Environmental Diseases

Question 1

how does smoking cause emphasema

Answer 1

ROS inactivate anti-proteases (functional AT def) –> inc activity of neutrophil elastase –> tissue damage –> inc MMP and macrophage proteases –> more damage

Question 2

gene that controls the response to injury after smoking

Answer 2

TGFB gene (TGF-beta reduced = inadequate repair)

Question 3

effect of toxins in cigarette smoke on lungs

Answer 3

1. Injure the mucociliary apparatus
   for escalating bacteria out of the lungs
2. Cause inflammation recruiting phagocytes
   that leak their proteases
3. Inhibit anti-proteases needed to protect
   against protease tissue injury
4. Cause mucus production and secretion,
   yielding a place for bacteria to grow
5. Inhibit phagocytosis and bacterial killing
   by phagocytes
6. Cause squamous metaplasia, removing
   mucociliary clearance of bacteria
7. Kill respiratory epithelial cells, removing
   a barrier to bacterial invasion

Question 4

what is basophillic stippliang and what is it assc with

Answer 4

clumped ribosomes** assc w/ lead poisoning and disorders of RBC maturation (B12 and folate def)

**ribosomes clump bc pyrimidine 5- nucleotidase is inhibited thus causing the degradation of ribosomes

Question 5

manifestations of lead tox in KIDS at low doses vs high doses

manifestations of lead tox in ADULTS at low doses vs high doses

Answer 5

KIDS

low: cognitive impairment, hyperactivity, dec verbal activity
high: abd pain, arthralgia, renal probs, tremor

ADULTS

low: short term meory loss, diff concentrating
high: periph demyelinating neuropathy, arthralgia, abd pain, renal

Question 6

pathophys of lead toxicity (heme and neuro effects)

Answer 6

HEME
electropositivity = has high affinity for sulfhydryl groups and when it binds it inhibs enzymes such as ALA DH and ferrochelatase –> accumution of protoporphyins –> toxic

NEURO
Pb competes with Ca2+ for mitochondrial respiration–> disrupts processes/activates PKC –> problems

Question 7

MC substance that is abused during pregnancy

Answer 7

cigarettes > alcohol > illicit drugs

Question 8

how does alcohol cause hepatic steatosis

Answer 8

ethanol required NAD for its metabolism by alcohol and acetylaldehyde DH –> depletes NAD pool which is needed for lipid oxidation –> lipid cannot be broken down so it accumulates in the liver

alcohol also decreases assembly and secretion of lipoproteins

Question 9

What are mallory-denk bodies

Answer 9

tangles of cytoskeleton (cytokeratin intermediate filaments)

Question 10

how does alcohol cause hepatitis

Answer 10

1. acetaldehyde induces lipid peroxidation + adducts proteins –> damage to membrane and cytoskeleton
2. alcohol directly damages cytoskeleton
3. generates ROS
4. activates inflammation TNF