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Pathology > Chapter 9- Environmental And Nutritional Disease > Flashcards

Chapter 9- Environmental And Nutritional Disease Flashcards

1
Q

What is environmental disease?

A

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

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2
Q

What is personal environment based on?

A

Individual behaviour

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3
Q

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

A

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

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4
Q

What is the single leading cause of health loss?

A

Under-nutrition

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5
Q

What contributes to increasing worldwide mortality?

A

HIV/AIDS

Emerging infectious disorders

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6
Q

How will climate change affect health?

A

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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7
Q

What are xenobiotics?

A

Exogenous compounds absorbed by the body

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8
Q

Most solvents/drugs are hydrophilic or lipophilic?

A

Lipophilic

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9
Q

What are the phases of drug metabolism?

A

Phase I- cytochrome P450

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

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10
Q

What are the reactions associated with Phase I metabolism?

A

Hydrolysis

Oxidation

Reduction

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11
Q

What are the reactions of Phase II metabolism?

A

Glucuronidation

Sulfation

Methylation

Conjugation with glutathione (antioxidant)

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12
Q

How does air pollution affect health?

A

Reduces pulmonary function

Lung inflammation

Increased airway reactivity

Diminished mucociliary clearance

Increased infections

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13
Q

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

A

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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14
Q

What is characteristic of CO poisoning?

A

Cherry red colouring

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15
Q

What are some examples of indoor pollutants?

A

Wood smoke

Bioaerosols

Radon

Formaldehyde

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16
Q

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

A

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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17
Q

What are common occupational health risks?

A

Organic solvents

Polycyclic hydrocarbons

Organochlorines

Dioxins and PCBs

Mineral dust

Vinyl chloride

BPA

Asbestos

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18
Q

What is the most common cause of exogenous malignancy?

A

Tobacco

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19
Q

How does tobacco affect health?

A

90% of lung cancers

CV and chronic pulmonary disease

Atherosclerosis and MI

Bladder and pancreatic cancer

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20
Q

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

A

Laryngeal

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21
Q

How is alcohol metabolized?

A

Converted in the liver to acetaldehyde and then acetate by CYPs

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22
Q

What are the acute symptoms of alcohol ingestion?

A

CNS depression

Hepatic fatty change

Gastritis

Ulceration

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23
Q

What are the chronic effects of alcohol consumption?

A

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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24
Q

What is Wernicke-Korsakoff syndrome?

A

Thiamine deficiency leading to psychosis and memory disorder

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25
Q

What therapeutic drugs can cause injury?

A

Anticoagulants

HRT- endometrial dysplasia

Oral contraceptives- hepatoma

Acetaminophen

Aspirin

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26
Q

What are the different kinds of mechanical traumas?

A

Abrasion- superficial

Contusion- blunt force

Incision- smooth, clean cut

Laceration- tear/disruptive stretching

Puncture- instrument or gunshot

27
Q

What are the two types of puncture?

A
  1. Penetrating- pierced

2. Perforating- entrance and exit wound

28
Q

What does the clinical significance of burns depend on?

A
  1. Depth
  2. Percentage of body surface
  3. Internal injuries (inhalation)
  4. Promptness and efficacy of post-burn therapy
29
Q

What layers do the different depths of burns effect?

A
  1. Superficial- epidermis
  2. Partial thickness- dermis
  3. Full thickness- subcutaneous
30
Q

What causes hyperthermia?

A

Prolonged exposure to elevated temperatures

31
Q

What causes hypothermia?

A

Prolonged exposure to low temperatures

32
Q

How does hypothermia cause direct and indirect injury?

A

Direct- slow freezing causes large crystal formation and artifact

Indirect- vasoconstriction and increased vascular permeability

33
Q

What are the effects of electrical injury?

A

Burns

V-fib

Cardiac/respiratory centre failure

34
Q

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

A

Ionizing- short, high frequency waves (x and gamma)

Non-ionizing- long and low frequency (UV, IR, radio, micro and sound)

35
Q

What is a curie?

A

Amount of radiation emitted from a source

36
Q

What is a gray?

A

Energy absorbed by a target tissue

37
Q

What is a Sievert?

A

The biological effect of a particular radiation dose

38
Q

What affects an injury caused by ionizing radiation?

A

Rate of delivery

Field size

Cell proliferation

Oxygen effects/hypoxia

Vascular damage

39
Q

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

A

High- overt necrosis

Intermediate- kills proliferating cells

40
Q

What is the difference between primary and secondary malnutrition?

A

Primary- components are missing from diet

Secondary- malabsorption, impaired utilization/storage, excess loss or increased need

41
Q

What is Marasmus?

A

Weight loss >60%

Protein and fat are mobilized from the somatic compartment

Serum protein levels maintained (calorie and protein reduced similarly)

42
Q

What is Kwashiokor?

A

Protein deprivation exceeds overall calorie reduction

Loss from visceral compartment

Hypoalbuminema leads to edema

43
Q

What is cachexia?

A

PEM I’m chronically ill patients

44
Q

What is anorexia nervosa? What are its characteristics?

A

Self induced starvation

Amenorrhea

Reduced thyroid hormone

Reduced bone density

Sudden death- arrhythmias, hypokalemia

45
Q

What is bulimia and it’s characteristics?

A

Binge eating followed by vomiting

Amenorrhea

Hypokalemia

Pulmonary aspiration

Esophageal and gastric rupture

46
Q

How many vitamins are required for health?

A

13

47
Q

What vitamins are fat soluble?

A

A, D, E and K

48
Q

What are the functions of vitamin A?

A

Vision maintenance

Cell growth and differentiation regulation

Lipid metabolism regulation

49
Q

Where is 90% of vit A found?

A

Ito liver cells

50
Q

What are the effects of vit A deficiency?

A

Xerophthalmia

Keritinizing metaplasia of epithelial surfaces

Desquamation of keritinized epithelium

51
Q

What are the effects of vit A toxicity?

A

Weight loss

Nausea

Bone/joint pain

Fracture

52
Q

What is the function of vit D?

A

Maintenance of plasma calcium and phosphorus

Stimulates calcium reabsorption (reduces blood levels)

53
Q

What are the effects of vit D deficiency?

A

Deficient calcium and phosphorus absorption

Bone softening and weakness

54
Q

What are the two forms of vit D deficiency?

A

Ricket’s- children

Osteomalacia- adults

55
Q

What is the function of vit C?

A

Collagen formation

Antioxidant

56
Q

What are the effects of vit C deficiency?

A

Scurvy

Hemorrhage and poor healing

Inadequate bone formation in children

57
Q

What is obesity?

A

Excess adiposity and body weight

58
Q

What is adipose a source of?

A

Pro-inflammatory cytokines

Hormones

59
Q

What are the three gut hormones and their functions?

A

Ghrelin- increases food intake

PYY- decreases food intake

Insulin- increased glycogen formation

60
Q

What are the consequences of obesity?

A

Metabolic syndrome

DMII

CAD- hypertroglyceridemia and low LDL

Non-alcoholic steatohepatitis

Cholelithiasis

Hypoventilation syndrome- sleep apnea

Osteoarthritis

Cancer association

61
Q

What are the symptoms of metabolic syndrome?

A

Visceral adiposity

Insulin resistance

Hypertension

Dyslipidemia

62
Q

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

A

Aflatoxin (HBV)

63
Q

What are common exogenous carcinogens in diet?

A

Pesticides and herbicides

64
Q

How might diet affect atherosclerosis?

A

LDL:HDL ratio

Pathology (25 decks)

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