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SS - Exam 1 > Toxicology 2 > Flashcards

Toxicology 2 Flashcards

1
Q

Bacterial neurotoxins

A

Tetanus (C. Tetani)
Botulism (C. Botulinum)

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2
Q

Mechanism of botulism

A

Toxin decreases acetylcholine release
Causes muscle paralysis & weakness
Differentials include other agents causing muscle weakness
Difficult to confirm diagnosis

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3
Q

Mechanism of tetanus

A

Decreases GABA causing muscle stiffness
Differential is strychnine
Treat with GABA agonist, time
Prevent with tetanus toxoid

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4
Q

Toxic mushrooms

A

Misc. GI
Hydrazines
Isoxazoles
Muscadine
Psilocybin
Amatoxins

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5
Q

Hydrazines

A

Decreased GABA lead to CNS stimulation, not a common problem.

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6
Q

Isoxazoles

A

Ibotenic acid & muscimol in Amanita muscaria causes CNS effect that mimic tremorgans. Almost as common as GI mushroom problems

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7
Q

Muscarine

A

Stimulate muscarinic parasymapthomimetic receptors; does not inhibit AChE

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8
Q

Psilocybe

A

Cause hallucinations & possible seizures but no coma; relatively rare toxicosis

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9
Q

Source of amintoxins

A

Death angel - 95% of mushroom fatalities
Grow under oak, birch, pine trees “fishy odor”

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10
Q

Toxicity of amatoxins

A

Cyclopeptide toxins - amatoxins
Rapidly absorbed, bioavailability greater in dogs
1-2 mushrooms will kill a dog
Enterohepatic recirculating - mostly excreted in urine
Not destroyed by heat, freezing or stomach acidity

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11
Q

Mechanism of action of amatoxins

A

Inhibits protein synthesis - cell death, especially hepatocytes

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12
Q

Clinical signs of amatoxins

A

GI signs delayed 6-24 hours, appear
Anorexia, vomiting, diarrhea, colic
Hepatic signs around 36-48 hours
Renal failure - multi-organ failure

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13
Q

Diagnosis and treatment of amatoxins

A

Liver lesions: massive hepatic & acute renal necrosis
Amatoxin detection in urine, serum, liver, kidney or GIT
- seen in urine & serum before clinical signs appear

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14
Q

GI signs for mushroom toxicosis

A

Chlorophyllum molybdities
- lawns & grow fairy rings, large caps

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15
Q

Clinical signs for gi mushrooms

A

Similar to gastroenteritis
Vomiting, diarrhea, abdominal pain
Good prognosis

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16
Q

Chlorophyllum molybdites

A

Produce fairy rings
Green spores mature specimens, late summer, early fall
Most common cause of mushroom poisoning in NA

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17
Q

Source of toxin for hydrazines

A

Gyomitra sp (false morel)
Under conifers & aspen in spring
Due to gyomitrin

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18
Q

Mechanism of hydrazines

A

Direct GI irritant
Gyomitrin hydrolized in GI tract - monomethylhydrazine (MMH) - decreased active form of Vit b6 - decreased GABA synesthesia and increased glutamic acid = increased CNS activity /seizures
Can cause oxidative damage to RBC, liver & kidney

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19
Q

Clinical signs of hydrazines

A

GI, CNS, hematopoietic, hepatic, renal
<3 onset, 1-2 days
Vomiting, depression/lethargy
Clonic-tonic seizures, coma
Methemoglobinemia, icterus

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20
Q

Diagnosing and treating hydrazines

A

ID of mushroom, increased AST/ALT, methemoglobin, hemolysis
Diazepam
Pyridozine (Vit B6)

21
Q

Source of toxin for isoxazoles

A

Amanita muscaria
Large & colorful
Coniferous & deciduous forests - oak, pine, hemlock

22
Q

Toxicity of isoxazoles

A

Thermostable toxin - not destroyed by boiling or drying
Ibotenic acid, muscazone, muscarine, muscimol
Ibotenic acid is present at highest levels
Passed in urin highest levels in cap

23
Q

Mechanism of action for isoxazoles

A

Ibotenic acid mimincs glutamate (excitatory neurotransmitter)
Muscimol as potent GABA agonist - CNS depressant at high doses, glutamate & GABA easily exchanged

24
Q

Clinical signs for isoxazoles

A

Onset <3 hrs, course of 1-2 days
Salivation, vomiting, diarrhea, depression/lethargy, disorientation, vestibular signs, respiratory depression, somnolence, miosis, abnormal behavior, bradycardia, muscle tremors, seizures, coma

25
Q

Diagnosing / treating isoxazoles

A

History of consumption, delirium, coma
Decontamination - act quickly due to short latent period
Emesis, GI lavage, activated charcoal
Symptomatic for seizure control, respiratory support

26
Q

muscarine

A

Inocybe pudica
Clitocybe dealbata

27
Q

Clinical signs for muscarine

A

SLUDDE
Salivation, lacrimation, urination, defecation, dyspnea, Emesis + Bradycardia, miosis, abdominal pain

28
Q

Diagnosis and treatment for muscarine

A

Muscarine detection in urine, response to atropine
Decontamination, activated charcoal, atropine dose of 0.04mg/kg
Prognosis is rarely fatal

29
Q

Source of toxin for muscarine

A

Inocybe lacera & I. Pudica - fishy order
Clitocybe dealbata & c. Truncicola- found in forests, lawns

30
Q

Toxicity of muscarine

A

Muscarine (0.1-0.3%)
Rabidly absorbed, doesnt cross BBB

31
Q

Mechanism of action for muscarine

A

Acetylcholine agonist - competes at parasympathetic muscarinic receptors
SLUDDE signs and decreased HR
Not inactivated by acetylcholinesterase
No nicotinic or CNS effects

32
Q

Source of psilocybin

A

Magic mushrooms, hallucinogenic mushrooms, straw mush
Commonly found in fields/cow pastures esp in north east

33
Q

Toxicity of psilocybin

A

Primarily toxin psilocybin metabolized via esterases to psilocin
Primarily dog & cat
Toxic dose for dogs

34
Q

Mechanism of action of psilocybin

A

Psilocin of similar in structure to serotonin
Lysergic acid diethylamine (LSD like properties)

35
Q

Clinical signs for psilocybin

A

Onset <1 hr, 12-24 hours
Ataxia, vocalization, anxiety, abnormal behavior, vomiting, nystagmus, mydriasis, muscle tremors, hyperthermia, tachycardia, seizures

36
Q

diagnosis and treatment for psilocybin

A

History of consumption w accompanying signs
Analysis of urine, serum, GI contents
Symptomatic, diazepam, short acting & resolve

37
Q

Blue green algae

A

Hepatotoxins
Neurotoxins

38
Q

Cyanobacteria

A

Bioaccumulation
Death caused by microcystins (liver) & anatoxins

39
Q

Microcystin

A

Cyclic heptapeptide, crosses BBB
Causes cytoskeletal disorganization
No treatment, mortality rates are high, prognosis is poor

40
Q

Clinical signs of mycrocystin

A

Acute hepatotoxicosis, vomiting, diarrhea, weak, shocky, death
Nodularin - onset within 5 hrs
Acutely lethargic, vomiting, diarrhea, inappetance, liver & kidney failure

41
Q

Diagnosing microcystins

A

History
Microcystin - increased ALT, AST, ALP; hyperbilirubinemia; hypoglycemia; abnormal coagulation & hyperammonemia
Nodularin: BUN, creatinine, phosphorus

42
Q

Anatoxins

A

Anatoxin A - potent nicotinic, cholinergic agonist leads to respiratory paralysis & death. Contributes to dopamine & noradrenaline release
Homoanatoxin -A - potent nicotinic, cholinergic agonist
Acetylcholinesterase inhibitor, does not cross BBB, opens L-type Ca2+ channels, release of acetylcholine in PNS

43
Q

Neurotoxin in tick saliva

A

Decreases release of acetylcholine
Differentials include botulism

44
Q

Latrodectus spiders

A

Black widow spiders - every state from Alaska
Both male/female bite, only female has long fangs

45
Q

Toxicity of latrodectus spiders

A

Bite causes Ca2+ to release neurotransmitters (esp ACh) from synaptic vesicles
Painful & can cause muscle spasms, LD50 - 0.43-1.39mg/kg
Toxicity highest in autumn & lowest in spring

46
Q

Venomous snakes in US

A

Elapids - coral snakes
Pit vipers & crotalids - rattle, copperheads, water moccasins

47
Q

Pit vipers

A

Aggressive, venom primarily proteolytic and anticoagulant

48
Q

Clinical signs for pit vipers

A

FAST onset
Bruising/swelling
Hypotension, tachycardia, nausea, shock, anticoagulation no cold & no tourniquet
Immobilize extremities

SS - Exam 1 (33 decks)

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