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Anat Path > ENVIRONMENTAL AND LIFESTYLE RELATED PATHOLOGY I > Flashcards

ENVIRONMENTAL AND LIFESTYLE RELATED PATHOLOGY I Flashcards

1
Q

What is an Environmental disease?

A

Environmental disease refer to conditions caused by exposure to chemical or physical agents in the ambient, workplace or personal environment (e.g. diet, drugs, alcohol, and tobacco), including diseases of nutritional origins (overnutrition or undernutrition).

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2
Q

What is the source and effect of ozone?

A

Source: Interaction of O2 and UV radiation.
Major component of smog in lower atmosphere

Effect: Loss of stratospheric ozone due to chlorofluorocarbon use increases skin cancer risk.

Ozone toxicity with release of free radicals injures the alveolar epithelium and induces release of inflammatory mediators. This results in cough, chest discomfort and pulmonary inflammation.

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3
Q

What is the source and effect of carbon monoxide?
Major characteristic of CO poisoning?

A

Source: Incomplete oxidation of carbonaceous materials(internal combustion engines, wood burning, home heaters, cigarette smoking,etc)

Effect: Ambient low-level exposure may cause impaired respiratory function.
10% non-lethal
30% dangerous
50% hypoxia (lethal)

Acute lethality occurs through CNS depression and systemic hypoxia.
Acute poisoning is characterized by cherry-red coloring of the victim due to high levels of caboxyhemoglobin.

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3
Q

What is the source and effect of sulfur dioxide?

A

Source: Combustion of coal and oil, copper smelting, and paper manufacture.

Effect: It is converted to surfuric acid and sulfur trioxide that cause burning, dyspnea and airway hyper-reactivity

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3
Q

What is the source and effect of soot?

A

Source: Emitted by coal, oil, and diesel combustion.

Effect: Toxic effect depends on size and shape of particles, and is attributed to macrophage and neutrophil uptake, with subsequent inflammatory mediator production.

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3
Q

What is the source and effect of bioaerosols?

A

Source: Include the bacterial aerosols responsible for Legionella pneumonia, and allergens form pet danders, dust mites, and molds.

Effect: Airway irritation and hypersensitivity/allergic reaction in susceptible individuals.

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4
Q

What is the source and effect of radon?

A

Source: Radioactive gas formed as a decay product of uranium found naturally in the soil.

Effect: Low-level radon in some homes may increase cancer risk in smokers.

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4
Q

What is the source and effect of wood smoke?

A

Souce: A complex mixture of particulates and other toxic components (e.g. polycyclic hydrocarbons)A complex mixture of particulates and other toxic components (e.g. polycyclic hydrocarbons)

Effect: Directly irritating; can increase the incidence of respiratory infections and are potentially carcinogenic.

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5
Q

What is the source and effect of formaldehyde?

A

Source: Soluble, volatile chemical used in the manufacture of many consumer products.

Effect: It can cause irritation of the eyes and upper respiratory tract. It is classified as a carcinogen

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6
Q

What is the source and effect of lead?

A

Soucrce: Lead spray painting, lead plumbing, foundries, leaded gasoline combustion

Effect: CNS toxicity: lethargy and somnolence (excessive drowsiness), cognitive impairment and behavioural problems, mental retardation, cerebral edema leading to encephalopathy.

Wrist and foot drop in adult due to peripheral motor nerve demyelination.
Abdominal pain(lead colic).

Renal tubular acidosis and renal failure.
Microcyctic anemia with basophilic stippling.
Deposition of lead at the gingivodental line (“lead line”).

X-ray: long bones have lead lines (increased bone density) at the epiphyseal growth plate.

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7
Q

Common outdoor air polluntants

A

Wood smoke
CO
SO2
Bioaerosol
Soot
Ozone
Radon
Formaldehyde

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8
Q

What is the source and effect of mercury?

A

Source: Methyl mercury-contaminated fish,
Mercury vapors released by metallic mercury in dental amalgams,
Mercury in gold mining that contaminates water run-off.

Effect: Nephrotoxicity (acute tubular necrosis)
Neurotoxicity: intention tremors, dementia and delirium.
In-utero exposure can cause cerebral palsy, deafness, blindness and mental retardation.

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8
Q

Common metal environmental pollutants

A

Lead
Mercury
Arsenic

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8
Q

What is the source and effect of arsenic?
What is a major characteristic of arsenic poisoning?

A

Source: Naturally found in soil and water.
It is used in herbicides and as a wood preservative.
Trivalent forms (e.g., arsenic trioxide and sodium arsenite) are most toxic.

Effect: Acute poisoning:
Hemorrhagic gastroenteritis, CNS toxicity (coma and seizures), “garlic-scented” breath.
Chronic poisoning:
Malaise and abominal pain, peripheral neuropathy and musclur weakness, skin changes (hyperpigmentation and dermatitis), Mees lines(transverse bands on the fingernails).
Complications: SCC of the skin and lung.

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9
Q

What specie of mushrooms are poisonous and which are lethal?

A

Amanita muscaria – recovery with supportive therapy; rarely lethal.

Amanita phalloides:
- Toxin (amanitin) inhibits RNA polymerase
- Fulminant hepatitis with extensive liver necrosis
-Coma and death

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10
Q

What is is the major characteristic and mechanism of CYANIDE POISONING?

A

-Clinical findings: “bitter almond” scented breath.
-Mechanism: blocks cellular respiration by binding to mitochondrial cytochrome oxidase
- A systemic asphyxiant.

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11
Q

What is the related occupation and pathology of soot?

A

Occupation: English chimney sweeps
Pathology: Scrotal cancer

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12
Q

What is the related occupation and pathology of Vinyl Chloride?

A

Occupation: Plastic industry
Pathology: Angiosarcoma of the liver

13
Q

What is the related occupation and pathology of uranium and radon gas?

A

Occupation: Miners
Pathology: Lung cancer, leukemia

14
Q

What is the related occupation and pathology of β-Naphthylamine?

A

Occupation: Dye makers and rubber workers
Pathology: Bladder cancer

15
Q

What is the related occupation and pathology of Benzo[a)pyrene?

A

Occupation: Steel mills and cigarette smoke
Pathology: Lung and bladder cancer

16
Q

What is the related occupation and pathology of Carbon tetrachloride?

A

Occupation: Dry cleaners
Pathology: Liver and kidney toxicity

17
Q

What is the related occupation and pathology of Organophosphates?

A

Occupation: Farmers
Pathology: Irreversible cholinesterase inhibitors

18
Q

What is the related occupation and pathology of Bisphenol A(BPA)?

A

Occupation: Synthesis of polycarbonate food and water containers

Pathology: Endocrine disruption

18
Q

What is the related occupation and disease of coal dust?

A

Occupation:
Pathology:

19
Q

What is the related occupation and disease of silica?

A
20
Q

What is the related occupation and disease of asbestos?

A
21
Q

What % of lung cancer is caused by tobacco?

A

Tobacco use is the most common exogenous cause of human malignancy responsible for 90% of lung cancers.
The vast majority of mortality due to cigarette smoking is from lung cancer, cardiovascular and chronic pulmonary disease.

21
Q

What are the components of smoke?

A

Smoke contains over 4,000 components and over 40 known carcinogens.

Some of its constituents include carbon monoxide, arsenic, formaldehyde, hydrogen cyanide, and nicotine (addictive component).

22
Q

What Cardiovascular diseases are caused by tobacco?

A

Cardiovascular disease:
-Major risk factor of atherosclerosis
-Coronary artery disease
-Myocardial infarctions
-May induce coronary vasospasm
-Peripheral vascular disease
-Aortic aneurysms
-Buerger’s disease
-Stroke.

22
Q

What are the 2 types of smoke?

A

Two types of smoke:
- Mainstream smoke (smoke inhaled by the smoker)

  • Sidestream smoke (passive smoke inhalation)
22
Q

How does tobacco cause cancer?

A

Cancers:
Polycyclic hydrocarbon, tar, benzopyrene, and nitosamines in cigarette smoke are potent carcinogens.
Tobacco contributes to the development of the following cancer in the following organs:
- lung
-Oral cavity, pharynx and larynx
-Esophagus and stomach
-Cervical cancer
-Pancreas
-Kidney, ureter and bladder
-Leukemia(benzene)

22
Q

What Respiratory diseases are caused by tobacco?

A

Respiratory diseases:
-Chronic bronchitis
-Emphysema
-Asthma
-Increased pulmonary infections

23
Q

What is the effect of tobacco on women?

A

Effect on women:
-Often develop early menopause
-Increased rate of postmenopausal osteporosis

Effect on pregnant women:
-Increased risk of spontaneous abortions and stillbirths
-Intrauterine growth retardation

24
Q

What is the Effect of tobacco on children?

A

Effect on children:
-Increased risk of sudden infant death syndrome (SIDS)
-Increased number of otitis media and upper respiratory infections (URIs)
- Increased incidence of asthma

25
Q

Effects of alcohol (statitically)

A

Alcohol accounts for 3.2% of all death annually.
15% of alcohol-related deaths are due to cirrhosis.
Majority of alcohol –related deaths are due to drunken driving or alcohol-related homicides and suicides.

26
Q

Describe Metabolism of ethanol

A

Oxidation of ethanol to acetaldehyde by three different routes and the generation of acetic acid.
1. By Alcohol dehydrogenase (ADH): in the cytosol, ADH converts ethanol into acetaldehyde (toxic metabolite)

  1. By Cytochrome P450 in the microsomes of the ER in the form CYP2E1 ( a member of the Cytochrome P450 superfamily) generates acetaldehyde
  2. Catalase in the peroxisome using hydrogen peroxide generates acetaldehyde and H2O
  3. Acetaldehyde moves into the mitochondria where ALDH (aldedehyde dehydrogenase) metabolizes acetaldehyde to non-toxic acetic acid
27
Q

What is the effect of alcohol on drug metabolism?

A
  • Induction of CYP (especially CYP2E1) by alcohol accelerates the metabolism of other drugs by the microsomal ethanol oxidizing system (MEOS)
  • However, when ethanol is in high concentration, it competes for the enzyme complex and the metabolism of other compounds can be delayed.
  • The metabolism of ethanol is directly responsible for most of toxic and chronic effect.
28
Q

What is the effect of acetylaldehyde?

A

Acetaldehyde: is responsible for many of the acute toxicities of alcohol and the development of oral cancers.

People with no acetaldehyde dehydrogenase activity (due to inactive ALDH enzyme as a result of its defective gene homozygosity) cannot oxidize acetaldehyde at all, and alcohol consumption is associated with nausea, flushing, tachycardia, and hyperventilation.

29
Q

ADH

A
29
Q

What is the Potential beneficial effect of alcohol?

A

Cardiovascular system – In moderation, alcohol can reduce cardiovascular disease risk by increasing HDL and reducing platelet aggregation.

29
Q

What are the ADVERSE EFFECTS OF ALCOHOL?

A

ACUTE ALCOHOL INTOXICATION:
- CNS depressant
-Inebriation (drunkedness/intoxication), coma, respiratory arrest
- vomiting (vomiting blood due to damage to damage to gastroesophageal junction)

CHRONIC ALCOHOLISM;
- Liver: fatty change, alcoholic hepatitis, and micronodular cirrhosis.
-GI: acute gastritis and the Mallory-Weiss syndrome

29
Q

What are the adverse effects of alcohol on the pancreas, blood, newborns, heart, CNS and Cancers?

A

Pancreas: acute and chronic pancreatitis
Blood: megaloblastic anemia
Newborns: fetal alcohol syndrome
Heart: dilated cardiomyopathy
CNS: Wernicke and Korsakoff syndromes
Cancers: Hepatocellular carcinoma, cancer of the oropharynx, larynx, esophagus, and possible the breast.

30
Q

What is METHYL ALCOHOL (METHANOL, WOOD ALCOHOL)?

A

Methyl alcohol is metabolized to formaldehyde (by ADH) and formic acid.
It is present in solvents, paint removers, and other household chemicals.
Effect:
Retina: necrosis of retinal ganglion cells resulting in blindness.
CNS: inebriation, coma and death.
Treatment: ethyl alcohol.

Anat Path (26 decks)

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