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Environmenta./Nutritional Diseases

Defined as lesions or diseases caused by exposure to chemical or physical agents in ambient, workplace, & personal environment, diseases of nutritional origin. Environmental Diseases
The science of poisons, studies that distribution, effects, and mechanism of action of toxic agents. Toxicology
Another name for Exogenous Chemicals Xenobiotics
Toxic metabolites cause cellular injury & may cause injury & accumulate in bone, fat, brain, or other tissue. These reactions occur in two phases in the liver. What system is involved in this reaction? Cytochrome P-450
Name 9 Environmental Pollutants 1. Air Pollution 2. Metals 3. Tobacco 4. Alcohol 5. Therapeutic Drugs (Adverse Drug Reactions) 6. Nontherapeutic Toxic Agents (Drug Abuse) 7. Physical Agents 8. Electrical 9. Ionizing Radiation
Name the 6 Air Pollutants monitored by the EPA 1. Sulfur Dioxide 2. Carbon monoxide 3. Ozone 4. Nitrogen Dioxide 5. Lead 6. Particulate matter
This is formed by the reaction of sunlight with nitrogen Oxides (mainly from automobile exhaust) Ozone
Ozone combined with particulate matter forms what? Smog
A non-irritating, colorless, tasteless, odorless gas produced by the imperfect oxidation of carbonaceous material, usually accidental or suicide as a cause of death. Carbon Monoxide (CO)
What is the mechanism by which CO causes death and the name of the product it forms? BINDING hemoglobin (200x more than O2) causing systemic asphyxiant resulting in HYPOXIC SHOCK. the product formed is CARBOXYHEMOGLOBIN.
At what % does Carboxyhemmoglobin concentration need to be to cause death? At what % concentration shows signs of carbon monoxide poisoning? 60-70% concentration. 20-30% concentration
What form of CO2 poisoning does tissue often develop a cherry red hyperemia due to increase in carboxyhemoglobin which has a bright red color? Acute Carbon Monoxide Poisoning
Acute Carbon Monoxide Poisoning can result in what severe symptoms? Renal, Hepatic or Cardiac failure (due to hypoxic damage)
Name the 5 types of Metal Pollutants 1. Lead 2. Mercury 3. Arsenic 4. Cadmium 5. Other metals from Industrial and Agricultural Exposures
Type of Metal poisoning due to ingestion or inhalation of soluble lead salts. Lead Poisoning (Plumbish)
What is the acceptable levels of lead and what levels of lead may produce neurological problems to Children? Acceptable @ 80 mg/100mL. Neurologic problem for children @ 50 mg/100mL
Where is lead typically absorbed and what does it compete with? Bone and Developing Teeth. Competes with Calcium
What is the name that appears as radiodense collection in the bone of children exposed to excess lead? Lead Lines
Absorbed lead can interfere with enzymes that aid in the development of RBC, What type of anemia can this result in and classify (morphology) this anemia? Hemolytic Anemia. Microcytic Hypochromic Anemia.
Hemolytic Anemia from lead poisoning can increase iron (heme) accumulation in the serum, these are secreted in the urine which is a marker for Lead poisoning, what is this term? Protoporphyrin
Term for another marker for lead poisoning but this develops from peculiar basophilic cytoplasmic granules. Basophilic Stippling
Mercury Poisoning is associated with tremor, gingivitis, and bizarre behavior, what is another name for this poisoning? Mad Hatter
What is the main source of mercury exposure today? Contaminated fish
This metal pollutant can be found in soil, water, wood preservatives, herbicides, & other agricultural products. Arsenic
Ingested Arsenic can lead to what types of problems? Disturbances in the GI, CNS, Cardiac system. Chronic exposure can lead to basal and squamous cell carcinomas.
This metal is often used in batteries. Cadmium
Excess Cadmium exposure can lead to what types of problems? Obstructive lung Disease, Kidney damage, Skeletal abnormalities (Osteomalacia & Osteoporosis)
Name 7 Industrial & Agricultural agents that can produce toxicity in humans. 1. Organic Solvents 2. Polycyclic hydrocarbons 3. Organochlorines 4. Dioxins, polychlorinated biphenyls (PCBs) 5. Phthalates 6. Vinyl chloride 7. Mineral dusts
What Environmental Pollutant is the most common cause of human cancers, primarily lung cancer (90%), laryngeal cancer, & oropharyngeal cancer? Tobacco
How many types substances does tobacco have and of those substances what causes addiction? 2000-4000, Nicotine
Name the 3 most common diseases associated with Cigarette smoking. 1. Emphysema 2. Chronic bronchitis 3. Lung cancer
What other malignancies are associated with smoking tobacco? Esophageal, Pancreatic, and Bladder cancer.
Maternal smoking can increase the risk of what 2 complications? Spontaneous Abortion & Preterm Births
Alcohol consumption is responsible for how many deaths per year? Of which 25% causes damage to the liver, what is this called? >100,000 per year. Cirrhosis of the Liver
What is the blood alcohol concentration that is defined as legally drunk in most states? 80mg/dl (0.08%)
What 3 enzymes oxidizes alcohol in the liver? Which is the main one? 1. Alcohol Dehydrogenase 2. Cytochrome P-450 3. Catalase The main enzyme is Alcohol Dehydrogenase.
List 4 common Therapeutic Drugs that can produce Adverse Drug Reactions 1. Exogenous Estrogen 2. Oral Contraceptives 3. Acetaminophen 4. Aspirin
Term for estrogen therapy used in postmenopausal women to prevent/slow the progression of Osteoporosis and reduce Myocardial infarction. Hormone Replacement Therapy (HRT)
Name the 3 adverse effects of HRT 1. Endometrial carcinoma & Breast carcinoma 2. Thromboembolism 3. Cardiovascular disease
Term for the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system, this includes deep vein thrombosis, pulmonary embolism and stroke. Thromboembolism
What is the relative risk to women who take Oral Contraceptives who develop Thromboembolic Disease? 3-6 fold increase
What is the Therapeutic dose of Acetaminophen? (0.5 g) - (15-25 g)
What is the lethal dose of Aspirin for small children and for adults? 2-4g Children 10-30g Adult
2 types of Poisoning from Aspirin 1. Acute Aspirin Poisoning 2. Chronic Aspirin Toxicity (Salicylism)
Characteristics of Acute Aspiring Poisoning Stimulation of CNS leading to HYPERVENTILATION, producing ALKALOSIS.
Characteristics of Chronic Aspiring Poisoning (Salicylism) CNS change that progress to CONVULSION & COMA. Erosion, Ulcers & Bleeding of the gut.
Mixture of Aspirin and Acetaminophen over years can cause Renal Papillary Necrosis, what is this term? Analgesic Nephropathy
Name 3 Nontherapeutic Toxic Agents (Drug Abuse) 1. Cocaine 2. Heroin 3. Marijuana
What is the most serious complications to the cardiovascular system due to Cocaine use? Tachycardia, Hypertension, Vasoconstriction (periphery & coronary), and Cardiac Arrhythmias
What is the term that results in spontaneous abortion and impaired neurologic development to the fetus due to cocaine use by the mother? Fetal Hypoxia
Name the 4 adverse effects of Heroin use. 1. Sudden Death 2. Pulmonary Problems 3. Infections 4. Skin Changes 5. Kidney Problems
What is the name of the most widely used illegal drug, some times called "pot"? Marijuana
What's the name of the leaves that Marijuana is made from and what does it contain? Cannabis Sativa and THC
Name some common respiratory complications with Marijuana Laryngitis, pharyngitis, bronchitis, cough, hoarseness, and asthma-like symptoms.
2 beneficial effects of Marijuana use Decrease Intraocular pressure from Glaucoma, Combat Nausea associated with Chemotherapy.
Name the 6 types of Injury By Physical Agents 1. Mechanical Trauma 2. Thermal Injury 3. Hyperthermia 4. Hypothermia 5. Electrical Injury 6. Ionizing Radiation
What is the most common type of Injury by Physical Agents? Mechanical Trauma
List the pattern of Injury to Soft Tissue caused by Mechanical Trauma Abrasion (scrapes), Contusion (bruises), Laceration (tears), Incised wounds, and Puncture wounds.
Term for the Shock that occurs due to massive losses of blood. Hypovolemic Shock
Thermal Burns can lead to death, what are the important Factors that contribute to this? 1. Depth of burn 2. % of body surface involved 3. Inhalation of hot & toxic fumes 4. Promptness & efficacy of therapy (fluid, electrolytes, prevent infections)
What are the 2 categories Regarding depth of burns? Partial-thickness or Full-thickness burns
Partial-thickness is further divided into 2 categories, what are they and what layer do they include? First-Degree (upper portion of epidermis) Second-Degree (majority of the epidermis)
What is another term for Full-thickness burns and what does it involve? Third-Degree burn, entire dermis & dermal appendages
What % of total body surface is potentially fatal? 50%
What can result from burns that involve 20% or more of the total body surface? Fluid shift to interstitial compartments and result in Hypovolemic Shock
What opportunistic organism is responsible for sepsis in burn victims? Pseudomonas Aeruginosa
What are the common serious complications due Burns? Pneumonia, Septic Shock, Acute Respiratory Distress Syndrome (ARDS).
Term for Prolonged exposure to high ambient temperatures that can lead to complications. Hyperthermia
Name the 3 common types of complications from Hyperthermia 1. Heat Cramps 2. Heat Exhaustion 3. Heat Stroke
Term for Loss of electrolytes via sweating; usually affects voluntary muscles during vigorous exercise; core temp remains normal. Heat Cramps
Term for failure of cardiovascular system to compensate for hypovolemia secondary to water depletion; result in sudden onset of prostration and collapse followed by equilibrium. Heat Exhaustion
Term for failure of thermoregulatory mechanism associated with peripheral vasodilation, peripheral pooling, decrease circulation, ceasing of sweat, & core body temp rises. Heat Stroke
Prolonged exposure to low ambient temp can result in loss of consciousness, bradycardia, and atrial fibrillation. What is this term? Hypothermia
This type of injury is associated with low-voltage or high-voltage currents. Electrical Injury
What two types of Electrical Injury may occur? 1. Burns 2. Ventricular Fibrillation or Cardiac/Respiratory Failure.
Besides Electrical Injury, what can produce burns and interfere with cardiac pacemakers? Electromagnetic Fields (EMF)
Name the 2 forms of Radiation 1. Electromagnetic waves (xray & gamma rays) 2. Charged particles (Alpha, Beta, Neutrons & others)
What is the most important target of radiation damage in living cells? DNA
Which type of cells are the most vulnerable to radiation damage? Rapidly dividing cells
What is another name for cells that is vulnerable to radiation damage? "Radiosensitive" cells
Radiation therapy is delivered in doses to allow cells to repair to prevent radiant energy to cumulate, what is the term for these doses? Fractionation
List the sequential order of changes to the skin that is receiving radiation therapy. 1. Post-irradiation Erythema 2. Edematous and purple coloration 3. Blotchy dark & light pigmentation 4. Loss of hair & Atrophy or Hyperkeratosis
Characterized by painful burning erythema of the mucosa, beginning w/in several days after radiation is administered, (damage to the oral mucosa). Radiation Mucositis
Name for the type of dental caries as a result of xerostomia from radiation therapy. Radiation Caries
Complication following radiationtherapy where an area of bone does not heal from irradiation, causes damage to the osteocytes and impair blood supply. Osteoradionecrosis (ORN)
2 factors involved in ORN 1. Heavy doses of irradiation to the bone 2. Trauma to the bone
What is the suggested timeline for surgical procedures to be performed Before or After radiation therapy to prevent ORN? 21 days prior to therapy or 12 months after therapy
Term for transformation of tissue to cancerous tissue caused by radiation therapy, sustained a mutation (DNA damage). Malignant Transformation
7 categories of Nutritional Diseases 1. Malnutrition 2. Anorexia Nervosa 3. Bulimia 4. Vitamin Deficiencies 5. Obesity 6. Diet & Systemic Diseases 7. Diet and Cancer
2 Classifications of Nutritional Deficiencies Primary Nutritional & Secondary Nutritional Deficiencies
Deficiency occurring as a direct result of inadequate nutrient intake. Primary Nutritional Deficiencies
Deficiency state that occur despite an adequate food intake. Secondary Nutritional Deficiencies
5 causes of Secondary nutritional deficiencies 1. Malabsorption Syndrome 2. Storage problems (liver) 3. Increased Losses (sweating, diarrhea, lactation) 4. Increased requirements (growing individuals, pregnancy, infections) 5. Inhibition of Utilization (blockage of enzyme system)
This type of malnutrition affects over one half of the worlds population. Protein-Energy Malnutrition (PEM)
PEM is divided into what 2 forms Marasmus & Kwashiorkor
Severe deficiency of calories Marasmus
Deficiency of Protein Kwashiorkor
Characteristic of children with Marasmus in the first year of life. Depletion of body fat and protein from the somatic protein compartment for production of energy.
Of the PEM, which is the more severe form of malnutrition and characteristic? Kwashiorkor. Severe Loss of visceral protein compartments, resulting in Hypoalbuminemia giving rise to edema.
Term for self-induced starvation and most often seen in young women, with similar findings seen in PEM. Anorexia Nervosa
Condition seen in individuals who binge on food and then induce vomiting. Bulimia
3 medical complication with Bulimia 1. Electrolyte Imbalance predisposing to cardiac arrhythmias 2. Aspiration of gastric contents 3. Esophageal & Gastric rupture.
Name of the 4 vitamins that are Fat Soluble Vit. A, D, E, & K
What vitamins can the body make (endogenous)? Vit. D, K, & Niacin
What vitamin helps with vision, differentiation of specialized epithelial cells and increase immunity? Vitamin A
Another name for Vitamin A Retinol
Term for keratin sloughing in the eye producing white plaque due to a deficiency of Vitamin A Bitot's Spots
Condition in which the eyes dry out producing a granular epithelial surface. Xerophthalmia
A disorder that results from Vit. A deficiency which is required to maintain specialized epithelia. Keratomalacia
Vitamin responsible for maintenance of plasma level of calcium and phosphorus Vitamin D
Major source for Vit. D The skin, synthesized when exposed to sunlight.
2 disease caused by Vit. D deficiency in children and adult. Rickets & Osteomalacia
A condition due to Rickets that produces an overgrowth of osteoid tissue in the costochondral junction (chest deformities) Rachitic Rosary
Term for collapsed rib cage combed with protrusion of the sternum. Pigeon-breasted Deformity
Term for excess osteoid tissue in the cranium Frontal Bossing
This vitamin is found in cooking oils, vegetables, & grains, important antioxidant & free radical scavenger. Vitamin E
Vitamin need by the liver for the formation of prothrombin (factor II) and other factors, this can predispose patients to hemorrhagic abnormalities. Vitamin K
This vitamin is associated with beriberi (deficiency of thiamine) Vitamin B1
2 clinical forms of Beriberi 1. Wet Beriberi 2. Dry Beriberi
Beriberi that has cardiovascular failure & peripheral edema Wet Beriberi
Beriberi that results in neuritis of peripheral nerves with paresthesia, paralysis, and muscle atrophy Dry Beriberi
This condition is seen most often in alcoholics, leading to thiamine deficiency. (mental confusion, abnormal eye movement, ataxia) Wernicke-Korsakoff Syndrom
Deficiency of this vitamin can result in angular stomatitis and cheilitis Riboflavin (B2)
Pellegra (rough skin) is caused by what vitamin deficiency? Niacin (B3)
3 symptoms of Pellegra Dermatitis, Diarrhea, and Dementia
A deficiency of this vitamin usually results in conditions indistinguishable from those related to other B-vitamin deficiencies, deficiency may occur due to antagonist reaction with other drugs. Pyridoxine
This vitamin is essential for the formation and maturation of collagen which can cause scurvy. Characterized by bone disease in growing children & hemorrhage & healing defects. Vitamin C
Term defined as an increase in bodyweight due to adipose accumulation sufficient to cause health effects. Obesity
How do you calculate BMI? and what is normal BMI? Kg/height (meters), 25
A cytokine secreted by adipocytes that regulates both food intake and energy expenditures. Leptin
name of the gene responsible for making Leptin. LEP gene
A naturally occurring mycotoxin produced by the fungus Aspergillus, carcinogenic and a major player in development of hepatocellular carcinomas. Aflatoxin
These two compounds are implicated in the development of gastric carcinomas in humans, formed in the body from nitrites and amines or amides. Nitrosamines & Nitrosamides
High ______ _______ intake along with low ____ ______ has been implicated in the development of colon cancer. Animal fat, Fiber intake
These vitamins are found to be anticarcinogenic because they are antioxidants, lack of proof though. Vitamin C, Vitamin E, Beta-carotenes, & Selenium
Created by: ddde227