Environmenta./Nutritional Diseases
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| Defined as lesions or diseases caused by exposure to chemical or physical agents in ambient, workplace, & personal environment, diseases of nutritional origin. | Environmental Diseases
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| The science of poisons, studies that distribution, effects, and mechanism of action of toxic agents. | Toxicology
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| Another name for Exogenous Chemicals | Xenobiotics
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| 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
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| 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
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| 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
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| This is formed by the reaction of sunlight with nitrogen Oxides (mainly from automobile exhaust) | Ozone
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| Ozone combined with particulate matter forms what? | Smog
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| 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)
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| 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.
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| 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
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| 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
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| Acute Carbon Monoxide Poisoning can result in what severe symptoms? | Renal, Hepatic or Cardiac failure (due to hypoxic damage)
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| Name the 5 types of Metal Pollutants | 1. Lead 2. Mercury 3. Arsenic 4. Cadmium 5. Other metals from Industrial and Agricultural Exposures
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| Type of Metal poisoning due to ingestion or inhalation of soluble lead salts. | Lead Poisoning (Plumbish)
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| 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
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| Where is lead typically absorbed and what does it compete with? | Bone and Developing Teeth. Competes with Calcium
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| What is the name that appears as radiodense collection in the bone of children exposed to excess lead? | Lead Lines
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| 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.
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| 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
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| Term for another marker for lead poisoning but this develops from peculiar basophilic cytoplasmic granules. | Basophilic Stippling
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| Mercury Poisoning is associated with tremor, gingivitis, and bizarre behavior, what is another name for this poisoning? | Mad Hatter
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| What is the main source of mercury exposure today? | Contaminated fish
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| This metal pollutant can be found in soil, water, wood preservatives, herbicides, & other agricultural products. | Arsenic
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| 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.
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| This metal is often used in batteries. | Cadmium
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| Excess Cadmium exposure can lead to what types of problems? | Obstructive lung Disease, Kidney damage, Skeletal abnormalities (Osteomalacia & Osteoporosis)
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| 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
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| What Environmental Pollutant is the most common cause of human cancers, primarily lung cancer (90%), laryngeal cancer, & oropharyngeal cancer? | Tobacco
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| How many types substances does tobacco have and of those substances what causes addiction? | 2000-4000, Nicotine
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| Name the 3 most common diseases associated with Cigarette smoking. | 1. Emphysema 2. Chronic bronchitis 3. Lung cancer
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| What other malignancies are associated with smoking tobacco? | Esophageal, Pancreatic, and Bladder cancer.
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| Maternal smoking can increase the risk of what 2 complications? | Spontaneous Abortion & Preterm Births
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| 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
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| What is the blood alcohol concentration that is defined as legally drunk in most states? | 80mg/dl (0.08%)
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| 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.
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| List 4 common Therapeutic Drugs that can produce Adverse Drug Reactions | 1. Exogenous Estrogen 2. Oral Contraceptives 3. Acetaminophen 4. Aspirin
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| Term for estrogen therapy used in postmenopausal women to prevent/slow the progression of Osteoporosis and reduce Myocardial infarction. | Hormone Replacement Therapy (HRT)
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| Name the 3 adverse effects of HRT | 1. Endometrial carcinoma & Breast carcinoma 2. Thromboembolism 3. Cardiovascular disease
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| 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
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| What is the relative risk to women who take Oral Contraceptives who develop Thromboembolic Disease? | 3-6 fold increase
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| What is the Therapeutic dose of Acetaminophen? | (0.5 g) - (15-25 g)
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| What is the lethal dose of Aspirin for small children and for adults? | 2-4g Children 10-30g Adult
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| 2 types of Poisoning from Aspirin | 1. Acute Aspirin Poisoning 2. Chronic Aspirin Toxicity (Salicylism)
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| Characteristics of Acute Aspiring Poisoning | Stimulation of CNS leading to HYPERVENTILATION, producing ALKALOSIS.
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| Characteristics of Chronic Aspiring Poisoning (Salicylism) | CNS change that progress to CONVULSION & COMA. Erosion, Ulcers & Bleeding of the gut.
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| Mixture of Aspirin and Acetaminophen over years can cause Renal Papillary Necrosis, what is this term? | Analgesic Nephropathy
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| Name 3 Nontherapeutic Toxic Agents (Drug Abuse) | 1. Cocaine 2. Heroin 3. Marijuana
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| What is the most serious complications to the cardiovascular system due to Cocaine use? | Tachycardia, Hypertension, Vasoconstriction (periphery & coronary), and Cardiac Arrhythmias
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| 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
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| Name the 4 adverse effects of Heroin use. | 1. Sudden Death 2. Pulmonary Problems 3. Infections 4. Skin Changes 5. Kidney Problems
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| What is the name of the most widely used illegal drug, some times called "pot"? | Marijuana
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| What's the name of the leaves that Marijuana is made from and what does it contain? | Cannabis Sativa and THC
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| Name some common respiratory complications with Marijuana | Laryngitis, pharyngitis, bronchitis, cough, hoarseness, and asthma-like symptoms.
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| 2 beneficial effects of Marijuana use | Decrease Intraocular pressure from Glaucoma, Combat Nausea associated with Chemotherapy.
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| 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
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| What is the most common type of Injury by Physical Agents? | Mechanical Trauma
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| List the pattern of Injury to Soft Tissue caused by Mechanical Trauma | Abrasion (scrapes), Contusion (bruises), Laceration (tears), Incised wounds, and Puncture wounds.
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| Term for the Shock that occurs due to massive losses of blood. | Hypovolemic Shock
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| 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)
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| What are the 2 categories Regarding depth of burns? | Partial-thickness or Full-thickness burns
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| 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)
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| What is another term for Full-thickness burns and what does it involve? | Third-Degree burn, entire dermis & dermal appendages
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| What % of total body surface is potentially fatal? | 50%
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| 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
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| What opportunistic organism is responsible for sepsis in burn victims? | Pseudomonas Aeruginosa
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| What are the common serious complications due Burns? | Pneumonia, Septic Shock, Acute Respiratory Distress Syndrome (ARDS).
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| Term for Prolonged exposure to high ambient temperatures that can lead to complications. | Hyperthermia
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| Name the 3 common types of complications from Hyperthermia | 1. Heat Cramps 2. Heat Exhaustion 3. Heat Stroke
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| Term for Loss of electrolytes via sweating; usually affects voluntary muscles during vigorous exercise; core temp remains normal. | Heat Cramps
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| 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
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| Term for failure of thermoregulatory mechanism associated with peripheral vasodilation, peripheral pooling, decrease circulation, ceasing of sweat, & core body temp rises. | Heat Stroke
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| Prolonged exposure to low ambient temp can result in loss of consciousness, bradycardia, and atrial fibrillation. What is this term? | Hypothermia
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| This type of injury is associated with low-voltage or high-voltage currents. | Electrical Injury
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| What two types of Electrical Injury may occur? | 1. Burns 2. Ventricular Fibrillation or Cardiac/Respiratory Failure.
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| Besides Electrical Injury, what can produce burns and interfere with cardiac pacemakers? | Electromagnetic Fields (EMF)
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| Name the 2 forms of Radiation | 1. Electromagnetic waves (xray & gamma rays) 2. Charged particles (Alpha, Beta, Neutrons & others)
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| What is the most important target of radiation damage in living cells? | DNA
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| Which type of cells are the most vulnerable to radiation damage? | Rapidly dividing cells
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| What is another name for cells that is vulnerable to radiation damage? | "Radiosensitive" cells
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| 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
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| 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
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| Characterized by painful burning erythema of the mucosa, beginning w/in several days after radiation is administered, (damage to the oral mucosa). | Radiation Mucositis
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| Name for the type of dental caries as a result of xerostomia from radiation therapy. | Radiation Caries
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| Complication following radiationtherapy where an area of bone does not heal from irradiation, causes damage to the osteocytes and impair blood supply. | Osteoradionecrosis (ORN)
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| 2 factors involved in ORN | 1. Heavy doses of irradiation to the bone 2. Trauma to the bone
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| 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
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| Term for transformation of tissue to cancerous tissue caused by radiation therapy, sustained a mutation (DNA damage). | Malignant Transformation
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| 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
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| 2 Classifications of Nutritional Deficiencies | Primary Nutritional & Secondary Nutritional Deficiencies
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| Deficiency occurring as a direct result of inadequate nutrient intake. | Primary Nutritional Deficiencies
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| Deficiency state that occur despite an adequate food intake. | Secondary Nutritional Deficiencies
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| 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)
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| This type of malnutrition affects over one half of the worlds population. | Protein-Energy Malnutrition (PEM)
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| PEM is divided into what 2 forms | Marasmus & Kwashiorkor
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| Severe deficiency of calories | Marasmus
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| Deficiency of Protein | Kwashiorkor
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| 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.
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| 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.
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| Term for self-induced starvation and most often seen in young women, with similar findings seen in PEM. | Anorexia Nervosa
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| Condition seen in individuals who binge on food and then induce vomiting. | Bulimia
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| 3 medical complication with Bulimia | 1. Electrolyte Imbalance predisposing to cardiac arrhythmias 2. Aspiration of gastric contents 3. Esophageal & Gastric rupture.
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| Name of the 4 vitamins that are Fat Soluble | Vit. A, D, E, & K
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| What vitamins can the body make (endogenous)? | Vit. D, K, & Niacin
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| What vitamin helps with vision, differentiation of specialized epithelial cells and increase immunity? | Vitamin A
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| Another name for Vitamin A | Retinol
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| Term for keratin sloughing in the eye producing white plaque due to a deficiency of Vitamin A | Bitot's Spots
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| Condition in which the eyes dry out producing a granular epithelial surface. | Xerophthalmia
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| A disorder that results from Vit. A deficiency which is required to maintain specialized epithelia. | Keratomalacia
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| Vitamin responsible for maintenance of plasma level of calcium and phosphorus | Vitamin D
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| Major source for Vit. D | The skin, synthesized when exposed to sunlight.
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| 2 disease caused by Vit. D deficiency in children and adult. | Rickets & Osteomalacia
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| A condition due to Rickets that produces an overgrowth of osteoid tissue in the costochondral junction (chest deformities) | Rachitic Rosary
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| Term for collapsed rib cage combed with protrusion of the sternum. | Pigeon-breasted Deformity
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| Term for excess osteoid tissue in the cranium | Frontal Bossing
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| This vitamin is found in cooking oils, vegetables, & grains, important antioxidant & free radical scavenger. | Vitamin E
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| Vitamin need by the liver for the formation of prothrombin (factor II) and other factors, this can predispose patients to hemorrhagic abnormalities. | Vitamin K
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| This vitamin is associated with beriberi (deficiency of thiamine) | Vitamin B1
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| 2 clinical forms of Beriberi | 1. Wet Beriberi 2. Dry Beriberi
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| Beriberi that has cardiovascular failure & peripheral edema | Wet Beriberi
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| Beriberi that results in neuritis of peripheral nerves with paresthesia, paralysis, and muscle atrophy | Dry Beriberi
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| This condition is seen most often in alcoholics, leading to thiamine deficiency. (mental confusion, abnormal eye movement, ataxia) | Wernicke-Korsakoff Syndrom
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| Deficiency of this vitamin can result in angular stomatitis and cheilitis | Riboflavin (B2)
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| Pellegra (rough skin) is caused by what vitamin deficiency? | Niacin (B3)
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| 3 symptoms of Pellegra | Dermatitis, Diarrhea, and Dementia
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| 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
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| 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
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| Term defined as an increase in bodyweight due to adipose accumulation sufficient to cause health effects. | Obesity
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| How do you calculate BMI? and what is normal BMI? | Kg/height (meters), 25
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| A cytokine secreted by adipocytes that regulates both food intake and energy expenditures. | Leptin
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| name of the gene responsible for making Leptin. | LEP gene
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| A naturally occurring mycotoxin produced by the fungus Aspergillus, carcinogenic and a major player in development of hepatocellular carcinomas. | Aflatoxin
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| 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
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| High ______ _______ intake along with low ____ ______ has been implicated in the development of colon cancer. | Animal fat, Fiber intake
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| These vitamins are found to be anticarcinogenic because they are antioxidants, lack of proof though. | Vitamin C, Vitamin E, Beta-carotenes, & Selenium
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