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MOD Midterm > Environmental and Nutritional Disorders: Part I > Flashcards

Environmental and Nutritional Disorders: Part I Flashcards

1
Q

What does the global disease burden estimate?

A

the burden imposed by environmental disease

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2
Q

what is disability adjusted life year (DALY)?

A

sum of years of life lost due to immature mortality and disability in a population

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3
Q

What was the GDB in 1990-2010 for HIV/AIDS?

A

there was a worldwide dramatic increase of mortality due to HIV/AIDS and associated infections

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4
Q

what was the single leading global cause of health loss (morbidity and premature death)?

A

undernutrition

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5
Q

what was the leading cause of death in developed countries?

A

ischemic heart disease and cerebral vascular disease

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6
Q

what was the leading cause of death in developing countries?

A

infectious disease

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7
Q

In the postnatal period, ~50% of all deaths in kids less than 5 years attributed to 3 conditions which are all preventable. What are these conditions?

A

PNA, diarrheal disease, and malaria

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8
Q

What is the trend associated with neonatal conditions in the GBD for 1990-2010?

A

its still wide, but its going down

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9
Q

what is the trend associated with diarrhea, lower respiratory infections, and other common infectious diseases in the GBD for 1990-2010?

A

still wide, but going down

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10
Q

what is the trend associated with HIV/AIDS and tuberculosis in the GBD for 1990-2010?

A

it had an increase around 2006/2007

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11
Q

Without immediate action, what stands to become the preeminent global cause of environmental disease in the 21st century and beyond?

A

climate change

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12
Q

climate change will have a serious negative impact on human health by increasing the incidence of a number of diseases; what is the effect of climate change on cardiovascular, cerebrovascular, and respiratory diseases?

A

these are all worsened by heatwaves and air pollution

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13
Q

climate change will have a serious negative impact on human health by increasing the incidence of a number of diseases; what is the effect of climate change on gastroenteritis, cholera, and other foodborne and waterborne infectious diseases?

A

contamination of foods and disruption of clean water supplies

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14
Q

climate change will have a serious negative impact on human health by increasing the incidence of a number of diseases; what is the effect of climate change on vector-borne infectious diseases?

A

there will be an increase in malaria and dengue fever due to increased temps, crop failures, and more extreme weather variations

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15
Q

climate change will have a serious negative impact on human health by increasing the incidence of a number of diseases; what is the effect of climate change on malnutrition?

A

climate change will increase the incidence of malnutrition by disrupting the crop production

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16
Q

what is toxicology?

A

the study of the distribution, effects, and mechanisms of action of toxic agents (physical agents, radiation and heat)

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17
Q

What limits the value of establishing “safe levels” for entire populations?

A

complex interactions between various pollutants and age, genetic predisposition, and different tissue sensitivities of exposed persons create wide variations

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18
Q

the definition of a poison is strictly dependent on what?

A

dosage

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19
Q

what are xenobiotics?

A

exogenous chemicals in the environment that may be absorbed into the body

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20
Q

most solvents and drugs are said to be what? and what does this allow them to do?

A

lipophilic; allows their transport and penetration through the basement membrane

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21
Q

What happens to most solvents, drugs, and xenobiotics in the body?

A

they are either metabolized to an inactive water-soluble product (detoxification) or activated to form toxic metabolites

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22
Q

What enzyme system is responsible for either detoxifying xenobiotics or convert them into active compounds that cause cellular injury?

A

Cytochrome P-450

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23
Q

where is the cytochrome P450 enzyme system primarily located?

A

endoplasmic reticulum of the liver; also present in the skin, lungs, GI mucosa, and other organs

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24
Q

What is produced when P450 metabolizes xenobiotics?

A

ROS

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25
Q

what are three examples of xenobiotics that P450 metabolizes?

A

carbon tetrachloride cigarette smoke, and EtOH

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26
Q

What effect does fasting and starvation have on P450?

A

decreases its activity

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27
Q

Air pollution is especially hazardous to whom?

A

people with preexisting pulmonary or cardiac disease

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28
Q

The US EPA sets limits on what environmental pollutions? (6)

A

sulfur dioxide, ozone, carbon monoxide, nitrogen dioxide, lead, and particulate matter

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29
Q

What populations are at risk of ozone exposure?

A

healthy adults and children; athletes, outdoor workers, and asthmatics

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30
Q

what happens if healthy adults and children are exposed to ozone?

A

decreased lung function, increased airway reactivity, lung inflammation

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31
Q

what happens if athletes or outdoor workers are exposed to ozone?

A

they will have a decreased exercise capacity

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32
Q

what happens if asthmatics are exposed to ozone?

A

increased hospitalizations

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33
Q

What populations are at risk when exposed to sulfur dioxide?

A

healthy adults, individuals with chronic lung disease, and asthmatics

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34
Q

what happens if a healthy adult is exposed to sulfur dioxide?

A

they will have increased respiratory symptoms

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35
Q

what happens if individuals with chronic lung disease are exposed to sulfur dioxide?

A

increased mortality

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36
Q

what happens if asthmatics are exposed to sulfur dioxide?

A

increased hospitalizations and decreased lung function

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37
Q

What is ozone?

A

UV radiation + Oxygen

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38
Q

ground level ozone toxicity is largely mediated by what? and these injure what?

A

free radicals; injure respiratory tract epithelial cells and type I alveolar cells, which cause mild symptoms

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39
Q

What is sulfur dioxide produced by?

A

power plants burning fossil fuels, copper smelting, and as a byproduct of paper mills

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40
Q

what are the effects of sulfuric acid and sulfuric trioxide?

A

a burning sensation in the nose and throat, difficulty breathing, and asthma attacks in those susceptible

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41
Q

What particulate matter (soot) particles are the most harmful?

A

fine or ultrafine particles less than 10 micrometers in diameter

42
Q

What happens to the particulate matter (soot) that is larger than 10 micrometers in diameter?

A

they are typically removed in the nose, trapped by the mucociliary epithelium of the airways

43
Q

Who is at risk for chronic poisoning of carbon monoxide?

A

those who work in tunnels, underground garages, and highway toll booths with high exposures to automobile fumes

44
Q

who is at risk for acute toxicity of CO?

A

improper use of gasoline-powered generators (e.g. during power outages)

45
Q

How does CO kill?

A

by inducing CNS depression; widespread ischemic changes

46
Q

Where is CO concentrated in the brain following toxicity?

A

basal ganglia and lenticular nuclei

47
Q

What would you see if someone has survived 24-48 hours after they have been exposed to the CO?

A

the brain may be slightly edematous, they may have hemorrhages in the pallidum, and there may be hypoxia-induced neuronal changes

48
Q

What are the likely symptoms a patient will have if they recover from CO poisoning?

A

impaired memory, vision, hearing, and speech

49
Q

What is a gross indicator that a patient has been poisoned by CO?

A

there is a generalized cherry-red color of the skin and mucous membranes

50
Q

What is the most common indoor pollutant?

A

tobacco smoke

51
Q

What makes wood smoke carcinogenic?

A

polycyclic hydrocarbons

52
Q

What is associated with bioaerosols as indoor air pollution?

A

legionnaires disease, viral PNA, pet dander, fungi, molds

53
Q

what is radon?

A

a radioactive gas derived from uranium

54
Q

what is the effect of radon exposure?

A

it increases the risk for lung cancer (2nd leading cause of lung cancer)

55
Q

Where might you be exposed to formaldehyde?

A

building materials, poorly ventilated trailers following disasters

56
Q

What is sick building syndrome?

A

when an indoor space to poorly ventilated and indoor pollutants build up

57
Q

What does lead in the body interfere with?

A

calcium metabolism

58
Q

how are children exposed to lead?

A

flaking lead paint and soil

59
Q

what are the occupational exposures of lead?

A

battery manufacturing, pigments, car radiators, and tin cans

60
Q

Where is most of the lead that is absorbed into the body incorporated? and what is the half life of lead?

A

bone and developing teeth; half life is 20-30 years

61
Q

What effect do low levels of lead in the body have?

A

intellectual issues, behavioral problems, hyperactivity, poor organizational skills in kids

62
Q

What effect does lead poisoning have on kids?

A

brain damage

63
Q

what effect does lead poisoning have on adults?

A

peripheral neuropathy (wrist drop/ foot drop)

64
Q

What are lead lines?

A

radiodense deposits in the metaphyses (which interferes with remodeling of cartilage); also lead lines in the gums

65
Q

What does lead do to you hematologically?

A

gives you hypochromic microcytic anemia, basophilic stippling, and ring sideroblasts

66
Q

What is lead colic?

A

extremely severe, poorly localized abdominal pain

67
Q

how can you diagnose microcytic hypochromic anemia with a lab test?

A

if MVC is less than 80 fL

68
Q

What is the effect of exposure to mercury?

A

damages the CNS in the developing brain and also the kidney

69
Q

what are the main sources of mercury?

A

contaminated fish (methyl mercury), mercury vapors from metallic mercury in dental amalgams

70
Q

what are the effects of minamata disease?

A

cerebral palsy, deafness, blindness, mental retardation, and major CNS defects in children exposed in utero

71
Q

What are the effects of arsenic exposure?

A

it interferes with cellular metabolism–> toxicities most prominent in the GI tract, nervous system, skin, and heart

72
Q

Where might you be exposed to arsenic?

A

in the soil and water naturally; wood preservatives, herbicides, and herbal medicines

73
Q

what might you notice after 2-8 weeks post exposure to arsenic?

A

sensorimotor neuropathy, paresthesias, numbness, and pain

74
Q

What is a very unique characteristic of arsenic poisoning?

A

there are chronic skin changes- hyperpigmentation and hyperkeratosis on the palms and soles too; mees lines in the nails

75
Q

what cancers are you at risk for if exposed to arsenic?

A

lungs, bladder, and skin (multiple on palms and soles)

76
Q

What is cadmium poisoning preferentially toxic to?

A

kidneys and lungs (involve increased ROS

77
Q

What are the main sources of cadmium?

A

nickel-cadmium batteries, soil, plants (aka food)

78
Q

what are the effects of cadmium poisoning?

A

obstructive lung disease, renal tubular damage, skeletal abnormalities associated with calcium loss

79
Q

What is Itai-Itai?

A

a disease in Japan; osteoporosis and osteomalacia with renal disease- came from cadmium pollution in the Jinzu river in the 1950s

80
Q

What cancer are you more at risk for if you are exposed to cadmium? and where might this happen?

A

increased risk of lung cancer (if you liver near zinc smelters)

81
Q

What cancer could benzene cause?

A

leukemia

82
Q

What cancer could vinyl chloride cause?

A

liver angiosarcoma

83
Q

What toxicants could cause fibrosis?

A

silica, asbestos, and cobalt

84
Q

What toxicants could cause lung cancer?

A

radon, asbestos, and silica

85
Q

What are two examples of organic solvents that cause occupational health risks?

A

chloroform and carbon tetrachloride

86
Q

what does acute exposure to chloroform and carbon tetrachloride cause?

A

dizziness and confusion leading to CNS depression and coma

87
Q

what are lower levels of exposure to chloroform and carbon tetrachloride toxic for?

A

the liver and the kidneys

88
Q

What are rubber workers exposed to?

A

benzene and 1,3-butadiene

89
Q

Benzene is oxidized by hepatic CYP to toxic metabolites that disrupt what?

A

the differentiation of hematopoietic cells in the bone marrow–> leads to marrow aplasia and increased risk of AML

90
Q

what is the main source of polycyclic hydrocarbons, and what does exposure to these lead to?

A

combustion of fossil fuels; scrotal cancers

91
Q

what are chimney sweeps at risk for?

A

prostate cancer due to being exposed to polycyclic hydrocarbons

92
Q

polycyclic hydrocarbons are among the most potent carcinogens and industrial exposure implicated in what cancers?

A

lung and bladder

93
Q

What are organochlorines?

A

synthetic lipophilic products that resist degradation

94
Q

what are common organochlorines?

A

pesticides (such as DDT) or non pesticides such as PCBs and dioxin

95
Q

what effect do organochlorines have on the body?

A

they disrupt hormonal balance because of antiestrogenic and antiandrogenic activity

96
Q

What do dioxins and PCBs cause?

A

folliculitis and a dermatosis known as chloracne

97
Q

what is chloracne?

A

an acne with cyst formation, hyperpigmentation, and hyperkeratosis of the face and behind the ears

98
Q

What do mineral dusts such as coal dust, silica, asbestos, and beryllium cause?

A

pneumonconioses

99
Q

What does asbestosis cause?

A

mesothelioma and black lung

100
Q

what are ferruginous bodies?

A

asbestos fibers coated in iron

101
Q

what is BPA known as?

A

a potential endocrine disruptor

MOD Midterm (22 decks)

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