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environment and brain student presentations > Antibiotics, Infrasound, Loud Music, Mountain Biking, and Percussion Drills > Flashcards

Antibiotics, Infrasound, Loud Music, Mountain Biking, and Percussion Drills Flashcards

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1
Q

Are aminoglycoside antibiotics bacteriostatic or bactericidal? (1)

A

Bactericidal

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2
Q

Which type of antibiotics has the biggest risk for hearing loss? (1)

Give four examples. (4)

Give another type which also increases risk. (1)

Give two examples. (2)

A

Aminoglycosides

Streptomycin; kanamycin; gentamycin; neomycin

Macrolides

Erythromycin; azithromycin

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3
Q

Give an occupational risk for antibiotic-induced hearing loss. (1)

A

Healthcare workers preparing drug

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4
Q

True or false? Explain your answer if necessary. (1)

Ototoxic effects of antibiotics always occur during the course of the antibiotics.

A

False - effects can occur during or after the course (sudden or gradual onset)

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5
Q

Give three vestibulotoxic signs/symptoms of antibiotics. (3)

A
  • Dizziness
  • Vertigo
  • Balance issues
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6
Q

Give two cochleotoxic signs/symptoms of antibiotics. (2)

A

Hearing impairment (especially high-pitched sounds)

Tinnitus

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7
Q

Name the type of hearing loss that is associated with antibiotics. (1)

ie. conductive or sensorineural

A

Sensorineural

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8
Q

Which two aminoglycoside antibiotics are vestibulotoxic? (2)

A

streptomycin

gentamycin

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9
Q

Which two aminoglycoside antibiotics are cochleotoxic? (2)

A

neomycin

kanamycin

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10
Q

Describe how aminoglycoside antibiotics enter the inner ear from the bloodstream. (1)

A

Enter endolymph through transporters on the blood-labyrinth barrier

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11
Q

Describe a factor which may increase aminoglycoside antibiotic uptake into the inner ear. (3)

A
  • Blood vessel dilation
  • caused by systemic inflammation
  • and noise
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12
Q

How do aminoglycoside antibiotics enter stereocilia or hair cells in the inner ear? (1)

A

Via mechanically-gated transmembrane channel-like protein 1 (TMC1)

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13
Q

Give five effects of aminoglycoside antibiotics on hair cells in the inner ear, once they have entered the hair cells. (5)

A
  • Bind to protein and lipids
  • Blockade of K channels
  • Dysregulation of ER
  • Degradation of presynaptic ribbons and synaptophysin
  • Kills hair cells
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14
Q

How is damage to the hair cells in the inner ear typically shown (what measurement is made)? (1)

A

DPAOE shifts (distortion product auditory otoacoustic emissions)

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15
Q

Give two risk factors which increase risk of antibiotic-induced hearing loss. (2)

A

Mitochondrial mutations (cause higher affinity aminoglycoside binding)

Sepsis and inflammation

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16
Q

Give six treatments or mitigative strategies aimed at reducing antibiotic-induced hearing loss. (6)

A
  • Do not overuse antibiotics
  • Audiometric testing during antibiotic course
  • Use alternative antibiotics
  • Antioxidants (antibiotics may produce free radicals)
  • Making larger antibiotic molecules (which don’t get into hair cells)
  • NMDA antagonists may prevent ototoxicity
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17
Q

What is infrasound? (1)

Relate this to human auditory capabilities. (1)

A

Low frequency sound (1.5-20Hz)

Beyond human auditory capabilities

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18
Q

Give four environmental sources (with examples where appropriate) of infrasound. (4)

A
  • Communication between animals
  • Horror films
  • Environmental sources (volcanoes; avalanches; earthquakes; ocean waves)
  • Man-made sources (aeroplanes; explosions; engines)
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19
Q

True or false? Explain your answer if necessary. (1)

Everyday levels of infrasound are thought to be much higher than what is safe.

A

False - everyday levels are thought to be very low

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20
Q

Give four potential symptoms caused by infrasound. (4)

A
  • Nausea
  • Dizziness
  • Fatigue
  • Ear ringing
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21
Q

Is infrasound detected by outer or inner hair cells in the cochlea? (1)

What is the normal role of these hair cells? (1)

A

Outer hair cells

Determine sensitivity to sound

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22
Q

Give four brain regions which show activity on fMRI on exposure to infrasound. (4)

A
  • Auditory cortex
  • Right superior temporal gyrus
  • ACC
  • Amygdala
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23
Q

Describe the general mechanism by which infrasound may increase anxiety. (2)

A
  • Upregulates expression of CRH (from PV nucleus of hypothalamus)
  • Activation of HPA axis
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24
Q

Describe the effect that infrasound is thought to have on microglia, and the mechanism of this effect. (3)

A
  • Neuroinflammation and more activated microglia
  • Upregulation of CRH receptor on microglia
  • Immunocytochemistry shows increased activated microglial markers (Iba1; OX42); activated microglial morphology; and increased CRH receptor expression
25
Q

Antalarmin can block the CRH receptor on microglia.

What would be the expected effect of exposure to antalarmin and infrasound? (2)

A

Blocked CRH receptor on microglia

So less infrasound-induced microglial activation

26
Q

Describe how important the everyday exposure to infrasound from diesel engines and machinery is thought to be to humans? (1)

A

Found to pose no everyday danger

27
Q

Describe a concern about a specific environmental source of infrasound, and how this may be mitigated. (2)

A

Worry about wind turbines causing infrasound (wind turbine syndrome)

However renewable energy sources are vital, so more thought may be required into placement of wind farms & government planning rules

28
Q

Give a proposed treatment for infrasound-induced CNS damage and neuroinflammation. (1)

Describe the proposed mechanism of this treatment. (1)

A

Epigallocatechin gallate (EGCG) found in green tea

May inhibit microglial activation triggered by infrasound

29
Q

Describe the deafness caused by loud music, in terms of:

  • Partial or complete
  • One or both ears
  • Other accompanying symptoms

(3)

A
  • Can be partial or complete
  • Can be one or both ears
  • Can be accompanied by tinnitus
30
Q

Give five symptoms or psychological consequences that can accompany loud music-induced deafness. (5)

A
  • Anxiety
  • Insomnia
  • Depression
  • Social isolation
  • Exclusion
31
Q

Give (and describe if required) four risk factors for loud music-induced deafness. (4)

A
  • Ageing
  • Genetics (eg. blood group; gender)
  • Duration and proximity of noise
  • Lower income (urban living areas; jobs with heavy machinery)
32
Q

Give a reason why loud music-induced deafness may be increasing in younger populations. (1)

A

Due to portable music players

33
Q

Give seven environmental sources of loud music that could lead to deafness. (7)
(Including occupational exposure)

A
  • Portable music players
  • Concerts
  • Clubs
  • Noisy homes and living environments (eg, living next to airport)
  • Occupational exposure (eg, heavy machinery)
  • Natural disasters (earthquakes; volcanoes)
  • Military (gunshots; explosions)
34
Q

Describe what is classified as ‘dangerously loud’ sound levels. (1)

A

Prolonged exposure (8hrs a day) of sound levels exceeding 85dB

35
Q

Describe the regenerative capacity of the organ of corti. (1)

A

Organ of Corti does not spontaneously regenerate when sensory cells are lost

36
Q

Give six mechanisms by which loud music may induce deafness in the organ of Corti. (6)

A
  • Mechanical destruction
  • Oxidative stress
  • Calcium ion overload and activation of calpain (due to increased opening of VGCCs)
  • Glutamate excitotoxicity
  • Potassium toxicity (outflow of K and synapse degeneration)
  • Inflammatory response after intense noise exposure
37
Q

Describe how loud music causes mechanical destruction of the organ of Corti. (3)

A

Large vibrations

cause stereocilia to detach from tectorial membrane

and hair cells detach from basilar membrane

38
Q

Describe how loud music causes oxidative stress of the organ of Corti. (4)

A
  • Intense noise exposure causes vasoconstriction in cochlea
  • Inner ear ischaemia-reperfusion following noise
  • Mitochondrial injury
  • ROS/RNOS production
39
Q

Give six gene alterations which may interact with loud music neurobiological pathways to increase risk of deafness. (6)

A
  • Nrf2 polymorphism (normally produces antioxidants such as glutathione)
  • SOD mutations
  • Mutations in voltage-gates K channels
  • Depletion of glutamate-aspartate transporter (GLAST)
  • Heat shock protein synthesis
  • Procaherin, myosin, and P2X2 receptor mutations
40
Q

Give six potential pharmacological treatments to reduce or prevent loud music-induced hearing loss. (6)

Some of these are preclinical.

A
  • Oridonin (blocks some inflammation in ear)
  • AMPA receptor blockade
  • Potassium channel blockers
  • Glucocorticoids
  • Neurotrophins (promote neurite outgrowth from auditory nerve)
  • Allopurinol
41
Q

Give three possible mitigative strategies aimed to reduce loud music-induced hearing loss. (3)

A
  • Workplace adaptations (noise exposure and ear defenders; noise at work regulations)
  • Technology showing when music is too loud
  • Hearing protection during loud recreational activities
42
Q

Describe the danger to humans of mountain biking and percussion drills. (1)

A

Repetitive and intense vibrations affecting hands and arms leads to neurological issues

43
Q

Give four environmental ‘sources’, or ways that people can be exposed to repetitive vibrations. (4)

A
  • Mountain biking trials
  • Construction sites
  • Manufacturing plants
  • Mining
44
Q

Give seven risk factors which may increase damage from mountain biking, percussion drills, or other forms of intense vibration. (7)

A
  • Uneven/rocky terrain
  • Unpredictable weather conditions
  • Ground instability for percussion drills
  • Geological conditions
  • Duration/intensity of vibration exposure
  • Pre-existing medical conditions
  • Potentially gender (maybe more male than female)
45
Q

Name the three components of hand-arm vibration syndrome. (3)

A
  • Vascular
  • Neurological
  • Musculoskeletal
46
Q

Describe two vascular symptoms for hand-arm vibration syndrome. (2)

A
  • Vasoconstriction (coldness and pallor of fingers)
  • Vascular disturbances (tingling or numbness of fingers)
47
Q

Describe two neurological symptoms for hand-arm vibration syndrome. (2)

A
  • Peripheral neuropathy (loss of sensation; paraesthesia in fingers)
  • Loss of dexterity (impaired fine motor skills)
48
Q

Describe three musculoskeletal symptoms for hand-arm vibration syndrome. (3)

A
  • Hand-arm pain
  • Loss of grip strength
  • Muscle fatigue
49
Q

Describe why some people with hand-arm vibration syndrome can experience sensorineural hearing loss. (1)

A

Vibrations transmitted to head and inner ear

50
Q

Describe the general neurobiological mechanism by which vibrations can cause tissue damage. (4)

A
  • Mechanical stress on tissues (can travel through muscles, ligaments, and blood vessels; causing them to deform and oscillate)
  • Mechanosensitive channels activated
  • Calcium influx into cells
  • Excitotoxicity and cell death
51
Q

Give six specific effects that vibration can have on peripheral nerves. (6)

A
  • Inflammation (irritation of nerves)
  • Compression
  • Demyelination
  • Axonal atrophy
  • Degeneration of cell bodies (sensory loss)
  • Blood supply to nerves may be lost
52
Q

Which specific part of the brain may be altered in hand-arm vibration syndrome? (1)

A

Somatosensory cortex representation of the hands

53
Q

Describe how hand-arm vibration syndrome may lead to carpal tunnel syndrome. (2)

A

Connective tissue inflammation

Lesions in myelin sheath

54
Q

Describe the neurobiological mechanism by which hand-arm vibration syndrome can cause white finger syndrome. (3)

A
  • Reduced production of NO by blood vessels
  • Mechanical stress and disruption of endothelium
  • Disruption of blood flow to fingers
55
Q

Describe a potential reason why there may be fewer vascular symptoms of hand-arm vibration syndrome in warmer climates. (1)

A

Due to heat causing vasodilation

56
Q

Give four ways that hand-arm vibration syndrome may be prevented in the workplace. (4)

A
  • Alternative work method
  • Replace old/worn-out equipment & regular equipment maintenance
  • Appropriate work clothing (keeping warm & dry improves blood flow)
  • Reduce exposure in the workplace
57
Q

Give nine potential treatments for hand-arm vibration syndrome and other vibration-related conditions, including both pharmacological and lifestyle changes. (9)

A
  • Physical therapy
  • Calcium channel blockers
  • Pentoxifylline (improves blood flow)
  • Smoking cessation
  • Pain medications
  • Avoid caffeine and alcohol (these affect blood vessel dilation)
  • Wrist-splinting for CTS
  • Cold packs and NSAIDs for muscular/inflammatory symptoms
  • Steroid injections for CTS
58
Q

Describe a regulation which aims to improve vibration-related conditions such as hand-arm vibration syndrome. (2)

A
  • Workplace regulations
  • HAVS, VWF, and CTS all covered under workplace regulations

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