Question | Answer |
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 |