9.1 Environmental & Nutritional Disorders Flashcards

1
Q

In healthy adults and children exposed to ozone what effects do we see with?

(3)

A

Decreased lung function

Lung inflammation

Lung inflammation

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2
Q

In asthmatics, outdoor workers, and athletes, what effects do we see when exposed to ozone?

A

Decreased exercise capacity

Increased hospitalizations

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3
Q

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):

A

Healthy adults: increased respiratory symptoms

People with chronic lung disease: increased mortality

Asthmatics (2): increased hospitalizations and decreased lung function

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4
Q

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

A

D. Sulfer dioxide exposure to people with chronic lung disease

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5
Q

What are the classic outdoor pollutants that make up the “witches brew”?

A

Ozone and sulfer dioxide

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6
Q

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

A

B. Soot (Particulate matter)

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7
Q

Particulates that are less than 10 um are the most harmful as they are able to travel to what location in the respiratory tract?

A

Alveoli

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8
Q

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

A. Bright red cytoplasm and loss of nuclei

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9
Q

CO kills through the induction of what two things?

A

CNS depression

Ischemia by competitively binding to Hb better than oxygen

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10
Q

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)

A

Brain swelling (edematous)

Puncate Hemorrhages

Hypoxia induced neuronal changes (red cytoplasm and loss of nuclei)

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11
Q

What is the hallmark presentation of a person who has suffered CO poisoning?

Where does CO tend to [] most in the brain (2)?

A

Cherry red skin and mucous membranes

Basal ganglia and Lenticulate nuclei

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12
Q

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

A

C. Paralysis of extensor muscles in the wrist and fingers

“wrist drop”

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13
Q

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

A

B. Calcium

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14
Q

What are the 5 toxicities that are associated with lead exposure?

A

Hematologic

Skeletal

Gastrointestinal

Neurologic

Renal

GNaSHeR

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15
Q

What are the morphologic or clincal changes we associated with the hematologic toxicities associated with lead exposure (3)?

A

Hypochromic microcytic anemia

Basophilic stippling

Ring sideroblasts

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16
Q

What are the morphologic or clincal changes we associated with the skeletal toxicities associated with lead exposure?

Why do these changes manifest?

A

Lead lines in metaphyses and gums

Lead competes with calcium and gets encorporated into teeth and bones

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17
Q

Lead lines are seen in the metaphyses of individuals due to lead interfering with what process?

A

Cartilage remodiling

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18
Q

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

A

C. Mercury and Lead

19
Q

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

A

Brain

Kidney

True

20
Q

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

A

B. Mercury

21
Q

Arsenic interferes with cellular metabolism and causes toxicities that are most prominant in what 4 locations?

A

GI tract

Skin

Heart

Nervous System

Arsenic? Have GIN

22
Q

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?

A

Hyperpigmentation

Hyperkeratosis

23
Q

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

A

B. Kidneys and Lungs

NOTE: we do see skeletal abnormalities associated with calcium loss

24
Q

What are 3 major clinical presentations of people exposed to cadmium?

A

Obstructive Lung Disease

Renal Tubular Loss

Skeletal abnormalities

25
Q

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

A

Cadmium

26
Q

Occupational exposure to CO and Lead act on the cardiovascular system to cause what?

A

Heart disease

9-2

27
Q

Occupational exposure to radon, asbestos, silica, bis-cholomethyl-ethyl, nickel, arsenic, chromium, mustard gas, and uranium act on the respiratory system to cause what?

A

Lung Cancer

9-2

28
Q

Occupational exposure to Silica, asbestos, and cobalt act on the respiratory system to cause what?

A

Fibrosis of the lung parenchyma

29
Q

Occupational exposure to mercury acts on the nervous system to cause what?

A

Ataxic gait

9-2

30
Q

Occupational exposure of mercury acts on the urinary system to cause what?

A

Renal Toxicity

31
Q

Occupational exposure to lead and mercury act on the reproductive system to cayse what 3 things?

A

Male Infertility

Femal Infertility/Stillbirths

Teratogenesis

32
Q

Occupational exposure to Benzene acts on the hematopoietic system to give rise to what?

A

Leukemia

33
Q

Occupational Exposure to Vinyle Chloride acts on the GI tract and gives rise to what?

A

Liver angiosarcoma

34
Q

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?

A

High levels:

CNS is affected, starting with dizziness and confusion > CNS depression and coma

Low Levels:

Kidney and Liver

35
Q

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?

A

Leukemia

Bone marrow

36
Q

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?

A

Hematopoietic stem cell differentiation in bone marrow

Marrow Aplasia

Acute Myeloid Leukemia (AML)

Benzene is fat and not cute leuking in the marrow

37
Q

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

A

D. Polycyclic Hydrocarbons

38
Q

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

A

Lungs and Bladder

I’d rather inhale pee than Polycyclic hydrocarbons

39
Q

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”?

A

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

40
Q

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?

A

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

41
Q

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?

A

Asbestos and Iron

Asbestosis

42
Q

What is pneumonconioses?

Exposure to what substances causes pneumoconioses?

A

Fibrosis of the lung parenchyma

Mineral dusts like asbestos, silica, coal dust, beryllium

43
Q

Vinyl Chloride is an occupational health hazard, as exposure to vinyl chloride leads to the development of what issue in what organ?

A

Angiosarcomas of the Liver

Vinyl Lo(i)vers are a cancer

44
Q

Bisphenol A or BPA lines almost all food bottles and cans, and is a disruptor of what?

A

Endocrine Disruptor

eating plastic disrupts my hormones