snake bite

Question 1

snake bite that doesnt have bite mark

Answer 1

krait

Question 2

Scientific name of hump nosed viper

Answer 2

Hypnale hypnale

Question 3

Low back pain in viper bite

Answer 3

ARF

Retroperitoneal bleeding

Question 4

Acute abdominal tenderness in viper bite

Answer 4

GI or retroperitoneal bleeding

Question 5

stomach pain in krait poisoning

Answer 5

submucosal hemorrhages in stomach

Question 6

Type of paralysis induced by elapids

Answer 6

descending paralysis

Question 7

Presentation of krait bite

Answer 7

Early morning with paralysis that may be mistaken for stroke

Question 8

Late onset envenomation is common with

Answer 8

Juvenile snakes
krait
hump nosed viper

Question 9

Viper that can present with neurotoxic features

Answer 9

Russell viper

Question 10

signs of local envenomation

Answer 10

PONDS
 Pain
 Oozing
 Node
 Discoloration
 Swelling

Question 11

Why 20WBCT is done every 6 hrly

Answer 11

liver cannot synthesize clotting factors in under 6 hours

Question 12

Frequency of 20WBCT in suspected poisonous snake bite cases

Answer 12

Every 30min for first 3 hours,then hourly

Question 13

RIGHT approach to snake bite

Answer 13

Reassure
Immobilise
Get to Hospital
Tell the doctor of any symptoms

Question 14

Half life of ASV

Answer 14

90 minutes

Question 15

Average amount of venom injected by russell viper

Answer 15

63mg

Question 16

One vial of ASV neutralises how much mg of russell viper venom

Answer 16

6 mg

Question 17

Pathogenesis of ASV reaction

Answer 17

complement mediated not IgE mediated

Question 18

Duration of administration of ASV

Answer 18

1 hour

Question 19

amount of isotonic saline in ASV infusate

Answer 19

5-10ml/kg

Question 20

Onset of action of im adrenaline

Answer 20

8 min

Question 21

Onset of action of S.C adrenaline

Answer 21

34 min

Question 22

Dilution of adrenaline available in wards

Answer 22

1:1000

Question 23

Rate of adrenaline infusion

Answer 23

0.25 ug/kg/min

Question 24

Dose of dexa and hydrocortisone in ASV reaction

Answer 24

Dexa: 0.1-0.4 mg/kg
Hydrocort: 2-6 mg/kg

Question 25

Treatment of late serum sickness reaction due to ASV

Answer 25

Prednisolone 5mg qid

Question 26

onset of late serum sickness reaction

Answer 26

1 to 2 wks after administration of ASV

Question 27

Max dose of ASV to be given in a neurotoxic snake bite patient

Answer 27

20 vials

Question 28

Max venom yield from a russell viper

Answer 28

147 mg

Question 29

Mech of neurotoxicity of elapids

Answer 29

Cobra- post synaptic | krait- pre synaptic

Question 30

Recovery after ASV: spontaneous systemic bleeding

Answer 30

15-30 min

Question 31

Recovery after ASV: blood hypocoagulability

Answer 31

6 hrs

Question 32

Recovery after ASV: neurotoxicity

Answer 32

Cobra: as early as 30 min krait: delayed

Question 33

Recovery after ASV: BP

Answer 33

30 min

Question 34

Refractory hypotension in russell viper bite

Answer 34

pitutary or adrenal necrosis

Question 35

Normal intracompartmental pressure

Answer 35

<20 mm Hg

Question 36

Fasciotomy is indicated if intracompartmental pressure is more than

Answer 36

30-40 mm Hg

Question 37

role of heparin in viper bites

Answer 37

contraindicated | venom induced thrombin is resistant to heparin