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Implications of human poisoning > disaster preparedness and terrosim > Flashcards

disaster preparedness and terrosim Flashcards

1
Q

chemical warfare

A

inentional use of weapons to kill, injure, incapacitate by toxic or noxious chemicals

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2
Q

biologic warfare

A

inentional use of weapons to kill, injure, or incapacitate by microorgansims/xenobiotics derived from living organisms

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3
Q

Terrorism

A

force against ppl or property to intimidate or coerce a government, civilian population for political or social objectives

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4
Q

unitary(traditional) vs Binary agents

A

Unitary agents are effective on their own and do not require mixing with other agents
Binary = the nerve agent is typically stored as two less toxic chemical ingredients that are easier to transport, handle and store.

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5
Q

(NBC) nuclear, biologic and chemical agent

why used?

A

easy to get and make

small amount needed in enclosed space

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6
Q

chemical terrorism limitations

A

dose makes the poison
difficult in disseminating the agent for effect on target population
can be hazardous to maker
development and use requires skill

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7
Q

chemical terrorism methods of delivery

A

explosive release - point source/line source
bulk release -agent spills out into airstream
base ejection - piston action
spray delivery - airplane

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8
Q

3 types of vesicants

A

mustard - fluid blister, hours later
lewisite - fluid blister, immediate
phosgene oxime - wheal, immediate

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9
Q

what is a vesicant?

A

blistering agent

causing skin, eye, respiratory and mucosal pain

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10
Q

geranium
garlic
new mown hay

A

lewisite
mustard-gassed
phosgene

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11
Q

mustard gases

A

no antidote
1st symptom is coughing
fluid blister

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12
Q

mustard gases treatment

A

remove clothing
soap and water
resin (SDK)
IV NAC – N-aceytlcytsiene

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13
Q

phosgine oxime

A

causes like an allergic rxn ( urticant/nettle agent)

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14
Q

Lewisite

A 
organoarsenic compound
potent lacrimator
inhibits krebs cycle
fluid blister
geranium smell
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15
Q

lewisite treatment

A

decontamination
water sufficient
(BAL) British Anti-lewisite aka dimercaprol

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16
Q

phosgene mechanism

A

slowly hydrolyzed to hydrochloric acid

causes necrosis and inflammation of small airways and alveoli

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17
Q

highly soluble gases

A

chlorine gas - makes hydrochloric acid and hypchlorous acid when dissolved in water

treatment is nebulized sodium bicarbonate
ABC’s
bronchodilators
no benefit from steroids or antibiotics

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18
Q

highly soluble gas nitrogen dioxide mechanism

and treatment

A

generates reactive nitrogen intermdieats that damage pulmonary epithelial cells
treatment = supportive care
corticosteroids
methylene blue

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19
Q

highly soluble gas is white phosphorous

A

combusts when added to O2

can be hydrolyzed to phosphoric acid in tissue

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20
Q

white phosphourous treatment

A

irrigation of burn and covered with damp cloth

apply 1% copper sulfate to precipitate phosphorous and stops oxidative rxn

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21
Q

hydrogen cyanide mechanism

A

cytochrome oxidase inhibitor

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22
Q

hydrogen cyanide clinicial effects

A 
unconciousness
seizure
tachycardia
acidosis
cardiogenic pulmonary edema
acute lung injury
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23
Q

hydrogen cyanide clinicial effects

A 
unconciousness
seizure
tachycardia
acidosis
cardiogenic pulmonary edema
acute lung injury
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24
Q

hydrogen cyanide treatment

A

hydroxocobalamin

sodium thiosulfate

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25
Q

nitrites mechanism

A

makes methemoglobin which cyanide binds preferentially to produce cyanmethemoglobin

26
Q

sodium thiosulfate

A

eases conversion of cyanide into thiocyanate via rhodanese

used for impaired oxygen carrying capacity

27
Q

hydroxocobalamin

A

vitamin b12 binds with cyanide to make cyanocobalamin

safe to use in setting of smoke inhalaiton

28
Q

arsenic

A

tastless

odorless

29
Q

trivalent arsenic

A

inhibits krebs cycle by blocking atp production
affects cardiac repolarization currents
inhibits insulin induced glucose transport and damages Beta cells
chronic vascular disease
hepatatic fibrosis
cancer

30
Q

pentavalent arsenic

A 
transformation to As3+
substitutes for inorganic phosphate uncoupling oxidative phosphyrylation
forms adp arsenate
rice water diarrhea
mutlisystem organ dysfunction
31
Q

arsenic treatment

A

supportive care
benxodiasepinez
ivf for fluid loss

32
Q

chelation

A

do not wait to chelate in acute toxicity
BAL (dimercaprol) = 1st line for acute toxicity
succimer (DMSA)

33
Q

antidote for anticholinergics

A

physostigmine

34
Q

nerve agents

A

organophosphates
sarin
cholinergic toxidrome

35
Q

organophosphates

A

mechanism inhibits acetylcholinesterase

36
Q

acetylcholinesterase

A

enzyme that degrades acetylcholine to choline and acetic acid
found in CNS and PNS and RBC

37
Q

different nerve agents

A 
g series = non persistent and volatile
tabun
sarin - most volatile
soman
cyclosarinn
v series = persistence and non volatile or less volatile
vx = least volatile
vr
vm
vg
ve
38
Q

nerve agents

A

most are lipohilic which leads to prolonged release from adipose (tissue absorbs it and leaks it back to blood stream)
seizures loss of conciousness, apnea, and death
confirmed by cholinesterase levels

39
Q

nerve agents toxidrome

A

mydriasis

40
Q

cholinesterase can age because of nerve agents

A 
soma  = 2 min 
sarin =  5 hours
tuban = 40 hours
41
Q

nerve agent antidotes

A

atropine
benzodiazepines
oximes

42
Q

sarin gas mechanism

A

binds to acetylcholinesterase. muscles only flex and the diaphram cramps causing asphyxiation
odorless
colorless
very volatile therefore easily enters lungs
short half life (very hard to detect after long time)

43
Q

nerve agent antidote

A

diazapam
2-PAM
atropine

44
Q

non ionzing radiation

A

low energy
no electron bumping
UV, visible spectrum, IR

45
Q

Ionzing
directly ionizing
indirectly ionzing

A 
directly = alpha and beta particles stopped by paper and clothing
indirectly = gamma/XR (stopped by several feet of concrete/inches of Pb)
46
Q

acute radiation syndromes progress through 4 stages in what order?

A
  1. hematopoietic syndrome (can possibly survive)
  2. GI syndrome (not survivable)
  3. cardiovascular/CNS (not survivable)
  4. survival or death

higher the dose you move through each system

47
Q

order of treatment for radiation injury?

A
  1. life threatening injuries
  2. externally contaminated
  3. internally contaminated
  4. externally irradiated
48
Q

biological agents

A 
anthrax
plage yersinia pestis
tularemia - arobic gram negative coocobaciluus
brucellosis - unpastuerized dairy
Q fever
small pox
viral hemorrhagic fevers
equine encephalitis
botulinum toxin - disrupts SNARE complex and acetylcholine fails to be released to the nmj
49
Q

treating bioological agents

A

supportive care

antitoxin; babybig, trivalent, and heptavalent

50
Q

treatment of ricin

A

supportive care

no antidote

51
Q

diagnosis of ricin

A

elisa assay of nasal swab, blood, or other body fluid

52
Q

staphylcoccal enterotoxin B

A

not lethal just incapacitates

53
Q

what is a super antigen?

A

activates immune system

leads to strong inflammatory response because of activation of oligoclonal (non-specific) t cell activation

54
Q

T-2 myctoxin

A

red rash

yellow rain

55
Q

strategic national stockpile

A

nations largest supply of potentially life saving parmaceuticals and medical supplies

56
Q

chempacks

A

containers of nerve agent antidotes in secure locations for rapid response

57
Q

push packages

A

strategically located ready for immediate deployment

58
Q

PPE A

A

breathing apparatus
encapsulated chemical protective suit
highest level of respiratory, eye, mucous membrane and skin protectioin

59
Q

ppe B

A

positive pressure respirator
non encapsulated chemical resistant garments
max respiratory protection with lower degree of skin protection

60
Q

ppe C

A

same skin protection as B with lower level of respiratory protection

61
Q

ppe D

A

hospital universal precautions

inadequate chemical protection

Implications of human poisoning (10 decks)

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