(5) Environmental Nutrition (Martin) Flashcards by Jaime Weber

Generally, what trends have we observed in diseases that are increasing?

Cardiovascular disease

Cancer

HIV/AIDs and TB

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Generally, what trends have we observed in diseases that are decreasing?

Neonatal conditions

Diarrhea

Lower respiratory infections

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What are some negative impacts on human health suffered from climate change?

Air pollution/heatwaves –> Cardiovascular, cerebrovascular and respiratory dzs

Floods/disruption of clean water supplies –> Gastroenteritis, cholera & foodborne/waterborne infectious dzs

Disrupted crop production –> malnutrition

Increased temps, extreme weather –> Malaria, dengue fever

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Pollutant:

Ozone

Populations at risk?

Healthy children

Healthy adults

Atheletes

Outdoor workers

Asthmatics

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Pollutant:

Ozone

Effects on healthy adults/chilrden?

Decreased lung function

Increased airway reactivity

Lung inflammation

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Pollutant:

Ozone

Effects on Athletes, outdoor workers, asthmatics?

Decreased exercise capacity

Increased hospitalizations

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Pollutant:

Sulfur Dioxide

Populations at risk?

Healthy adults

Individuals with chronic lung disease

Asthmatics

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Pollutant:

Sulfur Dioxide

Effect on healthy adults?

Increased respiratory symptoms

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Pollutant:

Sulfur Dioxide

Effect on Individuals with chronic lung disease?

Increased mortality

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Pollutant:

Sulfur Dioxide

Effect on Asthmatics?

Increased hospitalization

Decreased lung function

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Why is particulate matter (soot) so dangerous to inhale?

*THEY ENTER THE ALVEOLI –> which causes the release of inflammatory mediators

Induces pulmonary inflammation and secondary CV effects

Fine or Ultrafine particles less than 10microm in diameter are the most harmful

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What is the major hallmark for carbon monoxide poisoning?

Cherry red color of the skin and mucous membranes

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Describe carbon monoxide’s characteristics as a gas

Nonirritating

Colorless

Tasteless

Odorless

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What are some notable situations where a person is suceptible to chronic CO poisoning?

Working in tunnels

Underground garages

Highway toll booths

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What are some notable situations where a person is suceptible to acute CO poisoning?

In small, closed garage w/ running car

Mine fires

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How does CO poisoning ultimatley kill?

Kills by inducing CNS depression and widespread ischemic changes

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What anatomic structures are affected by CO poisoning?

Basal ganglia

Lenticular nuclei

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If your patient recovers from CO poisoning, what would you expect to be lasting effects?

Memory, vision, hearing and speech impairment

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With 60-70% CO saturation, a person can die in as little as…

5 min

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What is unique about a CO poisoned brain vs a normal brain?

CO posioned brain has increased detail in anatomical structures

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What are examples of indoor air pollution?

Wood smoke
Bioaerosols (pet dander, fungi, molds)
Radon
Formaldehyde
Sick building syndrome

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Lead

What are it’s effects on the human body?

Hematologic

Skeletal

Neurologic

Renal

TOXICITIES!!!!

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Where is lead frequently found by children?

Flaking lead paint and soil

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Where are common places for adults to encounter lead during occupational exposure?

Battery manufacturing

Pigments

Car radiators

Tin cans

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Where does **lead** primarily deposit in the human body? How long does it stay there?

Bone & Developing teeth 20-30 years!

Low levels of **lead** in the body lead to in children?

Subtle deficits in... - Intellect - Behavioral problems - Hyperactivity - Poor organizatinoal skills in kids - Brain damage

Low levels of **lead** causes what symptoms in adults?

CNS disturbances **Wrist drop** **Foot drop**

What is a hallmark finding in the bones to indicate lead poisoning?

"Lead lines"

What are the major things you will see on a **CBC** with a patient with lead posioning?

**Hypochromic microcytic anemia** Basophilic stippling Ring sideroblasts

What is **"lead colic"?**

Extremely severe and poorly localized abdominal pain caused by **lead poisoning**

What is this showing?

Lead lines

What is this showing?

Lead lines

What is this?

**_Ringed Sideroblast_** Associated with _sideroblastic anemia_ due to excess **IRON** in mitochondria

Classification of anemia What are the lab values for: MCV MCH That would allow a microcytic anemia diagnosis?

[average RBC size] MCV \<80 fL [hemoglobin amount per RBC] MCH \<27 pg

Histologically speaking... How big should a RBC be?

A RBC should be about the same size as the nucleus of a normal lymphocyte

What is this?

Microcytic/hypochromic anemia

What is this?

Basophilic stippling

What are **three major metals** that are enviornmental pollutants?

Mercury Arsenic Cadmium

What disease is related to **mercury poisoining?**

***_Minamata disease:_*** Cerebral palsy, deafness, blindness, mental retardation and major CNS defects in children exposed in utero

What disease is related to **cadmium poisoning?**

"***_Itai-Itai"_*** (ouch-ouch) Oseoporosis and osteomalacia w/ renal disease

What are visual indicators that someone has had **arsenic poisoning?**

Hyperpigmentation Hyperkeratosis "MEES lines" in the nails

What are examples of **organic solvents?**

Chloroform Carbon Tetrachloride

What can prolonged exposure of **chloroform** and **carbon tetrachloride** do to the human body?

CNS depression Coma

ASSOCIATE: Occupational exposure of rubber workers to ...

Benzene and 1,3-butadiene

What is the effect of **benzene/1,3-butadiene** on these rubber workers?

Marrow aplasia HUGE RISK for **acute myeloid leukemia**

Asbestosis leads to?

Mesothelioma ; black lung

What are **furrungious bodies?**

Asbestos fibers coated in iron

**Vinyl chloride** leads to?

Angiosarcomas in liver

What is bisphenol A?

BPA Lines almost all food bottles and cans \*Is a potential endocrine disruptor

What is this?

Aplastic anemia

Name the disease

Mesothelioma

Name the disease

Black lung

Tobacco accounts for \_\_\_% of lung cancers

90%

How do you calculate pack years?

Pack years = average number of cigarette packs smoked/day (x) # years smoking

Describe the benefits of cessation of smoking for a smoker

Within 5 years, cessation of smoking improves **mortality** and **decreases risk of death from cardiovascular disease** Lung cancer mortality drops by _21% w/in 5 years_

Even if you quit smoking, the excess risk of smoking persists...

For 30 years

Agents in tobacco smoke have a direct irritant effect on \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tracheobronchial mucosa

Tobacco smoke influences the tracheobronchial mucosa by...

Inducing **inflammation** and Increasing **mucus production (bronchitis)** \*Remeber, you get that nasty smokers cough b/c the smoke directly effects the ability of your respiratory cilia to "beat" debris out of the respiratory system

Cigarette smokers are at an increased risk of:

Emphysema Bronchitis ALL forms of cancer COPD MI Atherosclerosis

Maternal smoking poses in increased risk of?

Spontaneous abortions Preterm births Intrauterine growth redardation

The risk of lung cancer is determined by?

The **number of cigarettes smoked**

Considerations when combining alcohol and smoking?

Mutiplicative increase in the risk of **laryngeal cancer**

Most of the alcohol in the blood is oxidized to? By what enzyme?

Acetaldehyde Alcohol dehydrogenase (ADH)

What are the ACUTE adverse effects of EtOH?

- Steatosis (fatty liver) - CNS effects (depressant)

What are the CHRONIC adverse effects of EtOH?

**Liver:** steatosis, alcoholic hepatitis, cirrhosis, portal hypertension, hepatocellular carcinoma **Thiamine:** peripheral neuropathies, Wernicke-Korsakoff syndrome **Alcoholic cardioomyopathy**= dilated congestive cardiomyopathy **Malnutrition** - VITAMIN B!!!

Smooth philtrum is an indication of what disease process?

Fetal alcohol syndrome