Environmental Diseases

Question 1

Difference in survival b/w smokers and nonsmokers

Answer 1

7.5 years

Question 2

Four major patient safety issues

Answer 2

1. Infection Control
2. Surgical Errors
3. Communication Errors
4. Drug Errors

Question 3

Drug causing hepatocellular damage

Answer 3

acetominophen

Question 4

Drug causing thromboembolism

Answer 4

oral contraceptives or hormone replacement therapy

Question 5

Drug causing renal papillary necrosis

Answer 5

Aspirin or Phenacetin

Question 6

Drug causing pseudomembranous colitis

Answer 6

antibiotics

Question 7

Drugs leading to second cancers

Answer 7

chemotherapeutic agents or radiotherapy

Question 8

Primary cancer most commonly researched for second cancer development

Answer 8

Breast

Question 9

Cancers commonly studied for second cancer development

Answer 9

Hodgkin disease, NHL, Breast, Testicular, ovarian, cervical (cancers often treated with radiotherapy and/or chemotherapy) - also occur at an early age

Question 10

Second cancers associated with radiotherapy

Answer 10

AML, Thyroid, Female Breast

Question 11

Second cancers associated with chemotherapy

Answer 11

AML

Question 12

Signs of asbestos exposure

Answer 12

localized fibrous plaques, diffuse pleural fibrosis (rare), diffuse pulmonary interstitial fibrosis, lung cancer & mesothelioma

Question 13

Two forms of asbestos fibers

Answer 13

Chrysotile & Amphibole

Question 14

Chrysotile

Answer 14

• asbestos fiber that is curly & flexible
• accounts for 95% of all asbestos used in 20th century
• less potent than amphibole for mesothelioma

Question 15

Amphibole

Answer 15

• Straight, stiff, & brittle asbestos fiber
• More pathogenic than chrysotile (delivered deeper into lungs)
• Longer thinner are more pathogenic then shorter thicker fibers

Question 16

Most common sign of asbestos

Answer 16

localized pleural fibrous plaques

Question 17

Common unintentional poisoning in the U.S.

Answer 17

Carbon Monoxide - half of deaths caused by motor-vehicle exhaust

Question 18

Signs of carbon monoxide poisoning

Answer 18

headache, nausea, dyspnea, collapse, dizziness, loss of consiousness (signs of a good night out?)

Question 19

Common health effects of carbon monoxide poisoning

Answer 19

brain (neuropsychologic), heart, liver, kidneys (high O2 consumption)

Question 20

Pathologic brain findings of hypoxic brain injury (carbon monoxide poisoning)

Answer 20

cerebral cortex neurons, sommer’s sector of hippocampus, purkinje cells - cerebellum, BILATERAL NECROSIS OF GLOBUS PALLIDUS

Question 21

Government air-quality standard of carbon monoxide to keep carboxyhemoglobin at what level in non-smokers

Question 22

Carbon monoxide alarms designed to go off at what level of carboxyhemoglobin

Answer 22

> 10%

Question 23

most common way radon enters home

Answer 23

from soil beneath them (cracks in foundation)

Question 24

how is Iowa’s radon levels

Answer 24

consider the worst state with highest radon exposure on per household

Question 25

What two by products of radon radiation cause the most damage

Answer 25

1. polonium-218 | 2. polonium-214

Question 26

What pathology does radon cause

Answer 26

lung cancer - 21,000 deaths/yr would be 7th leading cause of cancer death if separated from other lung cancers

Question 27

Environmental gases you cannot See, Hear, Taste, or Smell

Answer 27

Radon & Carbon Monoxide

Question 28

Major categories of pesticides & what they control for

Answer 28

1. Insecticides - insects 2. Herbicides - weeds 3. Fungicides - fungus 4. Rodenticides - rodents 5. Fumigants - insecticides in the form of gases

Question 29

Major route of absorption of insecticides and herbicides

Answer 29

Skin

Question 30

Pesticide associated with more serious side effects

Answer 30

insecticides

Question 31

Signs/Symptoms of pesticide poisoning

Answer 31

tired, headache, dizzy, sweaty, blurred vision, nausea, muscle pain, cramps - NON SPECIFIC

Question 32

Insecticides associated with cholinesterase inhibition (neurotoxicity)

Answer 32

Organophosphates & Carbamates

Question 33

Signs/Symptoms of organophosphate exposure

Answer 33

miosis, salivation, lacrimation, diaphoresis, twitching muscles, restlessness, acute respiratory distress, convulsions, coma

Question 34

Suspected diseases of pesticide exposure

Answer 34

cancer, immunotoxicity, delayed neuropathy, respiratory distress, reproductive effects

Question 35

IARC reports what two pesticides as carcinogenic

Answer 35

arsenical insecticides & dioxin

Question 36

Types of radiation from lowest to greatest penetration

Answer 36

alpha

Question 37

Two aspects that make cells more sensitive to radiation

Answer 37

1. high mitotic activity | 2. low differentiation

Question 38

What three types of cancer are most sensitive to radiation

Answer 38

Lymphoma, Seminoma, Leukemia

Question 39

How does radiation cause cancer

Answer 39

DNA Damge

Question 40

Two ways radiation causes DNA Damage

Answer 40

Direct - double strand breaks | Indirect - Free radical formation

Question 41

Major way radiation causes DNA damage

Answer 41

Indirect pathway - free radical formation

Question 42

Morphologic changes to nucleus and cytoplasm from radiation

Answer 42

swelling, vacuolization, defects in membranes

Question 43

Vascular changes from radiation exposure

Answer 43

dilation, swelling & vacuolization of endothelial cells, vessel wall hemorrhage & occasional rupture

Question 44

Chronic cellular effects of radiation exposure

Answer 44

fibrosis, atrophy, vessel wall thickening, non-neoplastic complications, neoplasia

Question 45

Types of injury from atomic bombings

Answer 45

burns, mechanical, high blast pressure, radiation

Question 46

Types of injuries from atomic bomb based on location from bomb

Answer 46

Hypocenter - everything vaporized Blast area - most lethal casualties from heat burns, blast, fallen debris Outside blast area - casualties from fire & radiation Outside area damaged by explosion - casualties due to long-term health effects

Question 47

Whole body radiation exposure somatic effects in order

Answer 47

1. Transient prodromal phase - nausea/vomiting, headache, fever, diarrhea, cognitive impairment 2. Ensuing asymptomatic latent period 3. Principal phase - dose dependent

Question 48

Principal phase of illness in ionizing radiation

Answer 48

0-1 Sv: no injury - 100% survival 1-2 Sv: lymphocytes - lymphopenia in 1-7 days; 100% survival 2-10 Sv: bone marrow - leukopenia, hemorrhage, hair loss in 4-6 weeks; 0-80% survival 10-20 Sv: small bowel - diarrhea, fever, electrolyte imbalance in 5-14 days; 100% lethal >50 Sv: brain - ataxia, vomit, coma, convulsions in 1-4 hours; 100% lethal

Question 49

Leading modifiable risk factor for death in the U.S.

Answer 49

Tobacco