Environmental Diseases Flashcards
Difference in survival b/w smokers and nonsmokers
7.5 years
Four major patient safety issues
- Infection Control
- Surgical Errors
- Communication Errors
- Drug Errors
Drug causing hepatocellular damage
acetominophen
Drug causing thromboembolism
oral contraceptives or hormone replacement therapy
Drug causing renal papillary necrosis
Aspirin or Phenacetin
Drug causing pseudomembranous colitis
antibiotics
Drugs leading to second cancers
chemotherapeutic agents or radiotherapy
Primary cancer most commonly researched for second cancer development
Breast
Cancers commonly studied for second cancer development
Hodgkin disease, NHL, Breast, Testicular, ovarian, cervical (cancers often treated with radiotherapy and/or chemotherapy) - also occur at an early age
Second cancers associated with radiotherapy
AML, Thyroid, Female Breast
Second cancers associated with chemotherapy
AML
Signs of asbestos exposure
localized fibrous plaques, diffuse pleural fibrosis (rare), diffuse pulmonary interstitial fibrosis, lung cancer & mesothelioma
Two forms of asbestos fibers
Chrysotile & Amphibole
Chrysotile
- asbestos fiber that is curly & flexible
- accounts for 95% of all asbestos used in 20th century
- less potent than amphibole for mesothelioma
Amphibole
- Straight, stiff, & brittle asbestos fiber
- More pathogenic than chrysotile (delivered deeper into lungs)
- Longer thinner are more pathogenic then shorter thicker fibers
Most common sign of asbestos
localized pleural fibrous plaques
Common unintentional poisoning in the U.S.
Carbon Monoxide - half of deaths caused by motor-vehicle exhaust
Signs of carbon monoxide poisoning
headache, nausea, dyspnea, collapse, dizziness, loss of consiousness (signs of a good night out?)
Common health effects of carbon monoxide poisoning
brain (neuropsychologic), heart, liver, kidneys (high O2 consumption)
Pathologic brain findings of hypoxic brain injury (carbon monoxide poisoning)
cerebral cortex neurons, sommer’s sector of hippocampus, purkinje cells - cerebellum, BILATERAL NECROSIS OF GLOBUS PALLIDUS
Government air-quality standard of carbon monoxide to keep carboxyhemoglobin at what level in non-smokers
Carbon monoxide alarms designed to go off at what level of carboxyhemoglobin
> 10%
most common way radon enters home
from soil beneath them (cracks in foundation)
how is Iowa’s radon levels
consider the worst state with highest radon exposure on per household
What two by products of radon radiation cause the most damage
- polonium-218
2. polonium-214
What pathology does radon cause
lung cancer - 21,000 deaths/yr would be 7th leading cause of cancer death if separated from other lung cancers
Environmental gases you cannot See, Hear, Taste, or Smell
Radon & Carbon Monoxide
Major categories of pesticides & what they control for
- Insecticides - insects
- Herbicides - weeds
- Fungicides - fungus
- Rodenticides - rodents
- Fumigants - insecticides in the form of gases
Major route of absorption of insecticides and herbicides
Skin
Pesticide associated with more serious side effects
insecticides
Signs/Symptoms of pesticide poisoning
tired, headache, dizzy, sweaty, blurred vision, nausea, muscle pain, cramps - NON SPECIFIC
Insecticides associated with cholinesterase inhibition (neurotoxicity)
Organophosphates & Carbamates
Signs/Symptoms of organophosphate exposure
miosis, salivation, lacrimation, diaphoresis, twitching muscles, restlessness, acute respiratory distress, convulsions, coma
Suspected diseases of pesticide exposure
cancer, immunotoxicity, delayed neuropathy, respiratory distress, reproductive effects
IARC reports what two pesticides as carcinogenic
arsenical insecticides & dioxin
Types of radiation from lowest to greatest penetration
alpha
Two aspects that make cells more sensitive to radiation
- high mitotic activity
2. low differentiation
What three types of cancer are most sensitive to radiation
Lymphoma, Seminoma, Leukemia
How does radiation cause cancer
DNA Damge
Two ways radiation causes DNA Damage
Direct - double strand breaks
Indirect - Free radical formation
Major way radiation causes DNA damage
Indirect pathway - free radical formation
Morphologic changes to nucleus and cytoplasm from radiation
swelling, vacuolization, defects in membranes
Vascular changes from radiation exposure
dilation, swelling & vacuolization of endothelial cells, vessel wall hemorrhage & occasional rupture
Chronic cellular effects of radiation exposure
fibrosis, atrophy, vessel wall thickening, non-neoplastic complications, neoplasia
Types of injury from atomic bombings
burns, mechanical, high blast pressure, radiation
Types of injuries from atomic bomb based on location from bomb
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
Whole body radiation exposure somatic effects in order
- Transient prodromal phase - nausea/vomiting, headache, fever, diarrhea, cognitive impairment
- Ensuing asymptomatic latent period
- Principal phase - dose dependent
Principal phase of illness in ionizing radiation
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
Leading modifiable risk factor for death in the U.S.
Tobacco
