Environmental Post Test April 1, 2010

25 Questions | Total Attempts: 49

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Environment Quizzes & Trivia

Based on Rosen's chapters 141-144


Questions and Answers
  • 1. 
    A 42 year-old man arrived several hours earlier at Copper Mountain Ski Resort in Colorado. He is nauseous, has a headache, and experiences dyspnea on exertion.  His vital signs are normal and his oxygen saturation is 98% on room air.  Which of the following is not true?
    • A. 

      Immediate descent is not mandated at this time

    • B. 

      Sleep disturbance is a common manifestation of this syndrome

    • C. 

      A medication which induces metabolic acidosis can be given to speed the process of acclimatization and lead to quicker resolution of symptoms

    • D. 

      Infants and very young children almost never suffer from this syndrome due to their higher baseline respiratory rates

  • 2. 
    The most common fatal manifestation of severe high-altitude illness is:
    • A. 

      Arterial gas embolism

    • B. 

      High-altitude pulmonary edema (HAPE)

    • C. 

      Cryotoxic edema

    • D. 

      High-altitude cerebral edema (HACE)

  • 3. 
    In remote settings, where oxygen and medical expertise are unavailable, the next best step in treating high-altitude pulmonary edema (HAPE) is:
    • A. 

      Descend at least 1500-3000 feet

    • B. 

      Dexamethasone 8mg IM

    • C. 

      Furosemide 80mg PO

    • D. 

      Nifedipine 20 mg PO

  • 4. 
    "High altitude" is between
    • A. 

      6,000 - 8,000 feet

    • B. 

      8,000 - 10,000 feet

    • C. 

      10,000 - 18,000 feet

    • D. 

      18,000 - 25,000 feet

  • 5. 
    The most sensitive sign for early recognition of high-altitude cerebral edema (HACE) is:
    • A. 

      Papilledema

    • B. 

      Slurred speech

    • C. 

      Cerebellar ataxia

    • D. 

      Seizure

  • 6. 
    Although never proven, the mechanism of death from "dry" drowning has commonly been attributed to:
    • A. 

      Severe laryngospasm

    • B. 

      Syncope following cardiac dysrhythmia from sudden contact with cold water

    • C. 

      Severe hypothermia

    • D. 

      Prolonged QT leading to torsades de pointes

  • 7. 
    True/False: Immediate and routine cervical spine immobilization is warranted in the majority of submersion victims
    • A. 

      True

    • B. 

      False

  • 8. 
    Which of the following has been demonstrated to improve outcome in the setting of submersion injury?
    • A. 

      Antibiotics

    • B. 

      Corticosteroids

    • C. 

      Corticosteroids and hyperventilation

    • D. 

      Barbiturate-induced coma

    • E. 

      None of the above

  • 9. 
    Of the following choices, the degree of pulmonary injury from submersion injury is most greatly affected by:
    • A. 

      Quantity of water aspirated

    • B. 

      Composition of water aspirated (freshwater vs saltwater)

    • C. 

      Temperature of water aspirated

    • D. 

      Time to administration of antibiotics and corticosteroids

  • 10. 
    Microwave ovens, garage door openers, radio and television broadcasting are examples of:
    • A. 

      Ionizing radiation

    • B. 

      Non-ionizing radiation

    • C. 

      Beta-radiation

    • D. 

      Disseminating radiation

  • 11. 
    The absolute lymphocyte count obtained at 48 hours after a radiation exposure is a good predictor of hematopoietic involvement.  Levels in this range should prompt hospitalization and further treatment:
    • A. 

      1200-1500/microliter

    • B. 

      800-1200/microliter

    • C. 

      500-800/microliter

  • 12. 
    Proper decontamination of a radiation-exposed patient may include all of the following except:
    • A. 

      Decontamination in the field

    • B. 

      Trimming of nails

    • C. 

      Disposal of all clothing, waste water, washcloths, and towels in sealed containers labeled "radioactive waste"

    • D. 

      Limiting repetition of the cleansing process with soap/water/shampoo to no more than twice on an individual patient

  • 13. 
    Open wounds should:
    • A. 

      Be closed primarily in patients who have received whole-body radiation >1 Gy

    • B. 

      Be gently irrigated once with 500 ml sterile water

    • C. 

      Never be surgically debrided, due to friability of tissues

    • D. 

      Be left to heal by secondary intention

  • 14. 
    1 Gy (gray) is:
    • A. 

      = 100 joules of radiation absorbed per kilogram

    • B. 

      = 0.1 joules of radiation absorbed per kilogram

    • C. 

      1 joule of radiation absorbed per kilogram

    • D. 

      10 joules of radiation absorbed per kilogram

  • 15. 
    The earliest indicator of radiation dose received is:
    • A. 

      Increase in platelet count

    • B. 

      Decrease in monocytes

    • C. 

      Decrease in absolute lymphocyte count

    • D. 

      Increase in eosinophils

  • 16. 
    Following a radiation accident, 2 workers develop immediate gastrointestinal and CNS symptoms with headache, confusion, vomiting, and severe abdominal cramping.  These symptoms are reflective of tissues/organs which are most radiosensitive due to their:
    • A. 

      Relatively higher water content

    • B. 

      Higher lipid content

    • C. 

      Greater rates of cellular division

    • D. 

      Large surface areas

  • 17. 
    True/False: Alpha particles can potentially have serious long-term effects if absorbed in large amounts through open wounds
    • A. 

      True

    • B. 

      False

  • 18. 
    The term "incorporation" refers to:
    • A. 

      Ingestion of radioactive material

    • B. 

      Ingestion and inhalation of radioactive material

    • C. 

      Absorption through an open wound of radioactive material

    • D. 

      Ingestion, inhalation, and absorption through an open wound of radioactive material

  • 19. 
    Signs of hematopoietic involvement from a radiation exposure usually develop 
    • A. 

      Within 12 hours of the exposure

    • B. 

      Between 2 days and 4 weeks

    • C. 

      Between 2-3 months

    • D. 

      Between 6-8 months

  • 20. 
    The radiation exposure range for patients in the "survival possible group" is estimated to be:
    • A. 

      < 2Gy

    • B. 

      2 Gy to 10 Gy

    • C. 

      10 Gy to 15 Gy

    • D. 

      15 Gy to 20 Gy

  • 21. 
    Which of the following pulmonary barotrauma disorders requires recompression therapy?
    • A. 

      Pneumothorax

    • B. 

      Pneumomediastinum

    • C. 

      Alveolar hemorrhage

    • D. 

      Subcutaneous emphysema

    • E. 

      Acute gas embolism

  • 22. 
    "The staggers" refers to:
    • A. 

      Inner ear decompression sickness (DCS)

    • B. 

      Pulmonary DCS

    • C. 

      Spinal DCS

    • D. 

      Type I DCS

  • 23. 
    The US Navy guidelines recommend that, after recompression therapy for Type I DCS, the patient not return to diving for:
    • A. 

      1 days

    • B. 

      7 days

    • C. 

      2 months

    • D. 

      6 months

  • 24. 
    A 33 year-old diver ascends to the surface.  Within minutes of reaching the top, the diver is witnessed by a fellow diver to have seizure-like activity.  The most probable explanation for this is:
    • A. 

      Decompression sickness type II

    • B. 

      Hypoxia from alveolar hemorrhage

    • C. 

      Nitrogen narcosis

    • D. 

      Acute gas embolism

  • 25. 
    Chelating agents and blocking agents may be beneficial in preventing/limiting radionucleotide uptake when ingestion or inhalation has occurred.
    • A. 

      True

    • B. 

      False