Environment and Nutritional Flashcards
Cut-off size for fine or ultrafine particles
<10 micrometers (more dangerous)
Two mechanisms of toxicity of carbon monoxide
Decreased O2 delivery (200x greater affinity for hemoglobin) and decreased ATP (complex IV inhibitor)
Level of CO saturation for systemic hypoxia
20-30%
Level of CO saturation for coma and death
60-70%
Found in acute CO poisoning
Cherry-red discoloration
Found in chronic CO poisoning
Carboxyhemoglobin
Disease from airconditioning
Legionella (Legionnaire’s disease)
Silver legion (use silver stain to identify organism)
Mechanism of action of lead poisoning
Interferes with calcium metabolism
Lead inhibits which enzymes?
ALA dehydratase (second step in heme synthesis) and ferrochelatase (incorporates iron into heme)
Hematologic manifestation of lead poisoning
Microcytic, hypochromic anemia
More common neurologic involvement of lead poisoning in children
CNS (vs peripheral neuropathy among adults)
Iron-laden mitochondria
Ring sideroblasts
Disease caused by impaired uric acid excretion in lead poisoning
Saturnine gout
Primary target organ of metallic and inorganic mercury (Hg)
CNS (because it is nonpolar and can cross BBB)
Organic form of mercury
Methylmercury
Disease caused by organic mercury poisoning
Minamata disease (CP, blindness, MR, CNS defects in utero)
“The poison of kings, the king of poisons”
Arsenic
Complications of arsenic poisoning
Neurologic (parasthesias, pain), skin (hyperkeratosis and pigmentation), cancers (lung, bladder, and skin esp in non-sun exposed areas)
Heavy metal preferentially toxic to kidneys by ROS production
Cadmium
Osteoporosis and osteomalacia associated with renal disease in cadmium poisoning
Itai-itai (Japanese for masakit, kasi masakit ang bones nila; itay, ang sakit ng bones ko!)
Smoking is NOT a risk factor for which cancer?
Breast cancer
Lethal dose of alcohol (blood alcohol level)
500 mg/dl
Metabolism of alcohol
Ethanol > (alcohol dehydrogenase) > acetaldehyde > (aldehyde dehydrogenase) > acetic acid
How does alcohol cause lactic acidosis?
Because of increased NADH production, that pushes lactate dehydrogenase to create lactate (recall that if O2 not available, pyruvate will become lactate instead of acetyl CoA)
Mechanism of heat cramps
Electrolyte loss thru sweating (no derangement of core body temp)
Mechanism of heat exhaustion (most common)
Failure of CVS to compensate for hypovolemia from dehydration
Mechanism of heat stroke
Failure of thermoregulatory mechanisms causing hyperthermia (>40 C) and multiorgan dysfunction
Clinical findings of heat exhaustion
Syncope
Clinical findings of heat stroke
Hyperthermia, generalized vasodilation, hyperK, arrhythmia, rhabdo
Risk factors for hyperthermia
Inc ambient temp, inc humidity, exertion, older adults, CVDs, intense physical stress
Which is more injurious, alternating current (AC) or direct current (DC)?
Alternating current
Common sources of ionizing radiation
X-ray, gamma rays, high-energy neutrons, alpha and beta particles
Why is ionizing radiation injurious?
Has enough energy to remove bound electrons (to create ions)
Characteristic nuclear morphology of ionizing radiation damage
Nuclear swelling with chromatin clumping (BUT N:C ratio is maintained)
Definition of protein-energy malnutrition
BMI < 16 or weight <80% of normal (although may not be present if edema is signficant)
Characterized by greater protein than deprivation
Kwashiorkor
Characterized by greater caloric than protein deprivation
Marasmus
PEM with prominent edema and liver steatosis, cerebral atrophy, generally more complications
Kwashiorkor
Mediators of cachexia
Proteolysis inducing factor, lipid mobilizing factor, TNF and IL-6 (pro-inflammatory cytokines)
Interleukin / cytokine responsible for acute phase reactants
IL-6
Eponym for calluses found on knuckles of bulimic patients
Russell sign
Deficiency causes nyctalopia and epithelial keratinization
Vit A
Deficiency causes Bitot spots
Vit A
Excess causes pseudotumor cerebri
Vit A
Cholesterol-derived vitamin
Vit D
Found in yellow, leafy vegetables (caroteinoids)
Vit A
Synthesized in the body and found in deep-sea fish, plants, and grains)
Vit D
Vit D deficiency in children
Rickets (vs osteomalacia in adults)
Craniotabes, frontal bossing, pectus carinatum, rachitic rosary
Rickets
Disease of vit D deficiency resulting in fractures of vertebral bodies and femoral neck
Osteomalacia
Biochemical role of Vit C
Hydroxylation of collage
Vit that is also an antioxidant in combo with Vit C
Vit E
Lack of this enzyme means humans cannot synthesize Vit C
L-gulonolactone oxidase
Disease of vit C deficiency characterized by gum bleeding, impaired wound healing
Scurvy
This means “to make you hungry”
Orexigenic (vs anorexigenic)
Adipocyte signalling compound that is anorixgenic
Leptin (remember the leptin-deficient mouse is a fatty)
Adipocyte signalling compound that stimulates beta-oxidation
Adiponectin
Secreted by stomach and arcuate nucleus of hypothalamus that makes you hungry (orexigenic)
Ghrelin
Adipocyte signalling compound secreted in ileum and colon that is deficient in Prader-Willi
PYY
Consequence of obesity that results in hypoventilation, hypersomnolence, OSA, PCV, cor pulmonale
Pickwickian syndrome (he doesn’t PICK what he EATS)