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Flashcards in Airport Medicine and International Health Regulations Deck (22):
1

What is a sanitary airport?

An airport of entry or departure for international traffic, designated as sanitary by the local health administration, where the formalities for public health, lab resources, animal and plant quarantine and similar procedures are carried out; which is provided with pure drinking water and wholsome food; which is provided with an effective system for disposal of excrement, refuse, waste water, etc and which has at its disposal an organized medical service, facilities for isolation and care of infected patients, facilities for efficient disinfection, access to a laboratory, and facilities for vaccination against yellow fever.

2

One way of protecting areas, where vector-borne diseases do not currently occur, but which are susceptible to introduction or re-introduction of vectors and pathogens, is to disinfect aircraft coming from an area of threat into an area to be protected. In accordance with the IHR, disinfecting of aircraft shall be carried out:
a) so as not to cause undue discomfort to any person or injury to his health; so as not to produce any deleterious effect on the structure of the aircraft or on its operating equipment; and so as to avoid all risk of fire.
b) only when no passengers are present on board
c) before the aircraft leaves an airport situated in an area where transmission of malaria or other mosquito-born diseases are occuring.
d) either before take off, during cruise, or after landing, but before before the doors open and the air conditioning system will be switched off during spraying of the cabin with the insecticide for at least five minutes.
e) by residual spraying of all residual surfaces of the aircraft with permethrin.

A) so as not to cause undue discomfort to any person or injury to his health; so as not to produce any deleterious effect on the structure of the aircraft or equipment; and so as to avoid all risk of fire.

3

The insecticides recommended by the WHO for aircraft disinfecting are d-Phenothrin and permethrin. These insecticides:
a) have been used world-wide without any case of human poisoning being reported.
b) have, when used for aircraft disinfecting, given rise to no reports in the medical literature of adverse human response.
c) are of no toxicological concern to human beings (or other mammals) and are neither allergenic or teratogenic.
d) All of the above
e) none of the above

d) All of the above.

4

Special provisions are in force for certain infectious diseases, subject to the IHR, with regard to notification of WHO, duration of incubation periods, vaccination, certificates, isolation and medical examinations (including stool examination) of suspected crew and passengers. These diseases are:
a) identified weekly through the WHO Weekly Epidemiologic Report
b) cholera, plague, and yellow fever
c) cholera, plague, yellow fever, and malaria
d) cholera, plague, yellow fever, malaria and dengue
e) defined by the local health authority of each state

b) cholera, plague, and yellow fever. Malaria and dengue are not contagious.

5

More than half the world's population is at risk of infection by vector-borne disease. Vectors and pathogens can be transported either in infected humans or in infected vectors. There is abundant evidence that vectors and vector-borne disease agents are transported internationally, also by air. Each year cases of vector-borne diseases are documented in countries outside the known distribution of the disease. The purpose of the International Health Regulations (1969) is to ensure maximum security against the international spread of diseases with a minimum interference with world traffic. Concerning international civil aviation, compliance with the IHR is:
a) mandatory for all countries
b) mandatory for member states of the WHO
c) the responsibility of the International Civil Aviation Organization (ICAO) as stated in Annex 9 to the convention on International Civil Aviation.
d) The responsibility of all international air carriers.
e) optional and voluntary, but ICAO Contracting States and WHO States, Associate States and other states bound by the IHR shall comply with the regulations unless they have indicated to ICAO and WHO that their position is not to be bound by the IHR or to be bound with reservations only.

e) In the exercise of sovereignty, it is for each State to consent (or not) to be bound by these international regulations. Consequently, each WHO member state as well as each ICAO Contracting State is at liberty not to comply with the IHR or parts thereof, provided is notifies WHO and ICAO of its reservations and differences, including "not bound", if it so wishes.

6

International certificates of vaccination must conform to the requirements of Article 86 of the International Health Regulations. Which of the following methods of completion would provide an acceptable certificate?
a) A certificate with the official stamp of a medical practitioner or other person authorized by the national health administration.
b) A certificate issued collectively for a mother and child.
c) A letter from a vaccinator stating the rationale for his medical opinion that a specific vaccination is contraindicated.
d) None of the above.
e) All of the above.

C) A letter from a vaccinator stating the rationale as to why he/she believes the vaccine is contraindicated in this patient.

7

When a person who is under surveillance for suspected disease wishes to depart for another place, either within or without the same territory, which of the following actions should be taken?
a) The person should be isolated and his/her movement restricted.
b) The person should be subjected to medical investigation and any inquiries which may be necessary for ascertaining the state of his/her health.
c) The person must be required to inform the health authority of his departure and the health authority must immediately notify the health authority of the place to which the person is proceeding.
d) Both a and b
e) Both b and c

e) both b and c.

8

For the purposes of International Health Regulations, what is the incubation period of the following diseases:
Cholera
Yellow Fever
Plague

Cholera 5 days
Yellow Fever and Plague 6 days

9

For an airfield to be designated as a sanitary airport, which of the following conditions must be met?
a) The airport must have facilities for transport, isolation, and care of infected persons or suspects.
b) The airport must have facilities within the airport for vaccination against smallpox and facilities within the airport or available to it for vaccination against cholera and yellow fever.
c) the airport must have a bacteriological laboratory or facilities for dispatching suspected material to such a laboratory.
d) All of the above
e) None of the above

d) All of the above

10

Airline passengers who require continuous medical oxygen due to emphysema, upon embarking on a flight:
a) Will use the airline furnished "carry-on" oxygen.
b) Will use the drop out oxygen system located at every passenger seat.
c) Will advise the cockpit crew to keep the cabin pressurized to sea level pressures.
d) Will refuse to eat any meals served during the flight.
e) Will be required to bring a nurse along to operate the oxygen equipment.

a) Will use the airline furnished carry on oxygen.

11

Historically, what percentage of inflight medical emergencies require diversion?
a) 5%
b) 7%
c) 8%
d) 10%

c) 8%

12

When operating an unpressurized aircraft, supplemental oxygen by mask may be necessary to prevent hypoxia in flight crew and passengers. According to FAA regulations, above what altitude is supplemental oxygen required for BOTH crew and passengers of the aircraft?

15,00 feet (MSL)

13

All of the following are true concerning International Health Regulations (IHR) EXCEPT:
a) They were established by ICAO
b) They specify measures necessary to maintain International health control.
c) They specify the maximum measures which may be applied.
d) They define the minimum services and facilities required at all international airports.
e) They define the minimum services and facilities required at "sanitary airports".

All are true except A. The ICAO did not establish the IHR's, the WHO established them in 1969.

14

Concerning International Health Regulations (IHR), the following apply EXCEPT:
a) Most but not all countries are signatories
b) Any required updating to the IHR is published in the Weekly Epidemiological Record of the WHO.
c) Diseases "subject to the regulation" include plague, malaria, and yellow fever.
d) The WHO must be notified within 24 hours of the occurrence of any disease subject to the regulation.
e) The IHR's serve as guidelines for countries to customize to meet their health needs.

c) Plague, Yellow Fever, and CHOLERA. Not malaria.

15

Which of the following statements is true regarding health measures specified by the IHR:
a) Health measures stipulated by the IHR are the minimum any state may apply for protection against diseases of significance in international travel.
b) International diplomats are exempt from the provisions of the IHR.
c) Except in case of extreme emergency constituting a grave danger to public health, free pratique cannot be refused for diseases other than plague, cholera, and yellow fever.
d) Bodies in sealed coffins are subject to the IHR
e) A person under surveillance is restricted to the quarantine area of a sanitary airport.

C) Except in case of extreme emergency constituting a grave danger to public health, free pratique and movement cannot be refused for diseases other than plague, cholera, and yellow fever.

16

The best method of reducing the risk to baggage handlers of exposure to toxic substances in air cargo is:
a) requiring use of personal protective equipment when handling dangerous cargo.
b) providing education on proper handling of toxic substances.
c) biological monitoring for evidence of exposure to toxic substances.
d) ensuring toxic cargo is properly packaged prior to acceptance for shipment
e) providing rotating duties to provide risk-free period for baggage handlers.

d) ensuring proper storage and containment, via packaging and labeling, is the best method and represents engineering controls.

17

The endocrine response to air traffic control work is shown by:
a) adrenal corticosteroid secretion
b) adrenal medullary secretion
c) sympathetic nervous system secretion
d) all of the above

d) all of the above.

18

The most serious and prevalent health change found among air traffic controllers is:
a) vascular hypertension
b) peptic ulcers
c) diabetes mellitus
d) alcoholism

a) vascular hypertension

19

One of the major conclusions of the 5-year study of air traffic controllers in the Northeastern US was that:
a) working as an air traffic controller leads to high rates of coronary disease.
b) the work of air traffic control is unusually stressful
c) controller who were dissatisfied with their work had increased risk of negative health change.
d) all of the above.

c) controllers who were dissatisfied with their work had increased risk of negative health change.

20

While studies of job attitudes in air traffic controllers indicate that controllers are, on the whole, more satisfied with their work than employees in most other types of work settings, there are several factors mentioned frequently as sources of dissatisfaction by controllers. There include all but one of the following:
a) high level of responsibility
b) management
c) rotating shifts
d) night work

a) High level of responsibility is not associated with job dissatisfaction

21

When determining to what extent individuals are suited to air traffic control work, all BUT ONE of the following factors is considered:
a) age
b) overall level of adjustment
c) college grade point average
d) previous air traffic control experience

c) College grade point average is not considered in who is suitable to be an ATC.

22

Air Traffic Controllers primarily work two types of shift rotations schedules, depending on the choice of facility. These are the 2-2-1 schedule (2 day, 2 evening, 1 midshift) in each work cycle and the 5-5-5 schedule (5 days, 5 evenings, and 5 midshift). Research on these schedules has shown that:
a) the 2-2-1 shift is the more physically and psychologically costly of the two schedules.
b) There is not much difference between the two schedules in physiological and psychological costs.
c) The 5-5-5 schedule is psychologically, but not physiologically, more costly.
d) the 2-2-1 schedule is more costly in the psychological sense, but not in the physiologic sense.

b) there is not much difference between the two schedules in physiological and psychological costs.