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Posttest

There may be more than one correct answer per question.

1. Other names for PAHs include which of the following?
   1. Polynuclear aromatics (PNAs).
   2. Polynuclear hydrocarbons.
   3. Polynuclear aromatic hydrocarbons.
   4. Polycyclic organic matter (POM).
2. Which of the following statements regarding PAHs is (are) true?
   1. Heavier PAHs (more than 4 rings) tend to adsorb to particulate matter.
   2. Lighter PAHs (less than 4 rings) tend to remain gaseous until removed via precipitation.
   3. PAH concentration in water tends to be low (around 100 ng/l) due to their weak solubility.
   4. PAHs can be absorbed by plants.
   5. PAHs mostly accumulate in soil.
3. Potential sources of PAH exposure include
   1. Passive inhalation of cigarette smoke.
   2. Motor vehicle exhaust.
   3. Alcoholic beverages.
   4. Inhalation of paint vapors in poorly ventilated area.
   5. Wood stoves for home heating.
4. Which of the following statements regarding PAHs are false?
   1. PAHs are found only in a small number of industrial settings.
   2. PAHs mostly accumulate in soils.
   3. Benzo[a]pyrene is generally used as an environmental indicator for PAHs.
   4. Most PAHs in ambient air are the result of man-made processes.
5. In non-occupational settings, the majority of PAH exposure in a nonsmoking individual comes from which of the following?
   1. Foodstuff ingestion.
   2. Inhalation route.
   3. Dermal route.
   4. Water.
6. Persons with potentially increased PAH exposure include
   1. Hunters.
   2. Coke oven workers.
   3. Roofing asphalt applicators.
   4. Chimney sweeps.
   5. Breastfeeding mothers.
7. Which of the following statements are true about PAHs?
   1. Exposure is most often determined based on patient history.
   2. Direct assays in the body are not clinically useful.
   3. Exposure can cause pancreatitis.
   4. Acute exposure can cause convulsions or unexplained loss of consciousness.
   5. The prognosis for most acutely exposed patients is poor.
8. Which of the following statements regarding OSHA’s standards for PAHs is/are false?
   1. OSHA requires workers who are exposed to PAH above the PEL to be under medical surveillance.
   2. OSHA requires all workers to be trained in proper use of appropriate personal protective equipment and safety.
   3. Purchase of personal protective equipment is the responsibility of individual employees.
   4. The OSHA PEL is a legally enforceable standard.
9. Which of the following statements regarding PAHs in water is/are true?
   1. The EPA maximum contaminant level is a legally enforceable standard.
   2. The maximum contaminant level is an 8-hour time-weighted average.
   3. EPA has set maximum contaminant levels for PAHs in foodstuffs.
   4. EPA developed ambient water quality criteria to protect human health from the carcinogenic effects of PAH exposure.
10. Which of the following regarding the biologic fate of PAHs in the body are true?
    1. PAHs are metabolized in a number of organs and excreted in bile and urine.
    2. Information on the absorption, distribution, and elimination of PAHs in the human body is derived primarily from animal studies.
    3. Generally, PAHs bound to airborne particulate matter are not absorbed as well in the lungs as the same dose of PAHs that are unbound to particulate matter.
    4. The liver P-450 mixed-function oxidase system is the predominant mechanism of PAH metabolism.
    5. 1-Hydroxypryrene is a commonly measured urine metabolite for PAH exposure.
11. The following signs and symptoms can be found in patients chronically exposed to PAHs
    1. Chloracne.
    2. Bronchitis.
    3. Vertigo.
    4. Exotropia.
    5. Cutaneous photosensitization.
12. The mechanism of PAH-induced carcinogenesis is believed to be which of the following?
    1. Covalent binding of PAH metabolites to DNA.
    2. Generation of active oxygen species.
    3. Cell-mediated inflammatory mechanisms.
    4. All of the above.
13. Reported health effects associated with chronic exposure to coal tar and its by-products (e.g., PAH) include
    1. Warts on sun-exposed areas of the skin, with progression to cancer.
    2. Irritation of the eyes.
    3. Bronchogenic cancer.
    4. Leukoplakia.
    5. Lymphoma.
14. In the treatment of patients with PAH exposure, which of the following is/are true?
    1. Education and future avoidance of exposure are important.
    2. Continued use of tobacco products should be discouraged.
    3. Treatment of acute exposure is largely symptomatic.
    4. The specific PAH should be determined so that an antidote can be prescribed.
    5. A fat biopsy is integral to medical surveillance of PAH-exposed patients.
15. Which of the following should be included in the differential diagnosis of a patient suffering from the chronic effects of PAH exposure?
    1. Pancytopenia.
    2. Hepatic angiosarcoma.
    3. Pancreatitis.
    4. Tuberculosis.
    5. Lung abscess.
16. Regarding PAH distribution, metabolism, and excretion, which are true?
    1. The liver and kidney are both involved in metabolism.
    2. Binding of PAH metabolites to DNA is believed to be the mechanism of PAH-induced carcinogenesis.
    3. Metabolized PAHs cannot be eliminated by hepatobiliary excretion.
    4. Excretion is through bile and urine.
    5. Calcium EDTA chelation enhances PAH excretion.
17. Which of the following statements is (are) true?
    1. Management of a worker exposed to PAHs includes bone marrow aspiration.
    2. PAH metabolites can cross the placental barrier.
    3. Acutely exposed skin should be decontaminated by gently scrubbing with a 10% iodine solution.
    4. Hair analysis can reveal past PAH exposure.
    5. The bay region theory attempts to explain why PAHs are found in bay waters.
18. What steps can patients take to reduce the risk of overexposure to PAHs?
    1. Minimize hobby and recreational PAH exposures.
    2. Avoid exposure to all forms of smoke.
    3. Stop smoking.
    4. Minimize dietary PAH exposure.
    5. All of the above.

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