Notes in L06 Disaster Preparedness and terrorism

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Published	06/22/2023	{{c1::Chemical warfare}} is the Intentional use of weapons designed to kill, injure, or incapacitate based on toxic or noxious chemical properties…
Published	06/22/2023	{{c1::Biologic warfare}} is the Intentional use of weapons designed to kill, injure, or incapacitate based on microorganisms or xenobiotics derive…
Published	06/22/2023	{{c1::Terrorism}} is the unlawful use of force against persons or property to intimidate or coerce a government, the civilian population, or any s…
Published	06/22/2023	What is classified in the highest and lowest percentages when it comes to incidences of various chemical terrorism agents?Lowest percentage: {{c1::Ars…
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Published	06/22/2023	A unitary agent essentially has {{c1::one sort of delivery system and the agent is already in its active ready to go}} and reek havoc.
Published	06/22/2023	What are Binary Agents?Binary agents have {{c1::two separate canisters}}, it's only {{c1::once it's combined}} that it activates to get the active che…
Published	06/22/2023	What does NBC stand for? {{c1::Nuclear, biologic and chemical agent}}
Published	06/22/2023	What are the positives of utilizing Chemical Warfare agents?1. During an inital attack agents can {{c1::vary}} with onsets of symptoms and this variat…
Published	06/22/2023	What are limitations on Chemical Warfare?The dose makes the poison so you have to disseminate {{c2::large quantities}} to have a general clinical effe…
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Published	06/22/2023	What are {{c1::knock down agents}} defined as?the biggest class which is defined by : you're alive one second and you drop dead the next, that big exa…
Published	06/22/2023	Nerve agents are associated with {{c1::cholinergic}} toxidrome
Published	06/22/2023	What agents cause  symptoms that irritate your lungs, makes it difficult to breathe, irritating, your eyes are burning, your mouth is burning:{{c…
Published	06/22/2023	{{c1::Vesicants}} are things that bind to DNA.  They mess up the DNA and the cellular processes and you you end up with sloughing of skin, bliste…
Published	06/22/2023	What is an examle of an incapacitating agent? {{c1::BZ}}
Published	06/22/2023	Classic Vesicants are:{{c1::Mustard}} and {{c1::Lewisite}}
Published	06/22/2023	Vesicant Effects {{c1::Respiratory}} • Chemical Tracheobronchitis {{c1::Ophthalmologic}} Latency of hours Pain, miosis, photophobia, lacrim…
Published	06/22/2023	Mustard gas itself is colorless and odorless, it's oil and liquidlyy, pretty low volatility will puddle algorithms into the floor.  It's pretty w…
Published	06/22/2023	Sulfur Mustard: {{c1::bis-2-chloroethylsulphide(HD) }}
Published	06/22/2023	What are the Toxokinetics of Mustard Gas? AbsorptionVery {{c1::Lipid}} SolubleEasily absorbed via skin, lungs, GIT DistributionCSF > Fat &g…
Published	06/22/2023	What is this an example of?{{c1::Mustard Gas}} Poisining
Published	06/22/2023	What are the two theories in regards to how Mustard gas acts?1. THeory 1 is that it binds to DNA in cells and causes {{c1::breaks in DnA}}. Our NAD fo…
Published	06/22/2023	What are these diagnostics for? {{c1::Mustard Gas Poisining}}We can detect Thoidiglycol in urine We can treat using Respirators and Polyurethane …
Published	06/22/2023	What is Phosgene Oxime?It is a {{c1::Urticant/"nettle" agent}}It can cause "Erythema"Wheals UrticariaImmediate {{c1::skin and mucous membrane irr…
Published	06/22/2023	What type of compound is Lewisite?It is an inflammable {{c1::organoarsenic}} compound which is inflammable. It has a characteristic odor which is why …
Published	06/22/2023	WHat is the Mechanism for Lewisite toxicity?This is a mitochondrial agent and inhibits the {{c1::TCA or krebs cycle}}. It does this by inhibiting {{c1…
Published	06/22/2023	What is the treatment for Lewisites?You want to {{c1::decontaminate}} themYou want to make sure that health-care providers are in appropriate protecti…
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Published	06/22/2023	What is Phosgene?It is originally a war gas • Sources: Manufacturing of dyes, resins, and pesticides            …
Published	06/22/2023	What are these the clinical effects of?  {{c3::Phosgene}} • Initially minimal signs or symptoms        • Odor is considere…
Published	06/22/2023	Which Pulmonary Agents are High-solubility? {{c1::• Ammonia • Sulfur Dioxide • HCl }}
Published	06/22/2023	Which Pulmonary Agents are Intermediate-solubility? {{c1::• Chlorine}}
Published	06/22/2023	Which Pulmonary agents are Low-Solubility? {{c1::• Oxides of nitrogen• Phosgene }}
Published	06/22/2023	What are the Inhalational Exposure: Determinants of Toxicity? • {{c1::Dose}}: RR x Tidal Volume Exposure circumstances: Concentration, durati…
Published	06/22/2023	What are the highly soluble gases? {{c1::Ammonia}}: Fertilizer, Refrigerant, Explosives {{c2::Formaldehyde}}: Resin production, disinfectant, …
Published	06/22/2023	What are these effects of?  {{c1::Highly-soluble gases}} • Rhinorrhea • Dysphonia • Coughing • Laryngospasm
Published	06/22/2023	What does chlorine gas produce when dissolved in water? Produces {{c1::hydrochloric acid and hypochlorous acid}} when dissolved in water
Published	06/22/2023	What are the sources of Chlorine gas?
Published	06/22/2023	What is used to treat chorine gas inhalation?{{c1::Nebulized SOdium Bicarbonate}}
Published	06/22/2023	What are other chlorine gas treatments other than Nebulized SOdium Bicarbonate?{{c1::ABC'sBronchodilators}}
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Published	06/22/2023	{{c1::Nitrogen Dioxide}} poisining is seen in classic Silo Fillers (farming) disease.It may be generated during welding and burning of nitrocellulose …
Published	06/22/2023	What is {{c1::White Phosporous}}?  IT IS A MAJOR HEPATOTOXIN Spontaneously combusts when combined with oxygen • Thermal Burn Possible Ca…
Published	06/22/2023	How do we treat White Phosphorous Exposure? Prompt {{c1::irrigation}} of burn and covered with {{c1::damp}} cloth until definitive surgical debri…
Published	06/22/2023	THIS IS EXTREMELY IMPORTANT FOR THE EXAM! What is this? {{c1::Hydrogen Cyanide}}
Published	06/22/2023	What are Sources of Hydrogen Cyanide?{{c1::Structural Fires}} - wood in furniture is not made of real wood{{c2::Cyanide Salts }} {{c3::Cyano…
Published	06/22/2023	Big important thing, What does cyanide do and how does cyanide work?  It's a {{c1::mitochondrial toxin}}.  It's a {{c1::mitochondrial inhibi…
Published	06/22/2023	How does the mechanism of Cyanide work (in depth) ? Cyanide goes where oxygen is and it blocks {{c1::complex 4}} of the electron transport chain.…
Published	06/22/2023	What are Clinical Effects of Hydrogen Cyanide? • Rapid {{c1::Unconsciousness }}• Seizure • Tachycardia • Variable Blood Pressure • Acid{{…
Published	06/22/2023	Arterialization of venous blood means you wouldn't be able to tell the difference from a blood stick or the color of the blood between the vapors and …
Published	06/22/2023	What do the smell of these things refer too? The smell of {{c1::Hydrogen Cyanide}}
Published	06/22/2023	How do we diagnose Hydrogen Cyanide Poisining? Clinical • Rapid {{c1::Unconsciousness}}• {{c1::High}} Lactate Confirmatory testing • {{c1::Whole-b…
Published	06/22/2023	WHat is the biggest most recent and common Antidote to Hydrogen Cyanide poisin? {{c1::Hydroxocobalamin}}
Published	06/22/2023	How does Hydroxocobalamin work as an antidote to Hydrogen Cyanide?It's a {{c1::single agent}}, one and done sort of dose and what happens is it combin…
Published	06/22/2023	What are treatments for Hydrogen Cyanide Poisining? Temporizing measures • Amyl {{c1::nitrite}} • Sodium {{c1::nitrite}} Definitive managemen…
Published	06/22/2023	When Nitrites were used to treat Hydrogen Cyanide poisining, what was their mechanism? Generate {{c1::methemoglobin,}} to which cyanide binds pre…
Published	06/22/2023	We do not use nitrites if oxygen-carrying capacity is {{c1::reduced}}.Overall we mainly use Hydroxocobalamin for Hydrogen Cyanide poisining.
Published	06/22/2023	What was Sodium Thiosulfate used for? It was used for individuals with Hydrogen Cyanide Poisining.It facilitates the conversion of cyanide into thiocy…
Published	06/22/2023	What is this?   {{c1::Hydroxocobalamin (Vitamin B12a) which binds with cyanide to generate cyanocobalamin}} . It doesnt cause hypotension an…
Published	06/22/2023	What does Hydroxocobalamin artificially increase? Artificially Increases •{{c1::Creatinine}} • {{c1::Total bilirubin}} • {{c1::Glucose}} • {{…
Published	06/22/2023	When it comes to using Sodium Thiosulfate vs Hydroxocobalamin for Cyanide Poisining?There is a slower onset of action and no good human data on sodium…
Published	06/22/2023	In the Swine model of cyanide toxicity {{c1::Hydroxocobalamin + sodium thiosulfate}} are  superior to sodium nitrite and sodium thiosulfate&n…
Published	06/22/2023	Incapacitating agents have the ability to incapacitate people by doing {{c1::minimal harm}} to them.
Published	06/22/2023	Incapacitating Agents • Narcotics and sedatives: {{c1::Fentanyl}}• Dissociative Agents: {{c1::LSD}} • Anticholinergics: {{c1::BZ Agents}} • Tric…
Published	06/22/2023	What are characteristics of Riot Control Agents? {{c1::Non-lethal, temporarily disabling}} solids at room temperature and normal pressure that a…
Published	06/22/2023	What are different Riot Control Agents? • Chloracetophenone (CN) – chemical {{c1::mace}} • o-chlorobenzilidene malononitrile (CS) – {{c1::tear}} ga…
Published	06/22/2023	Nerve Agents are a very important topic!  {{c1::Organophosphates}} like insecticides • Diazinon and malathion {{c1::Sarin}} is often dis…
Published	06/22/2023	NERVE AGENTS:{{c1::Organophosphates}} are one of the most toxic chemical agents and It refers to agents in a chemical class that have a mechanism of a…
Published	06/22/2023	What is Acetylcholinesterase?It is an enzyme that degrades acetylcholine to {{c1::choline and acetic acid }}It is found in central and peripheral…
Published	06/22/2023	G series and V series are classes of different {{c1::nerve agents}} that have rapid absorption.
Published	06/22/2023	• G series: Non-persistent and volatile • {{c1::Tabun}} (GA) • {{c1::Sarin}} (GB) – most volatile • Soman (GD) • Cyclosarin (GF)
Published	06/22/2023	• V series: Persistent and non- volatile • {{c1::VX}} – least volatile, most persistent • VR • VM • VG • VE
Published	06/22/2023	WHat are Characteristics of Nerve Agents? • Most are {{c1::lipophilic}} • Leads to prolonged release from {{c1::adipose}} • Clinically can see {{c…
Published	06/22/2023	Nerve Agent symptoms are dependent upon:{{c1::Dose}}Route of {{c1::Exposure }}Specific {{c1::Agent}}Onset depends on route as well - dermal can b…
Published	06/22/2023	How does aging work?There are different half-lifes for aging depending upon the gas. When cholinesterase is aged that means it cannot be hydrolyzed ba…
Published	06/22/2023	How do we manage nerve agent poisining/damage? • Personal Protective Equipment ({{c1::PPE)}} • {{c1::Decontamination}} • Antidotes • {{c1::Atropin…
Published	06/22/2023	What is the mechanism of Pralidoxime (2-PAM)? 2-PAM attaches to the site where the cholinesterase inhibitor has attached to and blocked cholinester…
Published	06/22/2023	What is this?{{c1::A Mark I kit }}
Published	06/22/2023	What is this? {{c1::Diazepam-CANA}}
Published	06/22/2023	What are the two types of Radiation?{{c1::Ionizing}} and {{c1::Non-ionizing}}
Published	06/22/2023	What is Non-Ionizing radiation? {{c1::low energy, no electron bumping.}} • UV, Visible Spectrum, IR
Published	06/22/2023	What is Ionizing radiation?  • Directly – {{c1::alpha and beta particles}} (stopped by paper, stopped by clothing) • Indirectly – {{c1::Gamma…
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Published	06/22/2023	What are sources of radiation? Simple radiological {{c1::device}} – radiological emitting device Radiological Dispersal Device – Radioactive w…
Published	06/22/2023	What is this? {{c1::Local Radiation}} Injury and it is very similar to a thermal burn. Itching, swelling, sloughing of skin off.
Published	06/22/2023	What are Radiation Sydromes dependent upon? Dose!!!! The Dose makes the poisinDose absorbed depends on:{{c1::TimeDistance Shielding}}
Published	06/22/2023	Ultimately after a large amount of radiation exposure you would see For Hematopoietic syndrome, you could see hemorrhage, long term {{c1::cancer}…
Published	06/22/2023	The last phase of radiation exposure is recovery or death.  This is the final phase, {{c1::death or recovery.}}
Published	06/22/2023	What happens when there is Internal Radiation Exposure? Isotopes can get stuck inside the body and absorbed – they continue to emit {{c1::radiation…
Published	06/22/2023	What is the Approach to massive radiation exposure? Establish Incident Command • Secure scene and ID Hazard • PPE Dawned • Radiation {{c1::d…
Published	06/22/2023	What are specific Radiation Disasters? Luminous dial {{c1::watches}}–painted with radium Radithor killed Eben Byers from chronic radium exposu…
Published	06/22/2023	What are the 2 disease forms you get from Anthrax? {{c1::Cutaneous}} and {{c1::Inhalational}}
Published	06/22/2023	What is Anthrax?It is a {{c1::bacteria}}, bacillus anthracis. It is endemic in herbivores from spores.
Published	06/22/2023	What is Cutaneous Anthrax?In its more common form (95%) it is an incolulation of spores through abrasions in skin and the incubation period is hours t…
Published	06/22/2023	What is GI anthrax?Spores germinate and we get lesions anywhere in the body. There is a 3-7 day incubation period.{{c1::Abdominal}} - Lesions in …
Published	06/22/2023	What is Inhalational Anthrax?"{{c1::Wool Sorters}} Disease" Inhaled spores taken into lymphatics reproduce {{c1::toxins}}Leads to hemorrhagic med…
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Published	06/22/2023	What is the plague and were did it come from?The plague was responsible for 3 major pandemics in history and came from {{c1::bacteria (Yersinia pestis…
Published	06/22/2023	What are historical events involving the plague?{{c1::Siege of Caffa 1300}}s in which bodies succumbed to plague catapulted into the city{{c1::WWII Un…
Published	06/22/2023	What are the 3 forms of the plague?{{c1::Bubonic, Pneumonic , Septicemic}}
Published	06/22/2023	• Bubonic Plague involves • 2–10-day incubation • Fever, malaise, painful enlarged buboes (inguinal most common) • 23% progress to {{c1::sept…
Published	06/22/2023	Pneumonic plague involves • {{c1::Pulmonary}} infection • Can develop from {{c1::bubonic}} plague as a secondary problem • Fever, malaise, cough w…
Published	06/22/2023	What is this an example of?{{c1::Bubonic}} Plague
Published	06/22/2023	What is this an example of?{{c1::Pneumonic}} Plague
Published	06/22/2023	How do we treat the plague? • Early {{c1::antibiotics}} • Within 24 hours • Like {{c1::anthrax treatment}} • Vaccine available for bubonic, not re…
Published	06/22/2023	What these the characteristics of?  {{c1:: Tularemia}} • Francisella tularensis • Aerobic, gram-negative coccobacillus • Weaponized by t…
Published	06/22/2023	What are these the characteristics of?  {{c1::Brucellosis : Brucella sppp}}• Gram negative and aerobic, intracellular dwelling Humans develop …
Published	06/22/2023	What are these the symptoms of? {{c1::Q Fever}} Coxiella burnetii Rickettsia-like organismPersists on inanimate objects for weeks to months …
Published	06/22/2023	What are these symptoms associated with? {{c1::Smallpox}} Variola major  DNA virus Eradicated from the world in 1980 – WHO Stocks…
Published	06/22/2023	What are some complication of small pox Vaccine healing? Vaccinia {{c1::Necrosum}} or {{c1::Eczema}} Vaccinatum
Published	06/22/2023	What are Viral Hemorrhagic Fevers? • Several exist • {{c1::RNA Viruses}}: Lassa fever, dengue, yellow fever, Crimean-Congo hemorrhagic fever, Hant…
Published	06/22/2023	What are the characteristics below associated with? {{c1::Equine Encephalitis}} • Weaponized during the cold war• Alpha virus      …
Published	06/22/2023	What are the characteristics below associated with? {{c1::Botulinim toxin or Botox}} • Clostridium botulinum • Toxins produced • 7 Types: A thr…
Published	06/22/2023	How does Botunum toxin aka Botox work? • Toxin disrupts {{c1::SNARE complex formation}} • Required for {{c1::neurotransmitter (ACh) release}} • A…
Published	06/22/2023	What are the different forms that Botulinum Toxin \| Botox come in? • {{c1::Foodborne}} • Ingest toxin after bacteria produce in food (canning)&nbs…
Published	06/22/2023	What are different ways to treat Botulinum Toxin poisining?BabyBIG is used to treat {{c1::Botulinum Toxin Poisin}}We treat it with {{c1::Supportive Ca…
Published	06/22/2023	What does the antitoxin for botulism poisin do? Administration of the antitoxin does not reverse symptoms that you have, that takes time for your…
Published	06/22/2023	What are these characteristics associated with? {{c1::Ricin}} • Cheap, abundant in availability, toxin is heat-stable • Used by the Russians in ass…
Published	06/22/2023	How does Ricin work? It inactivates {{c1::ribosomes}}
Published	06/22/2023	What are these symptoms associated with? {{c1::Ricin poisining}} • Oral Ingestion      • Nausea,vomiting,diarrhea, circulatory colla…
Published	06/22/2023	What is the diagnosis and treatment for Ricin poisining? {{c1::ELISA assay}} of nasal swab, blood, or other body fluid{{c1::Supportive}} care&nbsp…
Published	06/22/2023	What are these characteristics associated with? {{c1::Staphylococcal Enterotoxin B}} Not usually lethal (will incapacitate) United States Inve…
Published	06/22/2023	What does a "Super Antigen" do? • Activates the {{c1::immune system}} • Leads to strong {{c1::inflammatory response }}
Published	06/22/2023	Different syndromes of {{c1::Staphylococcal Enterotoxin B}} look like:• The weaponized form:  • Inhalational   • Cough, Chest pain, SOB…
Published	06/22/2023	The characteristics below are associated with what? {{c1::T-2 Mycotoxin}} • Fusarium spp.    • Byproduct     • Can have n…
Published	06/22/2023	What are these the clinical effects of?  {{c3::Phosgene}}• Initially minimal signs or symptoms        • Odor is considered pl…
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