Bites and Stings

Question 1

What is the board answer for treatment of brown recluse bite?

Answer 1

Dapsone (but not always in practice) and can’t give to people with G6PD deficiency

Question 2

What does the a black widow bite cause?

Answer 2

Can mimic acute abdomen but can also cause tachycardia, tremors, excess salivation, cramping, shock, coma, and ST segment elevation myocarditis

Question 3

What should you do pre-hospital of a snake bite?

Answer 3

Remove all jewelry and keep in a neutral position

Question 4

What is the MOA of black widow toxin?

Answer 4

Releases huge about of acetylcholine at NMJ

Question 5

What is the treatment for black widow invenomation?

Answer 5

1. Pain relievers
2. Muscle relaxers
3. Dantrolene
4. Antivenom made in horses is rarely used

Question 6

What can brown recluse bites mimic

Answer 6

Flu-like symptoms in the summer but also with a bite site with local necrosis

Question 7

What do you remove a jellyfish barb from skin?

Answer 7

With gloves and forceps

Question 8

What is the TOC for jellyfish sting?

Answer 8

1. 5% acetic acid is first choice
2. 30-minutes of salt water is second (Portuguese man of war–1st choice)
3. Some centers have anti-venom

Question 9

Why can you still get ciguatera poisoning from cooked fish?

Answer 9

It is heat stable

Question 10

What are symptoms of ciguatera poisoning?

Answer 10

1. NVD
2. CV (bradycardia/hypotension)
3. Neuro: parasthesias, vertigo, temperature reversal coffee is now cold

Question 11

What is the treatment for ciguatera poisoning?

Answer 11

1. Supportive

2. Might need atropine or pressors

Question 12

What is the treatment for scombroid poisoning?

Answer 12

H1 and H2 blockers – this is a histaminergic reaction