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PAR2022 - Trauma > Week 9 > Flashcards

Week 9 Flashcards

1
Q

what agents does snake venom contain?

A
  • pain producing agents
  • enzymes
  • nephrotoxins
  • cardiotoxins
  • myotoxins
  • neurotoxins
  • haemotoxins
  • coagulopathy agents
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2
Q

what do myotoxins do?

A

direct effect on muscle:

  • pain
  • weakness
  • dark urine
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3
Q

what do haemotoxins do?

A
  • destroy red blood cells
  • reduces ocygen transport
  • stops clotting
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4
Q

how does snake venom neurotoxin affect nerves?

A
  1. presynaptic - presynaptic neuroblockade preventing release of aCH
  2. postsynaptic - toxins bind to aCH preventing the interaction between them and receptors on postsynaptic membrane.
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5
Q

what do nephrotoxins do?

A

kidneys are affected as a result of hypertension, myolysis or coagulopathy

  • more likely to get this if you have been drinking

Early signs are low and no urine production

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6
Q

what kind of snakes produce nephrotoxins?

A 
brown
tiger
mulga
taipans
rough scaled snake
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7
Q

what are cadiotoxins?

A

cause cardiac muscle damage or heart electrophysiology dysfunction

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8
Q

what are s&s of snake bites?

A
  • headache
  • pain and swelling
  • nausea/vomiting/abdo pain
  • paralysis with resp loss
  • ptosis (droopy eyelids)
  • Partial opthalmoplegia (paralysis of eye muscles)
  • diplopia (double vision)
  • Dysarthia (difficulty speaking)
  • loss of facial expression
  • myolysis (dark urine)
  • convulsions
  • progressive weakness
  • slurred speech
  • neurotoxins
  • coagulation disturbances
  • coagulopathy
  • anticoagulant
  • kidney damage
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9
Q

what snakes are in victoria?

A 
eastern brown
red-bellied black
some death adder species
toger
common copper head
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10
Q

how does venom move through the body?

A

lymphatic system

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11
Q

What are the 2 types of antivenoms?

A

Monovalent antivenom - against one species

Polyvalent - a combination of all species

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12
Q

what are some complications that can occur as a result of antivenoms?

A

anaphylactic shock

if given in excess it may block receptor sites

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13
Q

how does spider venom work?

A
  • targets neuromuscular joints
  • connective tissue
  • nervous system
  • neurotoxins
  • enzymes
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14
Q

what are the symptoms of a red back bite?

A
  • sharp pain at site
  • local sweating
  • nausea & vomiting
  • headache
  • piloerection
  • hypertension & tachycardia
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15
Q

When are redback bites more common?

A

warmer months

> 250 per year

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16
Q

how does the redback toxin work?

A

acts on pre-synaptic neuron. causing huge release and then leading to depletion of NA and ACh resulting in patchy paralysis of Neuromuscular junction

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17
Q

what are the 2 phases of a funnel web spider bite?

A 
Phase 1 - autonomic storm:
pain at bite site
piloerection
muscle spasms
tachycardia
hypertension
nausea
vomiting
abdo pain
salivation
lacrimation
death due to pulmonary oedema
Phase 2 - resolution:
resolution of phase 1 symptoms, 
refractory hypotension
cessation of breathing
cardiac arrest
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18
Q

What toxins are in a funnel web spider bite?

A

Neurotoxins act on nerve fibres producing spontaneous repetitive action potentials leading to uncoordinated muscle twitching

slows sodium channel inactivation

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19
Q

what are symptoms of mouse spider bite?

A

Venom similar to funnel web

muscle spasms
hypertension
opisthotonus (arched back)
unconscious

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20
Q

what are the symptoms of white tail spider bite?

A
  • mild stinging and sharp pain
  • swelling
  • erythema
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21
Q

How do you treat a red back spider bite?

A

ice packs
pressure immobilisation is NOT recommended
Red back antivenom

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22
Q

how do you treat a funnel web bite?

A

pressure imbolisation

same as snake

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23
Q

When do funnel web bites need antivenom?

A 
oral paraesthesia
tongue fasciculation
salivation
uncontrolled twitching
tachycardia
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24
Q

how do you treat white tail bite?

A

ice pack
simple analgesics
see doctor if pain and swelling persists

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25
Q

what are the group of insects that are medically significant in australia?

A

hymenoptera order of insects

  • bees
  • wasps
  • stinging ants
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26
Q

hat are symptoms of bee stings?

A

swelling
local pain
erythema

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27
Q

what is the toxin in bee stings?

A

Melittin - breaks down phospholipid layer of cells and releases histamine
Histamine

28
Q

how do you treat a bee sting?

A 
remove stinger
control swelling (ice + elevate)
remove jewlery that ay be restrictive
treat pain
antihistamines
29
Q

what are the symptoms of wasp sting

A

swelling
erythema
local pain

risk of severe allergic reaction

30
Q

How do you treat a wasp sting?

A
  • clean area with soap and warm water
  • remove jewlery
  • use cold pack to reduce swelling and pain
  • use pain-relieveing medications and creams
  • antihistamines
  • look for anaphylaxis
31
Q

what is the distinguishing feature of paralysis ticks?

A

front and back legs are darker than middle legs

32
Q

how does tick toxin work?

A

Holocytoxin

- acts pre-synaptically reducing release of ACh

33
Q

What are the symptoms of tick infestation?

A 
lethargy
weakness
unsteady gait
slurred speech
loss of apetitie
dilated oupils
ascending symmetrical aralysis

can result in lyme disease

34
Q

what is the pre hospital treatment for ticks?

A

ventilation due to resp paralysis

freeze dont squeeze

35
Q

What is lyme disease?

A

infection caused by bacteria transmitted when bitten by a tick

36
Q

what are the symptoms of lyme disease

A

bullseye rash
headache
fever
fatigue

37
Q

What is ross river fever?

A 
spread by mozzies
joint pain
influenze like sysmptoms
fever
fatigue
rash
38
Q

what is dengue fever

A

sudden fever
headache
muscle and joint pains

39
Q

what are the s&s of centipede bite

A

mild to sever local pain
- swelling and erythema
- minimal system effects
risk of infection

40
Q

how do you treat a centipede bite

A

analgesia

ice for pain and swelling

41
Q

what are s&s of caterpillar bites?

A

wheals and wide spread rashes
burning sensation
if in resp tract - laboured breathing
risk of infection

42
Q

how do you treat a catepillar sting

A 
sticky tape
wash injured area with soap and water
ice packs
monitor for allergic reactions
analgesia and antihistamines
43
Q

how do you treat a scorpion sting?

A

analgesia and ice packs

44
Q

how does the blue ringed octopus toxin work?

A

Tetrodotoxin
- neuromuscular blockade , rep arrest
blockade of voltage gated Na+ channels

45
Q

how do you treat blue ring octopus envenomation?

A

pressure immobilisation
resuscitation
closely monitor cardio vascular

NO ANTIVENOM

46
Q

how does cone shell toxin work?

A

conotoxins

- ion channel toxin that causes paralysis

47
Q

how do you treat a cone shell?

A

pressure bandage
supportive care
no antivenom

48
Q

what are symptoms of cone shell envenomaion?

A

local pain
neurologic impairment
progressive paralysis
resp failure

49
Q

what are syptoms of stone fish sting?

A

immediate severe pain
swelling and erythema
risk of shock

50
Q

how do you treat stone fish?

A 
wash site and clear debris
immerse in hot water for 20 mins
repeat as needed to 2 hours
pain relief
supportive care
if analgesic and hot water do not reduce effects, stonefish antivenom is needed
51
Q

what are S&S of lion fish?

A 
intense throbbing
sharp pain
tingling 
sweating
blistering
headache
nausea
abdo pain
seizures
paralysis of limbs
breathing difficulties
heart failure
pulmonary oedema
LOC
52
Q

how do you treat lion fish sting?

A

hot water
antivenom (stonefish)
narcotic analgesic

53
Q

how do you treat a scorpion fish sting?

A 
wash site
immerse in hot water
pain relief 
supportive care
stonefish antivenom
54
Q

what are s&s of a toadfish?

A 
parasethsia of lips and tongue
muscle weakness
cyanosis
hypotension
coma
55
Q

how do you treat toadfish if ingested

A

decontamination - activated charcoal
immediate supportive care
resp support

56
Q

what are some s&s of sting ray barbs

A 
nausea
vomiting
sweating
cramps
local pain
57
Q

how do you treat a stingray barb?

A 
bath wound in sea water and clean
if safe remove barbs
immerse in hot water
if bleeding apply pressure
pain relief
58
Q

what are s&s of bluebottle jellyfish stings?

A

immediate intense pain

rash or loacalised redness

59
Q

how to you treat a bluebottle sting?

A

wash with seawater
remove tenticles wih gloved hands
immerse in hot water for 20 mins (at least 45 degrees)
vinegar not recommended

60
Q

what are s&s of irunkandji syndrome?

A 
vomiting
profuse sweating
headache
agitation
rapid heart rate
increase in BP
pulmonary oedema
61
Q

how do you treat tropical jellyfish?

A 
wash with vinegar
remove tenticles
cool packs in plastic bags (want to keep dry)
pain relief
monitor for cardiovasulcar complications
62
Q

what are the venom components of sea snakes?

A

post synaptic neurotoxins

myotoxins

63
Q

S&S of sea snakes?

A

eye lids drooping
limb weakness
myoliysis

64
Q

what is the sea snake antivenom made with?

A

tiger snake and sea snake

65
Q

how do you treat sea snake bite?

A

pressure bandage

monitor for paralysis

PAR2022 - Trauma (12 decks)

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