disaster medicine/abuse

Question 1

tag color:

red:
yellow:
green:
black:

Answer 1

immediate, life threatening

delayed, non life threatening

minimal, minor injuries

expectant deceased or expected to die

Question 2

vectors: like anthrax

how are they released?

some places they are released?

Answer 2

aerosol

water supply
subway
major social events

Question 3

category A bioterrorism agents:

highest priority agents, they can grow easily, are sturdy and resistant to destruction, can infect large numbers of people

some examples are:

Answer 3

anthrax, smallpox, plague, botulism, tularemia, viral hemorrhagic fever

Question 4

smallpox:

incubation:
vulnerable to what?

how is it spread?

Answer 4

12 days 
bacterial superinfx (encephalitis, keratitis, corneal ulcerations) 

airborne or contact

Question 5

tx of small pox?

Answer 5

cidofovir (not super effective)

Question 6

prevention of small pox?

Answer 6

VIG (caccinia immune globulin) among exposed individuals

Question 7

anthrax: red papular lesions occur when?

Answer 7

after 2 weeks of exposure

Question 8

what does the red papular lesion become in anthrax?

Answer 8

progresses to necrotic ulceration and black eschar

Question 9

anthrax: inhalaion: like a URI that progresses to what?

Answer 9

sepsis, delirium, lethargy/somnolence, meningeal irritation

Question 10

Anthrax: GI: diffuse adb pain, D and fever

what else can occur?

Answer 10

hematemsis, melena, bowel perf

Question 11

tx of anthrax:

Answer 11

cipro or doxy

Question 12

what can be used for post exposure prophylaxis when no other options are avaliable?

Answer 12

monoclonal antibodies (human anthrax globulin)

Question 13

plague is caused by what?

Answer 13

yersinia pestis (fleas/rats)

Question 14

3 forms of plague:

bubonic:
septicemic:

Pneumonic:

Answer 14

inflammaion of tonsils, adenoids, spleen, thymus, severe lymph node swelling (buboes)

bacteremia, fever, chills, internal bleeding

most severe, contagios, potential for bioterrorism

Question 15

testing for plague:

bubonic:
speticemic:
penumonic:

Answer 15

buboes fluid sampling

blood culture

cxr, sputum culture

Question 16

tx for plague:

Answer 16

Gent, doxy, CIPRO

Question 17

Tularemia: tick borne

glandular: 
ulceroglandular:
oculoglandular:
penumonic: 
typhoidal:

Answer 17

painful lymph nodes, fever, chills, HA, fatigue

same with skin ulcers

eye pain, redness, discharge, ulcer on insid eof eyelid

sore throat, mouth ulcers, V, D (poorly cooked wild animals meat or contaminated water)

URI

rare but serious, fever, fatigure, hepato/splenomegaly

Question 18

tests for tularemia?

Answer 18

blood/sputum cultures to check for F tularenia or check for AB in blood (PCR)

Question 19

tx for tularemia:

Answer 19

streptomycin, gentamycin, doxy

NO CIPRO!!!!!!!

Question 20

ebola, dengue, lassa, yellow fever, marburg HF are all what?

Answer 20

viral hemorrhagic fever

Question 21

viral hemorrhagic fevers interfere with what?

Answer 21

clotting

Question 22

what can viral hemorrhagic fevers progress to?

Answer 22

shock, CNS malfunction, demerium, hepatorenal failure

Question 23

tx for viral hemorrhagic fever?

Answer 23

no tx, some immunizations (antiviral ribavirin may help shorten course)

Question 24

Q fever is caused by what?

Answer 24

coxiella burnetti

Question 25

this is a latent component that resurfaces months to years later causing damage to heart, liver, brain or lungs

Answer 25

Q fever

Question 26

transmitted from animals, livestock or sheep, mild initial may not rquire tx

Answer 26

q fever (coxiella burnetti)

Question 27

recurrence in q fever requires ab for how long?

Answer 27

18 months

Question 28

testing for q fever:

Answer 28

antibodies to coxiella burnetti, echo

Question 29

tx for q fever?

Answer 29

antibotics or valve replacement

Question 30

west nile, eastern equine, japanese, tick born encephalitis are all what?

Answer 30

viral encephalitis

Question 31

Headache, flulike symptoms, nausea, vomiting, anorexia, lethargy, nuchal rigidity what dxs?

Answer 31

viral encephalitis

Question 32

tests for viral encephalitis?

Answer 32

lumbar puncture, HEAD CT/mri, eeg, brain biopsy tx is symptomatic

Question 33

staphylococcal entertoxin B: food poisoning, bad meat, dairy, bakery how long do symptoms show up?

Answer 33

4-10 hours later, N/V/D!! can give zofran if its bad

Question 34

salmonella: water borne-streams, food posioning, fever, D how long does it last, how can we test it?

Answer 34

7-10 days stool culture (can possible give cipro but usually symptomatic tx)

Question 35

Nerve agents: affect both main types of what?

Answer 35

cholinergic (muscarinic and nicotinic)

Question 36

Sarin, tabun, Soman, VX are all what?

Answer 36

nerve agents

Question 37

miosis and rhinorrhea, along with bronchorrhea, paralysis, death, LOC, seizures can all occur with what?

Answer 37

nerve agents

Question 38

nerve agents or cyanide are what chemiclas?

Answer 38

quick onset

Question 39

liquid exposure: vapor exposure: how long till symptoms develop?

Answer 39

delayed symptoms, require prolonged exposure rapid onset

Question 40

tx for nerve agents:

Answer 40

Atropine!!! pralidoxime chloride, diazepam if seizures

Question 41

blood agents: cyanide: low concentrations: flushing, cherry red, anxious, high concentrations: 15 seconds: 30 seconds: 3-5 min: 6-10 min:

Answer 41

anxious, hyperventiliation seizures apnea asystole

Question 42

cyanide: tx:

Answer 42

amyl nitrate pearls combo of hydroxocobalamin, sodium nitrite and sodium thiosulfate is ideal

Question 43

sulfur mustard gas, lewisite are what?

Answer 43

blister agents skin redness, burns, conjunctivitis, upper airway iritiation tx: vaseline, cough suppressants, O2

Question 44

phosgene, chlorine, ammonia these are what?

Answer 44

choking agents delayed chest tightness, pulmonary edema wash eyes, flush, airway manangement

Question 45

mace, pepper spray, tear gas

Answer 45

crowd/riot control check opthalmic ph tx: wash, SABA, O2, eye irrigation

Question 46

#1 leading cause of death b/w 1-12 months of age?

Answer 46

child abuse

Question 47

failure to meet child's basic needs?

Answer 47

neglect

Question 48

mc reported and confirmed child abuse?

Answer 48

neglect

Question 49

failure to thrive, recurrent skin infx or gastroenteritis, occiptial alopecia from lying on back all day?

Answer 49

neglect in early infancy

Question 50

weight gain on hospitilization and unimmunized

Answer 50

neglect

Question 51

bowel disorders, anorexia, soiling onself, failing in school, disruptive behavior, fears, withdrawn, these can all correlate with what?

Answer 51

physical abuse

Question 52

doubel bubble sign on xray from abdominal trauma

Answer 52

duodenal hematoma from physical abuse

Question 53

retinal hemorrhages and intracerebral hemorrhage associated with what?

Answer 53

shaken baby syndrome

Question 54

spiral fractures or multiple fractures of different stages of healing?

Answer 54

physical abuse