environmental diseases Flashcards
factors affecting chemical injuries
CLADME: concentration, liberation, absorption, distribution, metabolism, and excretion
3 notable adverse drug reactions
- aspirin (acetylsalicylic acid or ASA)
- acetaminophen (tylenol)
- exogenous estrogens and oral contraceptives
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 ______
hemoglobin; iron; microcytic hypochromic anemia
a wound produced by scraping or rubbing leading to removal of a superficial layer of skin
abrasion
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
contusion
a tear in tissue- usually with irregular, jagged edges
laceration
forms of radiation
- electromagnetic waves- x-rays and gamma rays
2. high energy neutrons and charged particles (alpha and beta particles, protons)
unit that expresses amount of energy absorbed by target tissue
gray (Gy)
roughly equal to Gy, but dose also factors in relative biologic effect (RBE)
Sievert (Sv)
changes in the skin with radiation
erythema (redness)- 2-3 days
edema (2-3 weeks)
blistering and desquamation (4-6 weeks)
atrophy, fibrosis, and cancers (months-years)
_____ and ____ are very susceptible to radiation
hematopoietic; lymphoid tissues
___ 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
lymphocytes
lymph nodes; spleen
granulocytes
platelets and RBCs
lethal range of radiation in humans begins at about ____ and death is certain without medical care at ____ exposure
2 Sv; 7 Sv
3 fatal acute radiation syndromes
- hematopoietic
- gastrointestinal
- cerebral
when a diet is deficient in 1 or more components
primary malnutrition
supply is adequate, but there may be a problem with absorption, storage, utilization, excessive losses, or drug effects
secondary malnutrition
common in developing countries and up to 25% of children affected; causes morbidity in children < 5 years old
protein-energy malnutrition (protein-calorie malnutrition)
2 protein compartments in the body
- somatic protein compartment
2. visceral protein compartment
somatic protein compartment involves ____; can assess loss of this compartment by measuring _____
skeletal muscles; skinfold thickness
visceral protein compartment located mainly at the ____; can assess this compartment by measuring _____
liver; serum proteins (albumin, transferrin)
2 major disorders in which the intake of protein and/or calories is inadequate
marasmus and kwashiorkor
when weight falls to < 60% of normal, child has _____
marasmus
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
caloric intake; protein; amino acids
in marasmus, there is ____ deficit, especially involving ____; this leads to infections like ____
immune; T-cell mediated immune system; Thrush
in kwashiorkor, decreased ____ causes a loss of vascular oncotic pressure and _____ may result
albumin; generalized fluid retention and edema (can mask the true extend of the weight loss)
classic skin changes associated with kwashiorkor
alternating zones of hypo and hyperpigmentation with desquamation (flaky paint appearance)
functions of vitamin A
- maintain normal vision in reduced light
- augments differentiation of specialized epithelial cells (mucus-secreting)
- enhances immunity to infections, especially in children
fat soluble vitamins
A, D, E, K
vitamin C or _____ is water-soluble and is an _____ vitamin because we cannot synthesize it
ascorbic acid; essential
functions of vitamin C
- formation and stabilization of collagen (hydroxylation of proline and lysine)
- conversion of tyrosine to catecholamines
- role as an antioxidant
in scurvy (vitamin C deficiency), _____ (which needs collagen) and ability to _____ are impaired
wound healing; localize infections
____ (due to bleeding and iron deficiency), _____, ____, and _____ are common
anemia; gingival bleeding; swelling; periodontal infections
major acute injury of aspirin is ____; first there is ____ followed by _____
respiratory alkalosis; metabolic acidosis
toxicity of acetaminophen (tylenol) is by damage to the ____; early symptoms are _____ but will be followed by _____
liver; non-specific; jaundice and shock (as liver failure progresses)
lead deposits in the gums causes _____
hyperpigmentation
in adults, lead toxicity may lead to _____
peripheral neuropathies (wristdrop and footdrop)
treatment for lead toxicity is usually by _____ and supportive measures
chelation therapy (starting at 45 ug/dL)
regarding burns, ____ total body surface involvement is grave
> 50%
____ is frequent with burns that involve > 30-40% total body surface involvement; massive fluid shifts causing ____ and _____
shock; hypovolemic shock; sepsis/infections (pseudomonas species, candida)
most common cause of hyperthermia; failure of the CV system to adjust to hypovolemia (can result in shock)
heat exhaustion
heat stroke may lead to _____
DIC
fat-soluble vitamins need healthy ____, ____, and _____ for absorption
intestinal mucosa; bile; pancreatic secretions
scurvy is a disease of impaired _____, thus ____ are a common finding
collagen synthesis; hemorrhages (in the skin and gingival mucosa)
scurvy in kids causes insufficient production of ____ resulting in _____, ____ of the long bones, and depression of the _____
osteoid matrix; cartilaginous overgrowth; bowing ; sternum
