Forensic-Environmental

For each of the following patient histories, select the most likely environmental agent to cause the illness:

1. A 60-year-old woman develops a chronic cough, and a chest radiograph reveals a 5 cm right hilar mass. She is a non-smoker, and none of the persons with whom she lives are smokers. She has been healthy all her life. She is a homemaker and has raised 5 children:

2. Over a period of less than a day, a 45-year-old man develops increasing weakness and nausea with headaches, then progressive respiratory failure requiring intubation. He is a farmer. His wife says that he was out on his tractor spraying a field of melons with insecticide the day before. He has a markedly decreased serum cholinesterase level:

3. A 40-year-old man has an auto repair shop in which he does radiator repair, requiring welding. The shop is not properly ventilated. Over a period of months, he becomes more lethargic, drops his tools often, and has mental sluggishness. His dentist notes that there is a faint gray line at the gum margins. A CBC reveals a Hgb of 8.6 g/dL, and a peripheral blood smear shows basophilic stippling of the RBCs:

4. A 5-year-old girl develops headache followed by a seizure 12 hours after consumption of a bottle of a clear liquid. On examination she has decreased visual acuity:

5. Epidemiologic studies show increased prevalence of chronic bronchitis in adults residing for more than 20 years in a heavily industrialized city that generates much of its electric power from burning coal:

- - GO TO: NEXT SET - - EXAM MENU - -

A. Arsenic B. Asbestos C. Dioxin D. Carbon monoxide
E. Lead F. Methyl alcohol G. Organophosphate H. Ozone
I. Radon gas J. Silica K. Sulfur dioxide L. Vinyl chloride


right

out of


total


%