The most common illness related to occupational exposure is:
Correct Answer A:
While occupational exposure to large and small particles and gases is common and can lead to long-term pulmonary difficulties, asthma remains the most common illness related to on-the-job exposures. Bronchitis, obstructive pulmonary disease, and pulmonary fibrosis can be associated with occupational exposure to various toxins, but the incidence is less than that of asthma.
Which one of the following chemical occupational exposures is associated with leukemia?
Correct Answer B:
Benzene is a human carcinogen and causes aplastic anemia, leukemia, and multiple myeloma. It is absorbed through the skin and respiratory tract.
→ Arsenic is more toxic in the inorganic form and causes epidermal cancer.
→ Cadmium is associated with kidney toxicity.
→ Organophosphates are the most widely used insecticides today. They are one type of pesticide that works by damaging acetylcholinesterase. Long-term exposure to organophosphates can cause confusion, anxiety, loss of memory, loss of appetite, disorientation, depression, and personality changes. Organophosphates have been linked to non-Hodgkins lymphoma, lung cancer and leukemia, but the studies failed to account for multiple exposures to different pesticides. Therefore, no clear causative connection has been made.
→ Perchlorethylene causes peripheral neuropathy, chemical hepatitis, liver damage, and kidney damage.
Which one of the following is true regarding the risk of physical spousal abuse?
Correct Answer C:
Pregnancy represents a time of heightened risk for abuse, and prompts a shift in the area of physical abuse from the head and neck to the breasts and abdomen. Although some studies have shown a higher prevalence of partner abuse among some minority women, a National Crime Victimization Survey concluded that women of all races and ethnic backgrounds are equally likely to be abused by an intimate. Alcohol and/or substance abuse is a significant risk factors associated with the occurrence of partner abuse and family violence in general. Less education and lower occupational status or income (particularly when total family income is less than $10,000 per year) have been found to increase the risk of violence.
Women who have separated from their spouses are 3 times more likely to be victimized than those who are already divorced and 25 times more likely than women who are married. A woman’s danger substantially increases at the point of exiting an abusive relationship.
Which one of the following variables is the most important risk factor for being a victim of domestic abuse?
Correct Answer D:
Domestic violence can affect children, intimate partners, and older adults. It is a serious medical problem that should be considered in the care of patients and families. There is great variation in the profiles of patients affected by domestic violence. Neither demographic factors nor psychological problems have been found to be consistent predictors of victimization or violence. Domestic violence cuts across all racial, socioeconomic, religious, and ethnic lines. The only consistent risk factor for being a victim of domestic violence is female gender.
A 4-year-old boy is brought to the emergency department by his parents because of a swollen pinna. The father says that the boy fell off his tricycle in a playground. On physical examination the child's left ear is severely edematous and discolored. There is concern for the child because this is his third emergency department visit in the past 6 months. When discussing these concerns and the need for further evaluation with the parents, they become angry and want to take the child home now.
It would be most appropriate to:
Most states have laws that mandate that a clinician who suspects physical or sexual abuse must act immediately, separating the child from the parents if necessary. Discharge to another relative or neighbor will not prevent the abusing parent from retrieving the child and inflicting further abuse. Foster care placement can only be applied for after there is proof of physical abuse. If your suspicions of abuse are high, do not send the child home with the parents under any circumstances.
Again, sending the child home, even with an impending social work evaluation, leaves the child open for continued abuse. When angered, the abusing parent may inflict greater injury after a quiescent phase, resulting in death of the child. In a possible abuse case, the physician should take steps to both protect the child and investigate further.
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