9.1 Environmental & Nutritional Disorders Flashcards
In healthy adults and children exposed to ozone what effects do we see with?
(3)
Decreased lung function
Lung inflammation
Lung inflammation
In asthmatics, outdoor workers, and athletes, what effects do we see when exposed to ozone?
Decreased exercise capacity
Increased hospitalizations
In terms of sulfer dioxide exposure, what effects do we see in the following risk groups?
Healthy adults:
People with chronic lung disease:
Asthmatics (2):
Healthy adults: increased respiratory symptoms
People with chronic lung disease: increased mortality
Asthmatics (2): increased hospitalizations and decreased lung function
In which of the following scenarios are we most likely to see increased mortality?
A. Ozone exposure to asthmatics
B. Sulfer dioxide exposure to asthmatics
C. Ozone exposure to healthy adults and children
D. Sulfer dioxide exposure to people with chronic lung disease
D. Sulfer dioxide exposure to people with chronic lung disease
What are the classic outdoor pollutants that make up the “witches brew”?
Ozone and sulfer dioxide
What outdoor air pollutant is responsible for causing pulmonary inflammation and secondary cardiovascular events?
A. Ozone
B. Soot (Particulate matter)
C. Sulfer dioxide
D. Carbon monoxide
B. Soot (Particulate matter)
Particulates that are less than 10 um are the most harmful as they are able to travel to what location in the respiratory tract?
Alveoli
When neurons start to die due to hypoxia, what morphological changes do they undergo?
A. Bright red cytoplasm and loss of nuclei
B. Pale cytoplasma and darkening of nuclei
C. Bright red cytoplasm with swollen nuclei
D. None of the above
A. Bright red cytoplasm and loss of nuclei
CO kills through the induction of what two things?
CNS depression
Ischemia by competitively binding to Hb better than oxygen
CO doesn’t tend to cause morphological changes when death is rapid, but if there is prolonged survival what changes might we see in the brain? (3)
Brain swelling (edematous)
Puncate Hemorrhages
Hypoxia induced neuronal changes (red cytoplasm and loss of nuclei)
What is the hallmark presentation of a person who has suffered CO poisoning?
Where does CO tend to [] most in the brain (2)?
Cherry red skin and mucous membranes
Basal ganglia and Lenticulate nuclei
When adults are exposed to lead which of the peripheral neuropathies occurs first?
A. Foot drop
B. Paralysis of peroneal muscles
C. Paralysis of extensor muscles in the wrist and fingers
D. None of the above
C. Paralysis of extensor muscles in the wrist and fingers
“wrist drop”
Lead is absorbed into the system and binds to sulfahydryl groups in proteins and is able to directly interfere with the metabolism of what mineral?
A. Iron
B. Calcium
C. Copper
D. Zinc
B. Calcium
What are the 5 toxicities that are associated with lead exposure?
Hematologic
Skeletal
Gastrointestinal
Neurologic
Renal
GNaSHeR
What are the morphologic or clincal changes we associated with the hematologic toxicities associated with lead exposure (3)?
Hypochromic microcytic anemia
Basophilic stippling
Ring sideroblasts
What are the morphologic or clincal changes we associated with the skeletal toxicities associated with lead exposure?
Why do these changes manifest?
Lead lines in metaphyses and gums
Lead competes with calcium and gets encorporated into teeth and bones
Lead lines are seen in the metaphyses of individuals due to lead interfering with what process?
Cartilage remodiling
Which of the following metals bind to sulfhydryl groups on proteins and wreak havoc on the body?
A. Lead and Cadmium
B. Cadmium and Mercury
C. Mercury and Lead
D. Arsenic and Cadmium
C. Mercury and Lead
Mercury preferentially causes damage to what 2 organs?
T/F: The effects of mercury poisoning are more severe the early in life you are exposed
Brain
Kidney
True
Cerebral palsy, deafness, blindness, mental retardation, and major CNS defects are all fallouts of Minimata Disease, which develops in children due to exposure of what metal in utero?
A. Lead
B. Mercury
C. Arsenic
D. Cadmium
B. Mercury
Arsenic interferes with cellular metabolism and causes toxicities that are most prominant in what 4 locations?
GI tract
Skin
Heart
Nervous System
Arsenic? Have GIN
2-8 weeks post exposure to arsenic we can see esnsorimotor neuropathy, paresthesia, numbness, and pain. However, those symptoms aren’t nearly as unique as what 2 developments seen in people with chronic arsenic exposure?
Hyperpigmentation
Hyperkeratosis
Although the mechanism of cadmium’s affect on the body is not well understood outside of it’s involvement with increased ROS, we do know that cadmium is preferentially toxic to what 2 organs?
A. Kidneys and skeleton
B. Kidneys and Lungs
C. Kidneys and Brain
D. Kidneys and GI
B. Kidneys and Lungs
NOTE: we do see skeletal abnormalities associated with calcium loss
What are 3 major clinical presentations of people exposed to cadmium?
Obstructive Lung Disease
Renal Tubular Loss
Skeletal abnormalities
Itai-Itai is a renal disease with osteoporosis and osteomalcia. It is caused due to exposure to what metal?
A. Lead
B. Mercury
C. Arsenic
D. Cadmium
Cadmium
Occupational exposure to CO and Lead act on the cardiovascular system to cause what?
Heart disease
9-2
Occupational exposure to radon, asbestos, silica, bis-cholomethyl-ethyl, nickel, arsenic, chromium, mustard gas, and uranium act on the respiratory system to cause what?
Lung Cancer
9-2
Occupational exposure to Silica, asbestos, and cobalt act on the respiratory system to cause what?
Fibrosis of the lung parenchyma
Occupational exposure to mercury acts on the nervous system to cause what?
Ataxic gait
9-2
Occupational exposure of mercury acts on the urinary system to cause what?
Renal Toxicity
Occupational exposure to lead and mercury act on the reproductive system to cayse what 3 things?
Male Infertility
Femal Infertility/Stillbirths
Teratogenesis
Occupational exposure to Benzene acts on the hematopoietic system to give rise to what?
Leukemia
Occupational Exposure to Vinyle Chloride acts on the GI tract and gives rise to what?
Liver angiosarcoma
The organic solvents chloroform and carbon tetrachloride are found in degreasing, dry cleaning, and paint removing agents. Acute exposure to high levels of these chemicals affect what major organ? What do we see with acute exposure
Exposure to low levels of those chemicals are most toxic to what two organs?
High levels:
CNS is affected, starting with dizziness and confusion > CNS depression and coma
Low Levels:
Kidney and Liver
Benzene and 1,3-butadiene are commonly exposed to rubber workers where we tend to see an increased risk of what disorder?
What organ do these compounds tend to affect the most?
Leukemia
Bone marrow
Benzene is oxidized by CYP2E1 into toxic metabolites that disrupt what process?
What is the result of the disruption, or in other words what 2 pathologies often develop with benzene exposure?
Hematopoietic stem cell differentiation in bone marrow
Marrow Aplasia
Acute Myeloid Leukemia (AML)
Benzene is fat and not cute leuking in the marrow
Which of the following occupational toxins is associated with combustion of fossil fuels and the cause of scrotal cancer in chimney sweeps?
A. Organochlorines
B. Chloroform and Carbon tetrachloride
C. Benzene and 1,3-Butadiene
D. Polycyclic Hydrocarbons
D. Polycyclic Hydrocarbons
Polycyclic hydrocarbons are among the most potent carcinogen and industrial exposure is implicated in the cancer development of what 2 organs?
A. Liver and Kidneys
B. Bladder and Kidney
C. Lung and Bladder
D. Lungs and Liver
Lungs and Bladder
I’d rather inhale pee than Polycyclic hydrocarbons
What are the names of 3 organochlorines that are synthetic lipophilic products that resit degredation that are found in pesticides?
Low level exposure to those 3 agents disrupt hormonal balance because of what 2 activities that make me “anti pesticides”?
DDT
PCB
Dioxin
Antiestrogenic and antiandrogenic
NOTE: think of the pesticides as being pesty to your gonads
I Dont Do Pesticides because I care about my ovaries
Chloracne is acne characterized by cyst formation, hyperpigmentation, and hyperkeratosis of the face and behind the ears. This folliculitis and dermatosis is associated with toxicities of what 2 substances? (Think of Victor Yushenko)
High exposure to these two toxins may cause morphologies in the face, but are most toxic to what two organs systems?
PCB and Dioxin
Victor would have turned out fine if he went to PCB and avoided dioxin
Liver and CNS
Low levels hurt my gonads, but high levels hurt my liver, face and brain
The image below is an example of Ferruginous bodies, and while they look like dumbells the interaction of the fibers and iron are from exposure to what substance? In other words what are these fibers made of?
These Ferruginous bodies are seen in what pathology that leads to increase risk of developing mesothelioma?
Asbestos and Iron
Asbestosis
What is pneumonconioses?
Exposure to what substances causes pneumoconioses?
Fibrosis of the lung parenchyma
Mineral dusts like asbestos, silica, coal dust, beryllium
Vinyl Chloride is an occupational health hazard, as exposure to vinyl chloride leads to the development of what issue in what organ?
Angiosarcomas of the Liver
Vinyl Lo(i)vers are a cancer
Bisphenol A or BPA lines almost all food bottles and cans, and is a disruptor of what?
Endocrine Disruptor
eating plastic disrupts my hormones
