Examination for Green Tobacco Sickness

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1. Green Tobacco Sickness occurs primarily from ?
handling cured tobacco
handling wet tobacco sets during planting
handling wet tobacco during harvesting
working in tobacco fields recently sprayed with pesticides
wearing green clothes while harvesting tobacco


2. The National Institute for Occupational Safety and Health (NIOSH) estimates a crude incidence of Green Tobacco sickness as: ?
1 case per 1,000 workers
1 case per 10,000 workers
10 cases per 1,000 workers
10 cases per 10,000 workers
10 cases per 100,000 workers


3. Risk factors that may effect dermal absorption of nicotine are all of the following EXCEPT: ?
high ambient temperatures
physical exercise
duration of contact
recent rains
patient gender


4. Time to peak serum nicotine concentrations after dermal exposure is: ?
2 to 4 hours
1 to 2 hours
30 minutes
3 to 6 hours
12 hours


5. Neurologic effects seen with Green Tobacco Sickness might be all of the following EXCEPT: ?
headache
weakness
dizziness
prostration
delirium


6. Early in the poisoning, the primary cardiac effects seen Green Tobacco Sickness would most likely be: ?
tachycardia
bradycardia
prolonged QT interval
conduction disturbances, including AV block
EKG evidence of ischemia


7. Late cardiovascular symptoms in a more severe poisoning would likely include: ?
Tachycardia and hypertension
Bradycardia and hypotension
prolonged QT interval
conduction disturbances, including AV block


8. The most common effects seen with Green Tobacco Sickness include all of the following EXCEPT: ?
headache
vomiting
pallor
weakness
chest pain


9. Other potential problems seen with Green Tobacco sickness victims might include all of the following EXCEPT: ?
heat stress
electrolyte imbalances
dehydration
renal failure


10. Onset of symptoms of Green Tobacco Sickness are generally seen: ?
rapidly after entrance into the field
during the second day of field work
within the first 2 hours of beginning work in the field
usually greater than 6 hours after work began in the field
after showering


11. Duration of Green Tobacco Sickness is usually: ?
12 to 24 hours
2 to 4 hours
6 hours
2 days
< 2 hours


12. Patient decontamination should include full shower and a new set of clean/uncontaminated clothes because: ?
It will reduce/interrupt continued absorption of nicotine by removing nicotine source
It will protect staff from cross-contamination
The patient will smell better
Cooling the patient with a shower will reduce blood flow to the skin and reduce nicotine absorption


13. The usual primary interventions include all of the following EXCEPT: ?
decontamination
IV rehydration
antiemetics
atropine


14. The usual patient disposition after Green Tobacco Sickness is: ?
admission to a non-critical care bed
admission to a monitored critical care bed
treated and released from the ED
refer to out-patient clinic the following day for continued follow-up