3-CLIMATE AND ENVIRONMENTAL FACTORS IN

DISEASE

1
A T Secondary to fluid retention
B T Facilitating salt retention
C F Decreased
D F Decreased with decreased salt content
E F Increased stroke volume

2.
A T Intracellular and extracellular
B T Lack of thirst means may mislead the unwary
C F Sweating continues unabated
D T Salt and water replacement and a cool environment
E F Salt losses are greater in the unacclimatised

3.
A TPerhaps simply due to inappropriate clothing
B T Above 421 death is likely
C F Absent
D F 'Hot dry man'
E F Usually abrupt onset with rapid progression

4.
A T Can occur secondary to use of somedrugs
B T Impeding sweating
C T Decreased renal blood flow and rhabdomyolysis
D T May be disseminated intravascular coagulation
E T Or phenothiazines

5.
A T With hypotension and hypoglycaernia
B T Sometimes a presenting feature
C T Or acute hepatic failure
D T Particularly in the elderly
E T Especially barbiturates and phenothiazines

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6.
A F Haemoconcentration
B T May be as low as 25 degrees
C T And even loss of consciousness
D F Bradycardia and J waves on the ECG
E T Check amylase and blood gases

7.
A F Unusual below 2500 metres
B F May prevent development
C TAlso breathlessness, dizziness and insomnia
D T Even progressing to coma
E FSignificant risk of thrombosis due to dehydration and hyperviscosity

8.
A T Death occurs within 2 weeks
B F Lymphocytes are the most sensitive
C F However, above this, death becomes increasingly likely
D F Requires doses > 10 Gy
E T 80% of background radiation is attributable to radon

9.
A F Food and drink
B TAbdominal pain, gastrointestinal upset and dysgeusia
C F Adult lead levels = 10-25 Rg/1 00 ml
D T Together with punctate basophilia of the RBCs
E F Chelation therapy is advisable if blood lead > 100 Rg/1 00 m I

10.
A T Early signs
B T Peripheral neuropathies are common
C T In severe poisoning
D F Suggests acute poisoning
E F Suggests acute poisoning
11.
A F 1 atmosphere = 760 mmHg
B T Also causes hypoxia on surfacing
C T Pressure rises by 1 atmosphere for each 10 m of depth
D F Occurs in rapid ascent without expiration from shallower depths
E F Typically the tympanic membrane

12.
A T Rarely reversible 4 hours or more after surfacing
B F Due to intra-lymphatic gas
C F Affects fatty tissues particularly
D T The 'staggers' and the 'chokes'
E F Neurological deficits usually persist