Chapter 9 Flashcards
Which form of radiation is associated with the following types of cancer?
AML
CML
Thyroid papillary carcinoma
Ionizing radiation
What type of radiation is related to UV light and microwaves?
Non-ionizing radiation
Which form of radiation is associated with the following types of cancer?
Basal Cell Carcinoma of the Skin
Squamous Cell Carcinoma of the Skin
Melanoma of the Skin
Non-ionizing
__________ radiation results in the formation of double-stranded breaks in DNA and ________ which damage DNA
Ionizing ; ROS
Deep partial thickness burns involve which layers of the skin?
- Epidermis,
2. Dermis
Describe a 3rd degree burn?
white charred, NO PAIN, due to nerve damage
Patients who have been hit by lightning will present with a characteristic _________skin finding
litchenburg figures
Serious burns can lead to what type of shock?
HYPOVOLEMIC
\- burns damage capillaries in the skin, leading to a significant increase in capillary permeability (allowing massive fluid efflux which is lost to environment since interstitium is exposed)
- Treated with IV fluids, life-threatening if not promptly dealt with
Which degree burn causes blistering of skin?
2nd degree
_______ are injuries to tissue caused by heat, chemicals, and/or radiation
BURNS
Types include:
chemical (acid/alkali), electrical
radiation (UV/medical), thermal (fire)
What 3 things are likely to colonize on person with burned skin?
- Pseudomonas aeruginosa
- Candida,
- MRSA
Pregnant Mother rushes into the ER and it is found that the placenta has prematurely separated from the uterine wall prior to delivering her baby. Which of the following could apply to this situation?
- malnutrition
- cocaine abuse
- recent tobacco cessation
- mother has history of hypotension
Answer : COCAINE
cocaine use during pregnancy can result in spontaneous abortion
________ intoxication can cause agitation, hypertension and pupillary
Cocaine
What drug intoxication presents as pupillary dilation, euphoria, hypertension, and paranoia that lasts for multiple hours?
Amphetamines (ecx. METH)
differs from cocaine because cocaine is SHORTER DURATION
What is the most lethal complication of cocaine intoxication?
Sudden cardiac death
-can occur with FIRST time users too! YIKES
Pt is undergoing chemotherapy and experiences alot of nausea. What can you prescribe to alleviate the symptoms?
Marijuana
-has antiemetic effects
What drug intoxication presents as conjunctival injection, increased appetite, paranoid delusions, and dry mouth?
Marijuana
-also may present with euphoria,
anxiety,
perception of slowed time, impaired judgment,
hallucinations
In the united states, the majority of overdose deaths are caused by _____
- opiods
- MDMA
- LSD
- bath salts
- OPiods
A 34-year-old white male presented with dyspnea, fatigue, and dry cough. Urine drug screen for benzodiazepine, narcotics, methamphetamines was unremarkable. Chest imaging showed pulmonary talcosis. Which of the following does the patient have?
- side effect of allergy medication
- user of oxycodone
- has a genetic predispostition
- works around silica
- heroin user
- when prompted this pt would admit to injecting oxycodone
TALCOSIS:
Often seen in heroin users where the heroin has been cut with talc OR injection of drugs intended for oral administration (ex benzos), regardless of route (inhalation or injection) talc causes pulmonary effects
Pt comes into urgent care with erythematous rash present diffusely throughout the upper torso. Patient denies recent travel , exposure to chemicals or new lotions. What is at the top of you differential?
Drug - induced hypersensitvity
MOST commonly presents as SKIN RASH
What 3 structures in the brain can be damaged as a result of Wenicke Korsakoff syndrom?
- cerebellar atrophy (anterior vermis)
- necrosis of mamillary bodies
- necrosis of 3rd and 4th ventricles
___________is characterized by a triad of opthalmoplegia, ataxia and confusion
Wernicke Korsakoff
-other symptoms include nystagmus, confabulation, personality change, and permanent memory loss
___________is a late manifestion of Wernicke encephalopathy characterized by confabulations,irreversible memory loss, and personality changes
KORSAKOFF syndrome
What are key characteristics of fetal alcohol syndrome?
microcephaly, small palpebral fissures, flat midface Low nasal bridge among other defects
Which vitamin is deficient in alcholism?
Vitamin B1 (THIAMINE)
First step in ethanol metabolism?
Ethanol may be converted to {acetaldehyde} via the enzyme alcohol dehydrogenase
With excessive alcohol consumption you build up NADH as you convert ethanol. What 2 things occur due to increased NADH (alcoholic oxidation)?
- increased lactic acidosis
2. fatty liver (b/c NAD is required for fatty acid oxidation)
Which enzyme has the SMALLEST contribution to ethanol metabolism?
Catalase
ADH and ALDH are the biggest contributors
Many Asians are deficient of the ethanol metabolism b/c of deficiency of________
Acetaldehyde dehydrogenase
Why should patients avoid alcohol consumption with any certain medications?
alcohol induces. CYP2E1 and delays other drug metabolism that requires the CYP
Which of the following function in a microsome?
- Cyp2E1
- Catalase
- ADH
- ALDH
- CYP2E1
Catalse : peroxisome
ADH: cytosol
ALDH: mitochondria
Exposure to Radon increases someones risk for ?
Lung cancer!
inhaled radon tend to deposit in the lungs
-URANIUM miners are increased risk
-
Pt presents with injury to small bowel. Symptoms of diarrhea , fever and vomtiing. What amount of total body ionizing radiation would cause these symptoms?
A. 1-0 Sv
B. 50 Sv
C. 10-20 Sv
D. 1-2 Sv
C. 10-20 Sv is related to small bowel injury
Telangiectasia is a histological finding for ?
CHRONIC radiation exposure
- in biopsy of skin you would seee
DERMATITIS
DERMAL FIBROSIS
and TELANGIECTASIA (web like veins)
An 8 y/o boy present with malnutrition and weight loss of about 80%. Which of the following would NOT be seen in this patient?
A. generalized edema
B. decreased fat stores
C. increased albumin
D. reduced arm circumference
C. decreased protein
ALL others are assoicuated with malnutrition
A patient recently underwent about 1 year of chemotherapy. They present with fatigue , weight loss over time and muscle atrophy. This patient is most likely to die from?
This patient exhibits CACHEXIA
Mortality would be caused by ATROPHY of diaphragm oR other respiratory muscles
A child is brought to you with an infection of a wound. In addition the child has chronic diarrhea nd flaky skin.
- What is a potential differential for this pt? \
- What additional symptoms would this kid have?
a. broomstick extremities
b. skin rash
c. muscle wasting
d. pitting edema
e. loss of subcutaneous fat
- Kwashiorkor
- D.
this condition present with HYPOalbuminemia which would result in edema
What type of PEM affects bedridden patients the most?
Secondary PEM ;
Enteric bacteria (Gut flora) produce vitamins, particularly Vitamins _____ and ______
K and Biotin
Calcium oxalate kidney stones may result from vitamin ____ abuse
Vitamin C
Toxicity :
calcium oxalate kidney stones and
iron toxicity
Regarding Vitamin A metabolism, how is it taken into the liver and where is it stored?
- via Apoprotein B
2. stored in ITO cells in liver
5 year old boy came to the hospital with his mother with complaints of diarrhea, skin redness, rashes and roughness of the skin associated with
some mental disorientation. This condition is due to the deficiency in ?
Niacin
(three Ds) dementia,dermatitis diarrhea
60-year-old woman with rheumatoid arthritis presents to her doctor with a 2-month history of fatigue and memory fading. She also reports feeling “wobbly” lately. Blood smear shows hypersegmented neutrophils. Which of the following could be a cause of her symptoms?
A.Vitamin A deficiency
B. Vitamin D toxicity
C. Vitamin B12 deficiency
D.Niacin deficiency
C. B12
B12 deficiency associated with memory issues and is a cause of megaloblastic anemia which was hinted by the hypersegmented neutrophils
Wobbly because B12 deficiency causes degeneration of spinal cord tracts.
Which virus can benefit from Vitamin A supplementation?
Measles in children
pg 437