Hm Book Ch 23: Medical Aspects Of Chemical, Biological, And Radiological Warfare

The first large-scale use of chemcial agetns came in World War I when, in 1915, the Germans released __________ (1 word) gas agasint the Allied positions at Ypres, Belgium.

M8 Chemical Agent Detection Paper turns Olive or Verdana Green in the presence of __________.

"Riot-control agents" is the collective term used to describe a collection of chemical compounds, all having similar characteristics, though relatively nontoxic, produce an immediate but temporary effect in very low concentrations.  These agents are used to harass enemy personnel or to discourage riot actions.

• True

• False

Chemical agents classified as "lethal" will have a minimum __________% death rate among casualties.

Blister agents, or vesicants, exert their primary action on the skin, producing large and painful blisters that are incapacitating.  Although vesicants are classified as noonlethal, high doses can cause death. 

• True

• False

Lacrimators are also known as tear gas.

• True

• False

During the early attempts at chemical warfare, personnel were often victims of their own chemical attacks due to the crude new technology.

• True

• False

Terrorist groups are adding a new twist to chemical warfare.  There have been news reports and admissions by terrorist groups that they are actively developing chemical weapons.  The production of chemcial weapons on a small scale is not difficult.  The space required to set up a chemical agent lab is no larger than that of a narcotics drug lab.  The equipment necessary to produce chemical agents is available on the open market.

• True

• False

Which of the following makes it likely that terrorist organizations will attempt to produce and  use chemical weapons?

• Production of chemical weapons on small scales is not difficult

• Not much space is required to set up a chemical weapons lab

• The equipment necessary to set up chemical weapons is available on the open market

• All of the above reasons make it likely that terrorist organizations will attempt to produce and use chemical weapons

Indicators of a possible biological agent release include the following:

• Unusual disease for the geographic area
• Absence of a competent natural vector
• Restricted geographic distribution, epidemiological grouping or clustering
• High morbidity and mortality compared with a normal occurence of the disease
• Dead animals of multiple species are sentinels

• True

• False

Throughout history, chemical weapons have been used in one form or another.  The earliest form of chemical weapons was the use of spears and arrows dipped in poison.  The Spartans mixed pitch and sulphur and ignited it to create toxic fumes during battle in order to incapacitate the enemy.  Other armies dipped cloth in poison and lit it on fire to create a toxic cloud over opposing armies. The first large-scale use of chemical weapons came in World War I when, in 1915, the Germans released chlorine gas against the Allied positions at Ypres, Belgium, causing over 5,000 casualties.

• True

• False

Each blister agent is chemically different and can cause significantly specific symptoms.  They are all similar in their physical characterisitsics and toxicology.  Mustard (H), Distilled Mustard (HD), and Nitrogen Mustard (HN) are oily, colorless or pale yellow liquids, sparingly soluble in water.  HN is less volatile and more persistent than HD but has the same blistering qualities.  Lewisite (L) is an arsenic-based compound that comes as a light-to-dark brown liquid that vaporizes slowly.  It is more likely to flow spots such as valleys, ditches, holes, and the ground or deck.

• True

• False

The production of chemical weapons on a small scale is not difficult; the space required is small and the equipment necessary is available on the open market.

• True

• False

The MARK 1 antidote kit consists of an autoinjector of Atropine 2mg and an autoinjector of 2-PAM Cl 600mg.

• True

• False

Which of the following is the most effective shielding against radiation?

• Wood

• Leather

• Reinforced concrete

• Lead

• None of the above

In 1995 a terrorist group in Japan, Aum Shinrikyo, produced and used sarin gas in a Tokyo subway.  As a result, a dozen people were killed and approximately 5,000 people were incapacitated or injured.  The number of dead would have been higher if the agent was in a purer form.

• True

• False

The term "persisten" is given to chemical agents that continue to present a hazard for considerable periods (days) after delivery by remaining as a contact hazard, or by slowly vaporizing to produce an inhalation hazard.

• True

• False

Pulmonary agents such as Phosgene (CG) damage the membranes in the lungs that separate the alveolar tissue, resulting in fluid from the blood to leak into the alveoli and fill them with fluid.  This prevents necessary gas exchange, causing hypoxia and pulmonary edema. Phosgene is a colorless gas with a distinctive odor similar to that of new-mown hay or freshly cut grass.

• True

• False

Pulmonary agents damage the membranes in the lungs that separate the alveolar tissue resulting in fluid from the blood to leak into the alveoli, filling them with fluid.  This prevents necessary gas exchange within the alveoli causing hypoxia, creating a condition known as pulmonary edema. Pulmonary agents include gases such as phosgene (CG), and chlorine (Cl).  HC Smoke and Ammonia should also be considered pulmonary agents. Pulmonary agents are usually in vapor typically heavy than air, and travel close to the ground.  They tend to evaporate and disburse very quickly, depending on temperature and wind.  Chlorine and ammonia have very distinct smells.  Phosgene (CG) is a colorless gas with the distinctive odor similar to that of new-mown hay.

• True

• False

Over 5,000 casualties resulted from the first large-scale use of chemical agents in World War I when the Germans released chlorine gas (Cl) against the Allied positions at Ypres, Belgium.

• True

• False

Terrorists will not use chemcial agents because they are difficult to make.

• True

• False

Nerve agents can enter the body through the eyes, respiratory tract, and skin.

• True

• False

The MARK 1 antidote kit consists of an autoinjector of Atropine 2mg and an autoinjector of 2-PAM Cl 600mg.

• True

• False

Biological attacks may not be apparent and require a full epimediology study.  Small scale outbreaks or those occuring a long period of time require further investigation.  Outbreaks occuring in multiple geographical locations may either be a natural occurence or an intentional release.

• True

• False

Weather conditions will influence the effectiveness and duration of chemical agents in the following manner:

• Wind in an open area will disperse an agent quickly.  Calm winds or protected areas (wooded areas, ditches, and urban areas) will allow an agent to stay in an area longer.
• High temperatures decrease the persistency of agents and tend to cause higher vapor concentrations.  This is especially true with mustard agents.
• Low temperatures increase the persistency of agents.  Some agents may freeze, thus reducing the immediate contact hazard or vapor hazard but there is a danger of moving frozen agents on personnel clothing or equipment into a warm building where the agent can thaw providing a subsequent risk of toxic vapor contamination.
• Rain washes away, dilutes, and promotes hydrolysis of agents.  This reduces their risk but does not make them harmless.

• True

• False

Nerve agents are odorless, almost colorless liquids or vapors that vary greatly in viscosity and volatility.  They are moderately soluble in water and fairly stable unless strong alkali or chlorinating compounds are added.  They are very effective solvents, readily penetrating cloth either as a liquid or vapor.  Other materials, including leather and wood are fairly well penetrated.  Butyl rubber and synthetics such as polyester, are much more resistant.

• True

• False

Blister agents can be visually identified as follows: Mustard (H), Nitrogen Mustard (HN), and Distilled Mustard (HD) are oily, colorless or pale yellow liquids that are sparingly soluble in water. Lewisite (L) is an arsenic-based compound that is a light to dark brown liquid that vaporizes slowly.  It is more likely to flow to low spots such as valleys, ditches, holes, etc.

• True

• False

The first large-scale use of chemical agents came in World War I when, in 1915, the Germans released chlorine gas against the Allied positions at Ypres, Belgium.

• True

• False

Nerve agents can enter the body through which of the following?

• Eyes

• Respiratory tract

• Skin

• All of the above

There are three types of Biological Agents that can be used as weapons:

• Bacteria  - Single-celled organisms capble of causing a variety of diseases in animals, plants, and humans.
• Virus - Microorganisms smaller than bacteria.  They are intracellular parasites that lack a system for their own metabolism, meaning that they require living cells to multiply
• Toxins - Harmful substances produced by a variety of living organisms.

• True

• False

Recent history has shown a disturbing change in the potential use of nuclear weapons.  Terrorists organizations have added a new dimension to the use of radiological material.  These groups have been seeking a nuclear bomb or the materials necessary to develop a nuclear device.  However, terrorists may not be able to develop a fully functional nuclear bomb and may have to develp and utilize a radiological disbursa device, or "Dirty Bomb"

• True

• False

Lewisite, a powerful blister agent, is a dark green or brown oily liquid that smells like geraniums.

• True

• False

The following chart illustrates the five MOPP levels, from MOPP Level 0, also known as "MOPP Level Ready," to MOPP Level 4, the highest protective level.

• Copy, thanks!

• Huh? I don't get it

Decontamination of liquid nerve agent exposure consists of removing all contaminated clothing.  An M291 kit may be used or copiously irrigating the areawith water to physically remove the nerve agent.  The skin is then washed with an alkaline solution of soap and water or 0.5% hypochlorite solution (made by distilling household bleach 1:10) to chemically neutralize the nerve agent.  Avoid hot water, strong detergents, and vigrous scrubbing, since they tend to enhance nerve agent absorption.

• True

• False

Decontamination of blister agents within two minutes will reduce the toxic effects by 50%.

• True

• False

Outbreaks occuring in multiple geographical locations may either be a natural occurence or an intentional release.

• True

• False

Patients who have been exposed to a large amount of vaporized nerve agent will present with constricted pupils, difficulty breathing, or no breathing, flaccid paralysis, and a large amount of secretions from the nose, mouth, and lungs

• True

• False

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• True

• False

The three most common methods to detect chemical agents are: M9 CHEMICAL AGENT DETECTOR PAPER - The most widely used method of detecting liquid chemical warfare agents.  M9 paper indicates the presence of a nerve agent or a blister agent by turning a pink, red, reddish brown, purple color.  It does not identify which agent gives the positive reading. M8 CHEMICAL AGENT DETECTOR PAPER - This method is also used to test for the presence of liquid chemical agents.  It can detect the presence of liquid chemical agents, which M9 paper cannot.  When the paper touches a G-Class nerve agent it will turn a gold or yellow color, and will turn an Olive or Verdana Green color when it touches VX agent.  If it turns red or purple, then it has come in contact with blister agents. M256A1 CHEMICAL AGENT DETECTOR KIT - Portable kit that detects nerve gas, mustard gas, and cyanide.  This kit contains a package of M8 paper, detailed instructions, and a vapor sampler (12 enzymatic tickets that contain laboratory filter paper for detecting vapors).  The vapor sampler uses wet chemistry technology in which ampules containing different substrates are crused so that the liquids interact with strips of filter paper, chromatographic media, and glass fiber filter.  The reactions cause a color change alerting the user to the presence of a chemical agent.  These reactions usually take 15 minutes.

• True

• False

Which of the following is the most effective shielding against radiation?

• Water

• Anti-radiation plastics

• Leather

• Lead

Which of the following countries has the notoriety of being the first to use chemical agents in warfare?

• United States

• Belgium

• Germany

• France

• None of the above

British Anti-Lewisite (BAL) was developed as an antidote for Lewisite (L).  BAL is used as a chelating agent that combines with the heavy metal to form a water-soluble, non-toxic complex that is excreted.  However, BAL is somewhat toxic and an injection of more than 3mg/kg will cause severe symptoms.  Do not use on patients allergic to peanuts.

• True

• False

Which of the following types of radiation has the most penetrating power?

• Alpha Radiation

• Beta Radiation

• Gamma Radiation

• All radiation types have the same type of penetrating power

Gamma radiation has the most penetrating power of all radiation types.

• True

• False

The faster the onset of nausea and vomiting, the higher the dose of radiation received by the patient.

• True

• False

Patients exposed to mustard gas may remember seeing an oily substance and smelling an odor of garlic, mustard, or horseradish.

• True

• False

MOPP Level 4, pictured above, provides the highest level of protection against chemical attacks.

• True

• False

Riot control agents such as CN, CR, CS, DM, and OC are relatively non-toxic.

• True

• False