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Occ Med > Occ Med > Flashcards

Occ Med Flashcards

1
Q

Asbestos related plural plaques are associated with which type of PFT pattern

A

Normal

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2
Q

Asbestos fibrotic disease is usually associated with what type of asbestos?

A

Amphibole

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3
Q

Asbestos related pleural effusions usually occur within how many years?

A

10

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4
Q

Metal fume fever is caused by ___ and the time course is ___?

A

Welding fumes

Tachyphalaxis within ~48 hours

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5
Q

What joint is most commonly affected with decompression sickness?

A

Shoulder

MSK pain most common symptom of compression sickness

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6
Q

Chrome salts are skin/respiratory sensitizer/irritant? (Choose all that apply)

A

Skin sensitizer and irritant

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7
Q

A rare form of occupational asthma caused by inhaling hemp, flax, or cotton particles

A

Byssinosis

In the United States, byssinosis occurs almost exclusively in people who work with unprocessed cotton.

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8
Q

What is Caplan syndrome?

A

Aka Rheumatoid pneumoconiosis

Pulmonary rheumatoid nodules in pts w/ rheumatoid arthritis who’ve breathed in coal, asbestos or silica

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9
Q

Osseous complication of decompression illness

A

Dysbaric osteonecrosis

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10
Q

Risk factors (3) for dysbaric osteonecrosis

A

Obesity, alcohol, steroid use

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11
Q

Wood dust is a type I (known) carcinogen of … (3)

A

Nasopharynx, nasal cavity and paranasal sinuses

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12
Q

What is the causative agent of silo filler’s dz?

A

Gaseous oxides of nitrogen from organic material

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13
Q

Arsenic is a type I (known) carcinogen of … (3)

A

Lung, skin and bladder cancer

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14
Q

Pain on thumb side of wrist from repetitive motion

A

De Quervains tenosynovitis

Also called: radial styloid tenosynovitis

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15
Q

Thickening of the palmar fascia most commonly affecting the 4th and 5th digits

A

Dupuytren’s contracture

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16
Q

____ syndrome of hand caused by trauma to ____ artery.

A

Hypothenar hammer syndrome

Ulnar artery

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17
Q

Specific gravity of toxic heavy metals

A

5 g/cm3 or heavier

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18
Q

Carbon monoxide poisoning causes the ___ curve to shift to the ___

A

Oxyhemoglobin curve

Left shift

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19
Q

Allergic contact urticaria is diagnosed with…

A

Skin prick test

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20
Q

Aluminum is a known carcinogen for (2) …

A

Bladder and lung cancer

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21
Q

High blood levels of aluminum are associated with…

A

Poor cognitive function

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22
Q

Systemic sclerosis is associated with what environmental exposures (2)

A

Silica

Organic solvents

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23
Q

Types of UV spectrum radiation from welding

A

All… UVA, UVB and UVC

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24
Q

___ skin discoloration from exposure to silver is called ___

A

Blue-grey

Argyria

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25
Q

Frequency range of human hearing

A

20 Hz to 200 kHz

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26
Q

Sign/symptoms associated w following Lead blood Levels

1) 30 mcg/dL
2) 50 mcg/dL
3) 100 mcg/dL

A

1) HAs & poor concentration
2) anemia and abd pain
3) encephalopathy

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27
Q

Treatment of de Quervain’s tenosynovitis

A

Thumb spica splint

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28
Q

Test for de Quervain’s tenosynovitis

A

Finklestein’s test

Ulnar deviation w thumb flexed

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29
Q

Sudden death from overwork

A

Karoshi

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30
Q

First line treatment of Achilles tendinopathy

A

PT: eccentric exercises

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31
Q

Physiology of noise induced hearing loss

A

Sensorineural HL due to loss of cilia and hair cells in cochlear

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32
Q

Nighttime sign of carpal tunnel syndrome

A

Flick sign
Symptomatic relief when waking at night and shaking out their hand.
93% sensitive &
96% specific for CTS.

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33
Q

treatment for methemoglobinemia

A

methylene blue (reduces methemoglobin hemoglobin)

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34
Q

in cases of ___ d/t chlorate exposure do not treat with methylene blue d/t risk of more toxic __ production

A

methemoglobinemia

hypochlorite

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35
Q

medications that cause methemoglobinemia (3)

A

dapsone (and other ABX)
benzocaine (& other -caines)
nitrites

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36
Q

Where does cyanide bind (2)

A

To Fe3+ in
1) methemoglobin
2) cytochrome C reductace in e- transport chain (irreversible)
(Prevents reduction back to Fe2+)

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37
Q

Most common cause of cyanide poisoning in US

A

Fires/fire fighting

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38
Q

Cyanide is removed from methemoglobin by the enzyme ___
and ___
is excreted in the ___

A

Liver rhodanase
Thiocyanate
Urine

(Na thiosulfate is consumed)

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39
Q

In cyanide poisoning
is PaO2 low/ normal / high?
is PvO2 low/ normal / high?

A

PaO2 is normal.
PvO2 is high.
They are ~ equal because O2 does offload to the tissue.

Normally O2 would diffuse to cytochrome oxidase in mitochondria, but cyanide fixes Fe3+ oxidase in the oxidized form.

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40
Q

2 foods that contain cyanide

A

Almonds (cyanide poisoning associated w “bitter almond” breath)
Apricots

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41
Q

Cherry red skin is associated with what type of poisoning

A

Carbine monoxide poisoning (rarely 2-3%)

{Another source aside Cyanide 2/2
Tissue unable to offload O2 so there is a high venous concentration of O2 - high PvO2 }

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42
Q

Cyanide poisoning antidote (3)

A

Na thiosulfate
Na nitrite
Hydroxycobalamine (vit B12)

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43
Q

Cyanide poisoning antidote that directly binds cyanide

A

Hydroxycobalamine

Cyanocobalamine excreted in urine

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44
Q

This cyanide antidote induces methemoglobin formation

A

Na nitrite

Fe3+ in Methemoglobin has affinity for CN

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45
Q

This cyanide antidote is utilized by liver rhodinase to remove CN from cyanomethemoglobin

A

Na thiosulfate

Thiocyanate excreted in urine

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46
Q

Q fever bacteria

A

Coxiella Burnetti

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47
Q

Q fever treatment

A

Doxycycline

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48
Q

Carbon disulphide
Acute exposure -> ?
Chronic exposure -> ?

A

Neurotoxicity

CAD

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49
Q

Poisons that inhibit cytochrome C oxidase in e transport chain (complex IV)

A

Cyanide
Carbon monoxide
Hydrogen sulfide (H2S)

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50
Q

Lyme disease is caused by…

A

Borrelia burgdorferi

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51
Q

Lyme disease single dose ABX prophylaxis

A

200mg doxycycline

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52
Q

Group 1 (known) carcinogen for melanoma

A

Polychlorinated biphenyls

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53
Q

Most dangerous type of UV radiation

A

UVB

UVC does not reach surface of earth

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54
Q

Occupational voice loss risk factors (4)

A

low humidity
high background noise
increased vocal load
poor upper body posture

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55
Q

Toluene diisocyante is a skin/respiratory sensitizer/irritant? (Choose all that apply)

A

respiratory sensitizer

It causes occupational Asthma in ~1% of people when exposure > 5ppb

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56
Q

Size at which fibers are respirable

A

less than 3 microns

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57
Q

type of mercury poisoning associated with intestinal necrosis and bloody diarrhea

A

ingestion of inorganic mercury salts

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58
Q

mechanism of Pb poisoning

A

Replaces elements such a Ca in many biological pathways

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59
Q

treatment of Itai-itai disease

A

cadmium chelators

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60
Q

PFT pattern for hypersensitivity pneumonitis

A

restrictive pattern

61
Q

Bacteria in Legionnaire’s disease

A

Legionella pneumophila causes 90% of Legionnaire’s

The other 10% of cases caused by other Legionella serotypes.

62
Q

Audiometry threshold shift is considered permanent if it last greater than …

63
Q

form of ionizing radiation with highest weighting factor

A

alpha particles

weighting factor = 20

64
Q

radiation equivalent dose (HT) formula

A 
Absorbed dose (DT) 
x 
radiation weighting factor (WR) 
= 
equivalent dose (HT)
65
Q

Light flickering in what range (Hz) can cause seizures

A

5 to 30 Hz

66
Q

Illumination (lux) required for perception of detail in workplace

67
Q

Resting metabolic rate

68
Q

For 10m of seawater depth, pressure increases by how much? (ATA?, kPa?)

A

1 ATA

100 kPa

69
Q

Hypothermia is body temperature less than (C?, F?)

70
Q

In hypothermia, shivering may stop when body temp is less than …

A

32 C

~ 90 F

71
Q

Frequency of tuning fork used for Webber’s and Rinne’s tests

72
Q

How is Webber’s rest performed?

A

Place the fork in the midline high on the patient’s forehead.

Ask the patient: “Do you hear the sound louder in one ear than the other?”

73
Q

How is Rinne’s rest performed?

A

Place the fork at the pt’s mastoid process for ~2-3 secs, then 1 cm from meatus for ~2 secs.

Ask which is louder

74
Q

Rinne’s test has a high ___ for ___ hearing loss.

A

sensitivity (0.84)

conductive

75
Q

Rinne’s test can only detect a ____ hearing loss of at least ____

A

conductive

30dB

76
Q

Describe a false negative Rinne’s test

A

In total unilateral sensorineural hearing loss, when testing the “dead” ear, pt will hear bone conduction (conducted to the good ear) better than when the fork is EAC meatus.

77
Q

Describe a positive Rinne’s test (and significance)

A

A positive Rinne’s test is normal

Air louder than bone

78
Q

Describe a negative Rinne’s test (and significance)

A

A negative Rinne’s test is abnormal and c/w conductive hearing loss of at least 30 db

Bone louder than air

79
Q

With Weber’s test, in which ear would you the sound in conductive hearing loss?

80
Q

With Weber’s test, in which ear would you the sound in sensorineural hearing loss?

81
Q

What dose of ionizing radiation is 50% lethal at 60 days (LD50/60) without treatment?

82
Q

How is the Bradford Factor (score) calculated?

A

B = S × S × D
where:

B is the Bradford Factor
S is the total number of spells (instances) of absence of an individual over a set period
D is the total number of days of absence of that individual over the same set period

83
Q

Hepatitis Viruses
Enveloped? / DNA or RNA?

HAV
HBV
HCV
HDV
HEV
A 
Hepatitis Viruses
A: unenveloped RNA
B: enveloped DNA
C: enveloped RNA
D: enveloped RNA
E: unenveloped RNA
84
Q

Hepatitis E virus characteristics

? envelope, # of strands, sense?, RNA/DNA

A

HEV

nonenveloped
positive-sense
single-stranded
RNA

85
Q

Hepatitis Viruses Families

HAV
HBV
HCV
HDV
HEV
A 
A: Picornaviridae
B: Hepadnaviridae
C: Flavividae
D: Deltavirus
E: Hepeviridae
86
Q

Hepatitis Virus with zoonotic hosts (and what are the hosts)

A

HEV (genotypes 3 and 4) - swine & deer

87
Q

Which hepatitis virus is a satellite (subviral agent) and what other hepatitis virus does it propagate with?

A

HDV (propagates with HBV)

HDV is an RNA virus, HBV is a DNA virus

88
Q

Hepatitis D virus characteristics

? envelope, # of strands, sense?, RNA/DNA

A

HDV

enveloped
negative-sense
single-stranded
RNA

89
Q

Fatality rate of HBV and HDV coinfection

A

20%

highest of all hepatitis virus infection

90
Q

% of people who when exposed to HCV do NOT get chronic infection

A

~ 20% of infected clear the virus and do not progress to chronic infection

91
Q

Hepatitis C virus characteristics

? envelope, # of strands, sense?, RNA/DNA

A

HCV

enveloped
positive-sense
single-stranded
RNA

92
Q

Hepatitis B virus characteristics

? envelope, # of strands, sense?, RNA/DNA

A

HBV

enveloped
circular double-stranded
DNA

93
Q

HCV transmission

A

IVDU (#1 in USA, >60%)
Sexual contact
Unsafe medical procedure / transfusions (#1 in developing world)

94
Q

Medical treatments for HBV (4)

A

Tenofovir
Entecavir
Lamivudine
INF-alpha

95
Q

medication that can treat both HIV and HBV

A

Lamivudine

96
Q

entecavir black box warnings (3)

A

lactic acidosis with severe hepatomegally w/ steasosis
HIV resistance
acute HBV exacerbation upon d/c

97
Q

Hepatitis A virus characteristics

? envelope, # of strands, sense?, RNA/DNA

A

HAV

unenveloped
single-stranded
positive-sense
RNA

98
Q

What is the RNA/DNA sense of the the Hepatitis Viruses (A - E)

A 
HAV: +
HBV: N/A, dsDNA
HCV: +
HDV: -
HEV: +
99
Q

Isocyanates are skin/respiratory sensitizer/irritant? (Choose all that apply)

A

Both skin and respiratory sensitizer and irritant.

100
Q

Difference between Decompression Sickness (DCS) and Decompression Illness (DCI)

A

DCI encompasses both DCS and arterial gas embolism (AGE).

101
Q

DCS type I involves which systems

A

skin
MSK
lymphatic

102
Q

DCS type II involves which systems

A

neurologic,
audiovestibular or
cardiorespiratory

(in addition to skin, MSK, lymphatic of type I)

103
Q

In DCS, what % of patients have experienced symptoms by 8 and 24 hours?

A

83% and 98%, respectively

104
Q

In Decompression Illness, what is the time course of onset of Arterial Gas Emboli

105
Q

___ is the oxidized form of iron

106
Q

___ is the reduced form of iron

107
Q

Boyle’s law

A

P1V1 = P2V2

108
Q

Most important occupational risk factor for carpal tunnel syndrome

A

Forceful hand exertion

109
Q

Most toxic form of chromium

A

hexavalent chromium

highly water soluble

110
Q

Influenza virus characteristics

? envelope, # of strands, sense?, RNA/DNA

A

enveloped
negative sense
single stranded
RNA

111
Q 
Coronavirus characteristics
(? envelope, # of strands, sense?, RNA/DNA )
A

enveloped
positive sense
single stranded
RNA

112
Q

PFT pattern in Caplan’s syndrom

A

restrictive (or mixed)

Rheumatoid pneumoconiosis in people with rheumatoid arthritis who have breathed in dust (ie coal, silica)

113
Q

Vinyl chloride is a type I carcninogen of (1) …

A

hepatic cancer (including angiosarcoma of liver)

114
Q

Sedentary work expends how much energy …

115
Q

Which heavy metal exposure is know to cause nasal perforation?

A

chromium

chrome ulcers

116
Q

visual complication from recompression therapy

A

reversible myopia

117
Q

occupational acoustic trauma
vs
noise induced hearing loss

A

OAT: Sudden loud noise imulse
NIH: Hearing loss from prolonged steady state noise exposure.

Both are sensorineural type hearing loss

118
Q

Noise level that causes occupational acoustic trauma

119
Q

Henry’s law

A

The amount of a gas that dissolves in a liquid is directly proportional to the partial pressure of that gas.

120
Q

Medical reasons pilots must inform licensing authority (4)

A

deterioration in medical fitness > 20 days
illness requiring hospitalization
illness that renders unsafe to fly
pregnancy

121
Q

1 Gy =

122
Q

units of rate of transformation of radioactive material

A

becquerels

123
Q

When does vibration with finger present

A

usually on exposure to cold (not necessarily during the vibration exposure)

124
Q

ABX used as supplemental treatment of tetanus

A

metronidazol

125
Q

bacterial that causes tetanus

A

Clostridium tetani

126
Q

Besides supportive care, treatment for tetanus

A

1) Benzos
2) neuromuscular blockers
3) tetanus immune globulin (TIG)
4) ABX (metronidazol)
5) immunization

127
Q

Anthrax bacteria

A

Bacillus anthracis

128
Q

Most common for of occupational anthrax

A

cutaneous

GI & respiratory also possible

129
Q

What is the healthy worker effect?

A

A bias in occupational epidemiology studies that is typically characterized by lower relative M&M rates in an occupational cohort, possibly masking an increased risk of the disease under study

130
Q

Environmental asthma due to exposure to mouldy sugar cane

A

Bagassosis

131
Q

Heavy metal exposure that leads to renal tubular dysfunction

132
Q

Most common bacteria causing otitis external in saturation divers

A

Pseudomonas aerginosa

133
Q

treatment for streptococcus suis

134
Q

By what units is hand transmitted vibration monitored?

A

m/s^2 (acceleration)

135
Q

Allergic contact dermatitis is diagnosed with…

A

patch test

136
Q

Carbon monoxide binds to hemoglobin at ___ times the strength of O2.

137
Q

% carboxyhemogblogin in blood that indicates severe exposure

138
Q

‘slate bronze skin’ is associated with what type of poisoning

A

arsine gas

d/t a hemolytic jaundice

139
Q

diesel exhaust is a group 1 carcinogen for …

A

lung cancer

140
Q

Potential preventive treatments s/p needle stick exposure

A

HBV vaccine
HBV immunoglobulin
HIV prophylaxis

141
Q

medication for HIV post-exposure PEP

A

zidovudine AND
lamivudine AND
dolutegravir OR raltegravir

142
Q

time course for HIV post-exposure PEP

A

start within 72 hours

continue for 28 days

143
Q

Benign pneumoconioses (4)

A

Siderosis
Stannosis
Baritosis
Fuller’s earth pneumoconiosis

144
Q

Mechanism of organophosphate poisonings

A

Inhibition of acetylcholinesterase at neural junction

145
Q

Bacteria genuses (4) that cause human brucellosis

A

Brucella genuses

B melitensis (sheep/goats)
B aborted (cattle)
B suis (pigs)
B canid (dogs)
146
Q

Initial sign of noise induced hearing loss

A

Loss at 3000 to 6000 Hz

147
Q

How long should patient wait before flying for

1)
Pneumothorax
2) uncomplicated MI

A

1) 6 weeks

2) 10 days

148
Q

Laryngeal cancer group 1 carcinogens (3)

A

Cigarettes
Asbestos
Inorganic acid mists

Occ Med (1 decks)

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