Cs - Urticaria

Front 1

_ is Characterized by large, (often transient), irregularly shaped, pruritic, erythematous wheals.*

Back 1

urticaria

Front 2

A hive can have an _ (wheal) compared to the _ (flare) surrounding area.

Back 2

edematous, possibly pale central area

erythematous

Front 3

Angioedema appears as _, it may or may not have _.

It often involves what areas?

Back 3

brawny, non pitting edema that is transient.
associated itching

lips, tongue, eyelids, genitalia

Front 4

Symptoms of anaphylaxis include

Back 4

hypotension or shock,
respiratory distress
flushing
pruritis
urticaria
angioedema

Front 5

_ is a good lab test that should be done for patients suffering from recurrent angioedema

Back 5

C1-esterase inhibitor deficiency

Front 6

Genetic inheritance of HAE is _.

This Usually involves extremities but may involve _
Frequently have attacks of _

Back 6

Hereditary Angioedema (HAE)

-autosomal dominant
-any external body surface as well as mucosal surface
-severe abdominal pain

Front 7

Hereditary Angioedema is associated with low levels of _

(T/F) Histamine also plays a role

Back 7

C1 inhibitor (needed for dx)

False. Histamine has no role in this condition.

Front 8

6 y/o adopted boy presents to your office with recurrent laryngeal edema. Lab results show C1 inhibitor levels to be at 28% of lower limit. Labs are reordered 6 weeks later, with similar results. What is your diagnosis?

Back 8

hereditary angioedema


*HAE Lab criteria :C1 inhibitor levels less than 50 percent of the lower limit of normal at two separate determinations (at least one month apart) with the patient in their basal condition and after the first year of life. Usually family hx is helpful in dx but unavailable in this case

Front 9

6 y/o adopted boy presents to your office with recurrent laryngeal edema. Lab results show C1 inhibitor levels to be at 28% of lower limit. Labs are reordered 6 weeks later, with similar results. How do you treat him

Back 9

Fresh Frozen Plasma, IV fluids, and close monitoring of aiway

This patient has Hereditary Angioedema, in which case FFP is the quickest and easiest treatment in emergency situations

Front 10

Violin spiders are AKA _.

They have _ venom

Back 10

Brown Recluse Spiders

CYTOTOXIC (Cell destroying)...typical of a non web dwelling spider

Front 11

Loxosceles Reclusa venom is Composed of a collection of _ .

This will lead to what reaction in a patient?

Back 11

*This is the brown recluse spider.

hemolytic enzymes that destroy cell membranes

leads to the breakdown of skin, fat, and blood vessels. Necrosis of skin happens 10% of the time

Front 12

(T/F) Brown recluse bites are painful and noticeable immediately.

How long does it take to heal from a bite?

Back 12

False. Bites are usually painless and initially go unnoticed. Symptoms often begin 2-8 hours after bite, and do NOT cause serious systemic symptoms, only a small amount is injected


6-8 Weeks!

Front 13

Brown recluse bites can have a _ surrounding the central area of necrosis.
Necrosis is more common in what areas?
Can the wound spread outward?

Back 13

blue-white halo (Bull's eye)
Adipose areas
YES, They May develop severe destructive necrotic lesions with deep wide borders

Front 14

The female _ spider is the most venomous spider in North America. This venom is _ (cytotoxic/neurotoxic), and can cause _ pain

Back 14

black widow, neurotoxic,

abdominal, similar to appendicitis,** pancreatitis, or peptic ulcer....particularly following a bite to the LOWER extremities (It can also cause muscle spasms or pain to the sole of the feet)

Front 15

_ is the controversial treatment to Brown Recluse bites.

Back 15

Dapsone - Might reduce the local effects of the venom
-An antiinflammatory with bactericidal and bacteriostatic effects.
-To be effective, must use in first few hours

Front 16

Patient presents with Chest pain, also states that she has a "dull, crampy" pain in her left arm. She is currently hypertensive and Upon examination, you notice her arm is slightly swollen and erythematous. You locate 2 small fang marks. What is the likely diagnosis?

Back 16

Black Widow Bite

Front 17

Symptoms such as a boardlike abdomen, leg cramps, restlessness, and hypertension are typical of what kind of bite?

Back 17

Black Widow

Front 18

_ antivenom is recommended for Black widow bites on patients under 16 or over 65.

Other symptomatic treatment includes...

Back 18

Latrodectus Antivenom (May cause a placental abruption so should also be considered for pregos)

Diazepam or Lorazepam to help with muscle spasms

Front 19

What is the one species of scorpion that is dangerous to humans in the US?

What is the most potent 'ingredient' in their venom, and what does it do?

Back 19

Centruroides* Exilicauda –AKA the “Bark Scorpion”

Neurotoxin, results in repetitive firing and over-excitation symptoms

Front 20

Most deaths occur during the first _ hours after a centuroides sting and are secondary to _

Back 20

24

respiratory or cardiovascular failure

children and elderly at at greatest risk

Front 21

Patient comes in complaing that "something bit" her. Says there is a sharp, burning pain on her foot and it feels like an electric current. Now the area is pruritic and erythematous. What do you suspect?

What are other signs she is most likely experiencing if the envenomation is serious?

Back 21

Centruroides sting (scorpion)

Mydriasis (most common)* - dilated pupils; Nystagmus*,
Hypersalivation*, Restlessness*,Paresthesia (tingling)

Front 22

If a patient dies from a scorpion sting, it is usually via _secondary to _, _ and/or _.

It could also induce _ which plays a large role in deaths as well

Back 22

respiratory failure*

anaphylaxis*, ronchoconstriction*,
diaphragmatic paralysis.**

mutliorgan failure

Front 23

What is the initial sumptom of a rattlesnake bite?
Other symptoms include _
_ and _ may develop later

Back 23

severe pain

swelling that extends proximally,bloody wound drainage, numbness around mouth, rapid pulse, muscle fasciculations, visual disturbances, erythema, necrosis and subQ may develop later

Death is due to the coagulation mechanism leading to hemorrhage

Front 24

Death from a rattlesnake bite is often associated with _ leading to _

Back 24

a disruption of the coagulation mechanism, leading to hemorrhage*

Front 25

In rattlesnake bites, there is usually _, and therefore _.

Because of these symptoms you should avoid _ as treatment

Back 25

Edema and compartment syndrome

constricting bandages. Apply a mildly constricting bandage about 2 inches above bite unles antivenom is given

Front 26

When deciding to use antivenin or not or a rattlesnake bite, look at _ (3) effects

The antivenin is _. Is it the same for pediatric patients?

Back 26

1-Local effects
2-Coagulation effects
3-Systemic Effects (hypotension)

CroFab Antivenom, Yes, it's the same (dose and everything) . There is No adjustment for pediatric patients. It should be started early