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MOD Midterm > Environmental And Nutritional Diseases - Martin > Flashcards

Environmental And Nutritional Diseases - Martin Flashcards

1
Q

most deaths in children under 5yo

A
  1. pneumonia
  2. diarrhea
  3. malaria
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2
Q

what 3 diseases are increasing and what 2 are decreasing

A
  1. cardivascular d, cancer, HIV/AIDS/ TB

2. neonatal conditions, D or lower Resp infections

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3
Q

how does climate change affect cardi + resp

A

heatwaves and air pollution

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4
Q

how does climate change affect GI, cholera, food and water spreading infections

A

contamination from flooding, disrupting clean waters

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5
Q

how does climate change affect Vector-borne infections

A

malaria, Dengue fever happen when temperature increases = crop failures, which also leads to more extreme weather variations

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6
Q

how does climate change affect malnutruition

A

disruption of crop growth

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7
Q

xenobiotics

A

chemicals in environment like water, soil, food, air, absorbed through skin or inhaled

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8
Q

what detoxifies xenobiotics

A

CYP, Cytochrome P-450

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9
Q

CYP is located + function

A

liver, and also skin, lung, GI mucosa
- inside the ER
they detoxify or activate xenobiotics, can make ROS

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10
Q

what changes CYP activity

A

fasting and starving can lower it

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11
Q

what compounds are found in pollution

A 
sulfur dioxide
CO
ozone
NO
lead
particles of matter
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12
Q

ozone causes what in healthy people

A 
decreases lung function, 
lung inflammation 
increased airway reactivity 
chest discomfort
(free radicals injuring type 1 cells and epithelium -> inflammtation)
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13
Q

ozone causes what in athletes, outdoor workers, asthmatics, emphysema

A

higher hospitalizations, decreased exercise capacity

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14
Q

sulfur dioxide does what to healthy adults and COPD and Asthma

A

healthy : higher respiratory symptoms
COPD : higher mortality
Asthma : decreased lung function, higher hospitalizations

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15
Q

witches brew

A

surfure dioxide when combined with ozone and particles of matter
= from power plants burning fossil fules, paper mills
(burning nose and throat, SOB, asthma attack if susceptible)

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16
Q

particles of matter

A

SOOT
pulmonary inflammation
secondary cardiovascular effects
* most dangerous are smaller then 10um going to alveoli

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17
Q

CO chronic poisoning from

A

working in tunnels, underground garages, highway toll booths can do this (generator Heater, automobile fumes)

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18
Q

CO acute poisoning from

A

small closed garage with running car, in 5 min you die, or during power outage using gasoline powered generators, mine fires

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19
Q

CO poisoning happens due to

A

CNS depression = ischemic changes
(Basal ganglia + lenticular nuclei)
can cause edematous, punctuate hemorrhages, hypoxia-induced neuronal changes -> sommer’s sector in hippocampus

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20
Q

SX : CO poisoning

A

RED COLOR of skin and mucous membranes, V, dizzy

AFTER: loss of memory, vision changes, hearing and speech changes

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21
Q

CO poisoning can cause what in the brain

A

hemorrhage in pallidum

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22
Q

Wood smoke

A

polycyclic hydrocarbons are carcinogens

can give lung infections

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23
Q

Bioaerosols

A

can caused from Legionnaires disease (from cooling towers for AC), viral pneumonia, pet dnader, fungi, molds
SX: asthma, rhinitis, eye irritaiton

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24
Q

Radon

A

gas from uranium , (soil, well water, cracks, drains, windows)
HIGH lung cancer risk

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25
Q

Formaldehyde

A

building materials, after disasters in poorly ventilated trailers
= carcinogen

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26
Q

sick building syndrome

A

indoor pollutants, poor ventilation (fungi, molds)

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27
Q

Lead poisoning causes what and interferes with

A

causes hematologic, skeletal , GI and renal toxisity
= looks like low Fe+3
interferes with CA+2 metabolism

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28
Q

lead can be found

A

batteries, paint, car radiators, tin cans

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29
Q

children SX of lead poisoning

A

CNS changes, affects intellect, behavior problems, hyperactive, poor organization, = looks like ADHD
severe can be blindness, psychomotor problems, psychoses, seizures, coma

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30
Q

adults SX of lead poisoning

A

peripheral neuropathy

  1. EXTENSOR muscles of wrist and fingers = wrist drop
  2. if continued, PERONEAL muscles = foot drop
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31
Q

SX of lead poisoning form both adults and children

A
  1. lead lines : radiodense in metaphyses (bones) and gums
  2. hypochromic microcytic anemia (as in low Fe+), basophilic stippling, ring sideroblasts (Fe+ mitochondria)
  3. Lead colic : extremely sever, abd pain all over
  4. renal damage
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32
Q

ringed sideroblast

A

iron in mitochondria

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33
Q

how to determine if someone has microcytic and hypochromic anemia

A

MCV < 80fL

MCG < 27pg

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34
Q

Mercury causes

A

damage CNA + KIDNEY

-cerebral palsy, deafness, blindness, mental problems, especially inutero exposure

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35
Q

Arsenic causes

A
  1. GI , cardio, CNS toxicities
  2. sensorimotor neuropathy, paresthesias, numbness, pain
  3. hyperpigmentation + hyperkeratosis
  4. many cancers on soles and palms , lung and bladder
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36
Q

Arsenic comes from

A

soil, water, wood preservatives, herbicides, herbal medicine

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37
Q

mercury comes from

A

fish, mercury vapor from dental metallic amalgams

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38
Q

Cadmium comes from

A

high ROS from nickel-cadmium batteries, soil, plants , FOOD (contaminated rice)

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39
Q

Cadmium causes

A

LUNG + KIDNEY toxicity
CA +2 LOSS : osteoporosis and osteomalacia with renal disease = ITAI-ITAI
high lung cancer risk

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40
Q

what causes lung cancer

A

Radon, asbestos, silica, arsenic

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41
Q

what causes lung fibrosis

A

silica
asbestos
cobalt

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42
Q

what causes (hematopoietic) leukemia

A

Benzene

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43
Q

what causes liver angiosarcomas

A

Vinyl chloride

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44
Q

what causes heart disease

A

CO, lead, cadmium, cobalt

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45
Q

what causes COPD

A

cadmium

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46
Q

what causes ataxic gait

A

mercury, toluene

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47
Q

what causes renal toxicity

A

mercury, lead, cadmium

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48
Q

what causes male infertility

A

lead, cadmium, phthalate plasticizers

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49
Q

what causes female infertility

A

lead, mercury

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50
Q

what causes tetratogenesis

A

mercury, polychlorinated biphenyls

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51
Q

what causes peripheral neuropathies

A

lead, mercury, arsenic , DDT

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52
Q

chloroform + carbon tetrachloride causes what

A

dizzy, confusion, DEPRESS CNS, coma, toxic ot liver and kidney

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53
Q

chloroform + carbon tetrachloride from what

A

dry cleaning agents, paint removers, vapors, rubber that has benzene and 1,3-butadiene —-> can cause marrow aplasia and AML

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54
Q

Polycyclic hydrocarbons causes

A

scrotal cancer, very potent carcinogen, lung and bladder cancer

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55
Q

Polycyclic hydrocarbons form

A

fossil fuels, chimney sweeps

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56
Q

Organochlorines causes

A

hormonal imbalance like antiestrogenic or acntiandrogenic activity

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57
Q

Organochlorines from what

A

lipophilic products not degrading, pesticides, DDT, , PCBs, dioxin

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58
Q

Dioxins and PCBs cause what specifically

A

folliculitis and dermatosis, chloracne (acne and cycts, hyperpigmentation, hyper keratosis) - face and behind ears

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59
Q

Mineral dust causes what

A
  1. pneumonioses
  2. mesothelioma - outside of lung turns thick and black “pork-chop lung”
  3. asbestos fibers coated in FE+3 (FERRUNGINOUS BODIES)
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60
Q

Mineral dust comes from

A

coal dust, silica, asbestos, beryllium

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61
Q

Vinyl chloride causes , and from what

A

angiosarcoma of liver +endocrine effects in infants

from Bisphenol A (BPA) - food bottles and cans

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62
Q

Tobacco smoking quitting decreases death by how much

A

21% decrease 5 years from cardiovascular diseases and lung cancer

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63
Q

nicotine effect

A

increase HR and BP, increase cardiac contractility and output
CNS depressor, tumor promotor

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64
Q

formaldehyde and NO cuases

A

cilia toxicity and mucosal irritation (smokers cough in the morning)

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65
Q

what 2 things increaseee lung cancer or laryngeal + oral cancer with smoking

A

lung cancer with asbestos or uranium miners

oral + laryngyal cancer with alcohol

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66
Q

tobacco causes what to lungs

A

leukocytes to lung, = high elastase production, injury to lung, = emphysema + inflammation causing bronchitis

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67
Q

what is the thing that CAUSES lung cancer in smokers

A

polycyclic hydrocarbons and nitrosamines

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68
Q

Alcohol testing for chronic use

A

test vitrous fluid from eye

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69
Q

alcohol amount for drunk, drowsiness, coma

A

80mg/dL
200mg/dL
300mg/dL

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70
Q

what makes asians red with alcohol

A

X ALDH*2

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71
Q

what is alcohol in blood

A

acetaldehyde from ADH (alcohol dehydrogenase) in liver,

also makes it acetate

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72
Q

alcohol inhibits

A

CYP2E1, metabolism of other drugs or compounds

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73
Q

alcohol increases what for liver issues

A

NADH + lactic acid = steatosis

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74
Q

liver cirrhosis can cause

A

esophageal varices, due to blood in vein congestions

75
Q

alcohol affects what part of the brain

A

cerbellum, SUPERIOR VERMIS

76
Q

alcohol does what to HDL and what deficiency

A 
low HDL (unless it is wine low amounts in increases HDL)
Thiamine (B1) deficiency
77
Q

what does low B1 cause from alcohol

A

peripheral neuropathies

Wernicke- Korsakoff syndrome

78
Q

alcohol and fetus

A

microcephaly, low growth, facial anomalies, low mental function (esp 1st trimester)

79
Q

wine effects in moderation

A

high HDL
low platelet aggregation
low fibrinogen levels

80
Q

wernicke encephalopathy

A

low thiamine
= reversible
= TX: thiamine
= mamillary bodies hemorrhage and necrosis

81
Q

Korsakoff syndrome

A

irreverible worse form of wernickes encephalopathy
= short term memory loss confabulation
= trunctal ataxia, nystagmus
= Affects ANTERIOR VERMIS of cerebellum–> atrophy

82
Q

minocycline drug adverse effect

A
  • it is an AB with adverse effect of darkened skin discoloration rash looking like Lupus, hemolytic anemia, immune thrombocytopenia
83
Q

anticoagulant warfarin can cause

A

is also rat poisoning (VIT K antagonist) = bleeding

84
Q

anticoagulant pradaxa can cause

A

inhibits thrombin , so it can cause A-Fib, bleeding

85
Q

Menopausal hormone therapy

A

estrogens with progesterones (only fine in early menopause)

  • high breast cancer, high stroke
  • lowers ASCVD if under 60yo
86
Q

oral contraceptives

A
  • increases cervical cancer (especially from HPV)
  • protects against ovarian and endometrial cancers
  • high venous thrombosis
  • high CAD in women who smoke over >35yo
  • chronic use and old pt can get hepatic adenoma
87
Q

anabolic steroids cause

A

acne, stunt growth, testicular atrophy, facial hair, menstrual changes, high MI risk, gynecomastia, psychiatric issues

88
Q

Acetaminophen can cause

A

acute liver failure = centrilobular necrosis, will need liver transplant

89
Q

toxic level of acetaminophen

TX:

A

NORMAL : 0.5g
TOXIC : 15-25g
TX: N-acetylcysteine within 12hrs

90
Q

Asprin (acetylsalicylic acid) can cause

A

alkalosis due to medulla respiratory center stimulation
ACUTE : N, coma
CHRONIC : dizzy, tinnitus**, bleeding, coma, analgesic nephropathy (PHENACETIN —-> renal necrosis and analgesic nephropathy)

91
Q

Asprin toxic level

A

Child : 2g-4g
ADULT : 10-30g
(also found in wintergreen oil, methyl salicylate)

92
Q

how does actetominophen cause damage to liver

A
  1. activated CYP2E2 activity
  2. NAPQ1 activated
  3. lowers GSH (X conjugation) = high ROS, potentiated by alcohol
  4. covalent binding to hepatic cells= damage cells= mito dysfunction
93
Q

cocain causes what

A

tachycardia, HTN, peripheral vasoconstriction

  • platelet aggregation + vasoconstriction = MI *
  • lethal arrhythmias * (disrupt ion transport in myocardium)
  • LOW BF to PLACENTA* (fetal hypoxia and spontaneous abortion)
  • fever, seizures
94
Q

Opiates cause what

A
  • respiratory depression
  • arrhythmia
  • cardiac arrest
  • pulmonary edema**
  • injected with IV = ENDOCARDITIS* of RIGHT HEART**
95
Q

opiates SX:

A

bubbles coming out from mouth, nose, ears from pulmonary edema

96
Q

Metamphetamines cause

A

violent behavior, confusion, psychotic (paranoia, hallucinations)

97
Q

MDMA (Ecstasy) causes

A

sleep disorder, depression, anxiety, aggressive behavior, usually spiked with other CNS effective drugs

98
Q

Marijuana

A
  • high HR
  • low or high BP
  • angina if pt has CAD
  • high carcinogens
  • psychomotor dysfunction
99
Q

Huffing and glue sniffing

A

brain damage on MRI of dementia

100
Q

Bath salts

A

agitation, psychosis, MI, suicide

101
Q

internal burn can be caused by
skin burn can cause
% of body surface that is burned is

A
  • intubation
  • electrolyte disfunction, give a lot of fluids
  • rule of 9
102
Q

1st degree burn

A

epidermis

103
Q

2nd degree burn

A

epidermis and dermis

104
Q

3rd degree burn

A

epidermis, dermis, subcutaneous tissue

105
Q

4th degree burn

A

epidermis, dermis, subcutaneous tissue, muscle underneath

106
Q

thermal injury causing shock

A

when more then 20% body surface involved, fluids go to intestines + PULMONARY EDEMA, hyper metabolic state needing more nutritional support

107
Q

thermal injury causing sepsis

A

due to pseudomas aeruginosa, MRSA, Candida species colonization at burn site

108
Q

thermal injury cuasing respiratory insufficiency

A

direct heat on upper airway and inhaling noxious gases

109
Q

hypertrophic scars

A

original burn + donor graft , a lot of collagen deposition for healing (EX: Tilapia grafts of skin)

110
Q

pugilistic stance

A

how burned victims shape their body positioning

111
Q

heat cramps

heat exaustion

A
  • electrolyte dysregulation

- hypovolemia from dehydration –> no cardiac compensation , collapse

112
Q

heat stroke

A

NO SWEATING, vasodilation = pooling of blood
hyperkalemia
rhabomyolysis , RYR1 —-> CA release causing muscel contractions

113
Q

Malignant Hyperthermia

A

muscle contractures and body temperature rises from normal anesthetics due to RYR1 gene , TX : with muscle relaxer (not common however deadly)

114
Q

Hypothermia causes what

what makes it worse

A

bradycardia —-> a fib
loss of consciousness
vasoconstriction and increased vascular permeability
- alcohol

115
Q

paradoxical undressing

A

person experiencing hypothermia and before they die they have an extreme burst of heat

116
Q

electrical burns do what to eyes

A

star shaped cataracts

117
Q

electrical burns do what to the heart

A

V fib, cardiac-respiratory failure

118
Q

low voltage burns cause

A

tetanic muscle spasm, irreversible grasps

chest wall spasm = asphyxia

119
Q

high voltage burns cause

A

medullary centers paralysis, EX: lighting

120
Q

curie

A

radiation amount emitted

121
Q

Gray

A

energy absorbed thats radiation

122
Q

sievert (Sv)

A

absorbed radiation x effectiveness of radiation

123
Q

what determines if radiation will have bad effects

A
  1. Rate of delivery
  2. Field size
  3. Cell proliferation
  4. O2 effects (hypoxia)
  5. Vascular damage
124
Q

Sv of 5

A

Lens of eye —-> cataracts

125
Q

Sv of 0.15

A

Testes —-> Temporary steriliry

126
Q

Sv of 2.5- 6

A

Ovaries —-> permanent sterility

127
Q

Sv of 3-5

A

Skin —-> Temporary hair loss

128
Q

Sv of 3.5

A

Testes —-> permanent sterility

129
Q

what does ionizing radiation do

A

remove tightly bound electrons

130
Q

cell morphology of radiation

A

looks like cancer * hard to see if cancer is there

  • nuclear swelling, collagenous hyalinization, intima thickens of BVs,
  • high collagen (fibrosis, sclerosis)
  • mitotic figures, abnormal
  • high fat in cell stains
131
Q

radiation on lymophoid and hematopoietic system

A

aplastic anemia (low marrow in bone)

132
Q

places getting fibrosis after radiation

A

abd, lungs, salivary glands

133
Q

radiation on dna

A

can cause double stranded breaks

134
Q

radiation can cause high risk of what cancer

A

leukemia (AML) , solid tumor in thyroid, breast, lungs, MDS (myelodysplastic syndrome)

135
Q

chronic radiation effect on skin

A

dermititis = dermal fibrosis

136
Q

radiation can cause a lot of

A

fibrosis

137
Q

0-1 Sv causes

A

nothing

138
Q

1-2 Sv causes

A

Lymphocytes —-> Moderate granulocytopenia Lymphopenia (if exposed 1 day to 1 week)

139
Q

2-10 Sv causes

A

Bone marrow —-> Leukopenia, hemorrhage, hair loss, vomiting (if exposed 2-6 weeks)

140
Q

10-20 Sv causes

A

SI —–> D, Fever, electrolyte imbalance, V (if exposed 5-14 days)

141
Q

greater then 50 Sv causes

A

Brain —-> ataxia, coma, convulsions, V (if exposed 1-4hrs)

142
Q

primary malnutrition

secondary malnuttrition

A
  • not eating in diet something

- malabsorption, impaired utilization or storage, Gut microbe*

143
Q

iodine in found in

A

where sea life has been

NOT himalayan sea salt

144
Q

infant feed on formulas can miss what

A

iron

145
Q

only eating rice can cause what deficiency

A

thiamine (B1)

146
Q

scientific name for malutrition

A

Severe Acute Malnutrition (esp. low calories or proteins)

Protein-energy malnutrition

147
Q

SX: of SAM

A
  • low subcutaneous fat
  • wasting quads and deltoid
  • edema of ankles and sacrum
148
Q

somatic SAM

visceral SAM

A
  • marasums

- kwashiorkor

149
Q

Marasmus hallmarks

A

muscels loss, anemia, small, normal albumin

EXTREME : cachexia

150
Q

Kwashiokor hallmarks

A

edema, hypoalbuminemia, fatty liver, hyperpigmented area

151
Q

anorexia causes

A 
Gelatinous transformation (fat in BM, mucinous matrix)
HYPOKALEMIA, risk of arrhythmia and sudden death
152
Q

bulimia

A

electrolyte imbalance
HYPOKALEMIA (arrhythmia, sudden death)
pulmonary aspiration of gastric contents
esophageal and gastric rupture

153
Q

gelatinous transformation of BM looks like

A

high fat, very little hemopoietic tissue

154
Q

Vit A function

A

maintain normal vision (rhodopsin)

regulation of lipid metabolisms,

155
Q

Vit A can be from

A
  • X fat absorption (Celiac, crohns, CF)

- kids during infections

156
Q

VIT A deficiency

A
  • night blindness
  • epithelial to squamous metaplasia + keritinization (Bitot spots on eye, Xerophthalmia = dry eye, corneal destruction), pulmonary infections, stones in urinary tract
  • low immune system
157
Q

VIT A toxicity

acute

A

headache, dizzy, V, stupor, blurred vision, *pseudotumor cerebri (high intracranial P, only no tumor)

158
Q

VIT A toxicity

chronic

A

weight loss, anorexia, N,V, bone joint pain, high osteoclast activity
** people from Canada, Alaska, Artic (polar bears, shark, tuna, whale)

159
Q

VIT D function

A

absorb CA+2 and P

bone mineralization, neuromuscular transmission

160
Q

VIT deficiency children

A

RICKETS : epiphyses has not closed (frontal bossing, squared face, rachitic rosary, pigeon breast, lumbar lordosis, bowing of legs)

161
Q

VIT deficiency adults

A

OSTEOMALACIA : hypocalcemic tetany, weak bone

162
Q

low vit D risk for what infection

A

TB

163
Q

Hypervitaminosis D

A

metastatic calcification of soft tissues

- bone pain, hypercalcemia

164
Q

low iron leads to

A

Hypochromic microcytic anemia

165
Q

VIT C function

A

collagen, synthesis of NTs, antioxidant, regulate immune system, absorb FE+3

166
Q

VIT C found in

A

animal liver and fish, milk, fruits, veggies

167
Q

VIT C deficiency

A

SCURVY
hemorrhages, healing defects
(chronic alcoholics, bad eating habits, elderly living alone, dialysis)

168
Q

VIT C toxicity

A

rare, need megadose

FE overload, hemolytic anemia, calcium oxalate kidney stones, G6PD deficiency

169
Q

normal BMI

A

18.5-25

170
Q

anabolic

A

EAT, low energy usage

171
Q

catabolic

A

DONT eat, high energy expenditure

172
Q

Arcuate nucleus that

  1. for eating
  2. for not eating
A
  1. NYP/AgRP

2. POMC/CART

173
Q

Pickwickian syndrome

A

hypoventilation syndrome, form obesity

174
Q

obesity can cause

A
  • gallstones
  • NASH (non-alcoholic fatty liver)
  • Hypersomnolence (sleep apnea)
  • high inflammation —> procarcinogenic state
  • right heart failure
175
Q

obesity cancer risk in men

A

esophagus, thyroid, colon, kidney

176
Q

obesity cancer risk in women

A

esophagus, endometrium, gallbladder, kidney

177
Q

Aflatoxin

A

hepatocellular carcinoma (toxin from fungi in crops of humid environments)

178
Q

Nitrosamines and nitrosamides in food cause

A

gastric carcinomas (preservative, in veggies)

179
Q

high animal fat and low fiber diet causes

A

colon cancer

180
Q

breask cancer is correlated with

A

total fat in diet

181
Q

antioxidant vitamines

A

C, E, B-carotene, selenium

182
Q

garlic helps

A

prevent heart disease

183
Q

high fibers in diet helps

A

prevent diverticulosis

184
Q

low cholesterol and animal saturated fat (egg, butter, beef) helps to

A

prevent atherosclerosis

MOD Midterm (9 decks)

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