Snake Envenomation – Board-Style Questions

What this deck covers

Snake envenomation in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. At the edge of the field
2. The cord above the elbow
3. A pen and the clock
4. A glass tube on the bench
5. Who gets the treatment
6. How much for a child
7. A rash halfway through
8. The pinprick before the drip
9. Two marks and nothing else
10. Heavy eyes at two hours
11. Counting out loud
12. A drug that lifts the lids
13. Six hours later, and again
14. Where not to put a needle
15. The knife that can wait
16. Bringing it in a bag
17. Poorly again next week
18. Less in the bottle

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Rub the bite hard with a herbal paste and wait for an hour, It kills the tissue under it and the venom is not stopped, A photograph of the limb, repeated only at the end of each nursing shift, Take a blood film and look for fragmented cells under the lens, Systemic effects, or swelling that is climbing the limb quickly, A quarter of the adult amount, doubled if there is no response after an hour, Continue at the same rate and simply give an antihistamine, It uses up a vial that may be needed later in the night, Many bites deliver no venom at all, so observation is enough, Weakness of the legs that climbs upwards over the next several hours, Wait for her to complain that she is finding it hard to breathe, Plasma exchange, which removes the circulating venom within a few hours, Repeat the clotting test six-hourly and give a further quantity if it fails, Blood pressure is taken from the bitten arm every fifteen minutes.

Clinical pearls from this deck

• Splint it, keep her still, and get her to hospital.
• A tight band costs the limb and saves nothing.
• Mark the swelling and the time: measure the spread.
• No clot after twenty minutes: the venom has acted.
• Treat envenoming, not every bite that comes in.
• A child gets the adult dose: the venom is the same.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all emergency and critical care case decks · pediatric reference values.