MCQ Disasters
1
Which of the following is NOT appropriate treatment on site during a disaster
with multiple casualties
A
Amputation
B
Decompression of a tension pneumothorax
C
CPR
D
Regional nerve block
Answer
2
Which of the following statements regarding the management of radiation
incidents is FALSE
A
Staff caring for patients who have been exposed to radiation should wear
protective clothing including lead aprons, waterproof gowns, gloves,
facemasks and plastic covers over shoes
B
A radiation physicist with appropriate monitoring equipment should scan
potentially contaminated patients
C
Life saving procedures take priority over decontamination
D
Early enteral nutrition is beneficial in gastrointestinal syndrome
Answer
3
What DOES form part of the ETHANE report in major incidents?
A
Access to site
B
Number of priority 1 casualties
C
Number of dead
D
Exact cause of incident
Answer
4
The following is TRUE with regards to radiation injuries:
A
Pain from skin involvement is usually only significant if ulceration occurs
B
In a patient with acute radiation syndrome, emergency surgery should
preferably be delayed for a few days
C
If irradiated skin appears normal at 72 hours post incident, significant skin
problems will not occur
D
The palms of the hands are particularly prone to local irradiation injuries
Answer
5
Which one of the following statements are TRUE regarding radiation injuries:
A
Larger radiation doses are required to cause sterility in females as
compared to males
B
Foetal exposure to radiation at 11 weeks gestation is expected to cause
malformations
C
In humans, gonadal exposure to radiation affects future generations
D
The symptoms of the acute radiation syndrome is not dependent on the time
over which the radiation was delivered
Answer
6
Regarding radiation incidents, the following are true EXCEPT
A
Recovery of the haemopoietic system occurs about 30 days post exposure
regardless of dose
B
Acute bloody diarrhoea suggests death is inevitable within 2 weeks
C
Contaminated patients commonly suffer significant radiation exposure
D
Lethal injuries are dose dependent
Answer
7
With regard to Smallpox which of the following is FALSE?
A
The rash is initially vesicular
B
Disease is spread in droplet or aerosol form
C
Haemorrhagic cases are occasionally fatal
D
Antivirals are ineffective
Answer
8
Anthrax symptoms may include all of the following EXCEPT
A
Fever
B
Abdominal pain
C
Dyspnoea
D
Rhinorrhoea
Answer
9
Which of the following is FALSE?
A
The Black Death which killed 1/3 of Europe’s population was thought to have
been caused by Yersinia Pestis
B
Louis Pasteur developed the first effective anthrax vaccine in 1881
C
Cowpox provides immunity to Smallpox
D
Bubonic plague is associated with brown rats
Answer
10
Which colour is not used as part of the disaster triage in Australia?
A
Red
B
Green
C
Black
D
Blue
Answer
11
Which codes are not linked to the correct term?
A
Code green – natural disaster
B
Code purple – bomb threat
C
Code yellow – external disaster
D
Code orange – evacuation
Answer
12
Which of the following regarding ‘Radiation’ is FALSE?
A
It is important to distinguish between ‘exposure to radiation’ and
‘contamination with radioactive matter’.
B
0.25 sievert (Sv) represents a ‘significant’ exposure of whole body radiation.
C
There are ‘three phases’ described in the ‘Acute Radiation Syndrome’
D
Haemopoietic recovery commences 30 days after exposure.
Answer
13
Which of the following is FALSE after vapour exposure to nerve gas agents
like Sarin and Tabun?
A
Miosis can last for several weeks after exposure.
B
Visual acuity may be reduced for several days.
C
Lacrimation is a reliable sign.
D
Generalised sweating is common.
Answer
14
Nerve gas agent exposure
A
Can cause localised sweating on dermal exposure.
B
Almost universally produces diarrhoea.
C
Will likely lead to secondary exposure to carers if the victim is not
decontaminated with copious bathing in warm, soapy water.
D
Has no antidote therapy, only supportive care.
Answer
15
Phosgene is associated with
A
Cholinesterase inhibition and muscarinic clinical features
B
Immediate burning sensation to eyes, mucus membranes, upper airway
oedema, coughing, laryngospasm, stridor etc
C
High volatility with high risk of exposure to health-care workers from a
patient exposed to large vaporised dose
D
Delayed noncardiogenic pulmonary oedema from formation of corrosive
acids in the lungs
Answer
16
In bioterrorism which of these is TRUE?
A
Post-exposure prophylaxis is available for smallpox, anthrax, plague and
botulism.
B
Anthrax causes cutaneous, GIT, oropharyngeal, inhalational and
neurological types.
C
Epidemiological surveying such as frequency/clusters of illness are good
tools for detection of a bioterrorism event.
D
Class A risks include variola major, bacillus anthracis, Clostridium botulinum
and arenavirus.
Answer
17
Which of the following is TRUE regarding radiation accidents?
A
Germinal, haematopoietic, respiratory epithelial cells are relatively more
sensitive to radiation damage due to their higher turnover.
B
Effective triage to treatment plans can be made based on symptoms and
lymphocyte count.
C
The effect of radiation is proportional to type of radiation and tissue type with
no effect from the rate of disintegration.
D
Chronic radiation exposure is more dangerous than acute.
Answer
18
Which of the following does NOT appear on the ACEM Disaster Medical
Services Policy Document?
A
ED physicians are required to use their experience in organizing medical
services and prioritising medical treatment priorities
B
Disaster Planning should capture issues that potentially impact clinical
outcomes
C
A disaster is defined as a serious disruption of the functioning of society,
whereby it is no longer able to cope with its own resources
D
The Emergency Physician should make themselves available during times
of a disaster
Answer
Answers
1.
2.
3.
4.
5.
6.
7.
8.
9.
C
A
A
A
A
C
C
D
D
10.
11.
12.
13.
14.
15.
16.
17.
18.
D
C
C
C
A
D
D
D
D
Cameron p 790
Cameron, pages 865-872
Dunne, MIMMS card
rd
Textbook of Adult Emergency Medicine (Cameron et al.), 3 ed., p. 868
rd
Textbook of Adult Emergency Medicine (Cameron), 3 ed., p. 867
Cameron
th
Dunn 4 Ed pg 460
th
Dunn 4 Ed pg 460
Black rats. Increasing numbers of brown rats in Europe are thought to have
helped reduce plague episodes
Wikipedia. 
Tintinalli 35-41
Cameron 763-8
ACEM Policy Document: ‘Disaster Medical Services’ (ACEM website)