environmental diseases Flashcards

1
Q

factors affecting chemical injuries

A

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

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2
Q

3 notable adverse drug reactions

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

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 ______

A

hemoglobin; iron; microcytic hypochromic anemia

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4
Q

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

A

abrasion

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5
Q

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

A

contusion

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6
Q

a tear in tissue- usually with irregular, jagged edges

A

laceration

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7
Q

forms of radiation

A
  1. electromagnetic waves- x-rays and gamma rays

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

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8
Q

unit that expresses amount of energy absorbed by target tissue

A

gray (Gy)

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9
Q

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

A

Sievert (Sv)

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10
Q

changes in the skin with radiation

A

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

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11
Q

_____ and ____ are very susceptible to radiation

A

hematopoietic; lymphoid tissues

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12
Q

___ 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

A

lymphocytes
lymph nodes; spleen
granulocytes
platelets and RBCs

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13
Q

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

A

2 Sv; 7 Sv

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14
Q

3 fatal acute radiation syndromes

A
  1. hematopoietic
  2. gastrointestinal
  3. cerebral
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15
Q

when a diet is deficient in 1 or more components

A

primary malnutrition

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16
Q

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

A

secondary malnutrition

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17
Q

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

A

protein-energy malnutrition (protein-calorie malnutrition)

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18
Q

2 protein compartments in the body

A
  1. somatic protein compartment

2. visceral protein compartment

19
Q

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

A

skeletal muscles; skinfold thickness

20
Q

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

A

liver; serum proteins (albumin, transferrin)

21
Q

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

A

marasmus and kwashiorkor

22
Q

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

A

marasmus

23
Q

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

A

caloric intake; protein; amino acids

24
Q

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

A

immune; T-cell mediated immune system; Thrush

25
Q

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

A

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

26
Q

classic skin changes associated with kwashiorkor

A

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

27
Q

functions of vitamin A

A
  1. maintain normal vision in reduced light
  2. augments differentiation of specialized epithelial cells (mucus-secreting)
  3. enhances immunity to infections, especially in children
28
Q

fat soluble vitamins

A

A, D, E, K

29
Q

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

A

ascorbic acid; essential

30
Q

functions of vitamin C

A
  1. formation and stabilization of collagen (hydroxylation of proline and lysine)
  2. conversion of tyrosine to catecholamines
  3. role as an antioxidant
31
Q

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

A

wound healing; localize infections

32
Q

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

A

anemia; gingival bleeding; swelling; periodontal infections

33
Q

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

A

respiratory alkalosis; metabolic acidosis

34
Q

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

A

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

35
Q

lead deposits in the gums causes _____

A

hyperpigmentation

36
Q

in adults, lead toxicity may lead to _____

A

peripheral neuropathies (wristdrop and footdrop)

37
Q

treatment for lead toxicity is usually by _____ and supportive measures

A

chelation therapy (starting at 45 ug/dL)

38
Q

regarding burns, ____ total body surface involvement is grave

A

> 50%

39
Q

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

A

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

40
Q

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

A

heat exhaustion

41
Q

heat stroke may lead to _____

A

DIC

42
Q

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

A

intestinal mucosa; bile; pancreatic secretions

43
Q

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

A

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

44
Q

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

A

osteoid matrix; cartilaginous overgrowth; bowing ; sternum