Environmental and Nutritional Diseases IV

Question 1

abrasion

Answer 1

removal of superficial layer of skin

Question 2

contusion

Answer 2

bruise

-damage to blood vessels and extravasation of blood into tissues

Question 3

laceration

Answer 3

blunt force that causes tear of skin

-have intact bridging blood vessels and jagged irregular edges

Question 4

incised wound

Answer 4

one from sharp instrument

Question 5

puncture wound

Answer 5

long, narrow, instrument

penetrating - pierces tissue
perforating - creates exit wound

Question 6

gunshot wound

Answer 6

puncture wounds

Question 7

most common cause of mechanical injury

Answer 7

vehicular accident

Question 8

thermal injury

Answer 8

excessive heat or cold

Question 9

clinical significance of burns

Answer 9

depth
percent of body
internal injuries
promptness of therapy

Question 10

superficial burns

Answer 10

only epidermis

Question 11

partial thickness burns

Answer 11

injury to dermis

Question 12

full thickness burns

Answer 12

to subQ tissue

-may also damage muscle tissue

Question 13

greatest threats to life in burn patients

Answer 13

shock
sepsis
respiratory insufficiency

percent over 20%

Question 14

burn over 20% of body

Answer 14

body fluids to interstitium

-hypovolemic shock

Question 15

hypermetabolic state

Answer 15

excess heat loss
-with burns

with increased need for nutritional support

Question 16

most common infection in burns

Answer 16

pseudomonas aeruginosa

also s. aureus
and candida

Question 17

water soluble gases

Answer 17

chlorine, sulfur oxides, ammonia - to upper airways

Question 18

lipid soluble gases

Answer 18

nitrous oxide - to deep airways

Question 19

hypertrophic scars

Answer 19

in burn patients

-due to substance P excess

Question 20

different morph of burns

Answer 20

full thickness - white, charred, dry, anesthetic

partial thickness - pink, mottled, blistered, painful

Question 21

heat cramps

Answer 21

loss of electolytes via sweating

cramping of voluntary muscles with vigorous exercise

Question 22

heat exhaustion

Answer 22

failure of cardiovascular system to compensate to hypovolemia

Question 23

heat stroke

Answer 23

sweathing stops
thermoregulation fails
multi-organ dysfunction
generalized vasodilation

Question 24

nitrosylation of RYR1

Answer 24

in heat stroke
-rhabdomyolysis and myocardium necrosis

RYR1 involved in release of calcium from SR

Question 25

malignant hyperthermia

Answer 25

mutations in RYR1 rise in core temp and muscle contractures in response to common anesthetics

Question 26

body temp below 90

Answer 26

loss of consciousness occurs | -bradycardia and atrial fib

Question 27

direct hypothermic injury

Answer 27

physical disruptions within cells by high salt concentrations caused by crystallization of intra and extracellular water

Question 28

indirect hypothermic injury

Answer 28

result from circulatory changes - vasoconstriction and increased vascular permeability - edema and hypoxia result ex. trench foot

Question 29

electrical injuries

Answer 29

burns | ventricular fib, cardiac failure, and resp center failure

Question 30

alternating current

Answer 30

in most homes - induces tetanic muscle spasm - greater likelihood of burns and chest wall mm spasms

Question 31

radiation

Answer 31

energy traveling in forms of waves or particles

Question 32

non-ionizing radiation

Answer 32

UV, infrared, microwave, sound waves - cannot displace electrons

Question 33

ionizing radiation

Answer 33

energy to remove electrons | -X-rays, gamma ray, alpha particles, beta particles, high energy neutrons

Question 34

curie

Answer 34

Ci - disintegrations per second of radionuclide

Question 35

gray

Answer 35

Gy - unit that expresses energy absorbed by target tissue per unit mass

Question 36

Sievert

Answer 36

Sv - unit of equivalent dose absorbed dose multiplied by relative bio effectiveness of radiation

Question 37

determinants of bio effects of ionizing radiation

Answer 37

rate of delivery field size cell proliferation - dividing cells more vulnerable

Question 38

vulnerable to radiation

Answer 38

gonads, bone marrow, lymph tissue, GI mucosa

Question 39

DNA damage by radiation

Answer 39

ROS production from radiolysis of water

Question 40

brain and radiation

Answer 40

adult - resistant | child - destruction of neurons and glial cells

Question 41

skin and radiation

Answer 41

erythema and edema dyspigmentation atrophy/cancer

Question 42

lungs and radiation

Answer 42

edema ARDS fibrosis

Question 43

problem plaguing pathologist

Answer 43

similarity between cancer cells and radiation injured cells

Question 44

total body irradiation

Answer 44

large areas exposed to small doses | -may have devastating affects

Question 45

temporary sterility from radiation

Answer 45

0. 15 Sv | - testes

Question 46

depression of hematopoiesis from radiation

Answer 46

0. 5 Sv | - bone marrow

Question 47

reversible skin changes from radiation

Answer 47

1-2 Sv

Question 48

permanent sterility from radiation

Answer 48

2.5-6 Sv | ovaries

Question 49

hair loss from radiation

Answer 49

3-5 Sv

Question 50

permanent sterility from radiation in men

Answer 50

3.5 Sv

Question 51

cataracts from radiation

Answer 51

5 Sv

Question 52

fibrosis and radiation

Answer 52

in the irradiated field

Question 53

most serious DNA damage by radiation

Answer 53

double strand breaks fixed by NHEJ and homologous recombination

Question 54

bystander effects

Answer 54

irradiated cells with mutations secrete cytokines that influence cells around them

Question 55

radon

Answer 55

decay of uranium carcinogenic decay products polonium 214 and 218 -emit alpha particles