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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
Q

Abrasion

A

A wound produced by scraping or rubbing, leading to removal of a superficial layer of skin

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26
Q

Contusion

A

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

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27
Q

Laceration

A

A tear in tissues - usually irregular with jagged edges

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28
Q

What are the important factors affecting the clinical significance of burns

A

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

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29
Q

What are the surface area percentages of the body?

A 
Head & Neck = 9%
Trunk Front = 18%
Trunk Back = 18%
Legs = 18%
Arms = 9% each
Hands = 1% each
Perineum (crotch) = 1%
30
Q

Patients are in grave risk if how much bsa is covered?

A

50%

31
Q

Patients are at risk of shock if how much bsa is covered?

A

> 20%

Due to massive fluid shifts, infections, and electrolyte and nutrition issues

32
Q

How does the age of a patient effect clinical significance of burns?

A

Elderly and very young patients are at higher risk

33
Q

What are the clinical consequences of burns?

A

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
Q

What is a possible delayed consequence form burns?

A

Acute respiratory distress syndrome (ARDS)

35
Q

What are the different types of Hyperthermia

A

Heat cramps
Heat exhaustion
Heat stroke

36
Q

Heat cramps

A

Related to exercise with loss of fluid and electrolytes

37
Q

Heat exhaustion

A

Shock due to rapid hypovolemia (decreased blood volume) and cardiovascular system fails to adjust
Sudden onset, collapse, then recover
Recovery is usually spontaneous

38
Q

Heat stroke

A

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
Q

What things can facilitate the development of Hypothermia?

A

Humidity
Wet clothes
Vasodilation (EtOH)

40
Q

What are the direct effects of hypothermia caused by?

A

Crystalization of water

41
Q

What are the indirect effects of hypothermia caused by?

A

Circulatory changes - such as gangrene and trench foot

42
Q

What is the core temperature range of Mild hypothermia?

A

32-35’C

89-95’F

43
Q

What is the core temperature range of Moderate hypothermia

A

28-32’C

82-89’F

44
Q

What is the core temperature range of Severe hypothermia?

A
45
Q

Gray (Gy)

A

Unit that expresses the amount of energy absorbed by target tissue

46
Q

Sievert

A

Roughly equal to Gy, but the dose also factors in relative biologic effect

47
Q

How does radiation injury effect the skin?

A

Erythema: 2-3 days
Edema: 2-4 weeks
Blistering/Desquamation: 4-6 weeks
Atrophy, fibrosis, and neoplasia: months-decades

48
Q

What are the hematopoeitic/lymphoid effects of Radiation injury

A

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
Q

What effect on the gonads do radiation injuries have?

A

Both sexes are sensitive to possible sterility

Cervix and uterus are resistant

50
Q

What effect on the lungs do radiation injuries have?

A

Very sensitive to injury because of rich vascularity
Can lead to pulmonary congestion and edema
Acute respiratory distress syndrome (ARDS)

51
Q

What effect on the blood vessels do radiation injuries have?

A

Blood vessels exposed to radiation first have endothelial injury, then later become fibrotic and narrow

52
Q

Lethal range of radiaiton

A

Lethal range around 2 Sv

at 7 Sv, death is certain without treatment

53
Q

Hematopoietic Acute Radiation Syndrome

A 
2-10 Sv
Decrease in WBCs
Hair loss
Infections
Sepsis and bleeding
Death 2-6 weeks
54
Q

GI Acute Radiation Syndrome

A 
10-20 Sv
Vomitting
Bloody Diarrhea
Sepsis and Bleeding
Death in 5-14 days
55
Q

Cerebral Acute Radiation Syndrome

A 
>50 Sv
Listlessness
Drowsiness
Seizures
Coma
Death 1-4 hrs
56
Q

What are the primary types of malnutrition

A

Primary

Secondary

57
Q

Primary Malnutrition

A

Diet is deficient in 1 or more compounds

58
Q

Secondary Malnutrition

A

The supply is fine, but there is a problem with storage, utilization, excessive losses, or drug effectives

59
Q

What are the two major types of Protein-Energy Malnutrition (PEM)

A

Marassmus

Kwashiorkor

60
Q

What are the two protein compartments effected in PEM?

A

Somatic

Visceral

61
Q

What is the cause of Marasmus

A

Deficiency in caloric intake

62
Q

What protein compartment is effected in Marasmus?

A

Somatic

63
Q

What is the effect of Marasmus?

A 
Extremities appear amaciated
Growth retardation
Anemia
Multiple vitamin deficiencies
Immune deficiencies
Infections - Thrush
Bradycardia and drop in body temperature
64
Q

What causes Kwashiorkor?

A

Deficiency of proteins

It is the more common and more severe form of PEM

65
Q

What protein compartment is depleted with Kwashiorkor?

A

Visceral

66
Q

What is the effect of Kwashiorkor?

A

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
Q

Cachexia

A

A secondary form of PEM seen in cancer patients

68
Q

What are the functions of Vitamin A

A

Maintain vision in reduced light
Augments differentiation of specialized epithelial cells
Enhances immunity to infections

69
Q

What is an early sign of a Vitamin A deficiency?

A

Impaired night vision

70
Q

What are some other signs of a Vitamin A deficiency?

A

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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