|
| A) | Cottonmouth | ||
| B) | Western massasauga | ||
| C) | Eastern garter snake | ||
| D) | Eastern diamondback rattlesnake |
| A) | nighttime. | ||
| B) | early morning. | ||
| C) | fall and winter. | ||
| D) | spring and summer. |
| A) | Less than 1% | ||
| B) | 25% | ||
| C) | 50% | ||
| D) | 80% |
| A) | copperhead. | ||
| B) | water moccasin. | ||
| C) | Mojave rattlesnake. | ||
| D) | eastern diamondback rattlesnake. |
| A) | extensive and irreversible necrosis. | ||
| B) | less severe edema than crotalid bites. | ||
| C) | a predomination of neurotoxic symptoms. | ||
| D) | fasciculations, particularly across the muscles of the back. |
| A) | 5 seconds. | ||
| B) | 60 seconds. | ||
| C) | 2 to 4 minutes. | ||
| D) | 5 to 10 minutes. |
| A) | Bites rarely penetrate subcutaneous tissue. | ||
| B) | The early spread of venom is by venous flow. | ||
| C) | Swelling and tenderness of regional lymph nodes is rare. | ||
| D) | Deeper bites are more likely to result in rapid clinical deterioration. |
| A) | Copperhead | ||
| B) | Water moccasin | ||
| C) | Southern Pacific rattlesnake | ||
| D) | Northern black-tailed rattlesnake |
| A) | severe and extensive edema. | ||
| B) | severe pain that does not respond to strong analgesics. | ||
| C) | activation of the coagulation cascade coupled with hypovolemic shock. | ||
| D) | None of the above |
| A) | interrupting venom cell wall synthesis. | ||
| B) | binding with and neutralizing venom toxins. | ||
| C) | facilitating concentration of the venom in the target tissues. | ||
| D) | inhibiting coagulation cascade activation and causing cell death. |
| A) | The early clinical course does not necessarily indicate a benign outcome. | ||
| B) | It is important to observe patients who present with snakebite for at least eight hours. | ||
| C) | An unremarkable physical exam and laboratory profile at presentation does not reliably indicate that the degree of envenomation is insignificant. | ||
| D) | All of the above |
| A) | almost immediately after the bite. | ||
| B) | 30 to 60 minutes after the bite. | ||
| C) | 2 hours after the bite. | ||
| D) | more than 4 hours after the bite. |
| A) | the patient has moderate swelling and ecchymoses. | ||
| B) | the patient has a positive fibrin/FDP test result but only mild symptoms. | ||
| C) | swelling is localized 30 to 60 minutes after the bite and there are no other symptoms, including no coagulopathy after 8 to 12 hours of observation. | ||
| D) | the patient is only experiencing mild parasthesias and swelling is limited to the affected extremity. |
| A) | A comorbidity | ||
| B) | Direct effect of venom on the brain | ||
| C) | Cerebral bleed due to coagulopathy | ||
| D) | Hypoxia related to pulmonary failure |
| A) | Blood transfusions | ||
| B) | Dopamine agonists | ||
| C) | IV fluid resuscitation | ||
| D) | Sympathomimetic amines with vasoconstrictor (alpha-adrenergic) activity |
| A) | No risk of bleeding | ||
| B) | Continuous monitoring of fluid balance | ||
| C) | Early laboratory analysis, early detection, and early treatment of hematuria | ||
| D) | Facilitation of fluid management of myoglobinuria and prevention of renal failure |
| A) | be transported with lights and sirens. | ||
| B) | have any band or tourniquet removed immediately. | ||
| C) | not receive pain medication in order to avoid obfuscating symptoms. | ||
| D) | have the leading edge of swelling or tenderness marked, with time documented. |
| A) | 1 to 2 hours. | ||
| B) | 4 to 6 hours. | ||
| C) | 8 to 12 hours. | ||
| D) | 24 to 48 hours. |
| A) | Fibrinogen | ||
| B) | Lipid panel | ||
| C) | Urine myoglobin | ||
| D) | Hemoglobin and hematocrit |
| A) | Strict bed rest | ||
| B) | Morphine sulfate | ||
| C) | Withholding food and liquids | ||
| D) | Automated blood pressure measurements |
| A) | immediately. | ||
| B) | within 24 hours. | ||
| C) | on the fourth or fifth day. | ||
| D) | after resolution of all symptoms, usually after 10 to 14 days. |
| A) | frank bleeding. | ||
| B) | multicomponent coagulopathy. | ||
| C) | rapid swelling beyond the area of the bite. | ||
| D) | Any of the above |
| A) | 0.2 cm/hour. | ||
| B) | 1 cm/hour. | ||
| C) | 1 cm/day. | ||
| D) | 3 cm/day. |
| A) | the materials should be mixed by gentle swirling. | ||
| B) | the reconstituted materials should never be returned to the IV bag. | ||
| C) | the materials should be mixed by continuous gentle manual inversion. | ||
| D) | it is important not to release pressure from the vial after the diluent is added. |
| A) | 2 vials. | ||
| B) | 6 vials. | ||
| C) | 10 vials. | ||
| D) | 20 vials. |
| A) | within 24 hours after initial control. | ||
| B) | 2 to 7 days after initial control. | ||
| C) | 10 to 12 days after initial control. | ||
| D) | more than two weeks after initial control. |
| A) | cimetidine. | ||
| B) | epinephrine. | ||
| C) | methylprednisone. | ||
| D) | diphenhydramine. |
| A) | shock. | ||
| B) | intravascular volume depletion. | ||
| C) | a common delayed response to epinephrine. | ||
| D) | another cause of symptoms—not anaphylaxis. |
| A) | once prior to discharge. | ||
| B) | every 48 hours after the last antivenom dose. | ||
| C) | until the antivenom dose is fully administered. | ||
| D) | for 24 hours after the antivenom dose is fully administered. |
| A) | a low-risk comorbid condition. | ||
| B) | platelet count greater than 80,000/mcL. | ||
| C) | fibrinogen concentration less than 50 mg/dL. | ||
| D) | a clear improvement trend after mild early coagulopathy. |