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SP 16 - Path Test 2 > Environmental Disease > Flashcards

Environmental Disease Flashcards

1
Q

What types of agents are we responsible for knowing

A

Chemical Agents
Physical Agents
Radiation Injury
Nutritional Diseases

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2
Q

Occupational Medicine

A

A field that relates to injuries in the workplace

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3
Q

What US agencies are involved in regulating environmental hazards?

A

Environmental Protection Agency (EPA)
Food and Drug Administration (FDA)
Occupational and Safety Health Administration (OSHA)
Consumer Products Safety Comission

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4
Q

How can chemical agents cause problems?

A

Inhalation
Ingestion
Injection
Absorption through the skin

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5
Q

What are the factors that effect chemical injuries?

A 
CLADME:
Concentration
Liberation
Absorption
Distribution
Metabolism
Excretion
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6
Q

The more potent the drug…

A

The more likely it is to cause an adverse reaction

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7
Q

What are some minor adverse reactions to therapeutic agents

A

Rashes

Upset GI

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8
Q

What are some major adverse reactions to therapeutic agents?

A

Anaphylaxis
Blood clots
Arrhythmias
Hematologic reactions

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9
Q

What levels of aspirin are fatal?

A

2-4 gms in kids

10-30 gms in agults

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10
Q

What are the acute adverse reactions to Aspirin

A

Its metabolic

-first, there is respiratory alkalosis, followed by metabolic acidosis

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11
Q

What levels of aspirin lead to chronic Aspirin issues?

A

3 gms a day

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12
Q

Long term hormone replacement therapy and oral contraceptives can lead to what?

A

Increased risk for cancer, strokes, and blood clots

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13
Q

What is the mechanism of lead poisoning enzymatically?

A

Lead has a high affinity for enzymes involved in the synthesis of hemoglobin
It blocks or hinders the incorporation of iron into the molecule - patients develop microcytic hypochromatic anemia

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14
Q

How and where does the majority of lead go?

A

85% is taken up by the bones and teeth
Lead competes with calcium and interferes with the remodeling process - Pb can’t be removed by osteoclasts, and bone will become hyperdense

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15
Q

How does Lead affect the nervous system

A

In kids: it can cause toxicity of the CNS, reducing IQs and develop learning diabilities
In adults: Lead to peripheral neuropathies, including wristdrop and footdrop

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16
Q

How does Lead affect the kidneys

A

It damages renal tubules, which can lead to interstitial fibrosis and renal failure

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17
Q

How does lead affect the GI tract

A

Causes severe, poorly localized, colicky (abdominal) pain

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18
Q

What is the maximum allowable lead blood level, according to the CDC?

A

5 ug/dL

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19
Q

What are the classes of Drugs of Abuse?

A 
Sedative-Hypnotics
CNS stimulants
Opioids
Hallucinogens
Inhalants
Nonprescription drugs
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20
Q

What is a major side effect of MDMA that we might see?

A

Bruxism

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21
Q

What drugs fall under the sedative class?

A

Alcohol
Barbituates
Benzodiazopines

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22
Q

What drugs fall under CNS stimulants?

A

Cocaine

Amphetamines

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23
Q

What drugs fall under Opioids?

A

Heroine
Morphine
Methadone
Codeine

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24
Q

What drugs fall under Hallucinogens?

A

LSD
PCP
Mescaline
MDMA

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25
Abrasion
A wound produced by scraping or rubbing, leading to removal of a superficial layer of skin
26
Contusion
aka a bruise A wound caused by a blunt object, doesn't break the skin, but may lead to damage to blood vessels and extravasation of blood in the tissues
27
Laceration
A tear in tissues - usually irregular with jagged edges
28
What are the important factors affecting the clinical significance of burns
Percentage of total body surface involved Depth of burn Potential for internal injuries from inhalation of fumes or hot gases Age of the patient Speed and quality of treatment
29
What are the surface area percentages of the body?
``` Head & Neck = 9% Trunk Front = 18% Trunk Back = 18% Legs = 18% Arms = 9% each Hands = 1% each Perineum (crotch) = 1% ```
30
Patients are in grave risk if how much bsa is covered?
50%
31
Patients are at risk of shock if how much bsa is covered?
>20% | Due to massive fluid shifts, infections, and electrolyte and nutrition issues
32
How does the age of a patient effect clinical significance of burns?
Elderly and very young patients are at higher risk
33
What are the clinical consequences of burns?
Death risk if >50% of bsa covered Shock risk if >20% of bsa is covered Internal injuries from fumes (CO, HCN) - damages both URT and LRT
34
What is a possible delayed consequence form burns?
Acute respiratory distress syndrome (ARDS)
35
What are the different types of Hyperthermia
Heat cramps Heat exhaustion Heat stroke
36
Heat cramps
Related to exercise with loss of fluid and electrolytes
37
Heat exhaustion
Shock due to rapid hypovolemia (decreased blood volume) and cardiovascular system fails to adjust Sudden onset, collapse, then recover Recovery is usually spontaneous
38
Heat stroke
Abnormal elevated body temperature over 40'C Peripheral vasodilation causes pooling and decreased circulating blood volume Tissues become ischemic, causing necrosis of the muscles and heart may lead to DIC
39
What things can facilitate the development of Hypothermia?
Humidity Wet clothes Vasodilation (EtOH)
40
What are the direct effects of hypothermia caused by?
Crystalization of water
41
What are the indirect effects of hypothermia caused by?
Circulatory changes - such as gangrene and trench foot
42
What is the core temperature range of Mild hypothermia?
32-35'C | 89-95'F
43
What is the core temperature range of Moderate hypothermia
28-32'C | 82-89'F
44
What is the core temperature range of Severe hypothermia?
45
Gray (Gy)
Unit that expresses the amount of energy absorbed by target tissue
46
Sievert
Roughly equal to Gy, but the dose also factors in relative biologic effect
47
How does radiation injury effect the skin?
Erythema: 2-3 days Edema: 2-4 weeks Blistering/Desquamation: 4-6 weeks Atrophy, fibrosis, and neoplasia: months-decades
48
What are the hematopoeitic/lymphoid effects of Radiation injury
Lymphocytes decrease in hours, they hopefully rebound after several weeks/months Lymph nodes and spleen shrink in size Neutrophils decrease over 1-2 weeks - rebound in 2-3 months, but the patient is susceptible to infection Platelets and RBCs decrease and take a long time to stabalize
49
What effect on the gonads do radiation injuries have?
Both sexes are sensitive to possible sterility | Cervix and uterus are resistant
50
What effect on the lungs do radiation injuries have?
Very sensitive to injury because of rich vascularity Can lead to pulmonary congestion and edema Acute respiratory distress syndrome (ARDS)
51
What effect on the blood vessels do radiation injuries have?
Blood vessels exposed to radiation first have endothelial injury, then later become fibrotic and narrow
52
Lethal range of radiaiton
Lethal range around 2 Sv | at 7 Sv, death is certain without treatment
53
Hematopoietic Acute Radiation Syndrome
``` 2-10 Sv Decrease in WBCs Hair loss Infections Sepsis and bleeding Death 2-6 weeks ```
54
GI Acute Radiation Syndrome
``` 10-20 Sv Vomitting Bloody Diarrhea Sepsis and Bleeding Death in 5-14 days ```
55
Cerebral Acute Radiation Syndrome
``` >50 Sv Listlessness Drowsiness Seizures Coma Death 1-4 hrs ```
56
What are the primary types of malnutrition
Primary | Secondary
57
Primary Malnutrition
Diet is deficient in 1 or more compounds
58
Secondary Malnutrition
The supply is fine, but there is a problem with storage, utilization, excessive losses, or drug effectives
59
What are the two major types of Protein-Energy Malnutrition (PEM)
Marassmus | Kwashiorkor
60
What are the two protein compartments effected in PEM?
Somatic | Visceral
61
What is the cause of Marasmus
Deficiency in caloric intake
62
What protein compartment is effected in Marasmus?
Somatic
63
What is the effect of Marasmus?
``` Extremities appear amaciated Growth retardation Anemia Multiple vitamin deficiencies Immune deficiencies Infections - Thrush Bradycardia and drop in body temperature ```
64
What causes Kwashiorkor?
Deficiency of proteins | It is the more common and more severe form of PEM
65
What protein compartment is depleted with Kwashiorkor?
Visceral
66
What is the effect of Kwashiorkor?
Low albumin leading to generalized edema Weight is 60-80% of normal, but is misleading because of edema Alternating zones of hyper and hypopigmentation Desquamation Changes in hair texture and color Growth retardation Infections
67
Cachexia
A secondary form of PEM seen in cancer patients
68
What are the functions of Vitamin A
Maintain vision in reduced light Augments differentiation of specialized epithelial cells Enhances immunity to infections
69
What is an early sign of a Vitamin A deficiency?
Impaired night vision
70
What are some other signs of a Vitamin A deficiency?
Persistent deficiency can cause dry eyes leading to corneal damage Squamous metaplasia of respiratory and urinary tracts - increasing the risk for infections and stones Impaired immunity Gingival bleeding and periodontal infections are common

SP 16 - Path Test 2 (5 decks)

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