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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
nitrites mechanism
makes methemoglobin which cyanide binds preferentially to produce cyanmethemoglobin
26
sodium thiosulfate
eases conversion of cyanide into thiocyanate via rhodanese | used for impaired oxygen carrying capacity
27
hydroxocobalamin
vitamin b12 binds with cyanide to make cyanocobalamin | safe to use in setting of smoke inhalaiton
28
arsenic
tastless | odorless
29
trivalent arsenic
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
pentavalent arsenic
``` transformation to As3+ substitutes for inorganic phosphate uncoupling oxidative phosphyrylation forms adp arsenate rice water diarrhea mutlisystem organ dysfunction ```
31
arsenic treatment
supportive care benxodiasepinez ivf for fluid loss
32
chelation
do not wait to chelate in acute toxicity BAL (dimercaprol) = 1st line for acute toxicity succimer (DMSA)
33
antidote for anticholinergics
physostigmine
34
nerve agents
organophosphates sarin cholinergic toxidrome
35
organophosphates
mechanism inhibits acetylcholinesterase
36
acetylcholinesterase
enzyme that degrades acetylcholine to choline and acetic acid found in CNS and PNS and RBC
37
different nerve agents
``` 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
nerve agents
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
nerve agents toxidrome
mydriasis
40
cholinesterase can age because of nerve agents
``` soma = 2 min sarin = 5 hours tuban = 40 hours ```
41
nerve agent antidotes
atropine benzodiazepines oximes
42
sarin gas mechanism
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
nerve agent antidote
diazapam 2-PAM atropine
44
non ionzing radiation
low energy no electron bumping UV, visible spectrum, IR
45
Ionzing directly ionizing indirectly ionzing
``` directly = alpha and beta particles stopped by paper and clothing indirectly = gamma/XR (stopped by several feet of concrete/inches of Pb) ```
46
acute radiation syndromes progress through 4 stages in what order?
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
order of treatment for radiation injury?
1. life threatening injuries 2. externally contaminated 3. internally contaminated 4. externally irradiated
48
biological agents
``` 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
treating bioological agents
supportive care | antitoxin; babybig, trivalent, and heptavalent
50
treatment of ricin
supportive care | no antidote
51
diagnosis of ricin
elisa assay of nasal swab, blood, or other body fluid
52
staphylcoccal enterotoxin B
not lethal just incapacitates
53
what is a super antigen?
activates immune system | leads to strong inflammatory response because of activation of oligoclonal (non-specific) t cell activation
54
T-2 myctoxin
red rash | yellow rain
55
strategic national stockpile
nations largest supply of potentially life saving parmaceuticals and medical supplies
56
chempacks
containers of nerve agent antidotes in secure locations for rapid response
57
push packages
strategically located ready for immediate deployment
58
PPE A
breathing apparatus encapsulated chemical protective suit highest level of respiratory, eye, mucous membrane and skin protectioin
59
ppe B
positive pressure respirator non encapsulated chemical resistant garments max respiratory protection with lower degree of skin protection
60
ppe C
same skin protection as B with lower level of respiratory protection
61
ppe D
hospital universal precautions | inadequate chemical protection

Implications of human poisoning (10 decks)

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