environmental diseases

Question 1

factors affecting chemical injuries

Answer 1

CLADME: concentration, liberation, absorption, distribution, metabolism, and excretion

Question 2

3 notable adverse drug reactions

Answer 2

1. aspirin (acetylsalicylic acid or ASA)
2. acetaminophen (tylenol)
3. exogenous estrogens and oral contraceptives

Question 3

lead has a high affinity for enzymes involved in the synthesis of ____ which blocks or hinders the incorporation of ____ into the molecule; this causes patients to develop a ______

Answer 3

hemoglobin; iron; microcytic hypochromic anemia

Question 4

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

Answer 4

abrasion

Question 5

bruise; a wound caused by a blunt object, doesn’t break the skin but may lead to damage of BVs and extravasation of blood in tissues

Answer 5

contusion

Question 6

a tear in tissue- usually with irregular, jagged edges

Answer 6

laceration

Question 7

forms of radiation

Answer 7

1. electromagnetic waves- x-rays and gamma rays

2. high energy neutrons and charged particles (alpha and beta particles, protons)

Question 8

unit that expresses amount of energy absorbed by target tissue

Answer 8

gray (Gy)

Question 9

roughly equal to Gy, but dose also factors in relative biologic effect (RBE)

Answer 9

Sievert (Sv)

Question 10

changes in the skin with radiation

Answer 10

erythema (redness)- 2-3 days
edema (2-3 weeks)
blistering and desquamation (4-6 weeks)
atrophy, fibrosis, and cancers (months-years)

Question 11

_____ and ____ are very susceptible to radiation

Answer 11

hematopoietic; lymphoid tissues

Question 12

___ decrease in hours (rebound in weeks/months), ____ shrink in size, _____ decrease over 1-2 weeks and rebound in 2-3 months; ___ and ____ also decrease but take longer to rebound

Answer 12

lymphocytes
lymph nodes; spleen
granulocytes
platelets and RBCs

Question 13

lethal range of radiation in humans begins at about ____ and death is certain without medical care at ____ exposure

Answer 13

2 Sv; 7 Sv

Question 14

3 fatal acute radiation syndromes

Answer 14

1. hematopoietic
2. gastrointestinal
3. cerebral

Question 15

when a diet is deficient in 1 or more components

Answer 15

primary malnutrition

Question 16

supply is adequate, but there may be a problem with absorption, storage, utilization, excessive losses, or drug effects

Answer 16

secondary malnutrition

Question 17

common in developing countries and up to 25% of children affected; causes morbidity in children < 5 years old

Answer 17

protein-energy malnutrition (protein-calorie malnutrition)

Question 18

2 protein compartments in the body

Answer 18

1. somatic protein compartment

2. visceral protein compartment

Question 19

somatic protein compartment involves ____; can assess loss of this compartment by measuring _____

Answer 19

skeletal muscles; skinfold thickness

Question 20

visceral protein compartment located mainly at the ____; can assess this compartment by measuring _____

Answer 20

liver; serum proteins (albumin, transferrin)

Question 21

2 major disorders in which the intake of protein and/or calories is inadequate

Answer 21

marasmus and kwashiorkor

Question 22

when weight falls to < 60% of normal, child has _____

Answer 22

marasmus

Question 23

in marasmus, there is a deficiency of ____ which results in growth retardation and loss of muscle mass as the body catabolizes ____ to ____ as a source of energy

Answer 23

caloric intake; protein; amino acids

Question 24

in marasmus, there is ____ deficit, especially involving ____; this leads to infections like ____

Answer 24

immune; T-cell mediated immune system; Thrush

Question 25

in kwashiorkor, decreased ____ causes a loss of vascular oncotic pressure and _____ may result

Answer 25

albumin; generalized fluid retention and edema (can mask the true extend of the weight loss)

Question 26

classic skin changes associated with kwashiorkor

Answer 26

alternating zones of hypo and hyperpigmentation with desquamation (flaky paint appearance)

Question 27

functions of vitamin A

Answer 27

1. maintain normal vision in reduced light 2. augments differentiation of specialized epithelial cells (mucus-secreting) 3. enhances immunity to infections, especially in children

Question 28

fat soluble vitamins

Answer 28

A, D, E, K

Question 29

vitamin C or _____ is water-soluble and is an _____ vitamin because we cannot synthesize it

Answer 29

ascorbic acid; essential

Question 30

functions of vitamin C

Answer 30

1. formation and stabilization of collagen (hydroxylation of proline and lysine) 2. conversion of tyrosine to catecholamines 3. role as an antioxidant

Question 31

in scurvy (vitamin C deficiency), _____ (which needs collagen) and ability to _____ are impaired

Answer 31

wound healing; localize infections

Question 32

____ (due to bleeding and iron deficiency), _____, ____, and _____ are common

Answer 32

anemia; gingival bleeding; swelling; periodontal infections

Question 33

major acute injury of aspirin is ____; first there is ____ followed by _____

Answer 33

respiratory alkalosis; metabolic acidosis

Question 34

toxicity of acetaminophen (tylenol) is by damage to the ____; early symptoms are _____ but will be followed by _____

Answer 34

liver; non-specific; jaundice and shock (as liver failure progresses)

Question 35

lead deposits in the gums causes _____

Answer 35

hyperpigmentation

Question 36

in adults, lead toxicity may lead to _____

Answer 36

peripheral neuropathies (wristdrop and footdrop)

Question 37

treatment for lead toxicity is usually by _____ and supportive measures

Answer 37

chelation therapy (starting at 45 ug/dL)

Question 38

regarding burns, ____ total body surface involvement is grave

Answer 38

> 50%

Question 39

____ is frequent with burns that involve > 30-40% total body surface involvement; massive fluid shifts causing ____ and _____

Answer 39

shock; hypovolemic shock; sepsis/infections (pseudomonas species, candida)

Question 40

most common cause of hyperthermia; failure of the CV system to adjust to hypovolemia (can result in shock)

Answer 40

heat exhaustion

Question 41

heat stroke may lead to _____

Answer 41

DIC

Question 42

fat-soluble vitamins need healthy ____, ____, and _____ for absorption

Answer 42

intestinal mucosa; bile; pancreatic secretions

Question 43

scurvy is a disease of impaired _____, thus ____ are a common finding

Answer 43

collagen synthesis; hemorrhages (in the skin and gingival mucosa)

Question 44

scurvy in kids causes insufficient production of ____ resulting in _____, ____ of the long bones, and depression of the _____

Answer 44

osteoid matrix; cartilaginous overgrowth; bowing ; sternum