A doctor is treating a patient with viper snake bite. He should not forget that viper venom is:

Ans, b. Vasculotoxic (Ref: Reddy 33/e p562, 25/e pe p484, 486-487)Viper venom is vasculotoxic.NeurotoxicQElapids (Cobra, Coral, Krait)VasculotoxicQVipersHyotoxicQSea SnakesViper BiteMore than 50% of the victims have minimal or no poisoning, as little or no venom is injected.The area around the bite is red and painful. The onset of selling starts within 15 minutes and there is often blood- stained discharge from the woundQ.In severe cases, the main feature is persisting shockQ.A hemorrhagic syndrome with blood-stained sputum, hemorrhages from gumsQ, the site of bite, etc. occur due to the increased coagulation time.Intravascular hemolysis may lead to hemoglobinuria and renal failure.Death is usually due to shock and hemorrhageQ. Poisonous snakeNon-poisonous snakeBody scalesLarge and cover entire breadth of bellyQSmall like those on the back or the moderately large but do not cover the entire breadth of the bellyQHead scales* Small in vipersQ* Large and with- An opening or pit between eye and nostril (pit viper)Q- Third labial touches the eye and nasal shield (cobra or coral snake)Q- Central row of scales on back enlarged and undersurface of the mouth has only four infralabials, the fourth being the largest (krait)* LargeFangLong and grooved or canalisedQShort and solidQTailCompressedQNot markedly compressedHabitsGenerally nocturnalQNot soBiteTwo fangs marksQ with or without small marks of other teethA number of small teeth marks in a rowQ FeatureElapids Cobra, Coral, KraitVipersSea SnakesType of venomNeurotoxicQVasculotoxicQMyotoxicQSite of actionMotor nerve cellsQ and resembles curareEndothelial cells and RBC leads to hemolysisQMusclesQLocal symptoms at site of biteMinimalSevereQ(severe swelling, oozing of blood and cellulites)MinimalClinicalpresentation* Muscle weakness of legs and face* Cobra venom produces convulsionsQ* Krait venom produces only paralysisQVenom causes enzymatic destruction of cell walls and Coagulation disorderQGeneralized muscle pain, weakness, polymyositis, myoglobinuriaQ