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Carbon Tetrachloride Toxicity

Course: WB2888
CE Original Date: December 31, 2017
CE Expiration Date: December 31, 2019
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For each question, select the one best choice

  1. Which of the following statements about carbon tetrachloride (CCl4) is INCORRECT?
    • CCl4 is a manufactured chemical.
    • Its chemical instability results in an atmospheric half-life of 24-48 hours.
    • CCl4 is a clear, nonflammable, heavy liquid producing an odor similar to chloroform.
    • Because of CCl4's toxicity, consumer uses of this chemical have been discontinued in the United States.
  2. All of the following statements about exposure sources are correct EXCEPT:
    • U.S. public can be exposed to small amounts of CCl4 through ambient air.
    • Across the U.S., overall ambient air concentrations are slowly declining.
    • Household cleaning products containing bleach can produce volatile organic compounds, including chloroform and carbon tetrachloride. Use of these common agents might, in part, explain elevated indoor CCl4 concentrations.
    • It is not permitted in products intended for home use; however, chemicals containing CCl4 can still be purchased online.
  3. Today, the U.S. general public is most commonly exposed to CCl4 through
    • Use of consumer products that contain CCl4.
    • Ingestion of contaminated food.
    • CCl4-contaminated ambient air and drinking water.
    • All of the above.
  4. Of the following occupations in the United States today, which is most likely to be at increased risk for exposure to CCl4?
    • Pesticide applicators.
    • Dry cleaners.
    • Hazardous waste workers.
    • All of the above.
  5. Which of the following statements about CCl4 is NOT TRUE?
    • Most inhaled CCl4 is excreted unchanged in the urine.
    • Metabolism of CCl4 is required for toxicity.
    • The CCl3 radical is the key metabolite responsible for ultimate plasma membrane disruption and death of the cell.
    • Alcoholic patients are far more susceptible to hepatotoxic effects of CCl4 than are others.
  6. All of the following statements are true EXCEPT
    • Liquid CCl4 is not easily absorbed through the human skin.
    • Metabolism of CCl4 is required for toxicity.
    • Mixed function oxidase inducers can increase the toxicity of CCl4.
    • Unmetabolized CCl4 is eliminated primarily in exhaled air.
  7. Which of the following statements regarding U.S. guidelines and regulations for CCl4 is FALSE?
    • EPA classifies CCl4 as a hazardous air pollutant.
    • NIOSH has determined an air level of CCl4 that might be immediately dangerous to life and health.
    • Use of pesticide products containing CCl4 is a major source of exposure in the general public in the United States today.
    • EPA has set a maximum contaminant level for CCl4 in drinking water.
  8. Which of the following statements regarding signs and symptoms in patients exposed to a high dose of CCl4 is INCORRECT?
    • They will likely exhibit CNS and gastrointestinal effects.
    • Symptoms that persist beyond 24 hours are most likely psychophysiologic in nature.
    • Patients with acute and chronic exposures might exhibit some of the same symptoms.
    • Hepatic and renal injury might manifest in 48 hours.
  9. In general, patients over-exposed to CCl4 by any route PREDOMINANTLY exhibit which of the following symptoms?
    • Hepatomegaly.
    • CNS depression.
    • Nephritis.
    • Pulmonary edema.
  10. Which of the following is a direct biomarker of exposure to carbon tetrachloride?
    • Kidney function tests.
    • Blood CCl4
    • Liver function tests.
    • None of the above.
  11. Treatment for a patient with acute exposure to CCl4 might include all of the following EXCEPT
    • Administration of a free-radical scavenger such as N-acetylcysteine.
    • Hyperbaric oxygen therapy.
    • Irrigation of eyes and skin.
    • Induced emesis for patients who have ingested CCl4.
  12. Patients should be advised on ways to avoid CCl4 exposure and educated about possible health effects from exposure to CCl4. Which of the following should be discussed with a patient exposed to CCl4?
    • The use of safer alternatives to products with CCl4.
    • The use of CCl4-appropriate personal protective equipment (PPE), such as gloves, goggles, and respiratory protection.
    • Increased area air ventilation when using products containing CCl4.
    • All of the above.

Relevant Content

Use the table below to assist with review of content relevant to the posttest questions.

Question Location of Relevant Content

What is Carbon Tetrachloride?

  • Describe carbon tetrachloride (CCl4).
2 Where is Carbon Tetrachloride Found?
  • Identify sources of carbon tetrachloride (CCl4) exposure.

What Are Routes of Exposure to Carbon Tetrachloride?

  • Identify the routes of exposure to carbon tetrachloride (CCl4).

Who is at Risk for Exposure to Carbon Tetrachloride?

  • Identify who is at risk for exposure to carbon tetrachloride (CCl4).
5 What is the Biologic Fate of Carbon Tetrachloride in the Body?
  • Describe the characteristics of carbon tetrachloride (CCl4) metabolism.
6 What is the Biologic Fate of Carbon Tetrachloride in the Body?
  • Describe the characteristics of carbon tetrachloride (CCl4) metabolism.

What are Guidelines and Regulations for Carbon Tetrachloride Exposure?

  • Describe current U.S. guidelines and regulations for CCl4 exposure.
8 What are the Toxicological Effects of Carbon Tetrachloride Exposure?
  • Describe the toxicological effects associated with carbon tetrachloride (CCl4) exposure.
9 Clinical Assessment - History and Physical Exam
  • Describe what is included in the initial history and physical exam of patients potentially exposed to carbon tetrachloride (CCl4).
10 Clinical Assessment - Laboratory Tests
  • Identify tests that may assist with diagnosis of carbon tetrachloride (CCl4) toxicity.
11 How Should Patients Exposed to Carbon Tetrachloride be Treated and Managed?
  • Describe treatment strategies for patients with carbon tetrachloride (CCl4) poisoning.
12 What Instructions Should be Given to Patients Exposed to Carbon Tetrachloride?
  • Describe instructions that can be provided to patients exposed to carbon tetrachloride (CCl4).
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