elevated liver enzymes (AST, ALT)
Treat: detox with charcoal and cathartics if early; good nursing care and nutrition; treat cattle for ketosis; avoid consumption of milk by neonates and humans; monitor EKG in horses |
|
|
Term
| T/F: Taxus spp. are cardiac glycosides that depress conduction and depolarization, with direct action on the cardiac myocyte ion channels. |
|
Definition
| False: Taxus (yews) do depress conduction or depolarization and have direct action on cardiac myocyte ion channels, but they are not cardiac glycosides. |
|
|
Term
| _____________ and _______________ are capable of degrading the toxin in yew plants and are unaffected, while ________________ are highly susceptible to yews. |
|
Definition
Deer/birds degrade
Monogastrics/horses highly susceptible
Some ruminants such as deer/goats are considered resistant. |
|
|
Term
| T/F: the yew seed is highly toxic if chewed. |
|
Definition
True
Also, taxine (the toxin) is higher in older leaves; toxic all seasons of year; toxic either fresh or dried; only the aril is non-toxic |
|
|
Term
| T/F: horses affected by yew toxicity will show nervous signs (trembling, dyspnea, incoordination, and collapse) in addition to the cardiac signs associated with ingestion of the plant. |
|
Definition
True
May also see gastroenteritis and diarrhea
Lesions are minimal--may see mild uper GI irritation, mild pulmonary congestion or edema. |
|
|
Term
| Acer rubrum is the __________________. |
|
Definition
|
|
Term
Which of the following does NOT induce Heinz body formation and intravascular hemolysis, leading to weakness, tachypnea, icterus, and hemoglobinuria?
a. Red Maple
b. Onions
c. Rape
d. Kale
e. White Snakeroot |
|
Definition
e. White snakeroot
Note that Red Maple causes methemoglobinemia and cyanosis; note that rape and kale (Brassica spp.) are dimethyl disulfide, which oxidizes hemoglobin) |
|
|
Term
Melilotoside is a coumarin glycoside that, when converted to coumarin in the plant and then to dicoumarol by fungi in the plant stems, acts as a vitamin K antagonist and depresses the formation of vitamin K dependent coagulation factors, leading to hemorrhagic diathesis.
a. Veratrum spp.
b. Taxus spp.
c. Melilotus spp.
d. Liliaceae spp.
e. Pyrrolizidine Alkaloids |
|
Definition
c. Melilotus spp. (yellow sweet clover/sweet clover)
Fungi involved: Aspergillus fumigatus, others |
|
|
Term
| T/F: melilotoside is the toxic agent found in yellow sweet clover that can lead to prolonged postsurgical hemorrhage, large hematomas, anemia, weakness, and pallor in large animal species. |
|
Definition
| False: melilotoside is not toxic on its own--requires conversion to coumarin in plant, and then to dicoumarol by fungi in the stems of the plant. |
|
|
Term
| _________ and ___________ are the coagulation parameters that will be elevated with Melilotus toxicity. |
|
Definition
PT
PTT
Note that platelets will be normal |
|
|
Term
| Cevanine/Jervanine alkaloids of the Veratrum spp. are neurotoxic and work by binding open voltage-selective sodium channels, while Cevanine/Jervanine alkaloids are teratogenic and interfere with intracellular signaling and patterning during embryogenesis and organogenesis. |
|
Definition
Cevanine = neurotoxic
Jervanine = teratogenic; toxins are cyclopamine, cycloposine, and jervine; cyclopamine is the most important due to its greater concentration in the plants. |
|
|
Term
If ingested on 14 of gestation, lamb offspring will demonstrate:
a. Cleft palate and lip
b. Syndactylism
c. Cyclops
d. Tracheal defects
e. Shortening of the metacarpal/metatarsal bones |
|
Definition
c. Cyclops
Day 12-30 = cleft palate and lip, syndactylism, craniofacial defects (so could argue all of these)
Day 14 = Cyclops
Day 28-33 = limb and tracheal defects
Acute poisoning: excessive salivation, emesis, ataxia, collapse, death in severe cases |
|
|
Term
| Pyrrolizidine alkaloid is present in all parts of the plant (Senecia, Crotalaria, Cynoglossum), but is highest in the ___________. |
|
Definition
|
|
Term
The main target of pyrrolizidine alkaloids is the:
a. Kidney
b. Liver
c. Brain
d. GI tract
e. Reproductive system |
|
Definition
b. Liver
Alkaloids are readily absorbed into portal circulation-->converted by mixed function oxidases to toxic pyrroles-->some detoxified and excreted; others activated and remain in liver-->further react with cellular proteins and nucleic acids-->form adducts
Cause hepatocyte necrosis at higher doses
Chronic lower doses-->prevent mitosis in hepatocytes-->hepatocytomegaly-->chronic hepatopathy |
|
|
Term
All of the following can be passed via milk except:
a. Pyrrolizidine alkaloids
b. Yew
c. Red Maple
d. White snakeroot |
|
Definition
|
|
Term
| _____________ are resistant to Pyrrolizidine alkaloids and are sometimes used to control Senecia spp. |
|
Definition
Sheep
Horses and cattle are susceptible (young > old) |
|
|
Term
Icterus, hepatic insufficiency, hepatoencephalopathy, emaciation, cirrhosis, photosensitivity, periportal fibrosis, and bile duct proliferation would all be consistent with:
a. Cocklebur toxicity
b. Oak toxicity
c. Red Maple toxicity
d. Pyrrolizidine toxicity
e. Melilotoside toxicity |
|
Definition
| d. Pyrrolizidine toxicity |
|
|
Term
Carboxyatractyloside is present in the seeds and cotyledons of the ________________, is stable to drying, and competitively inhibits oxidative phosphorylation-->blocks ATP transport-->cellular damage, predominantly of hepatocytes and proximal convoluted tubules.
a. Pyrrolizidine alkaloids
b. Oak (Quercus)
c. Red maple (Acer)
d. Cocklebur (Xanthium)
e. Sweet clover (Melilotus) |
|
Definition
|
|
Term
| _______________ are the most affected by cocklebur toxicity. |
|
Definition
Swine
Cattle/sheep are also susceptible |
|
|
Term
You are doing your awesome 4 circles at a swine finishing unit, and when you get to the 4th circle, you notice a pig away from the rest of the group having convulsions and opisthotonus. You humanely euthanize and perform a necropsy, where you notice a pale liver with an enhanced lobular pattern and centrilobular hemorrhage. On histopathology, centrilobular hepatic necrosis and hemorrhage is noted, as well as renal tubular degeneration and necrosis. After speaking to the farmer, you suspect a plant origin. Which of the following is a reasonable differential?
a. Veratrum spp.
b. Acer rubrum
c. Xanthium spp.
d. Quercus spp.
e. Taxus spp. |
|
Definition
| c. Xanthium spp (cocklebur)--most often affects swine and produces the clinical signs noted |
|
|
Term
| __________________, metabolites of tannic acid of the Oak tree, work by three pathways: (1) direct toxicity to the GI epithelium leading to ulceration; (2) hydrolyzed tannins absorbed and damage endothelia; and (3) metabolites of ingested tannins are toxic to proximal tubular epithelia, leading to acute tubular necrosis. |
|
Definition
|
|
Term
The most commonly affected species by oak (Quercus) toxicity is the:
a. Cat
b. Dog
c. Horse
d. Cow
e. Pig |
|
Definition
d. Cow--spring calves are often poisoned in the fall by acorns
There are a few reports in horses |
|
|
Term
3-7 days post ingestion of acorns, one would expect to see:
a. Anorexia, dullness, rumen atony, constipation, melena
b. Weakness, prostration, icterus, hematuria, dehydration
c. A and B |
|
Definition
b. Weakness, prostration, icterus, hematuria, dehydration
Lesions: ascites, hydrothorax, perirenal blood-tinged edema, hemorrhagic and ulcerative gastroenteritis, acorns in rumen
Histology: coagulation necrosis of PCTs--tubular regeneration if chronic
Serum: increased BUN, creatinine, Phosphorous
Urinalysis: hematuria, proteinuria, protein casts |
|
|
Term
| T/F: Amaranthus retroflexus (Redroot pigweed) causes acute renal tubular necrosis and accumulates nitrates and some soluble oxalates. |
|
Definition
|
|
Term
The animal least likely to get redroot pigweed toxicosis is the:
a. Cow
b. Sheep
c. Goat
d. Horse
e. Pig |
|
Definition
| d. Horse--they can, but rarely |
|
|
Term
You are a pig farmer with a swine extensive operation and notice some weird plants growing in the fields. You remove them, but 5 days later you notice your pigs have posterior weakness, incoordination, and sternal recumbency. When you call the vet and necropsies are performed, affected pigs have perirenal edema, ascites, and acute tubular necrosis of both the proximal and distal tubules. What plant could have caused this?
a. Black walnut
b. Redroot pigweed
c. Oak
d. Cocklebur
e. Sweet clover |
|
Definition
b. Redroot pigweed
Clinical signs and deaths may continue up to 10 days after removal of plants |
|
|
Term
| T/F: soluble oxalates are rapidly absorbed and complex with serum calcium to be excreted in the kidney and form crystals in the tubular epithelia. |
|
Definition
|
|
Term
| T/F: soluble oxalates may cause a functional hypercalcemia. |
|
Definition
| False: functional HYPOcalcemia |
|
|
Term
A sheep is brought into your clinic after being found dead after observing the following clinical signs: dullness, depression, abdomenal pain, rumen atony, bruxism, prostration, and coma. Upon gross necropsy, you note ascites and hydrothorax. A microscopic analysis demonstrates rosettes in the renal tubular epithelia when placed under polarized light. Which of the following should be on your differential list?
a. Gallotannins
b. Soluble oxalates
c. Grayanotoxins
d. Pyrollizidine alkaloids
e. Jugulone |
|
Definition
|
|
Term
| ________________ is a toxic compound present in the leaves (but not heartwood) of the black walnut tree and has vasoactive effects in horses leading to ischemia, reperfusion, and reperfusion injury. |
|
Definition
|
|
Term
| T/F: exposure to black walnut toxicity in horses appears to be via dermal contact. |
|
Definition
| False: appears to be via ingestion |
|
|
Term
Which of the following is not a clinical signs associated with black walnut toxicity in horses?
a. Reluctance to move due to laminitis and rotation/separation of P3
b. Depression
c. Increased temperature, heart rate, respiratory rate, digital pulses, and hoof temperature
d. Lower limb edema
e. All of the above are clinical signs of black walnut toxicity in horses |
|
Definition
|
|
Term
| T/F: fescue foot is caused by taxine alkaloids present in Fescue plants. |
|
Definition
False: ERGOT alkaloids (ergovaline, ergotamine)
Taxine alkaloids are found in the yew plant (Taxus spp.) |
|
|
Term
All of the following are syndromes/clinical signs associated with fescue toxicosis except:
a. Fescue foot caused by peripheral vasoconstriction and observed as dry gangrene and sloughing of the extremities.
b. Photophobia and photosensitization manifested as pruritus and erythema over nonpigmented areas of the skin
c. Fat necrosis associated with endophyte infected fescue and manifested as hardened fat in the abdomen
d. Summer slump during periods of high ambient temperatures manifested as heat intolerance, seeking shade, reduced grazing, decreased milk production, and decreased fertility
e. Late term abortion, prolonged gestation, dystocia, oversized foals, thickened edematous placentas, and retained placentas associated with reduced serum prolactin and progesterone |
|
Definition
| b. Photophobia and photosensitization |
|
|
Term
| T/F: ergot alkaloids induce peripheral vasodilation |
|
Definition
False: vasoCONSTRICTION
Leads to vascular stasis, inadequate heat dissipation, subsequent necrosis, impaired perfusion to abdominal fat stores and placenta, and decreased prolactin secretion |
|
|
Term
| T/F: Fescue has a symbiotic relationship with the endophyte fungus Neotyphodium coenophialum, which is actually responsible for toxin production. |
|
Definition
|
|
Term
Which of the following pairs of plants is associated with photosensitization?
a. St. John's Wort and Buckwheat
b. Rape and Kale
c. Yellow Sweet clover and Yellow Star thistle
d. Oak and Red Maple
e. Red Maple and Black Walnut |
|
Definition
| a. St. John's Wort and buckwheat |
|
|
Term
Which of the following is not a necessary factor for photosensitization?
a. Presence of photodynamic pigment in skin
b. Exposure to sunlight
c. Susceptible skinned animal (i.e. light colored skin)
d. Ingestion of preformed photodynamic agent
e. All of the above are required for photosensitization |
|
Definition
d. Ingestion of preformed photodynamic agent
This can occur (St. John's Wort, Buckwheat) and then would undergo primary photosensitization (quinolones absorbed and circulate to cutaneous vasculature where they are activated by light-->singlet oxygen formation -->reacts with nucleic acids and membrane lipids in capillary endothelia-->vascular injury-->clinical signs)
HOWEVER, there is also secondary photosensitization, where severe liver damage (>80% loss of function) or biliary obstruction occurs-->phylloerythrin not excreted into bile by liver-->metabolyte of chlorophyll formed by bacterial degredation in gut and uses same pathway as bilirubin-->acts as photodynamic pigment similar to toxic quinolones
So, ingestion of preformed toxins are not required, as long as the animal's liver sucks |
|
|
Term
| T/F: blindness can result from photosensitization |
|
Definition
True
See blindness, pruritus, erythema, and sloughing of damaged skin
Keep animals out of sunlight and cover eyes to prevent corneal damage
Give antibiotics for secondary bacterial infections
Ointments, anti-inflammatories as needed for soft tissue swelling |
|
|
Term
Which of the following is responsible for the most toxicoses in animals?
a. Plants and mushrooms
b. Pesticides: insecticides, rodenticides, fungicides, fertilizers
c. Human drugs and pharmaceuticals
d. Household products
e. Food |
|
Definition
| c. Human drugs and pharmaceuticals |
|
|
Term
| _____________ is converted to alcohol dehydrogenase in the liver to form toxic organic acids and cause acidosis. |
|
Definition
Ethylene glycol
Also see hypocalcemia and calcium oxalate crystals in kidney |
|
|
Term
| T/F: ethylene glycol is absorbed intact |
|
Definition
|
|
Term
| Ethylene glycol has a ____% death rate. |
|
Definition
|
|
Term
Match the stages of ethylene glycol toxicity (acute stage, second stage, third stage) with the following sets of clinical signs:
1. Oliguric renal failure, acidosis
2. Severe depression from acidosis, vomiting, dehydration, oliguria with isosthenuria, miosis, coma, occasional seizures due to hypocalcemia
3. vomiting, ataxia, depression, PU/PD |
|
Definition
1. Stage 3--oliguric renal failure, acidosis
2. Stage 2: renal stage; occurs at 12-24-72 hours; cats early; dogs later; severe depression, vomiting, dehydration, oliguria with isosthenuria, miosis, coma, occasional seizures due to hypocalcemia.
3. Acute stage: 30 min-12 hours--vomiting, ataxia, depression, PU/PD |
|
|
Term
An ultrasound halo sign can be diagnostic for:
a. Ethylene glycol toxicity
b. Methylxanthine toxicity
c. Acetaminophen toxicity
d. 5-Fluorouracil toxicity
e. Ibuprofen toxicity |
|
Definition
a. Ethylene glycol toxicity
Diagnosis: stress leukogram, dehydration, large anion gap, osmole gap x 5, hyperglycemia, hyperkalemia, hypocalcemia, elevated BUN/creatinine, low USG, severe metabolic acidosis, calcium oxalate crystalluria, nephrosis |
|
|
Term
The antidote for ethylene glycol toxicity is:
a. 4-methyl pyrazole
b. Fomepizole
c. Ethanol
d. A and B
e. A, B, and C |
|
Definition
|
|
Term
| T/F: a Wood's lamp and sodium fluorescein can be used to detect ethylene glycol in the oral cavity or urine. |
|
Definition
| True, although fluorescence is not always consistent. |
|
|
Term
| T/F: diethylene glycol is more toxic than ethylene glycol, causing oxalate-related renal injury and CNS depression. |
|
Definition
False: diethylene glycol is less toxic and causes renal injury that is not oxalate related
It does cause CNS depression--vomiting, anuric renal failure 1-3 days PI, uremic coma, death
Tx with fomepizole |
|
|
Term
________________ is metabolized by alcohol dehydrogenase to form D-lactic acid accumulation, as well as binds SH groups on hemoglobin to cause Heinz body formation.
a. Ehtylene glycol
b. Diethylene glycol
c. Propylene glycol
d. Acetaminophen
e. Methylxanthine Alkaloids |
|
Definition
|
|
Term
Which of the following is not a clinical sign associated with propylene glycol toxicity?
a. Narcotic effects and lactic acidosis causing depression, ataxia, and muscle twitching
b. Hypotension, shock, and seizures
c. Osmotic diuresis and dehydration
d. Heinz bodies, reticulocytes, and anemia
e. All of the above can be seen with propylene glycol toxicity |
|
Definition
| e. All of the above can be seen |
|
|
Term
| _______________ is the methylxanthine found in chocolate products and cocoa mulch bark, __________________ is the methylxanthine found in tea and human asthma drugs, and __________________ is the methylxanthine found in OTC stimulants, coffee beans, coffee, and soft drinks. |
|
Definition
Theobromine = chocolate
Theophylline = tea, asthma drugs
Caffeine = OTC stimulants, coffee products, soda |
|
|
Term
Which of the following is not an effect of methylxanthines?
a. Cerebral stimulant
b. Oliguria
c. Myocardial stimulation
d. Increased motor activity
e. Over response to stimuli |
|
Definition
| b. Oliguria---methylxanthines are diuretics |
|
|
Term
| T/F: cats excrete theobromine slowly compared to other species. |
|
Definition
| False: dogs excrete theobromine slowly compared to other species. |
|
|
Term
_________________ is a strong cardiac stimulant that can cause premature ventricular contractions, as well as CNS excitement, seizures, and hyperreflexia.
a. Caffeine
b. Theobromine
c. Theophylline
d. A and B
e. A, B, and C |
|
Definition
|
|
Term
| Why would you want to take urine, serum, stomach, and liver samples when trying to detect methylxanthines? |
|
Definition
| Several other toxicants (strychnine, organophosphates, chlorinated hydrocarbons) can cause similar clinical signs, so you want to be sure to have collected enough samples to test for other agents in case you are wrong. |
|
|
Term
Which of the following has drug interactions with methylxanthis that interfere with excretion? Choose all that apply:
Corticosteroids
Ibuprofen
Erythromycin
Acetaminophen
Tetracycline
Albuterol |
|
Definition
Corticosteroids
Erythromycin |
|
|
Term
| T/F: unsweetened chocolate is the most dangerous for animals. |
|
Definition
|
|
Term
| T/F: lidocaine can be used to treat premature ventricular contractions in dogs. |
|
Definition
True
Don't use in cats--not sure why |
|
|
Term
________________ has a metabolite that conjugates to glutathione and binds to liver proteins, leading to liver necrosis and Heinz body anemia, and is especially toxic to cats.
a. Methylxanthines
b. Ibuprofen
c. Propylene glycol
d. Acetaminophen
e. Meloxicam |
|
Definition
d. Acetaminophen
In cats, no dose is safe |
|
|
Term
A cat presents to your clinic for reddened urine, a puffy face and paws, lacrimation, and pruritus. Her owners say that she hasn't been herself for the last several hours and refuses to eat. Bloodwork reveals a methemoglobinemia and Heinz body formation. Which of the following is a plausible differential?
a. Acetaminophen toxicity
b. Propylene glycol toxicity
c. Ibuprofen toxicity
d. Methylxanthine toxicity
e. Aspirin toxicity |
|
Definition
a. Acetaminophen toxicity
Cats typically have blood and metabolic problems.
Dogs have GI problems: vomiting, diarrhea, liver problems (icterus) and hemolysis later (2-7days) |
|
|
Term
The antidote for acetaminophen toxicity is:
a. Fomepizol
b. Ethanol
c. N-acetylcysteine
d. 4-methyl pyrrazole
e. Doxapram |
|
Definition
c. N-acetylcysteine
also can use SAMe (S-adenosylmethionine), ascorbic acid, RBC or oxyglobin, and cimetidine as adjunct treatments
Methylene blue can be used for methemoglobinemia if no other choices |
|
|
Term
High doses of which of the following lead to uncoupling of oxidative phosphorylation?
a. Ibuprofen
b. Aspirin
c. Acetaminophen
d. Meloxicam
e. Ketoprofen |
|
Definition
|
|
Term
Which of the following is not seen with aspirin toxicity?
a. Metabolic alkalosis
b. Emesis, depression, anorexia, fever
c. Gastric bleeding, increased bleeding time
d. Muscle weakness
e. Coma/death |
|
Definition
a. Metabolic alkalosis
See metabolic ACIDOSIS |
|
|
Term
| T/F: pepto bismol is toxic to dogs and cats. |
|
Definition
| True: contains as much salicylate as 15-grain aspirin (??) |
|
|
Term
| T/F: ibuprofen has a wide margin of safety. |
|
Definition
False: narrow margin of safety
Note: cats have a toxic dose about half those in dogs |
|
|
Term
Which of the following will not cause blood loss anemia, PU/PD, acidosis, hematochezia, and acute renal failure like ibuprofen toxicity?
a. Naproxen
b. Meloxicam
c. Ketoprofen
d. Carprofen
e. All of the above will cause similar clinical signs |
|
Definition
| b. Meloxicam--different class of NSAID |
|
|
Term
| T/F: to inhibit the GI effects of oral NSAIDs, misoprostol can be administered to patients with toxicoses. |
|
Definition
|
|
Term
Which of the following is consistent with 5-FU toxicity?
a. Rapid onset of action leading to death in 7 hours
b. Sloughing of the GI tract causing bloody vomitus and feces
c. CNS problems including depression, tremors, and seizures
d. Bone marrow suppression
e. All of the above |
|
Definition
|
|
Term
Treatment for 5-FU toxicity generally requires heroic therapy and includes:
a. IV fluids and antiemetics
b. GI protectants and H2 blockers
c. Phenobarbital
d. Neupogen and broad spectrum antibiotics
e. All of the above |
|
Definition
e. All of the above
Neupogen for bone marrow stimulation
Antiemetics = martopitant or ondansetron |
|
|
Term
| T/F: one pill of pseudoephedrine can kill a dog. |
|
Definition
|
|
Term
| __________________ is a beta adrenergic agonist that stimulates cAMP, causing bronchial and vascular smooth muscle relaxation. |
|
Definition
| Albuterol (probably also Clenbuterol and others...) |
|
|
Term
| T/F: overdose of albuterol leads to arrhythmias, bradycardia, tachycardia, heart block, extrasystole, tachypnea, and hypertension |
|
Definition
True
Also see CNS hyperactivity, tremors, seizures, vomiting, salivation, and hypokalemia |
|
|
Term
The treatment of choice to counteract albuterol toxicity is:
a. Epinephrine
b. Clenbuterol
c. Propanolol
d. Atropine
e. Pentobarbitol |
|
Definition
| c. Propanolol--beta adrenergic antagonist |
|
|
Term
| T/F: sympathomimetic amines, tricyclic antidepressants, inhalant anesthetics, and digitalis all counter albuterol and therefore reduce toxicity. |
|
Definition
| False: these agents enhance the effects of albuterol |
|
|
Term
| _________________ are H1 receptor antagonists, commonly used as sedatives and antiemetics. |
|
Definition
|
|
Term
Which of the following causes atropine-like signs and CNS depression?
a. Ethylediamine antihistamines
b. Piperazine antihistamines
c. Ethanolamine antihistamines
d. Piperadine antihistamines |
|
Definition
c. Ethanolamine histamines
Ethyldiamine: depression, tachycardia, intestinal atony, urinary retention
Piperazine: seizures in puppies for 6-24 hours
Piperadine: hyperactivity, depression, tachycardia |
|
|
Term
| T/F: epihephrine and phenothiazine tranquilizers should be avoided in patients with antihistamine toxicosis. |
|
Definition
|
|
Term
| SSRI's inhibit uptake of serotonin at the pre/post synaptic membrane. |
|
Definition
|
|
Term
Clinical signs of SSRI toxicity include all of the following except:
a. CNS stimulation/excitation
b. Tremors
c. Seizures
d. Hypothermia
e. GI effects--salivation, vomiting, colic, diarrhea |
|
Definition
| d. Hypothermia--SSRI toxicity causes hyperthermia, presumably from the seizures |
|
|
Term
| The species most susceptible to serotonin syndrome is the ________. |
|
Definition
|
|
Term
| _____________________, caused by anything that increases serotonin levels, causes agitation, vocalization, vomiting, tremors, hyperthermia, and transient blindness, among other clinical signs. |
|
Definition
|
|
Term
Which of the following is a serotonin antagonist?
a. Methylene blue
b. Cyproheptadine
c. Fomepizole
d. N-acetylcysteine
e. 4-methyl indole |
|
Definition
|
|
Term
____________ inhibit the reuptake of norepinephrine and serotonin in the CNS, are alpha-1 adrenergic antagonists, and have an affinity for muscarinic and histamine H1 receptors.
a. Tricyclic antidepressants
b. SSRIs
c. MAOIs
d. Sleep aids
e. Amphetamines |
|
Definition
| a. Tricyclic antidepressants |
|
|
Term
| T/F: cardiac arrhythmias associated with tricyclic antidepressants that demonstrate QRS widening can be treated with sodium bicarbonate |
|
Definition
|
|
Term
| T/F: ADD medications are simpathomimetic drucs that are potent and structurally related to norepinephrine, stimulating the release of NE, alpha and beta adrenergic receptors, and slow catecholamine metabolism by inhibiting monoamine oxidase. |
|
Definition
|
|
Term
Which of the following would not be caused by toxicity with ADD medication?
a. Head bobbing
b. CNS depression
c. Serotonin syndrome
d. Seizures
e. Panting |
|
Definition
| b. CNS depression--usually have agitation, although my notes say that coma could potentially occur (so who knows) |
|
|
Term
| T/F: diazepam is the drug of choice to control seizures associated with ADD drug toxicity. |
|
Definition
| False: use chlorpromazine |
|
|
Term
| T/F: Tricyclic antidepressants potentiate GABA, promoting chloride channel opening and overall inhibition of neuronal excitation. |
|
Definition
| False: sleep aids, such as benzodiazepines or hypnotics, do this |
|
|
Term
| T/F: approximately 50% of dogs with sleep aid toxicity develop paradoxical CNS stimulation, rather than the common clinical signs of depression, lethargy, weakness, dullness, and ataxia. |
|
Definition
|
|
Term
| What two drugs should be used to treat patients with sleep aid toxicity that experience paradoxical stimulation? |
|
Definition
Phenothiazines
Barbituates
NO BENZODIAZEPINES |
|
|
Term
| T/F: amphetamines are sympathomimetic. |
|
Definition
|
|
Term
__________________ is a CNS depressant that first causes euphoria before causing depression. Delta-9-tetrahydro-cannabinol is the most active and main psychogenic agent. The agent acts on brain receptors selective for cannabinoids, leading to a release of norepinephrine, dopamine, and serotonin, and causing enhanced GABA turnover.
a. Amphetamines
b. Marijuana
c. Cocaine
d. Narcotics
e. Xylitol |
|
Definition
|
|
Term
| T/F: there is no significant first pass effect after ingestion of marijuana. |
|
Definition
False: there is a significant first pass effect.
Excreted through bile. Metabolized by the liver via hydroxylation and oxidation. |
|
|
Term
| T/F: marijuana is lipophilic. |
|
Definition
| True--it distributes to the brain or other fatty tissues and has a short plasma half life, but long biologic half life due to adipose storage |
|
|
Term
| T/F: horses are resistant to the effects of marijuana. |
|
Definition
False: horses may present with signs of colic
Other animals CS (Because I couldn't make a good question): euphoria-->depression, ataxia, incoordination, excitation, hypothermia, vocalization, mydriasis, hypotension, vomiting, diarrhea, urinary incontinence, seizures, coma, death (rare), dilated pupils/glazed eyes, nystagmus |
|
|
Term
| Detection of marijuana can be performed for several days by testing the _______________, but can also be found from sampling the ________________-. |
|
Definition
Urine--several days
Stomach content |
|
|
Term
| If respiration is slow/absent, ________________ can be used to stimulate respiration in patients with cannabinoid toxicity. |
|
Definition
|
|
Term
_________________ is an alkaloid derivative that acts to stabilize axonal membranes by interfering with activity of gated sodium channels and inhibits nerve conduction locally.
a. Amphetamines
b. Marijuana
c. Cocaine
d. Opioids
e. Xylitol |
|
Definition
|
|
Term
Cocaine:
a. Has a relatively long half-life due to slow absorption
b. Is a powerful CNS depressant
c. Has parasympathomimetic effects
d. Can cause cardiotoxicity in large doses
e. Causes anesthesia, bradycardia, and hypothermia |
|
Definition
d. Can cause cardiotoxicity in large doses
Cocaine is a powerful CNS stimulant: sympathomimetic symptoms (dilated pupils, hyperactivity, seizures, hyperesthesia, pyrexia, hyperthermia, tachycardia)
Can eventually cause respiratory depression, coma, and death |
|
|
Term
Propanolol would be an appropriate treatment modality for all of the following toxicities except:
a. Cocaine
b. Antihistamines
c. Albuterol
d. ADD medication (amphetamine-like)
e. Ethanol |
|
Definition
|
|
Term
Opioid derivatives include all of the following except:
a. Heroin
b. Cocaine
c. Morphine
d. Codeine
e. Fentanyl |
|
Definition
|
|
Term
| In ______________ (species), narcotics cause drowsiness, ataxia, vomiting, seizures, miosis, coma, respiratory depression, hypotension, and death due to respiratory depression. However, in ______________ and ______________, narcotics can have a profound excitatory effect on the CNS. |
|
Definition
Dogs--depression of CNS
Cats/Horses--CNS excitement |
|
|
Term
The antidote for opiods is:
a. Naloxone
b. Yohimbine (YAY!)
c. Domperidone
d. Tolazoline
e. Fomepizol |
|
Definition
|
|
Term
___________________ acts as an anesthetic agent by reversibly blocking action potentials of neurons.
a. Xylitol
b. Marijuana
c. Cocaine
d. Ethanol
e. Propylene Glycol |
|
Definition
|
|
Term
Ethanol:
a. Is rapidly absorbed and distributed throughout the body
b. Produces behavioral changes including excitability, vocalizing, and incontinence
c. Can cause emesis, ataxia, and incoordination
d. Can cause drowsiness, depression, unconsciousness, loss of reflexes, respiratory depression, respiratory/ cardiac arrest, and death
e. All of the above |
|
Definition
|
|
Term
Diagnosing ethanol toxicity can best be accomplished by:
a. Stomach contents
b. Measuring blood alcohol
c. Measuring urine alcohol
d. Liver samples
e. All of the above can be used |
|
Definition
|
|
Term
| T/F: lactic acid containing fluids are contraindicated in ethanol toxicity. |
|
Definition
|
|
Term
| T/F: xylitol toxicity is associated with a sudden drop in blood sugar, resulting in depression, loss of coordination, and seizures. |
|
Definition
True
Also see vomiting and lethargy within 2 hours
Hepatic and GI toxicity
Hyperbilirubinemia, hypoglycemia, hyperphosphatemia, increased clotting times, oral hemorrhage
See widespread petechial GI hemorrhages |
|
|
Term
| T/F: bleach has an extremely low pH, which can cause chemical burns. |
|
Definition
| False: HIGH pH (11-12) that causes chemical burns |
|
|
Term
| ______________ is a direct dermal irritant that causes irritation with edema of the pharynx, glottis, larynx, and lungs, hypersalivation, oral ulceration, corneal damage, coughing, choking, pulmonary edema, and respiratory failure. |
|
Definition
| Bleach--although you could probably argue any cleaning product |
|
|
Term
| Bleach toxicosis can lead to a metabolic acidosis/alkalosis. |
|
Definition
|
|
Term
Emesis and lavage are contraindicated in which of the following? Choose ALL that apply:
Bleach
Anionic detergents
Cationic detergents
Essential oils
Soaps
Disinfectants (phenols, cresols, iodine, alcohol)
Pine-Sol
Alcohols
Acids
Alkalis
Solvents
Polyeurethane adhesives
Nicotine patches
Cyanoacrylate adhesives
Homemade play-dough
Mothballs
Paintballs
Batteries |
|
Definition
Bleach
Anionic Detergents
Cationic Detergents
Disinfectants
Pine-sol
Acids
Alkalis
Solvents
Polyeurethane adhesives |
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Term
Rank the following in order from least toxic to most toxic: Cationic detergents, anionic detergents, non-ionic detergents
Nonionic < anionic < cationic |
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Definition
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Term
______________ causes nausea, vomiting, oral/ pharyngeal/esophageal burns, possible hemolysis, and secondary nephrotoxicity.
a. Non-ionic detergents
b. Anionic detergents
c. Cationic detergents |
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Definition
b. Anionic detergents
Non-ionic: mild irritation, vomiting, diarrhea
Cationic: irritate MM, corrosive burns to mouth, esophagus, salivation, muscle weakness, CNS and respiratory depression, shock, seizures |
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Term
Dilution with milk, egg whites and water is indicated for toxicity with:
a. Non-ionic detergents
b. Anionic detergents
c. Cationic detergents
d. A and B
e. A, B, and C |
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Definition
e. A, B, and C
Technically egg whites are only in cationic section, but dilution is in all three and I don't see why egg whites and milk can't be used for all three. |
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Term
| T/F: essential oils are mucosal irritants that cause cause hypersensitivity reactions and neurological effects. |
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Definition
True
Tea tree oil: CNS depression, ataxia, tremors, hypothermia, possible hepatotoxicity |
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Term
| Corticosterods for the treatment of toxicity (especially soaps and essential oils) should never be given if there is an ________________ or __________________. |
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Definition
| Infection or perforation = DON'T DO IT |
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Term
| T/F: homemade soaps may be more toxic than store-bought soaps due to their high alkalin content. |
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Definition
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Term
Activated charcoal is ineffective for:
a. Essential oils
b. Soaps
c. Disinfectants
d. A and B
e. A, B, and C |
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Definition
d. A and B
Note that charcoal is also ineffective for alkalis and solvents. |
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Term
| The species most susceptible to disinfectants (phenols, cresols, iodine, alcohol) is the _________ due to hepatic metabolism |
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Definition
Cats
See ulcers, liver, and renal damage--may see tremors, incoordination, icterus
Aromatic odor |
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Term
| Pine sol is readily absorbed and excreted in the urine as _______________ conjugates, making __________ (species) more susceptible because of their low capacity for this type of metabolism. |
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Definition
Glucuronide
Cats--have poor ability for glucuronidation |
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Term
Pine sol toxicity causes all of the following except:
a. Gastritis, hematemesis, diarrhea
b. CNS stimulation
c. Renal tubular necrosis
d. Pulmonary edema when aspirated
e. All of the above are seen with pine-sol toxicity |
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Definition
| b. CNS stimulation--should be CNS depression |
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Term
| T/F: egg whites or milk can be used to dilute or bind disinfectants. |
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Definition
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Term
Which of the following is not an appropriate treatment strategy for pine-sol toxicity?
a. Milk dilution
b. Water dilution
c. Egg white dilution
d. Activated charcoal
e. Gastric lavage |
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Definition
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Term
Which of the following is not seen with acid (toilet bowl cleaners, metal cleaners, etc.) toxicity?
a. Localized coagulative necrosis
b. Intense oral/dermal pain
c. Esophageal involvement
d. Acute inflammation followed by granulation and fibroblast-induced stricture
e. All of the above are seen |
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Definition
| c. Esophageal involvement |
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Term
| T/F: when treating a patient for acid cleaner toxicity, neutralization of the acid is essential. |
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Definition
False: neutralization of the acids and emesis are contraindicated
Dilution with water or milk are indicated |
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Term
| T/F: alkali cleaner toxicity is more common and more severe than acid cleaner injury. |
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Definition
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Term
Which of the following is not seen with alkali cleaner toxicity?
a. Liquefactive necrosis on contact
b. Obliteration of the esophageal wall
c. Seizures within 5 minutes
d. Mucosal sloughing with scarring that can result in stricture formation
e. All of the above are seen |
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Definition
| e. All of the above are seen |
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Term
| T/F: steroids may help inhibit stricture formation associated with alkali toxicity by limiting inflammation and fibroblast activity. |
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Definition
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Term
| __________ and ____________ are the species most at risk of solvent toxicity. |
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Definition
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Term
| T/F: solvents tend to have toxic effects on multiple body systems. |
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Definition
True
GI--vomiting, bloat, anorexia
Respiratory--coughing, pneumonia, labored breathing, pleuritis, death
CNS--depression, tremors, convulsions, coma
Skin and ocular damage
Bone marrow suppression
Cardiac arrest in high doses |
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Term
| T/F: prolonged exposure to solvents can result in leukopenia, anemia, and thrombocytopenia. |
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Definition
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Term
| Polyeurathane adhesives is a fancy name for _________. |
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Definition
Glue
Also, floor and wood finishes and expanding spray foam. |
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Term
| T/F: polyeurathane adhesives are dangerous due to their expandable properties. |
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Definition
True--warm, moist environment of the stomach causes expansion 3-5 times normal and creates a foreign body obstruction rather than toxicosis
Clinical signs associated with obstruction: vomiting, hematemesis, anorexia, anxiety, lethargy, abdominal distention, pain, hyperventilation, tachypnea, protracted vomiting with secondary dehydration
RADIOGRAPHY is diagnostic of choice--may need contrast |
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Term
| Why is water by mouth, emesis, and charcoal contraindicated in polyeurethane adhesive ingestion? |
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Definition
All increase the expansion of the agent.
Gastrotomy is indicated to remove large mass |
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Term
The biggest risk in toxicity with homemade play dough is:
a. Hyponatremia
b. Hyokalemia
c. Hypernatremia
d. Hyperkalemia
e. Hyperphosphatemia |
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Definition
c. Hypernatremia
Want to lower the Na concentration over 48-72 hours |
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Term
| T/F: a single naphthalene mothball is toxic in companion animals. |
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Definition
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Term
Which type of mothball causes the following: methemoglobinemia, Heinz body anemia, hemoglobinuria, hypoxia?
a. Naphthalene
b. Paradichlorobenzene |
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Definition
a. Naphthalene
Paradichlorobenzene causes vomiting, seizures, tremors, and liver/kidney injury |
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Term
| T/F: methylene blue is an appropriate treatment for mothball toxicity. |
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Definition
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Term
| T/F: paintball ingestion can lead to a profound hyponatremia. |
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Definition
False: cause hypernatremia
Correct acid/base balance |
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Term
| T/F: battery ingestion can cause corrosive injury to the esophagus if they get lodged there, but more often cause obstruction and tissue necrosis due to impaction. |
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Definition
True
Removal is warranted if not passed within 24-36 hours |
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Term
Which of the following must be present to be considered "risk"?
a. Exposure
b. An adverse effect
c. A and B |
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Definition
c. A and B
Need BOTH to have risk |
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Term
Which of the following is not one of the steps of risk assessment?
a. Problem formulation
b. Effects characterization
c. Management characterization
d. Exposure characterization
e. Risk characterization |
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Definition
| c. Management characterization |
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Term
| T/F: despite the diversity of toxicants considered and the complexity of the regulatory system, all toxicant risk can be understood within the context of risk assessement as a four step process: problem formulation, effects characterization, exposure characterization, and risk characterization. |
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Definition
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Term
__________________ is the likelihood of harm to be manifested under relavent conditions of exposure.
a. Risk
b. Risk assessment
c. Hazard
d. Risk management
e. Risk communication
f. Risk analysis |
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Definition
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Term
_____________ is the systematic scientific evaluation of potential adverse effects from exposures to hazardous agents or situations.
a. Risk
b. Risk assessment
c. Hazard
d. Risk management
e. Risk communication
f. Risk analysis |
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Definition
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Term
_______________ are intrinsic toxic properties.
a. Risk
b. Risk assessment
c. Hazard
d. Risk management
e. Risk communication
f. Risk analysis |
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Definition
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Term
_______________ is the process by which policy actions are chosen to address and mitigate risk.
a. Risk
b. Risk assessment
c. Hazard
d. Risk management
e. Risk communication
f. Risk analysis |
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Definition
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Term
____________________ deals with making risk assessment outcomes and risk management decisions comprehensible to interested and affected parties.
a. Risk
b. Risk assessment
c. Hazard
d. Risk management
e. Risk communication
f. Risk analysis |
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Definition
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Term
________________ is the interrelated activities of risk assessment, management, communication, and perception.
a. Risk
b. Risk assessment
c. Hazard
d. Risk management
e. Risk communication
f. Risk analysis |
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Definition
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Term
| T/F: risk is the joint probability of exposure and effect. |
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Definition
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Term
| A ____________________ risk assessment describes the pathway of exposure for a population of concern and predicts the consequence of exposure, generally through toxicological principles, while a __________________ risk assessment describes a pathway of exposure for a population of concern and observes the consequence of exposure, generally using epidemiological principles. |
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Definition
Prospective = forward prediction
Retrospective = backward prediction |
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Term
Which of the following is the most common method of hazard identification?
a. Epidemiological
b. Animal bioassay
c. In vitro effects
d. Structure-activity relationships
e. In silico toxicity testing |
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Definition
b. Animal bioassay
In vitro effects are most advanced for mutagenicity and carcinogenicity screening, but are less amenable to non-cancer risk |
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Term
Exposure assessment:
a. Is the determination of the source, type, magnitude, and duration of contact
b. Establishes the causal path linking the stressor to the adverse effect
c. Generically known in toxicological risk assessment as the Estimated Environmental Dose
d. Is equal in importance to effect assessment, since risk is a function of exposure and effect
e. All of the above |
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Definition
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Term
| T/F: effects characterization is a dose-response assessment |
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Definition
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