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HM Manual CH 23 CBRNE Flashcards

1
Q

How would you classify a chemical agent that continues to persist for days after delivery?

A

Persistent

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2
Q

How would you classify a chemical agent that disperses rapidly after release and has a short duration?

A

Non-persistent

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3
Q

What meteorological conditions influence the effectiveness and duration of chemical agents?

A

Wind
Temperature
Rain

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4
Q

What affect does low temperatures have on the persistency of chemical agents?

A

Increase persistency

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5
Q

What are the three common detection methods for chemical agents?

A

M9 detection paper
M8 detection paper
M256A1 chemical agent detector kit

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6
Q

What is the most widely used method of detecting liquid chemical warfare agents?

A

M9 paper

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7
Q

What color will M9 paper turn in the presence of a nerve or blister agent?

A

pink, red, reddish brown, purple

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8
Q

What color will M8 paper turn in the presence of G class nerve agents?

A

Gold/yellow

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9
Q

What color will M8 paper turn in the presence of VX?

A

Olive or Verdana Green

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10
Q

What color will M8 paper turn in the presence of a blister agent?

A

red or purple

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11
Q

What agents can the M256A1 chemical agent detector kit detect?

A

Nerve gas
mustard gas
cyanide

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12
Q

What does JSLIST stand for?

A

Joint Service Lightweight Integrated Suit Technology

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13
Q

What is the nomenclature of the skin decontamination kit?

A

M291

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14
Q

What are the Nerve agents?

A 
VX
Tabun
Sarin
Soman
CycloSarin
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15
Q

What is the NATO code for Tabun?

A

GA

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16
Q

What is the NATO code for Sarin?

A

GB

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17
Q

What is the NATO code for Soman?

A

GD

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18
Q

What is the NATO code for CycloSarin?

A

GF

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19
Q

Pharmacologyically, the nerve agents are _________ inhibitors.

A

cholinesterase

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20
Q

What symptoms would you expect in a person with a small exposure to vapor nerve agents?

A

Miosis
Rhinorrhea
Mild difficulty breathing

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21
Q

What symptoms would you expect in a person with a large exposure to vapor nerve agents?

A 
Miosis 
Sudden loss of consciousness
Convulsions
Apnea
Flaccid paralysis
Copious secretions from the nose, mouth and lungs
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22
Q

What is the drug of choice for treating nerve agent poisoning?

A

Atropine

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23
Q

What medication is used for nerve agent poisoning and is considered an acetylcholine blocker?

A

Atropine

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24
Q

What medication is used for nerve agent poisoning and acts by removing the nerve agent from the enzyme actylcholinesterase?

A

2-PAM CL

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25
What medication is found in the Convulsive Antidote, Nerve Agent (CANA)?
Diazepam 10mg
26
What medications are found in the the MARK 1 Antidote kit?
Atropine 2mg | 2-PAM CL 600mg
27
What antidote kit is replacing the MARK 1?
the Autoinjector treatment; Nerve Agent Antidote (ATNAA)
28
What further treatment should medical personal provide to a severe nerve agent casualty who has already received 3 Mark 1 Kits?
Atropine 2mg at 5-10 intervals until there is a reduction in secretions and breathing difficulty If symptoms persist after one hour, 3 more 2 PAM-CL auto injectors can be administered, No more than 6 doses total.
29
In what order should nerve agent casualties be decontamination?
``` Face Neck Area Chest area abdomen Arms and hands Other ```
30
What are the Blister/vesicant agents?
Mustard Distilled Mustard Nitrogen Mustard Lewisite
31
What is the NATO code for Mustard?
H
32
What is the NATO code for Distilled Mustard?
HD
33
What is the NATO code for Nitrogen Mustard?
HN
34
What is the NATO code for Lewisite?
L
35
Which of the blister agents has an immediate onset?
Lewisite
36
What are some physical characteristics of H, HD, and HN?
Oily | colorless or pale yellow liquids
37
What are some physical characteristics of Lewisite?
light to dark brown liquid that vaporizes slowly
38
What odor may Patients exposed to mustered report smelling?
Garlic, mustard or horseradish
39
What odor may patients exposed to lewisite report smelling?
geranium
40
What are some symptoms indicating Blister agent exposure?
``` pain and gritting feeling in eyes spastic blinking photophobia Swelling of eye lids Eythema and blisters to skin ```
41
What symptoms would you expect in a patient who inhaled a blister agent?
``` Sore throat sinus pain hoarseness Productive cough and shortness of breath My hear crackles and rales ```
42
What is the treatment for systemic involvement of Lewisite?
British Anti-Lewisitie (BAL)
43
What allergies contraindicate the use of British Anti-Lewisitie?
Peanut allergies
44
What are the Blood Agents?
Hydrogen cyanide | Cyanogen chloride
45
What is the NATO code for Hydrogen cyanide?
AC
46
What is the NATO code for Cyanogen Chloride?
CK
47
What chemical agent is a cyanide that disrupts oxygen utilization at the cellular level causing cellular suffocation?
Blood agents
48
What odor does Hydrogen Cyanide have?
bitter almonds
49
What symptoms would you see in a patient with a moderate exposure to blood agents?
``` Transient increase in rate and depth of breathing Dizziness nausea and vomiting headache eye irritation ```
50
What symptoms would you see in a patient with high exposure to blood agents?
``` Rapid onset of: Increase rate and depth of breathing convulsions apnea cardiac arrest ```
51
What is the treatment of blood agent casualties?
1) two amyl nitrite ampules crushed and inhaled (every few minutes) until 8 have been used, or IV sodium nitrate 300mg-600mg 2) IV Sodium thiosulfate
52
What are the pulmonary agents?
Phosgene Chlorine Diphosgene
53
What is the NATO symbol for Phosgene?
CG
54
What is the NATO symbol for Chlorine?
CL
55
What is the NATO symbol for Diphosgene?
DP
56
What chemical agent acts by causing damage to the membranes in the lungs that separate the alveolar tissue resulting in plasma leaking into the alveoli?
Pulmonary
57
What is the odor of phosgene?
new-mown hay or freshly cut grass
58
What are the latent symptoms of Pulmonary agent exposure?
``` Rapid, shallow and labored breathing Painful cough Cyanosis Frothy sputum clammy skin rapid, feeble pulse Low blood pressure Crackles and rales ```
59
What is the treatment for a Pulmonary agent casualty?
Supportive, limit exertion as mild exertion can exacerbate effects of pulmonary agents.
60
What are the three types of biological agents?
Bacteria Viruses Toxins
61
What are the common bacterial agents that are weaponized?
Anthrax (Bacillus Anthracis) Plague (Yersina Pestis) Tularemia (Francisella Tularensis)
62
What bacteria causes Anthrax?
Bacillus Anthracis
63
What bacteria causes plague?
Yersina Pestis
64
What bacteria causes Tularemia?
Francisella Tularensis
65
What are the three types of anthrax?
Cutaneous Pulmonary Gastrointestinal
66
The average incubation period for anthrax is ___ to ____ days, although it can be incubated for periods up to ____ days.
1-7 days | 60 days
67
What would you expect to see on a chest x-ray in a patient suffering from inhalation anthrax?
Mediastinal widening due to hemorrhagic lymphadenitis
68
What is the first line treatment for anthrax?
Ciprofloxacin 500mg BID PO or Doxycycline 100mg BID
69
What is the second line of treatment for anthrax?
Amoxacillin 500mg TID or PCN 2mU every 4 hours IV
70
What is the dose schedule for Anthrax vaccine?
0,2,4, wekks and then 6,12,18 months followed by annual booster
71
The bacterium Yersina Pestis is found on rodents and their fleas and is easily destroyed by?
sunlight and drying
72
What are the three types of plague?
Pneumonic Bubonic Septicemic
73
What type of plague can spread from person to person?
Pneumonic
74
what type of plague is the most common form?
Bubonic
75
What type of plague is spread by infected flea bites?
Bubonic
76
What type of plague is the result of the plague bacteria multiplying in the blood?
Septicemic, can be seen as a complication of Pneumonic and bubonic plague
77
What is the average incubation period for plague?
1-7 days
78
What are some symptoms of Pneumonic Plague?
Sudden onset of high fever, chills, malaise, tachycardia, intense headache, severe myalgias Rapidly developing pneumonia, cough with hemoptysis, dyspnea and stridor, cyanosis and death
79
What are some symptoms of Bubonic plague?
Swollen painful lymph nodes called buboes, high fever, chills, headache, and malaise.
80
What are the primary antibiotics when treating plague?
Streptomycin 1g ever 12 hrs IV | Gentamicin
81
What is the alternative antibiotic treatment of plague?
Doxycycline, Ciprofloxacin or chloramphenicol
82
What disease is also known as rabbit fever?
Tularemia
83
What are the two types of tularemia?
Ulcerglandular and Pneumonic/typhoidal
84
What biological agent is a neuroparalytic disease that blocks actylcholine release from peripheral nerves?
Botulinum toxin
85
What is the most toxic substance known?
Botulinum
86
Can botulism be transmitted person-to-person?
no
87
What are the types of botulism?
Food-borne Infant wound Inhalational
88
What is the incubation period of botulism?
12-36 hours
89
What are the common Toxins?
Botulism and Ricin
90
What are the common symptoms of a botulism casualty?
Cranial nerve palsies (double vision, blurred vision, drooping eyelids, slurred speech) Dysphagia Dry mouth and throat muscle weakness Symptoms may progress to paralysis of arms and legs, trunk and respiratroy muscles
91
What is the treatment for botulism?
Early administration of Trivalent antitoxin
92
Where is Ricin Derived from?
the beans of the castor plant
93
What is the mechanism of action of Ricin?
Blocks protein synthesis at the cellular level, leads to irreversible cell death
94
What are the common weaponized viruses?
Smallpox and Hemorrhagic Fevers
95
What virus causes the smallpox disease?
Variola Major and Variola Minor

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