Chapter 9- Environmental And Nutritional Disease Flashcards by Taylor Horlock

What is environmental disease?

Conditions caused by exposure to chemical or physical agents in the environment

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What is personal environment based on?

Individual behaviour

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What is disability adjusted life year (DALY) a metric of?

Combines years lost to premature death and years lived with illness/disability

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What is the single leading cause of health loss?

Under-nutrition

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What contributes to increasing worldwide mortality?

HIV/AIDS

Emerging infectious disorders

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How will climate change affect health?

Heat waves and air pollution- CV and respiratory disease increased

Flooding and environmental disruptions- gastroenteritis and infection epidemics

Expanding areas affected by vector-borne diseases

Crops affected- malnutrition

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What are xenobiotics?

Exogenous compounds absorbed by the body

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Most solvents/drugs are hydrophilic or lipophilic?

Lipophilic

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What are the phases of drug metabolism?

Phase I- cytochrome P450

Phase II- metabolism into water soluble compounds (less toxic)

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What are the reactions associated with Phase I metabolism?

Hydrolysis

Oxidation

Reduction

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What are the reactions of Phase II metabolism?

Glucuronidation

Sulfation

Methylation

Conjugation with glutathione (antioxidant)

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How does air pollution affect health?

Reduces pulmonary function

Lung inflammation

Increased airway reactivity

Diminished mucociliary clearance

Increased infections

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What are some examples of outdoor pollutants and how do they cause harm?

Ozone- free radical production

SO2- conversion to sulfuric acid causes burning, dyspnea, hyperreactivity

Particulate matter- inflammation

CO- CNS depression and systemic hypoxia

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What is characteristic of CO poisoning?

Cherry red colouring

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What are some examples of indoor pollutants?

Wood smoke

Bioaerosols

Radon

Formaldehyde

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What metals cause toxicity and how do they exert their effects?

Lead- competes with Ca, accumulation in bones and teeth, neurotoxicity, disrupts heme synthesis (anemia), GI pain and anorexia

Mercury- lipid soluble, CNS accumulation

Arsenic- inhibition of ox phos, GI, CV and neurovascular disease, skin and lung cancer (chronic low levels)

Cadmium- alveolar mac necrosis and renal tubular damage

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What are common occupational health risks?

Organic solvents

Polycyclic hydrocarbons

Organochlorines

Dioxins and PCBs

Mineral dust

Vinyl chloride

BPA

Asbestos

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What is the most common cause of exogenous malignancy?

Tobacco

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How does tobacco affect health?

90% of lung cancers

CV and chronic pulmonary disease

Atherosclerosis and MI

Bladder and pancreatic cancer

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Together with alcohol, tobacco increases the risk of what cancer?

Laryngeal

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How is alcohol metabolized?

Converted in the liver to acetaldehyde and then acetate by CYPs

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What are the acute symptoms of alcohol ingestion?

CNS depression

Hepatic fatty change

Gastritis

Ulceration

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What are the chronic effects of alcohol consumption?

Hepatitis and cirrhosis

GI tract bleeding and esophageal varices

Wernicke-Korsakoff syndrome

Cerebral and cerebellar atrophy

Cardiomyopathy

Pancreatitis

FAS

Increased risk of many cancers

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What is Wernicke-Korsakoff syndrome?

Thiamine deficiency leading to psychosis and memory disorder

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What therapeutic drugs can cause injury?

Anticoagulants HRT- endometrial dysplasia Oral contraceptives- hepatoma Acetaminophen Aspirin

What are the different kinds of mechanical traumas?

Abrasion- superficial Contusion- blunt force Incision- smooth, clean cut Laceration- tear/disruptive stretching Puncture- instrument or gunshot

What are the two types of puncture?

1. Penetrating- pierced | 2. Perforating- entrance and exit wound

What does the clinical significance of burns depend on?

1. Depth 2. Percentage of body surface 3. Internal injuries (inhalation) 4. Promptness and efficacy of post-burn therapy

What layers do the different depths of burns effect?

1. Superficial- epidermis 2. Partial thickness- dermis 3. Full thickness- subcutaneous

What causes hyperthermia?

Prolonged exposure to elevated temperatures

What causes hypothermia?

Prolonged exposure to low temperatures

How does hypothermia cause direct and indirect injury?

Direct- slow freezing causes large crystal formation and artifact Indirect- vasoconstriction and increased vascular permeability

What are the effects of electrical injury?

Burns V-fib Cardiac/respiratory centre failure

What is the difference between ionizing and non-ionizing radiation?

Ionizing- short, high frequency waves (x and gamma) Non-ionizing- long and low frequency (UV, IR, radio, micro and sound)

What is a curie?

Amount of radiation emitted from a source

What is a gray?

Energy absorbed by a target tissue

What is a Sievert?

The biological effect of a particular radiation dose

What affects an injury caused by ionizing radiation?

Rate of delivery Field size Cell proliferation Oxygen effects/hypoxia Vascular damage

How do high/intermediate doses of ionizing radiation differ in their effects?

High- overt necrosis Intermediate- kills proliferating cells

What is the difference between primary and secondary malnutrition?

Primary- components are missing from diet Secondary- malabsorption, impaired utilization/storage, excess loss or increased need

What is Marasmus?

Weight loss >60% Protein and fat are mobilized from the somatic compartment Serum protein levels maintained (calorie and protein reduced similarly)

What is Kwashiokor?

Protein deprivation exceeds overall calorie reduction Loss from visceral compartment Hypoalbuminema leads to edema

What is cachexia?

PEM I’m chronically ill patients

What is anorexia nervosa? What are its characteristics?

Self induced starvation Amenorrhea Reduced thyroid hormone Reduced bone density Sudden death- arrhythmias, hypokalemia

What is bulimia and it’s characteristics?

Binge eating followed by vomiting Amenorrhea Hypokalemia Pulmonary aspiration Esophageal and gastric rupture

How many vitamins are required for health?

What vitamins are fat soluble?

A, D, E and K

What are the functions of vitamin A?

Vision maintenance Cell growth and differentiation regulation Lipid metabolism regulation

Where is 90% of vit A found?

Ito liver cells

What are the effects of vit A deficiency?

Xerophthalmia Keritinizing metaplasia of epithelial surfaces Desquamation of keritinized epithelium

What are the effects of vit A toxicity?

Weight loss Nausea Bone/joint pain Fracture

What is the function of vit D?

Maintenance of plasma calcium and phosphorus Stimulates calcium reabsorption (reduces blood levels)

What are the effects of vit D deficiency?

Deficient calcium and phosphorus absorption Bone softening and weakness

What are the two forms of vit D deficiency?

Ricket’s- children Osteomalacia- adults

What is the function of vit C?

Collagen formation Antioxidant

What are the effects of vit C deficiency?

Scurvy Hemorrhage and poor healing Inadequate bone formation in children

What is obesity?

Excess adiposity and body weight

What is adipose a source of?

Pro-inflammatory cytokines Hormones

What are the three gut hormones and their functions?

Ghrelin- increases food intake PYY- decreases food intake Insulin- increased glycogen formation

What are the consequences of obesity?

Metabolic syndrome DMII CAD- hypertroglyceridemia and low LDL Non-alcoholic steatohepatitis Cholelithiasis Hypoventilation syndrome- sleep apnea Osteoarthritis Cancer association

What are the symptoms of metabolic syndrome?

Visceral adiposity Insulin resistance Hypertension Dyslipidemia

What dietary components may lead to the endogenous synthesis of carcinogens?

Aflatoxin (HBV)

What are common exogenous carcinogens in diet?

Pesticides and herbicides

How might diet affect atherosclerosis?

LDL:HDL ratio