Chemical Agents of Opportunity Final Test Answer Key and Rationale:
1. Which of the following would best be characterized as a toxic industrial compound?
Ammonia
Anthrax
Sarin
Mustard Gas
Water
2. The goal of toxic terrorism is best accomplished by which of the following scenarios or releases?
Immediately lethal agent release in restaurant
Disruption of a transportation corridor
Creating fear leading to incapacity
Occult insertion of a carcinogen
Targeting a single factory component
3. Which characteristic is common to most TICs and TIMs?
Limited availability
Stored in small quantities
Inexpensive
Securely maintained and transported
Generally low toxicity
Only vulnerable during transport
4. Which of the following is not a component of a hazard score or ranking?
Toxicity of a chemical
Amount of a chemical on site
Volatility of chemical
Wind direction at time of release
History of use in prior terrorist event
5. A large scale chemical release will place substantial demands on our health care system’s ability to respond. Efforts geared towards prevention and mitigation of such events should include:
Placing more information about chemicals on the Internet
Designing response strategies only on the basis of historical examples of major chemical events
Providing a framework for first responders and first receivers for the early detection and recognition of toxic chemicals in order to optimally prepare, identify and defend against chemical threats
Distribute gas masks to individuals in every community
6. In order to be able to participate in a timely and appropriate manner to a large scale chemical event, first responders and first receivers need:
subject matter level expertise in all chemicals
awareness-level and responder-level training including knowledge across a variety of toxic syndromes likely to be encountered following exposure to chemical agents of opportunity
experience designing and implementing legislation addressing the transport of toxic chemicals
Extensive training in search and recovery
7. One of the multiple sources where terrorists and other individuals can obtain common industrial chemicals include:
grocery stores
farm, garden and home improvement stores
the federal government
libraries
8. Chemical agents most likely to be used by terrorists include:
Anthrax, smallpox and plague
Metals, cyanide, pesticides, rodenticides, and poison gas
Paint thinner, candle wax, peat moss
Food coloring and other preservatives
9. Which of the following is a common mechanism by which coma occurs following exposure to a toxin?
Enhanced inhibitory tone
Reduced inhibitory tone
Enhanced excitatory tone
Reduced excitatory tone
10. Which of the following was the most likely agent responsible for the poisoning event at the Theatrical Center in Russia that resulted in over 100 fatalities?
Diazepam
Carfentanyl
Halothane
Morphine
11. What is the major direct complication of overdose with a sedative agent?
Bleeding
Cardiac arrhythmia
Respiratory depression
Seizure
12. What is the most important treatment for patients who have respiratory depression?
Artificial ventilation
Chest compressions
Naloxone
Oxygen
13. Due to the abundance of chemicals produced and the relative ease of access to industrial chemicals there is serious concern that…
Prices of these chemicals will soon drop significantly
U.S. industry will fail to compete successfully in the global arena
Events will occur involving the accidental or intentional release (by terrorists) of these chemicals
Individuals will fail to safely store these chemicals
14. The main initial priority in a potential toxic exposure is…
Notification of the appropriate regulatory body
Initiation of cardiopulmonary resuscitation
Intubation and positive pressure ventilation
Removal of the victim from ongoing exposure
Extensive decontamination
15. The Acute Emergency Guideline Level-3 is the…
Tonal alert system for the Washington D.C. area
Maximum storage capacity guideline for phosgene
Amount of a toxic compound that triggers required notification of authorities when crossing state lines
Predicted airborne concentration above which people will experience life-threatening health effects or death
16. A characteristic of a toxic gas that is predictive of the types of symptoms that victims will experience is its…
Odor
Flavor/taste
Water solubility
Color
17. Anhydrous Ammonia (NH3) is:
A stable solid compound rarely used in the U.S.
Used mainly as a fertilizer and is the third most produced chemical in the U.S.
Common window cleaner that poses little threat to human health
Causes damage resulting from acidic burns when exposed
18. Exposure to toxic gases will create serious health consequences for victims and will be determined primarily by:
Age of the victim
Prevailing weather conditions during the time of the exposure
Length of time until responders arrive
Dose (concentration and duration of exposure)
19. Which of the following is not a fumigant?
Methylene chloride
Sulfuryl fluoride
Methyl Bromide
Phosphine
20. Which of the following agents is most likely to cause gasping and death after being inhaled?
Cyanide
Sulfuryl fluoride (Vikane)
Methyl Bromide
Phosphine
Chloropicrin
21. Which of the following agents is added to fumigant gases in order to make it more easily detectable when inhaled?
Chloropicrin
Mercaptans
Hydrogen sulfide
Organophosphates
Yellow dye number 20
22. Which of the following agents is a potent lachrymator?
Chloropicrin
Sulfuryl fluoride (Vikane)
Methyl bromide
Phosphine
Cyanide
23. Antidotes are available for which of the following agents?
Cyanide
Sulfuryl fluoride
Methyl bromide
Phosphine
Chloropicrin
24. Management of which of the following exposures may involve the administration of a vitamin precursor?
Cyanide
Sulfuryl fluoride
Methyl bromide
Phosphine
Chloropicrin
25. In 2003, the Department of Homeland Security issued a bulletin warning of which of the following threats:
Introduction of cyanide gas into ventilation systems
Increased use of chloropicrin in agriculture
Increased purchase of Vikane by uncertified users
Increased imports of aluminum phosphide from China
Theft of Vikane from delivery trucks in Texas.
26. Which of the following agents was purchased on the Internet in order to commit a murder?
Potassium cyanide
Sulfuryl fluoride (Vikane)
Methyl bromide
Phosphine
Chloropicrin
27. Which of the following statements regarding drinking water standards is correct?
FDA enforces standards set by EPA
EPA sets and enforces the standards either directly or through state-run programs
USDA enforce standards set by EPA
EPA specifies the methods used to achieve required regulatory standards for water quality
28. Which of the following statements regarding drinking water disinfection in the US is correct?
Chlorine is added at the beginning of the process to help with coagulation
Ozone is often used because of its excellent residual effects on contaminating organisms
Chlorine has poor residual antimicrobial effects against viruses
Chlorine may not inactivate bacterial spores and some protozoans and its effect on chemical hazards is variable
29. Which of the following statements regarding food safety in the US is correct?
FDA is responsible for the majority of food safety issues in the USA
USDA is not involved in food safety
The current food -safety system in the USA was designed to help prevent acts of food terrorism
FDA is the agency responsible for regulation of all aspects of milk production and safety
30. Which of the following statements regarding food terrorism is true?
Food terrorism would be difficult to detect quickly because it would likely appear similar to common food-borne outbreaks
Current strategies in place are adequate to prevent food-borne terrorism in the USA
Limited geographic distribution of processed foods makes food terrorism unlikely
The methods most commonly used in the USA to pasteurize milk makes it unlikely that milk would be used in a terror attack
31. Which of the following statements regarding the prevention of poisoning of medications is correct?
The FDA routinely inspects drugs for contamination
The “Tylenol Act” was passed by the US Congress to help prevent intentional drug contamination after a series of deaths due to cyanide-contaminated Tylenol
Terror attacks on the medication supply would only include the primary ingredient and not any other additives since they are all present in amounts too small to be significant
The FDA has a mandatory reporting system in place for medical providers who recognize adverse events associated with medications
32. Which one of the following describes a reason that a toxin with a delayed-onset would be desirable as a terrorist weapon?
The exposed victim can leave the immediate area of release, making diagnosis difficult
It is likely to produce a large number of victims in a small geographic area
Always produce unrecognizable syndromes
Easier to produce than acute onset toxins
33. Which of the following describes the toxicity of organochlorines such as dioxin?
They rapidly cause cardiovascular toxicity upon inhalation
They are highly carcinogenic to humans
They produce a classic syndrome of skin toxicity
They are associated with neurologic toxicity following long term exposure
34. Which of the following explains the differences among the various toxic metals?
All metals produce a similar toxicological syndrome
The toxicologic syndrome produced by a specific metal varies by its chemical form
Metal-containing toxins cannot be absorbed through the skin
The expense of metal-containing toxins makes them unlikely to be used by terrorists
35. In addition to having a delayed onset of symptoms, which of the following describes a desirable feature of some organochlorines, such as dioxin, as a terrorist weapon?
Biopersistence
Explosive
Difficult to diagnose toxic syndrome
Transmissible between people
36. The majority of most health care workers’ annual exposure to radiation is due to:
Proximity to diagnostic tests, such as x-rays and fluoroscopy, performed on patients
Caring for contaminated patients
Background radiation found in our environment
Consumer products
37. When caring for patients exposed to high levels of radiation, it is important to understand that:
They are radioactive and pose a significant risk to providers
Seriously injured patients must be decontaminated before being stabilized
Providers must be decontaminated before emergency care is given
Patients are not necessarily radioactive and pose little health risk to others
38. A patient presents to the ED with a severe burn to the skin with evidence of charring. This patient has most likely sustained a:
Lethal radiation injury
Serious radiation injury but will benefit from medical intervention
Thermal injury
Radiation injury with active “hot” (radioactive) particles still present on the skin
39. Almost immediately after a radiation exposure of 10,000 rem or more, symptoms including nausea, vomiting, disorientation, and seizures develop. This form of radiation sickness is called:
Prodromal syndrome.
Hematopoietic syndrome
Gastrointestinal syndrome
Cerebrovascular syndrome
40. A drop in which lab value gives the earliest indication of a serious whole body radiation:
Red blood cell count
Platelet count
O2 saturation
Absolute lymphocyte count
41. If a person gets radioactive material on his/her clothes, the person is said to be:
Radioactive
Externally contaminated
Radiation exposed only
Extremely dangerous
42. An immediate concern regarding a person who has been exposed to radiation and has an open wound is:
Stroke
Tissue necrosis
Internal contamination
Development of a local radiation injury
43. The largest group of patients that typically present to an ED after a potential mass chemical exposure is/are:
Requesting evaluation for non-specific symptoms or “just to get checked out”.
Mildly Poisoned
Critically ill and poisoned
Grossly contaminated with toxic chemicals on their clothing
44. “Mass Hysteria” during a large-scale chemical exposure is:
Common with at least a 5:1 ratio of hysterical to ill
A common, but pejorative term for victims with perceived poisoning and anxiety-induced autonomic arousal
Is a term used for panic commonly,observed during a disaster
Is the most widely accepted term for a group of victims complaining of symptoms without objective findings or without symptoms that are just coming to get checked out
45. Fear, anxiety and emotional reactions following a mass chemical exposure are:
A normal reaction to extraordinary circumstances
Easy to distinguish from toxic chemical effects
Is a form of panic often observed during disasters
Is not contagious
10TH CENTRAL EUROPEAN CONFERENCE FIBRE GRADE POLYMERS CHEMICAL FIBRES
17 HAVERFORD COLLEGE LABORATORY SAFETY STANDARD CHEMICAL HYGIENE PLAN
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