Navmed P-5042

Front 1

What is the intentional use of viruses, bacteria, other microorganisms, or toxins derived from living organisms to cause death or disease in humans, animals, or plants?

Back 1

Biological warfare.

Front 2

How are biological warfare agents most effectively delivered?

Back 2

As an aerosol.

Front 3

What size aerosolized particles are most efficiently delivered to their target?

Back 3

1 to 5 microns (μ) in diameter.

Front 4

What is the target of a BW agent?

Back 4

The air sacs of the lung.

Front 5

How may aerosols be delivered?

Back 5

Via point source (stationary release point, bomblets, or other devices equipped with sprayers) or from a line source (such as a moving vehicle or cruise missile releasing agent).

Front 6

What destroys most pathogens and toxins?

Back 6

Heat.

Front 7

Are nuclear, biological, and chemical weapons/agents, and radiological dispersal devices classified as weapons of mass destruction (WMD)?

Back 7

Yes.

Front 8

What are most BW agents incubation periods?

Back 8

Several days to weeks.

Front 9

What are the mode of deliveries for BW agents?

Back 9

Aerosal, food- or waterborne, vectorborne, or injection.

Front 10

How do BW agents enter the body?

Back 10

Via the "portals of entry" of naturally occurring infectious diseases.

Front 11

Name portals of entry.

Back 11

Respiratory tract, exposed mucosal surfaces, digestive tract, traumatic wounds, superficial abrasions and cuts.

Front 12

What is the first indication that a BW attack has occurred?

Back 12

Large numbers of patients simultaneously presenting with a similar disease.

Front 13

What kind of of blood cultures should be collected to detect bacterial agents?

Back 13

Aerobic and anaerobic cultures.

Front 14

Where should cultures and impression smears be taken from?

Back 14

Involved lymph nodes, sputum, pleural fluid, cerebrospinal fluid (CSF), tissues, or body fluids as clinically indicated.

Front 15

How much acute serum should be collected for suspected infectious agents?

Back 15

At least 3 milliliters.

Front 16

How much acute serum should be collected for suspected intoxications?

Back 16

At least 20 milliliters.

Front 17

When should acute serum be collected?

Back 17

As early as possible after onset of symptoms.

Front 18

When should convalescent sera be collected from survivors and asymptomatic unit members?

Back 18

3 to 4 weeks later.

Front 19

How much postmortem blood should be obtained and submitted as serum and or cells?

Back 19

Up to 20 milliliters.

Front 20

Which organs should be sampled?

Back 20

Lung, mediastinal lymph nodes, spleen, liver, and other tissues as clinically indicated.

Front 21

How should tissue samples obtained at autopsy be collected?

Back 21

In multiple aliquots; minimally, one (25-50 grams [gm]) to freeze for microbiology or toxicology testing and one in formalin for histopathology testing should be obtained.

Front 22

What are the time frames for specimen collection following exposure?

Back 22

Early post-exposure, clinical, and convalescent/terminal/ postmortem.

Front 23

Specimens sent rapidly (less than 24 hours) to analytical laboratories require only?

Back 23

Wet ice or refrigeration at 2° to 8° Celsius (C).

Front 24

Who should be contacted if the time span increases beyond 24 hours for other shipping requirements such as shipment on dry ice or in liquid nitrogen?

Back 24

Contact the US Army Medical Research Institute for Infectious Disease (USAMRIID).

Front 25

Tiger-top tubes that have been centrifuged are preferred over?

Back 25

Red-top clot tubes with serum removed from the clot.

Front 26

Blood culture bottles are preferred over?

Back 26

Citrated blood for bacterial cultures.

Front 27

What form should be used to maintain a strict chain of custody for every sample/ specimen collected?

Back 27

Department of the Army (DA) Form 4137 (Evidence/Property Custody Document) or Department of Defense (DD) Form 1911 (Materiel Courier Receipt).

Front 28

What should be recorded with each change of custody?

Back 28

Date and time of change.

Front 29

What is the currently fielded chemical protective equipment used to provide protection against BW agents?

Back 29

Military protective mask (MCU-2A/P and M40), battle dress overgarment (BDO), Joint service lightweight integrated suit technology (JSLIST), protective gloves, and overboots.

Front 30

The mask should be worn until?

Back 30

The "all clear" signal is given.

Front 31

When may units be directed to conduct unmasking procedures?

Back 31

If the trailing edge of the hazard area indicates the BW contamination has passed and there are no other indications of BW attacks (example: negative BIDS/LRBSDS results).

Front 32

Infection control procedures should be reinforced for mass casualty situations with?

Back 32

Undifferentiated febrile illness following a suspected BW attack.

Front 33

What should be done with patients until plague and smallpox can be reasonably excluded?

Back 33

Isolate patients and use respiratory droplet precautions, in addition to standard precautions.

Front 34

Why should ground ambulances be used first in a contaminated environment?

Back 34

They are easier to decontaminate than are air evacuation assets.Already contaminated ground and air evacuation assets should be used first. Only commit clean assets if they are required to meet the medical evacuation needs of the command.

Front 35

What specific control measures must be applied for plague?

Back 35

Do not evacuate across international borders unless authorized by the theater surgeon. Droplet precautions are added to standard precautions for patients with pneumonic plague until sputum cultures are negative.

Front 36

What specific control measures must be applied for smallpox?

Back 36

Do not evacuate across international borders unless authorized by the theater surgeon. Standard, contact, and airborne isolation precautions are to be observed.

Front 37

What specific control measures must be applied for viral hemorrhagic fevers?

Back 37

Do not evacuate hemorrhagic fever patients across international borders unless authorized by the theater surgeon. Patients may be evacuated using standard, contact, plus respiratory droplet isolation precautions.

Front 38

Patient movements will require approval of the destination country, over-flight privileges, and approval of any country where the aircraft will land for servicing or where patients will remain overnight. Countries from which approval is sought are bound by?

Back 38

Article 37 of the Geneva Conventions for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field of 12 August 1949 to ensure humanitarian treatment to wounded and sick.

Front 39

What is Executive Order (EO) 13139?

Back 39

On 30 September 1999, the President of the United States issued Executive Order (EO) 13139, Improving Health Protection of Military Personnel Participating in Particular Military Operations, which outlines the conditions under which investigational new drugs (IND) and off-label pharmaceuticals could be administered to US service members.

Front 40

When may the President waive the informed consent requirement before IND administration and off-label use of products?

Back 40

Upon request of the Secretary of Defense if—
Service member informed consent is not feasible. Informed consent is contrary to the best interest of the service member. Obtaining informed consent is not in the best interest of national security.