1st Faculty of Medicine Charles University 1st Faculty of Medicine Charles University Department of Occupational Medicine
tinnok 14.11.2012

Control questions

QUESTIONS

 

OCCUPATIONAL DISEASES

 

  1. Which occupational diseases are the most frequent?
  2. Which have the worst prognosis?
  3. Which may occur in miners? in nurses? in bakers?
  4. What is called a “biological monitoring”?
  5. What questions are important for patient´s occupational history?
  6. Which 3 types of compensation the Czech patient receives?
  7. What one type of compensation the patient receives in the case of “endangerments”?

 

LEAD

 

  1. Is lead allowed in glazes for food ceramics?
  2. What is the target of inorganic lead toxicity?
  3. What tests prove lead intoxication?
  4. What is the preferred chelating agent for the treatment?

 

 

MERCURY

 

  1. Does ingestion of mercury from a thermometer represent a danger for humans?
  2. What danger may represent a high concentration of inhaled Hg?
  3. What is the trias for chronic toxicity of mercury?
  4. What antidote is used for the treatment?

 

 

METHEMOGLOBINAEMIA

 

  1. What is metHb?
  2. What symptoms are typical for 40 – 50% metHb?
  3. What industries are known for metHb formation risk?
  4. What pharmaceuticals are used to treat the “blue patient “?

CYANIDE

 

  1. What is the lethal dose of cyanide salts?
  2. What is the smell of hydrogen cyanide?
  3. Why a “therapeutic methemoglobinemia” is used?
  4. Is there a “no risk” therapy of intoxication?
  5. When HCN is created in the fires?
  6. Why metHb-forming antidote cannot be used for smoke intoxication with insufficient oxygen supply?

 

 

CARBON MONOXIDE

  1. When is CO formed in the environment?
  2. How many times is the affinity of hemoglobin for CO higher than for O2?
  3. What symptoms are typical for 30% COHb?
  4. What is the lethal concentration of COHb?
  5. What is the half-life of COHb after the patient is placed in the fresh air?

 

 

PESTICIDES

  1. What are the muscarinic symptoms, for which exposures are they typical?
  2. Can atropin reverse all symptoms of organophosphates poisoning?
  3. What are the “acetylcholine esterase reactivators“?
  4. What laboratory test can prove organophosphates ingestion/inhalation?
  5. Why is rodenticide ingestion usually harmless?
  6. What would be the antidote of choice for a severe intoxication?
  7. What test would prove this poisoning?

 

 

SILICA

 

  1. At which worksites silica exposure represents a real risk?
  2. What minerals are fibrogenic?
  3. What structure has the silicotic nodule?
  4. Is there a typical physical finding on auscultation?
  5. What size of nodules is the borderline between simple and complicated silicosis?
  6. What is called “egg shell” in silicosis?
  7. What is the treatment of silicosis?
  8. What treatment may delay the right-heart failure?

 

 

ASBESTOS

 

  1. Which asbestos induced disease develops only after high cumulative asbestos exposure?
  2. What is the “asbestos body” and where can it be found?
  3. What sounds can be heard by auscultation in asbestosis?
  4. What is the radiological finding of asbestosis?
  5. What lung function impairment is typical for asbestosis?
  6. What is the end-stage of the lung and heart in severe cases?
  7. What brings the patient with mesothelioma to the doctor?
  8. What are the “maps-like” opacities in the radiograph of the chest?

 

ASTHMA

  1. What is the target lung structure affected in asthma?
  2. What sounds can be heard during asthma attacks?
  3. What is the mechanic explanation for the sounds?
  4. What ventilatory disturbance is typical?
  5. Must dyspnoea due to occupational asthma develop always at the workplace?
  6. What is considered a gold standard for occupational asthma diagnosis?
  7. What tests may support asthma diagnosis in type I immunological reaction?
  8. May asthma develop after a single high concentration of irritants?
  9. Are specific bronchoprovocation tests to diagnose asthma performed for RADS?

 

 

SOLVENTS

 

1. What organ is involved in exposure to all organic solvents?

2. What solvent is the most commonly abused?

3. Is milk appropriate for first aid?

4. What is the most frequent risk of a minor ingestion of petroleum

distillates?

5. What are the metabolites of toluene, trichloroethylene, benzene?

6. What examination is needed to diagnose irreversible brain damage

called “organic psychosyndrome”?

7. Which solvents can damage peripheral nerves? Is it common among organic

solvents?

 

 

HEPATOTOXICITY

 

1. What is typical for chemicals causing obligatory hepatic toxic injury?

2. Which is the typical pharmaceutical with dose-dependent hepatotoxicity?

3. Which mechanisms play role in facultative hepatotoxic chemicals?

4. Is prognosis of centrizonal damage hepatic injury better than periportal?

5. What hepatic cells damage is usually related to liver cirrhosis?

6. What chemicals cause irreversible periportal damage?

 

CANCER

 

1. What is the percentage of cancer due to occupational exposure?

2. Can wood dust be carcinogenic?

3. What malignancy causes benzene?

4. What malignancy is typical for vinyl chloride?

5. What malignancy is typical for dyes production (aromatic amines)?

6. What cancer may occur in uranium miners?

7. Why is occupational cancer under-diagnosed?

8. What 2 tumours may be called “signal” for exposure to some agents?

9. What laboratory test may be used to monitor occupational exposure to carcinogens?

 

 

ACUTE INHALATION INJURY

 

1. Which chemicals have more pronounced warning properties?

2. What is the latency period for acute lung injury/ARDS (lung oedema) development?

3. Is high concentration of gasoline vapours dangerous?

4. What is the Monday fever?

5. What metals can cause welder´s fever?

 

 

EXTRINSIC ALLERGIC ALVEOLITIS

 

 

1. What vegetal products may represent a risk of EAA?

2. What animal products may represent a risk of EAA?

3. What is the target lung structure affected in extrinsic allergic alveolitis?

4. What imitates the acute form? Why is it frequently underestimated?

5. What are the symptoms of the chronic form?

6. What sounds are typical for the auscultation?

7. What blood test can substantially help in the diagnostics to confirm the

exposure?

8. What cells are typically increased in bronchoalveolar lavage (BAL) fluid?

9. What treatment is used for EAA?

 

TREATMENT OF INTOXICATIONS

 

  1. What means “primary elimination“ of a toxic compound?
  2. When is contraindicated induction of vomiting and gastric lavage?
  3. How long after ingestion of drugs is the evacuation of stomac recommended?
  4. What non-specific complications are common in severe intoxications?
  5. If there is an antidote – is it preferred to extra-corporal elimination?
  6. What is called a “universal antidote“?
  7. At what dose and regimen is it given?

 

 

PHARMACEUTICALS

 

  1. Are benzodiazepins toxic for liver and kidneys?
  2. What antidote is used for treatment of this intoxication?
  3. When – what is the indication?
  4. What is the hepatotoxic dose of paracetamol?
  5. What is the treatment of severe paracetamol overdose?
  6. How can the need of antidote be confirmed?
  7. What is the main risk of morphine derivates intoxication?
  8. What is the antidote and when it is indicated?
  9. What symptoms are typical for antidepressants toxicity?
  10. What is the appropriate treatment for tricyclic antidepressants?
  11. How long after ingestion is indicated gastric lavage in tricyclic antidepressants?
  12. What is the role of PEG-containing laxatives in poisonings?

 

 

ALCOHOLS

 

1. What are the metabolites of ethanol?

2. Can the elimination rate be accelerated by forced diuresis?

3. What is the mean lethal dose of a distillate?

4. What is the lethal plasma level of ethanol?

5. What are the main risks in severe ethanol intoxication?

6. What treatment is appropriate?

7. What are the sources or ethylene glycol?

8. What is used for first aid?

9. What organ is damaged by the final metabolite? Which metabolite is it?

10. What level of ethanol in blood is recommended for treatment of toxic alcohols intoxication?

11. What metabolic disturbance causes the final metabolite of methanol?

12. What is the typical subjective symptom of severe methanol damage?

13. What extracorporal method is indicated in methanol intoxication?

 

MUSHROOMS

 

  1. Which are the amatoxin-type mushrooms and how they look like?
  2. When is the typical latency before the inset of symptoms?
  3. How many caps of A. phalloides represent the lethal dose?
  4. What antidotes are used?
  5. What colour has A. muscaria and A. pantherina ?
  6. What are the typical symptoms and when they begin?
  7. Is there an antidote for treatment of this intoxication?
  8. What are the symptoms of Psilocybe intoxication?
  9. What mushroom presents with symptoms of renal failure after a 3 weeks´ latency?
  10. Is this kidney damage usually reversible?

 

PHYSICAL OVERLOAD

 

  1. Which diseases may occur due to physical overload of upper extremities?
  2. How should typically be the strain, causing the diseases?
  3. What diseases may develop in the elbow?
  4. Using which imaging method can tennis elbow be objectively diagnosed?
  5. Which fingers are involved in carpal tunnel syndrome?
  6. What method is used in the diagnostics of carpal tunnel?

 

VIBRATIONS

 

1. What is the causal factor in occupational Raynaud´s syndrome?

2. What is the provoking factor and how is it used in the diagnostics?

3. Why is used a finger plethysmography?

4. What is the prognosis?

5. May finger necrosis be related with occupational vibrations exposure?

 

RADIATION

 

  1. What are the deterministic effects of the ionizing radiation?
  2. When the cataract due to radiation exposure is usually fully developed?
  3. When should the first eye examination after the radiation exposure of the lens be performed?
  4. What severity levels has the Acute Radiation Syndrome (ARS)?
  5. How the stages and intervals of ARS relate to the dose?
  6. What is meant by the biodosimetry and when it is used?
  7. What chromosome aberrations are typical for ionizing radiation?
  8. May some radioisotopes be eliminated from the body using antidotal treatment?
  9. What is threshold dose for acute radiation syndrome?
  10. What is METREPOL?

 

 

ILLEGAL DRUGS

 

1. Which symptom is characteristic for the sympathomimetic toxidrome?

2. How look the pupils of the patient with this syndrome?

3. What is the main risk of serotonin syndrome? How is it treated?

4. To what class of illegal drugs belong the chemicals JWH-019, JWH-250?

5. How is called metamphetamine product common in the Czech Republic?

6. What illegal drug exposure causes pinpoint pupils?

7. What recreational drug is associated with ulcerative cystitis and urination problems?

8. What are the “first-choice” treatment of seizures and agitation in amphetamines/MDMA overdose?

 

 

CORROSIVES

 

1. What is the gold standard for the diagnostics of corrosives ingestion?

2. Why is charcoal contraindicated in corrosives ingestion?

3. What are the household source of acids and alkalis?

4. What is the most important information in the Material Safety Data Sheets?

5. What is the first aid in corrosives ingestion?