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

Environmental and Nutritional Disorders: Part III Flashcards

1
Q

What three major symptoms does cocaine cause?

A

tachycardia, HTN, and peripheral vasoconstriction

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2
Q

how does cocaine use lead to myocardial ischemia?

A

coronary artery vasoconstriction + platelet aggregation+ thrombus formation leads to myocardial ischemia

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3
Q

what does cigarette smoking and cocaine use potentiate

A

cocaine induced coronary vasospasm

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4
Q

what can be said about the lethal arrhythmias that are associated with cocaine use?

A

they are not dose related; so this could be a first time use of cocaine and it could be a very small amount and still cause lethal arrhythmias

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5
Q

What effect does cocaine have on the placenta?

A

it decreases blood flow to the placenta, which causes fetal hypoxia and spontaneous abortion

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6
Q

what effect does cocaine have on the CNS?

A

hyperpyrexia (fever) and seizures

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7
Q

what are the major effects of opiate use?

A

profound respiratory depression, arrhythmia, cardiac arrest, and pulmonary edema

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8
Q

if a drug abuser injects opiates or heroin, what could happen?

A

they are injecting into a vein so there could be an infection leading to endocarditis of the right side of the heart (NOT THE LEFT)

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9
Q

what are the symptoms of methamphetamine use?

A

violent behavior, confusion, psychotic symptoms (paranoia and hallucinations)

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10
Q

what is MDMA?

A

ecstasy; often spiked with other drugs which can enhance its effects on the CNS

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11
Q

what are the effects of chronic use of ecstasy?

A

sleep disorders, depression, anxiety, and aggressive behavior

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12
Q

what are the effects of marijuana?

A

increased heart rate, changes to blood pressure (could cause angina in a patient with CAD), cognitive and psychomotor impairment with continued use; there are also large carcinogens in smoke

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13
Q

what are the effects of huffing/glue sniffing?

A

there is MRI detectable brain damage that ranges from mild to severe dementia

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14
Q

what are the effects of bath salts?

A

agitation, psychosis, MI, and suicide

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15
Q

if you open a body bag of a person that overdosed on opiates, what would you expect to find?

A

a foam cone centered over the nose and mouth–> bubble frothy fluid coming out of the lungs and out through the nose and mouth due to pulmonary edema

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16
Q

The clinical significance of burn injuries depends on 4 things, what are they?

A

depth of the burn, % of body surface covered by the burn, internal injuries, and fluid and electrolyte management and infection control

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17
Q

What classifies a burn as 1st degree?

A

superficial; epidermis only

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18
Q

what classifies a burn as 2nd degree?

A

partial thickness; epidermis and dermis

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19
Q

what classifies a burn as 3rd degree?

A

full thickness; extend into the subcutaneous tissue

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20
Q

what classifies a burn as 4th degree?

A

full thickness; involves the underlying muscle and the subcutaneous tissue

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21
Q

what percentage is the adult torso?

A

a: 18% p: 18%

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22
Q

what percentage is the adult arm?

A

a: 4.5% p: 4.5%

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23
Q

what percentage is the adult leg?

A

a: 9 p: 9%

24
Q

what percentage is the adult head?

A

a:4.5% p: 4.5%

25
Q

what percent is the male genitalia?

A

1%

26
Q

when we are talking about internal injuries what are we talking about?

A

inhalation of toxic fumes and heat injuries especially considering the trachea (important to consider this because this could cause issues when trying to incubate)

27
Q

when you have loss of skin, what issue arises?

A

maintenance of fluid and electrolyte balance–> must monitor

28
Q

What should you expect to see if a patient has more than 20% of their body surface covered in burns?

A

there will be a rapid shift of body fluids into the interstitial compartment leading to shock–> this ultimately can lead to PULMONARY EDEMA

29
Q

what happens if more than 40% of the body surface is burned?

A

the resting metabolic rate doubles

30
Q

what are some of the colonizations that occur on burns?

A

pseudomonas aeruginosa (most common), MRSA, and candida species

31
Q

what happens within 24-48 hours of being burned?

A

respiratory insufficiency–> direct heat effects on the upper airway (mouth, nose, trachea) and inhalation of noxious gases (Cl, sulfur dioxide, and ammonia)

32
Q

what is the stance that is found when bodies are burned beyond recognition?

A

pugilistic stance

33
Q

what is the effect of heat exhaustion?

A

sudden prostration and collapse; lack of cardiac compensation for hypovolemia caused by dehydration; if you rehydrate you should recover

34
Q

what are the signs of heat stroke?

A

sweating ceases and core body temperature rises to more than 40 degrees C, leading to multiorgan dysfunction

35
Q

what all occurs during heat stroke?

A

generalized vasodilation with peripheral pooling of blood and decreased effective circulating blood volume; hyperkalemia, tachycardia, arrhythmias

36
Q

what does sustained contractions of skeletal muscle lead to?

A

muscle necrosis (rhabdomyolysis)

37
Q

what regulates calcium release from the sarcoplasm (and the calcium leak stimulates the muscle contraction)?

A

the RYR1 gene

38
Q

what is malignant hyperthermia?

A

“heat stroke-like” rise in core body temp and muscle contractures in response to common anesthetics

39
Q

how do you treat malignant hyperthermia?

A

muscle relaxers

40
Q

what is hypothermia defined as?

A

when body temperatures fall below 90 degrees

41
Q

what can hypothermia lead to within the body?

A

loss of consciousness, bradycardia, then atrial fibrillation

42
Q

what could worsen hypothermia?

A

high humidity, wet clothing, and it is exacerbated by EtOH

43
Q

what are the direct effects of hypothermia?

A

frostbite (which is crystallization if the intra and extracellular water)

44
Q

what are the indirect effects of hypothermia?

A

vasoconstriction and an increase in vascular permeability, which leads to edema and hypoxia, which leads to hypoxia and infarction of the extremities which causes GANGRENE

45
Q

What is paradoxical undressing?

A

often times before a person dies from hypothermia, they experience a burst of extreme heat and it causes them to undress themselves

46
Q

when discussing electrical injuries, there are two types of injuries. What are these?

A

1) burns 2) ventricular fibrillation or cardiac-respiratory failure

47
Q

What does the extent of electrical injury depend on?

A

the strength (amps), duration, and path of current through body

48
Q

What are low-voltage electrical injuries?

A

typically household injuries; burn sites at entry and exit if sustained

49
Q

in low-voltage electrical injuries, the alternating currents induce what?

A

tetanic muscle spasms; irreversible grasp; spasm of the chest wall (asphyxia)

50
Q

what are high-voltage electrical injuries?

A

lightening is a classic example; causes paralysis of the medullary centers and more extensive burns

51
Q

what is the pattern that occurs on the skin if a patient has been struck by lightening?

A

lichtenberg figures (these are transient)

52
Q

What is the morphology after someone undergoes ionizing radiation?

A

nuclear swelling, giant cells, pleomorphic nuclei, >1 nucleus, cytoplasmic swelling

53
Q

what problem might a pathologist have when evaluating irradiated tissues for the possible persistence of tumor cells?

A

the histological constellation of cellular pleomorphism, giant-cell formation, conformational changes in nuclei, and abnormal mitotic figures creates a more than passing similarity between radiation-injured cells and cancer cells

54
Q

What are secondary cancers?

A

individuals who received radiation therapy for cancers such as Hodgkin’s lymphoma may develop different cancers-secondary cancers- such as AML, myelodysplastic syndrome (MDS), and solid tumors

55
Q

if someone has radiotherapy to the mediastinum, what might happen?

A

they could get extensive fibrosis in the area- so not just the lungs, but the pericardial sac can become very thick and fibrotic and this can have some interference with its functionality

MOD Midterm (22 decks)

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