Environmental Hazards

Question 1

The _____ is the gold standard for determining health effects of lead.

Answer 1

Blood Lead Level (BLL)

Question 2

A BLL of _____ is considered a level of concern for public health purposes.

Answer 2

≥ 10 μg/dL

Question 3

The _____ of young children is the most common pathway by which lead enters the body.

Answer 3

nonnutritive hand-to-mouth activity

Question 4

Most retained lead accumulates in _____, where it may reside for _____.

Answer 4

bone

years

Question 5

The _____, present in all cells, has 3 enzymes susceptible to lead inhibitory effects.

Answer 5

Heme Pathway

Question 6

The accumulation of excess amounts of _____ and other heme precursors is toxic.

Answer 6

Protoporphyrin

Question 7

A second mechanism of lead toxicity works via its competition with _____.

Answer 7

Calcium

Question 8

A third mechanism of lead toxicity prevents development of the normal _____ brain structure.

Answer 8

tertiary

Question 9

Lead Encephalopathy is more likely to be observed in children with BLLs _____.

Answer 9

> 100 μg/dL

Question 10

Children with BLLs _____ are 2x as likely to have GI complaints.

Answer 10

> 20 μg/dL

Question 11

CNS symptoms in lead poisoning are related to _____.

Answer 11

cerebral edema

increased ICP

Question 12

There is no clear cutoff BLL value for the appearance of hyperactivity, but it is more likely to be observed in children who have levels _____.

Answer 12

> 20 μg/dL

Question 13

_____ is preferred to capillary sampling because chances of false-positive and false-negative results are less.

Answer 13

Venous Sampling

Question 14

A confirmed venous BLL of _____ requires prompt chelation.

Answer 14

≥ 45 μg/dL

Question 15

Lead toxicity is treated with chelation therapy using _____.

Answer 15

2,3-dimercaptosuccinic acid (DMSA)
CaNa2EDTA
British Anti-Lewisite (Dimercaprol)
Penicillamine

Question 16

Parental efforts at reducing the _____ of the affected child are necessary to reduce the risk of lead ingestion.

Answer 16

hand-to-mouth activity

Question 17

Dog-Bite Injury Categories

Answer 17

1. abrasions
2. puncture wounds
3. lacerations with or without an associated avulsion of tissue

Question 18

The most common type of injury for cat and rat bites is _____.

Answer 18

puncture wound

Question 19

Types of Human Bite Injuries

Answer 19

1. Occlusion Injury

2. Clenched-Fist Injury

Question 20

Types of Human Bite Injuries:

upper and lower teeth come together on a body part

Answer 20

Occlusion Injury

Question 21

Types of Human Bite Injuries

occurs in older children and young adults, the injured fist comes in contact with the tooth of another individual

Answer 21

Clenched-Fist Injury

Question 22

_____ is the most common complication of bite injuries, regardless of the species of biting animal.

Answer 22

Infection

Question 23

Unless they are deep and extensive, dog bite wounds that are _____ do not need to be cultured unless there is evidence of contamination or early signs of infection if the patient is immunocompromised.

Answer 23

< 8 hrs

Question 24

The infection rate in cat bite wounds that receive early medical attention is at least _____, therefore, it is prudent to obtain material for culture.

Answer 24

50%

Question 25

All animal bite wounds that are not brought to medical attention within _____ should be cultured.

Answer 25

8 hrs

Question 26

All _____ wounds, regardless of mechanism of injury, should be regarded as carrying high risk of infection and should be cultured.

Answer 26

human bite

Question 27

Because all _____ wounds are at high risk for infection, particularly if there has been disruption of tendons or penetration of bones, _____ is recommended.

Answer 27

hand

delayed primary closure

Question 28

Antibiotics should be given to all victims of _____ bites.

Answer 28

human bites

all but the most trivial dog, cat and rat bites

Question 29

Bacteria in Dog Bites

Answer 29

Staphylococcus aureus
Pasteurella multicoda
Staphylococcus intermedius
Capnocytophaga canimorsus

Question 30

Bacteria in Cat Bites

Answer 30

Pasteurella multicoda

Question 31

_____ is used for empiric oral therapy for human and animal bites.

Answer 31

Amoxicillin-Clavulanate

Question 32

_____ is the drug of choice for prophylaxis and treatment of rat bites.

Answer 32

Procaine Penicillin

Question 33

It is important to provide _____ to all patients who are incompletely immunized or those in whom it has been _____ since the last immunization.

Answer 33

Tetanus Toxoid

> 10 yrs