Chemical Warfare and Bioterrorism

Question 1

Nerve Agents

Answer 1

• GA-Tabun (liquid)
• GB-Sarin (gaseous liquid)
• GD-Soman (liquid)
• VX (gaseous liquid)

Question 2

Blood Agents

Answer 2

• Hydrogen Cyanide (liquid)
• Cyanogen Chloride (gas)

Question 3

Choking/Vomiting Agents

Answer 3

• Phosgene (gas)
• Adamsite-DM (crystalline dispensed in aerosol)

Question 4

Blister/Vesicant Agents

Answer 4

• Phosgene oxime (crystalline or liquid)
• Mustard-lewisite Mixture- HL
• Nitrogen Mustard- HN-1, HN-2, HN-3
• Sulfur Mustard Agents

Question 5

Symptoms of Nerve Agents

Answer 5

• Headaches and confusion
• Miosis (excessive pupillary constriction)
• Dysphagia and runny nose
• Excessive saliva
• Nausea and vomiting
• Incontinence
• Convulsive cramping, twitching, jerking of muscles
• Coma and death

Question 6

Symptoms of Hydrogen Cyanide (Blood Agent)

Answer 6

• Headaches
• Red eyes
• Flushing of the skin
• Nausea
• Weakness
• Hypoxic convulsions
• Death

Question 7

Symptoms of Cyanogen Chloride gas (Blood Agent)

Answer 7

• Anorexia (loss of appetite)
• Respiratory tract irritation
• Pulmonary edema
• Death

Question 8

Symptoms of Phosgene gas (Choking/Vomiting Agent)

Answer 8

• Dizziness
• Eye and throat irritation
• Thirst
• Chills
• Cyanosis
• Frostbite-like lesions
• Respiratory and circulatory failure

Question 9

Symptoms of Adamsite-DM (Choking/Vomiting Agent)

Answer 9

• Irritation of eyes and respiratory tract
• Chest tightness
• Nausea and vomiting

Question 10

Symptoms of Blister/Vesicant Agents

Answer 10

• Destruction of mucus membranes, eye tissue
• Subcutaneous edema and blisters on the skin
• Irritation of eyes, nasal membranes, and lungs
• Nausea and vomiting
• Cytotoxic reactions in hematopoietic tissue (bone marrow, lymph nodes, spleen, and endocrine glands)

Question 11

Symptoms of Acute Radiation Syndrome

Answer 11

• Nausea and vomiting
• Diarrhea
• Anorexia and weight loss
• Fatigue
• Bone marrow suppression
• High risk for cancers in surviving patients

Question 12

Antidotes for Nerve Agents

Answer 12

• ATROPINE
• Flush eyes w/ water
• Apply sodium bicarbonate/ 5% liquid bleach solution to skin
• DO NOT induce vomiting

Question 13

Antidotes for Blister/Vesicant Agents

Answer 13

• Flush affected area with copious amounts of water
• 5% solution of sodium hypochlorite
• 10% solution of sodium carbonate
• house-hold bleach
• Drink milk
• DO NOT induce vomiting if ingested

Question 14

Antidotes for Hydrogen Cyanide (Blood Agent)

Answer 14

• Flush eyes and wash skin with water
• Inhalation- O2 and amyl nitrate
• Ingestion- 1% sodium thiosulfate
• INDUCE vomiting if ingested

Question 15

Antidotes for Cyanogen Chloride (Blood Agent)

Answer 15

• O2 and amyl nitrate
• Drink milk or water
• DO NOT induce vomiting

Question 16

Antidotes for Phosgene gas (Choking/Vomiting Agent)

Answer 16

• Flush eyes w/ NS or water
• Administer O2 and provide fresh air
• Keep pt warm and calm

Question 17

Antidotes for Adamsite-DM (Choking/Vomiting Agent)

Answer 17

• Rinse nose/throat w/ NS
• 10% solution of sodium bicarbonate
• Treat skin w/ borated talcum powder

Question 18

Symptoms of Cutaneous Anthrax

Answer 18

• Small skin lesions → black scabs

Question 19

Symptoms of GI Anthrax

Answer 19

• Sore throat
• Dysphagia
• Abdominal cramping/swelling
• Diarrhea

Question 20

Symptoms of Inhalation Anthrax

Answer 20

• Fatigue and fever for several days
• Then persistent cough/SOB

Question 21

General Symptoms of Anthrax Exposure

Answer 21

• Tissue necrosis
• Edema
• Hemorrhaging
• Accumulation of exudate (pain, swelling, activity restriction)
• Meningitis

Question 22

Antidotes for Anthrax

Answer 22

• Ciprofloxacin (Cipro) antibiotic
• Anthrasil: treats Inhalation anthrax in combination with w/ antibiotics
• Other antibiotics:
  - Penicillin
  - Doxycycline