8: Environment and Nutrition Flashcards
Benzopyrene and Methyl Cholanthrene are examples of what compounds?
Potent experimental carcinogens that are aromatic hydrocarbons
What kind of cancer does Aflatoxins produce?
Experimental liver cancer
How do aflatoxins develop?
They are made by certain mold types
Asbestos is an example of what type of lung disease?
Mineral dust induced (exposure from mining, and fabrication of ores and materials, installing and removing insulation- disease can appear after 20/30 years exposure)
What are possible clinical manifestations of Asbestosis?
- Pleural Tumor aka Malignant mesothelioma
- Interstitial fibrosis of the lungs
- Pleural plaques (dense connective tissue)
What are Asbestos bodies? What is its nickname?
Asbestos fibers coated with protein and iron
aka Ferruginous bodies
How does gastrointestinal hemorrhage lead to anemia? What type of anemia?
Loss of heme iron at a rate faster than it is replaced from dietary Fe. This leads to microcytic hypochromic anemia.
What is the major toxicity of ethylene glycol?
acute tubular necrosis of the kidney
What is the ultimate clinical manifestation of toxic ethylene glycol?
renal failure
Acute renal failure caused by antifreeze imbibe and alcoholic hepatitis causes what symptoms?
yellow discoloration of the eyes
abdominal pains
weight loss
low grade fever
What disease is the most common acquired cause of mental retardation in the US?
Fetal Alcohol Syndrome
What are some common features of Fetal Alcohol Syndrome?
- intrauterine growth retardation
- facial dysmorphology
- neurological impairment
- congenital anomalies
later: mental retardation and minor dysmorphic features
Are cocaine and heroine intake during gestation associated with facial dysmorphology of fetus?
No
What are the symptoms of chronic lead poisoning?
Neurological: Cognitive Loss and ataxia
Microcytic Hypochromic Anemia
Describe the pathology of lead poisoning
(Delta amino levulinic dehydratase and ferrochelatase ) enzymes essential for Heme synthesis are inhibited
How do erythrocytes respond to lead posoning?
Inhibition of heme synthesis due to lead poisoning causes basophilic stippling of erythrocytes due to residual ribosome clusters in the cytoplasm.
What distinguishes mercury poisoning from lead poisoning?
Both have neurologic pathology however only lead poisioning causes hematologic symptoms such as basophilic stippling of RBCs.
Vinyl chloride can be found in what industry?
those producing plastics
What cancer is predicted for a patient exposed to vinyl chloride?
Angiosarcoma of the liver
What is Angiosarcoma associated with exposure to what substances?
Vinyl chloride
Arsenic ( found in pesticides)
Thorotrast (radioactive contrast medium used by radiologists before the 1950s)
What is the mechanism of CO poisoning?
CO displaces O2 on hemoglobin (it has a 24 X greater affinity)
What are some symptoms of CO poisoning at 50% carboxyhemoglobin?
Cerebral anoxia, convulsions, coma, death
Where does Inorganic and Organic Mercury do damage respectively?
Kidneys and brain
What neurologic symptoms can be seen in mercury poisoning?
VF constriciton hearing loss dysarthria paresthesia ataxia
What is the mechanism of frostbite?
Water in tissues are crystallized when exposed to the cold
How does frostbite lead to gangrene?
Localized thrombosis leads to focal ischemia causing gangrene
when a limb loses its blood supply and undergoes coagulative necrosis involving multiple tissue layers, this non-distinctive pattern of cell death is known as
gangrenuos necrosis
What is the most common cause of death in burn patients?
Sepsis after infection of burned skin
What type of trauma is associated with Cushing ulcers?
Trauma to the CNS
Stress or Curling ulcers are examples of what type of ulcer?
Gastric
If a marathon runner presents with the following symptoms post-run, what would be the first illness on the differential diagnosis?
- Hot dry skin
- Cessation of sweating
- lactic acidosis
- Hypocalcemia
- Muscle necrosis (rhabdomyolysis)
Heat stroke
An individual working with electrical energy would be at risk for what heart abnormality?
Cardiac Arrhythmia, specifically Ventricular Fibrillation, because of the disruption of the electrical system in the heart
Rads of radiation causes destruction to what type of tissues? What radiation level is necessary for this damage?
proliferating cells, most nserious ly, the GI tract, 1000 rads
What ar esome symptoms of 300 rads of radiation/
- depression
- granulocytopenia and thrombocytopenia develop within 2 weeks.
What is the major mechanism of death caused by radiation sickness?
Massive fluid loss from the intestinal mucosa and passage of bacteria through the damaged intestine.
Microwave energy absorption produces what substance?
heat
What health risks are associated dwith microwave iinjury?
none
Wound healing requires what biosynthetic process?
Collagen synthesis
What deificiency would present with poor wound healing, perifollicular hemorrhages from weak capillary walls, gingivitis and alveolar bone resorption/loss of tooth?
Vitamin C (scurvy)
What are the the three main symptoms of Niacin deficiency?
Dermatitis Diarrhea, dementia
Osteomalacia is characterized by what inadequacy?
Inadequacy to mineralize newly formed bone matrix
What vitamin deficiency is associated with encephalopathy, mammillary body atrophy, loss of ganglion cells, peripheral neuropathy and rupture of small blood vessels
Vitamin B1 Thiamine
What are the two syndromes seen with thiamine deficiency?
beeri beri- heart, and Wernicke-Korsakoff - grain
In what population is thiamine deficiency often seen in?
patients with chronic alcohol abuse
Vitamin A Deficiency presents with what symptoms?
- squamous metaplasia at a numbeer of sites
- Xerophthalmia at the cornea (dry eye)
- Keratomalacia- preogressive softening of the tissue
- corneal ulceration
What organism is often the cause of bacterial endocarditis?
S.taphylococcus aureus
What is a major complication of IV drug abuse?
Bacterial endocarditis
Infected emboli in bacterial endocarditis can cause what other pathologies?
- Gangrene from occluded blood vessels
- cerebral abscess
What is the composition of the vegetations seen in endocarditis?
- platelets
- masses of organisms
- fibrin
- cell debris
List primary risk factors for endocarditis
- I V drug abuse
- Rheumatic heart disease
- Prosthetic Heart Valves
- Transient Bacteremia
- Diabetes
Are autoimmune diseases that are associated with endocarditis bacterial? Give an example of one such disease
No, the verrucous egetations are sterile
ex . Libman-Sacks
Cyanocobalamin B12 deficiency is usually the result of what disease?
pernicous anemia- an autoimmune disease of the stomach
What cellular activity is B12 necessary for/
DNA synthesis
What are characteristic features of Kwashiorkor syndrome?
edema, large fatty liver, depigmentation of the skin
Extreme apathy is notable, diarrhea is common , and anemia is the rule
Deficiency in what vitamin causes hemorrhagic disease of a newborn? Why?
Vitamin K
_ It is a coagulation factor necessary to corboxylate and activate prothrombin and clotting factors VII, IX, and X.
Why are newborns susceptible to Vitamin K deficiency?
- Vit. K can’t be transported across the placenta
2. The sterile gut of the newborn does not have bacteria to produce Vitamin K
What pigment is seen in most visceral organs in Marasmus? What organs mostly?
Lipofuscin
Liver and heart
What is Cheilosis?
fissures at the angles of the mouth
What deficiency is associated with cheilosis?
Vitamin B2- riboflavin
Riboflavin deficiency presents with what symptoms?
- Cheilosis
- Seborrheic Keratosis
- Interstitial keatitis of the cornea
What deficiency is often seen in strict vegetarians?
Vitamin B12- it is contained only in animal products including eggs
What changes are seen in the heart due to chronic alcoholism?
- hypertrophy
- dilation
Cigarette smoking and diabetes mellitus leads to what cardiovascular disease?
coronary heart disease
Rheumatic heart disease is associated with what type of heart abnormalities?
valvular
How does a normal term infant born to a woman who smokes differ from another normal infant?
The infant born to a smoker is lighter by almost 200g
A woman who smokes while pregnant increases her risk of what uteroplacental unit pathologies?
- Abruptio Placentae (separation of the placenta from the uterine wall prior to delivery)
- Placenta Previa (placenta lies very low and covers all or parts of the cervix)
- Uterine bleeding
- Premature rupture of the membrane
What are the various forms of Placenta Previa?
Marginal: The placenta is next to cervix but does not cover the opening.
Partial: The placenta covers part of the cervical opening.
Complete: The placenta covers all of the cervical opening.
Describe the normal location of the placenta during pregnancy
During pregnancy, the placenta moves as the womb stretches and grows. It is very common for the placenta to be low in the womb in early pregnancy. But as the pregnancy continues, the placenta moves to the top of the womb. By the third trimester, the placenta should be near the top of the womb, so the cervix is open for delivery.
What is the major independent risk factor for MI?
Cigarette Smoking
How does smoking increase the risk for sudden cardiac death?
by exacerbating regional ischemia
Cornonary Artery Disease is protected by what risk factor for a dilated cardiomyopathy?
Chronic Alcohol Consumption
men who smoke more than 2 ppd have a 5x greater risk of developing cancer of what organ (that is not the lungs) in addition to emphysema?
Pancreas
What deficiency is likely caused by steatorrhea and destruction of intestinal flora?
Vitamin K deficiency. Steatorrhea is severe fat malabsorption and Vit K is fat soluble. Intestinal flora makes vit. k.
What clotting factors require vitamin K for activity?
Prothrombiin
Factor VII
Factor IX
Factor X
What CNS problems develop from Cocaine overdose?
Anxiety, Delirium, and some seizures
What might cause the cardiomyopathy seen in cocaine overdose?
the effects in intramyocardial coronary arteries
90 percent of cancers of the lip and buccal mucosa are associated with what risk factor?`
tobacco use
80% of cancers of the larynx and esophagus result from what risk factor?
smoking
What organ system does acute benzene poisoning affect? What secondary outcome is seen?
The CNS. Death results from respiratory failure
Which organ system is the principal target of chronic benzene intoxication?
the bone marrow
What abnormalities are seen in the bone marrow of benzene intoxicated patients/
hypoplasia and aplasia and pancytopenia
A reduction in the number of red and white blood cells, as well as platelets is known as…
pancytopenia
What secondary disease often occurs in benzene-induced anemia?
actue myeloblastic leukemia
Where are most cases of benzene exposure found?
Industrial exposure
Whole body radiation can lead to what disease?
Cancer; Chronic myelogenous leukemia
Which vitamin confers calcium-binding properties to certain proteins is also important for clotting factors?
Vitamin K
A force that causes a laceration leads to what kind of displacement is seen in a laceration?
Unidirectional displacement. A linear tear of skin is produced.
What causes an abrasioon?
crushes or scrapes
What is the name for a localized mechanical injury with focal hemorrhage?
contusion
