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Common Toxicities in Pets – NAVLE Styled Questions

    Human Foods:

    1. Raisins/GrapesQuestion: A dog presents with vomiting, diarrhea, and lethargy after eating a large number of raisins. Blood work shows elevated BUN and creatinine. What is the most likely cause of these symptoms?
      • A) Xylitol toxicity
      • B) Grape and raisin toxicity
      • C) Lead toxicity
      • D) Chocolate toxicity
      • Correct Answer: B) Grape and raisin toxicity
      • Explanation: Grapes and raisins are toxic to dogs, causing acute renal failure. Symptoms include vomiting, diarrhea, lethargy, and azotemia on blood work.
    2. ChocolateQuestion: A Labrador presents with vomiting, hyperactivity, and tachycardia after ingesting a box of dark chocolate. What is the most appropriate treatment?
      • A) Administer activated charcoal and IV fluids
      • B) Induce vomiting and administer anti-seizure medications
      • C) Provide supportive care and monitor for arrhythmias
      • D) Administer vitamin K for coagulation disorders
      • Correct Answer: A) Administer activated charcoal and IV fluids
      • Explanation: Chocolate toxicity is caused by theobromine, a methylxanthine that causes GI upset, hyperactivity, arrhythmias, and seizures. Activated charcoal helps reduce absorption.
    3. XylitolQuestion: A small dog presents with hypoglycemia and seizures after eating sugar-free gum. What is the most appropriate first step in treatment?
      • A) Administer glucose and IV fluids
      • B) Induce vomiting and administer activated charcoal
      • C) Administer anti-seizure medications and monitor blood glucose
      • D) Provide supportive care and start liver protectants
      • Correct Answer: A) Administer glucose and IV fluids
      • Explanation: Xylitol ingestion causes a rapid insulin release, leading to hypoglycemia. IV glucose is necessary to correct hypoglycemia and prevent seizures.

    Human Medications:

    1. AcetaminophenQuestion: A cat presents with muddy mucous membranes, depression, and facial swelling after ingesting acetaminophen. What is the most appropriate treatment?
      • A) Administer N-acetylcysteine and ascorbic acid
      • B) Induce vomiting and administer activated charcoal
      • C) Administer IV fluids and provide supportive care
      • D) Start corticosteroids and antihistamines
      • Correct Answer: A) Administer N-acetylcysteine and ascorbic acid
      • Explanation: Acetaminophen toxicity causes methemoglobinemia and liver damage in cats. N-acetylcysteine is the antidote to replenish glutathione, and ascorbic acid helps reduce methemoglobin.
    2. SSRIsQuestion: A dog presents with hyperthermia, tremors, and tachycardia after ingesting an owner’s SSRI medication. What is the most appropriate management?
      • A) Administer activated charcoal and IV fluids
      • B) Induce vomiting and provide benzodiazepines for tremors
      • C) Start gastric lavage and administer cooling therapy
      • D) Administer anti-arrhythmic medications and monitor heart rate
      • Correct Answer: B) Induce vomiting and provide benzodiazepines for tremors
      • Explanation: SSRI toxicity can lead to serotonin syndrome, characterized by tremors, hyperthermia, and tachycardia. Treatment includes inducing emesis and controlling seizures or tremors.
    3. MethylphenidateQuestion: A dog presents with hyperactivity, dilated pupils, and tachycardia after ingesting methylphenidate (Ritalin). What is the most appropriate next step in management?
      • A) Provide supportive care and monitor the heart rate
      • B) Administer benzodiazepines and IV fluids
      • C) Induce vomiting and administer activated charcoal
      • D) Administer beta-blockers and anticonvulsants
      • Correct Answer: C) Induce vomiting and administer activated charcoal
      • Explanation: Methylphenidate is a stimulant that can cause hyperactivity, tachycardia, and seizures in dogs. Inducing emesis and administering activated charcoal can reduce absorption.
    4. Sleep AidsQuestion: A dog presents with lethargy and ataxia after ingesting a large number of over-the-counter sleep aids. What is the most appropriate treatment?
      • A) Administer flumazenil to reverse sedative effects
      • B) Administer activated charcoal and monitor for CNS depression
      • C) Induce vomiting and administer anti-seizure medications
      • D) Administer naloxone to reverse opioid effects
      • Correct Answer: B) Administer activated charcoal and monitor for CNS depression
      • Explanation: Over-the-counter sleep aids often contain sedatives like diphenhydramine. Activated charcoal helps prevent further absorption, and monitoring for CNS depression is important.

    Household Hazards:

    1. AlcoholQuestion: A small dog presents with ataxia, hypothermia, and respiratory depression after ingesting beer. What is the most appropriate next step in treatment?
      • A) Induce vomiting and provide supportive care
      • B) Administer IV fluids and maintain body temperature
      • C) Administer activated charcoal and monitor the dog closely
      • D) Perform gastric lavage and start oxygen therapy
      • Correct Answer: B) Administer IV fluids and maintain body temperature
      • Explanation: Alcohol toxicity causes CNS depression, hypothermia, and respiratory depression in dogs. Supportive care includes IV fluids, maintaining body temperature, and monitoring respiration.
    2. Chlorine BleachQuestion: A cat presents with hypersalivation, vomiting, and oral ulceration after ingesting household bleach. What is the most appropriate treatment?
      • A) Induce vomiting and administer activated charcoal
      • B) Provide supportive care and administer GI protectants
      • C) Perform gastric lavage and provide IV fluids
      • D) Administer corticosteroids and antihistamines
      • Correct Answer: B) Provide supportive care and administer GI protectants
      • Explanation: Chlorine bleach ingestion causes GI irritation and ulceration. Supportive care with GI protectants and fluids is key. Inducing vomiting is contraindicated.
    3. Dishwasher PacketsQuestion: A dog presents with vomiting and esophageal pain after ingesting a dishwasher detergent packet. What is the most appropriate management?
      • A) Induce vomiting and provide anti-emetics
      • B) Perform gastric lavage and administer corticosteroids
      • C) Administer anti-emetics and monitor for esophageal injury
      • D) Provide supportive care and perform endoscopy if necessary
      • Correct Answer: D) Provide supportive care and perform endoscopy if necessary
      • Explanation: Ingestion of dishwasher detergent packets can cause significant esophageal damage. Supportive care and endoscopy are required to assess for esophageal burns or necrosis.

    Rodenticides:

    1. AnticoagulantQuestion: A dog presents with lethargy and bruising after ingesting rodenticide. Blood work reveals a prolonged PT and PTT. What is the most appropriate treatment?
      • A) Administer vitamin K1 and monitor clotting times
      • B) Induce vomiting and administer activated charcoal
      • C) Administer IV fluids and start corticosteroids
      • D) Perform blood transfusion and provide supportive care
      • Correct Answer: A) Administer vitamin K1 and monitor clotting times
      • Explanation: Anticoagulant rodenticides inhibit vitamin K-dependent clotting factors, leading to bleeding. Vitamin K1 is essential for clotting factor regeneration.
    2. BromethalinQuestion: A dog presents with tremors, hyperthermia, and seizures after ingesting a rodenticide containing bromethalin. What is the most appropriate treatment?
      • A) Induce vomiting and administer activated charcoal
      • B) Start anticonvulsants and supportive care
      • C) Administer vitamin K1 and IV fluids
      • D) Provide oxygen therapy and monitor for neurologic signs
      • Correct Answer: B) Start anticonvulsants and supportive care
      • Explanation: Bromethalin is a neurotoxic rodenticide that causes cerebral edema, tremors, and seizures. Treatment focuses on managing seizures and providing supportive care.
    3. CholecalciferolQuestion: A dog presents with polyuria, polydipsia, and muscle weakness after ingesting a rodenticide containing cholecalciferol. Blood work shows hypercalcemia and hyperphosphatemia. What is the most appropriate treatment?
      • A) Induce vomiting and provide anti-emetics
      • B) Administer IV fluids and start diuretics to lower calcium levels
      • C) Start corticosteroids and provide vitamin D supplements
      • D) Administer activated charcoal and monitor calcium levels
      • Correct Answer: B) Administer IV fluids and start diuretics to lower calcium levels
      • Explanation: Cholecalciferol rodenticides cause hypercalcemia and hyperphosphatemia, leading to renal failure. Treatment focuses on lowering calcium levels with IV fluids, diuretics, and possibly calcitonin.
    4. Zinc PhosphideQuestion: A dog presents with vomiting, abdominal pain, and dyspnea after ingesting zinc phosphide rodenticide. The owner reports a strong garlic odor on the dog’s breath. What is the most appropriate next step?
      • A) Induce vomiting in a well-ventilated area and provide supportive care
      • B) Administer activated charcoal and IV fluids
      • C) Provide anti-emetics and monitor for acidosis
      • D) Administer oxygen therapy and corticosteroids
      • Correct Answer: A) Induce vomiting in a well-ventilated area and provide supportive care
      • Explanation: Zinc phosphide rodenticide releases phosphine gas, causing severe GI and respiratory signs. Inducing emesis should be done in a well-ventilated area to avoid exposure to the toxic gas.

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