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MOD > Chapter 9 Part 2 > Flashcards

Chapter 9 Part 2 Flashcards

1
Q

Deaths associated with alcohol use include…

A

drunken driving, alcohol-related homicides, suicide, cirrhosis of the liver

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2
Q

How is alcohol distributed throughout the body?

A

in direction proportion to the blood level!

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3
Q

Legal definition of drunk driving in US

A

80 mg/dL

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4
Q

BA level that causes drowsiness

A

200mg/dL

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5
Q

BA level that causes stupor

A

300 mg/dL

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6
Q

In what form is alcohol found in blood?

A

Acetaldehyde

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7
Q

Enzyme responsible for EtOH oxidation

A

alcohol dehydrogenase

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8
Q

CYP involved in alcohol breakdown

A

CYP2E1

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9
Q

Decrease in NAD causes…

A

fat accumulation in liver

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10
Q

Alcohol cerebellar degeneration

A

atrophy of superior part of vermis

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11
Q

acute alcoholism sxs

A

CNS depression, hepatic steatosis, acute gastritis, ulceration

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12
Q

Chronic alcoholism impact on liver

A

steatosis, alcoholic hepatitis, cirrhosis, portal hypertension, increased risk for hepatocellular carcinoma

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13
Q

Chronic alcoholism impact on GI

A

bleeding from gastritis, gastric ulcer, esophageal varices

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14
Q

Chronic alcoholism impact on Thiamine

A

peripheral neuropathy and wernicke-korsakoff due to deficiency, cerebral atrophy, cerebellar degeneration

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15
Q

Chronic alcoholism on alcoholic cardiomyopathy

A

dilated congestive cardiomyopathy, decrease HDL and increase in coronary heart dz

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16
Q

Positive effects of moderate amounts of alcohol

A

increase HDL, inhibit platelet aggregation, decrease levels of fibrinogen

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17
Q

Wernicke encephalopathy

A

occurs due to thiamine deficiency, acute psychotic symptoms and ophthalmoplegia, hemorrhage of mamillary bodies

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18
Q

Korsakoff syndrome

A

disturbances of short term memory and confabulation

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19
Q

Definition of adverse drug reaction

A

untoward effects of drugs given in therapeutic settings

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20
Q

Presentation of drug-induced hypersensitivity

A

skin rashes most common

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21
Q

Two drugs that most frequently cause adverse reactions

A

warfarin and dabigatran –excessive bleeding or thrombosis

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22
Q

Action of warfarin

A

Vitamin K antagonist

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23
Q

Action of dabigatran

A

inhibits thrombin

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24
Q

What is menopausal hormone theory?

A

Hormone replacement for post-menopausal women containing estrogens and progesterone

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25
Q

Adverse reactions associated with MHT

A

increased risk of breast CA, VTE–should not be used long term

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26
Q

Oral Contraceptive AE conclusions

A

does not increase breast CA, increase risk of cervical CA, 3-6x increase in VTE, does not increase CAD in young women but increases 2x in smokers>35, hepatic adenoma

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27
Q

AR associated with anabolic steroids

A

stunted growth, acne, gynecomastia, testicular atrophy, facial hair and menstrual changes in females, psych issues, increased MI risk

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28
Q

AR associated with acetaminophen

A

centrilobular necrosis that may progress to liver failure

29
Q

What enzyme breaks down acetaminophen?

A

CYP2E1

30
Q

Acetaminophen breakdown metabolites

A

NAPQ, combines with glutathione

31
Q

Injury produced by NAPQI

A

binding to hepatic proteins, depletion of GSH leading to increased risk of ROS damage

32
Q

AR associated with aspirin

A

acts on brain (alkalosis by stimulating medulla) leading to metabolic acidosis, nausea, coma

33
Q

Chronic aspirin toxicity

A

HA, dizziness, tinnitus, bleeding, coma, vomiting, diarrhea, gastric ulceration, analgesic nephropathy

34
Q

Side affects of cocaine

A

intense euphoria and stimulation, HTN, tachycardia, arrhythmia, myocardial ischemia, hyperpyrexia, fetal hypoxia and spontaneous abortion, perforated nasal septum, decreased lung capacity

35
Q

Neurotransmitters involved in cocaine usage

A

DA and NE

36
Q

AE of opiates

A

resp depression, arrhythmia, cardiac arrest, pulmonary edema, endocarditis, lung abscess, foreign body granulomas, amyloidosis, glomerulosclerosis

37
Q

Effects of opiates on CNS

A

euphoria, hallucination, somnolence, sedation

38
Q

AE of methamphetamine

A

violent behavior, confusion, psychotic sx

39
Q

AE of MDMA

A

increase in serotonin, euphoria; decreases 5HT receptors and synthesis, increase adrenergic and DA effects

40
Q

Marijuana AE

A

increased heart rate, possible change in BP causing angina in CAD pt, cognitive and psychomotor impairment, carcinogens

41
Q

AE of glue sniffing

A

cognitive abnormalities, MRI-detectable brain damage, violence, aggressive behavior

42
Q

AE of bath salts

A

agitation, psychosis, MI, suicide

43
Q

What does the clinical significance of a burn injury depend on?

A

depth of burn, percent of body covered by burn, internal injuries, promptness and efficacy of treatment

44
Q

First degree burn

A

superficial, epidermis only

45
Q

second degree burn

A

partial thickness, epidermis and dermis (blistering

46
Q

third degree burn

A

full thickness, extending to subcutaneous tissue

47
Q

Pathogenesis of shock in burn victims

A

burns>20% body surface causes rapid shift of body fluids to interstitial compartment; generalized edema and pulm edema can be severe, develops a hypermetabolic state causing increased heat loss and increased need for nutritional support

48
Q

Pathogenesis of sepsis in burn victims

A

burn site ideal for microorganism so most will be colonized, most commonly with P. aeruginosa, MRSA, candida

49
Q

Pathogenesis of respiratory insufficiency in burn victims

A

within 24-48 hours, direct heat effects upper airway and noxious gas inhalation can lead to inhalation and airway obstruction

50
Q

Pathogenesis of hypertrophic scars in burn victims

A

original bone and site of graft may have excessive collagen deposition

51
Q

Heat cramps result from… and cause…

A

Result from loss of electrolytes and cause cramping of muscles

52
Q

Heat exhaustion results from… and causes…

A

Results from hypovolemia caused by dehydration and causes collapse

53
Q

Heat stroke caused by… and leads to…

A

lack of sweating leads to multiorgan dysfunction, hyperkalemia, tachycardia, arrhythmia, RYR1 stimulation causing muscle contraction

54
Q

Malignant hyperthermia

A

RYR1 mutation characterized by “heat-stroke-like” rise in body temp and muscle contractures following exposure to anesthetics

55
Q

Pathogenesis of hypothermia

A

physical disruptions within cells caused by water crystallization; vasoconstriction and increased vascular permeability leading to edema and hypoxia

56
Q

Clinical symptoms of hypothermia

A

loss of consciousness, bradycardia, afib

57
Q

Types of electrical injuries

A

Burns, vfib or cardiac resp failure

58
Q

Sources of ionizing radiation

A

x-rays, gamma rays, high energy neutrons, alpha and beta particles

59
Q

AE of ionizing radiation

A

fibrosis, mutagenesis, carcinogenesis, teratogenesis

60
Q

Curie (Ci)

A

radiation emitted

61
Q

Gray (Gy)

A

energy absorbed by target tissue

62
Q

Sievert (Sv)

A

equivalent dose that responds to absorbed dose multiplied by relative biologic effectiveness of radiation

63
Q

Determinants of radiation effect

A

rate of delivery, field size, cell proliferation, oxygen effects and hypoxia, vascular damage

64
Q

Morphology of ionizing radiation

A

nuclear swelling, giant cells, polymorphic nuclei, multinucleated, cytoplasmic swelling, endothelial cell proliferation and collagenous hyalinization, scarring and contractions

65
Q

Acute effects of radiation to hematopoietic and lymphoid systems

A

marrow aplasia, neutropenia, lymphopenia, thrombocytopenia, aplastic anemia

66
Q

Common sites of fibrosis after radiation treatment

A

lungs, salivary glands, colorectal and pelvic areas

67
Q

Major morphologic consequences of radiation injury

A

erythema, edema, hyperpigmentation, acute tissue loss, interstitial fibrosis, mucosal injury, ulceration, ovary and testes destruction, anemia

68
Q

CA risk from radiation exposure

A

increased risk of leukemia and solid tumors in hiroshima, thyroid CA in Chernobyl, “second cancer” development from radiation treatments

MOD (34 decks)

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