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General Pathology > Environmental Diseases > Flashcards

Environmental Diseases Flashcards

1
Q

“Environmental diseases” refers to injuries or disorders that are caused by ________ or _______ agents.

A

chemical

physical

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2
Q

It’s estimated that U.S. work-related injuries occur _ times more frequently than home injuries.

A

2

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3
Q

List the U.S. agencies involved in regulating environmental hazards.

A

EPA
FDA
OSHA
Consumer Products Safety Commission

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4
Q

These agents typically cause injuries via inhalation, ingestion, injection, or absorption through the skin

A

Chemical agents

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5
Q

There are an estimated _______ (how many?) potentially hazardous exposures each year in the U.S.?

A

2 million

Note: Most (90%) are unintentional

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6
Q

Name some common household items that are the most frequent chemical agents to cause harm.

A 
cleaning agents
analgesics
cosmetics
plants
cold medications
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7
Q

Children (<6 years) account for over __% of exposures.

A

60

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8
Q

There are several factors that affect chemical injuries. What does CLADME stand for?

A 
Concentration
Liberation
Absorption
Distribution
Metabolism
Excretion
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9
Q

___________ can occur with any medication, but is most often associated with antibiotics (penicillin is a classic example)

A

Anaphylaxis

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10
Q

The more ______ the drug, the more likely it is to cause an adverse reaction.

A

potent

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11
Q

Some other notable adverse drug reactions include:

A

Aspirin - acute metabolic injury (respiratory alkalosis followed by metabolic acidosis)
Acetaminophen - liver damage
Exogenous estrogens & oral contraceptives - increased risk for breast cancer, strokes, and blood clots

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12
Q

Lead has a ____ affinity for enzymes involved in the synthesis of _________ which blocks or hinders the incorporation of ____ into the molecule.

A

high
hemoglobin
iron

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13
Q

Patients with lead toxicity will develop what condition?

A

microcytic hypochromic anemia

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14
Q

The majority of absorbed lead is taken up by the…

A

bones and teeth

80-85%

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15
Q

Lead competes with _______ and interferes with the normal __________ process.

A

calcium

remodeling

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16
Q

T/F

In lead toxicity, bone becomes hyperdense with visible changes on x-rays (lead lines).

A

True

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17
Q

T/F
In children, lead toxicity in the CNS may result in reduced IQ’s and learning disabilities, while adults may develop peripheral neuropathies (wrist/foot drop)

A

True

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18
Q

Lead deposits in the gingiva causes…

A

hyperpigmentation (lead lines of soft tissue)

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19
Q

T/F

Lead toxicity in the GI tract is characterized by mild, localized, “colicky” pain.

A

False

severe, poorly localized

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20
Q

T/F

Lead toxicity can also affect the kidneys.

A

True

Lead damages renal tubules which may lead to interstitial fibrosis and possibly even failure.

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21
Q

The maximum allowable blood lead level is _ ug/dL

A

5

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22
Q

Treatment for lead toxicity consists of ________ therapy and _________ measures.

A

chelation (starting at 45 ug/dL)

supportive

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23
Q

Name the general classes of drugs of abuse

A 
sedative-hypnotics
CNS stimulants
opioids
cannabinoids
hallucinogens
inhalants
non-prescription drugs
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24
Q

This is a collective term for substances that have become popular in dance clubs, bars, raves, or trances.

A

club drugs

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25
Q

____ is a methamphetamine and is the pure crystalline form of ________.

A

MDMA

ecstasy

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26
Q

One of the side effects of MDMA is _______ which users deal with by using a ________.

A

bruxism

pacifier

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27
Q

Mechanical injuries include, but are not limited to… (3 types)

A

abrasion
contusion
laceration

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28
Q

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

A

abrasion

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29
Q

A wound caused by a blunt object - doesn’t break the skin but may lead to damage to blood vessels and extravasation of blood in tissues (AKA bruise)

A

contusion

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30
Q

A tear in tissue - usually irregular, jagged edges

A

laceration

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31
Q

About how many deaths per year in the U.S. are caused by thermal burns?

A

> 5000

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32
Q

The body operates in a temperature range of…

A

31-41 degrees Celsius (89-106 degrees Fahrenheit)

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33
Q

What are the factors affecting the clinical significance of burns?

A
  • percentage of total body surface involved
  • depth of the burn (full vs particle thickness)
  • possible internal injuries
  • age of the patient
  • how fast and how well is it treated
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34
Q

> __% total body surface involvement is grave.

A

50

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35
Q

With >30-40% total body surface involvement, ______ is frequent.

A

shock

36
Q

T/F

Internal thermal injury is a possible clinical consequence of burns.

A

True

noxious fumes, any part of respiratory tract may be damaged, delayed ARDS

37
Q

Heat cramps, heat exhaustion, and heat stroke are all consequences of what condition?

A

Hyperthermia

38
Q

Abnormal elevation of the body temperature above 40 degrees Celsius causing vasodilation, pooling, decreased circulating blood volume, ischemia of tissues, muscle and heart necrosis.
- May lead to DIC

A

heat stroke

39
Q

Abnormally low body temperature

  • Mild range:
  • Moderate range:
  • Severe range:
A

Hypothermia
32-35 degrees C (89-95 F)
28-32 degrees C (82-89 F)
< 28 degrees C (<82 F)

40
Q

Name some sources of radiation.

A 
cosmic rays
UV light
elements in Earth's crust (radon)
medical diagnostic/therapeutic equipment
industrial products
nuclear power plants
nuclear weapons
41
Q

Electromagnetic waves include:

A

x-rays and gamma rays

42
Q

This is a unit that expresses the amount of energy absorbed by target tissue.

A

Gray (Gy)

43
Q

_______ is roughly equal to Gy but dose also factors in relative biologic effect (RBE).

A

Sievert (Sv)

44
Q

What are the two forms of radiation that cause injury?

A

electromagnetic waves

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

45
Q

A single intraoral dental image emits how many mSv?

A

0.002

46
Q

Cone beam CT (CBCT) emits how many mSV?

A

0.02-0.08 mSV

47
Q

Occupational exposures should be less than __ mSV per year.

A

50

48
Q

In general, describe the mechanism of radiation injury.

A

Radiation interacts with atoms and molecules by excitation and ionization

49
Q

Damage to DNA, causing mutations is which type of radiation mechanism of injury?

A

target effect (direct)

50
Q

The production of free radicals that interact with membranes, nucleic acids, and enzymes is which type of radiation mechanism of injury?

A

indirect effect

51
Q

Radiation injuries may be/could lead to…

A 
reversible
apoptosis/mitotic rest
nuclear abnormalities
DNA strand breaks (latency -> long term effects)
cytoplasm swelling
membrane/mitochondria/ER changes
52
Q

Name 6 organ systems affected by radiation.

A 
skin
hematopoietic/lymphoid
gonads
lungs
GI tract
circulatory
53
Q

What is the clinical significance of when lymph nodes and spleen are shrunken and granulocytes/lymphocytes are decreased in a patient following excessive radiation exposure?

A

The patient would be susceptible to infections at this time.

54
Q

T/F

With regard to radiation injury, the gonads in both sexes are sensitive, while the uterus and cervix are resistant.

A

True

55
Q

The lethal range for humans begins at about _ Sv, and at _ Sv death is certain without medical treatment.

A

2

7

56
Q

This fatal acute radiation syndrome occurs during 2-10 Sv, GI symptoms, decreased WBCs/platelets, anemia, sepsis, bleeding problems, and death in 2-6 weeks.

A

Hematopoietic

57
Q

This fatal acute radiation syndrome occurs from 10-20 Sv and causes severe GI symptoms, bloody diarrhea, dehydration, shock, sepsis, and death n 5-14 days.

A

Gastrointestinal

58
Q

This fatal acute radiation syndrome occurs at >50 Sv and causes listlessness, drowsiness, seizures, coma, and death in 1-4 hours

A

Cerebral

59
Q

An adequate diet should provide:

A

sufficient carbs, protein, and fats
essential amino acids and fatty acids
vitamins and minerals

60
Q

If the diet is deficient in 1 or more components it is termed…

A

primary malnutrition

61
Q

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

A

secondary malnutrition

62
Q

What are the 2 protein compartments in the body?

A

Somatic (skeletal muscles)

Visceral (mainly liver)

63
Q

This disease is characterized by:

  • deficiency of caloric intake (growth retardation and loss of muscle mass)
  • somatic protein compartment is depleted
  • emaciated extremities
  • anemia and immune deficiency (esp. T cells)
  • body temp. and pulse decreased
A

Marasmus

64
Q

______ is a common finding in individuals with marasmus and an indicator of immune system deficits.

A

Thrush

65
Q

This disease is characterized by:

  • greater deficiency of protein than total calories
  • severe loss of the visceral protein compartment
  • decreased albumin leads to generalized fluid retention and edema
  • skin changes (“flaky paint” appearance)
  • fatty liver (pot bellies)
A

Kwashiorkor

66
Q

How do you assess loss of the somatic protein compartment?

A

measuring skinfold thickness

67
Q

How do you assess loss of the visceral protein compartment?

A

measuring serum proteins (albumin, transferrin)

68
Q

When the weight falls below __% of the normal, the child has marasmus.

A

60

69
Q

A form of wasting that is associated with cancer patients, probably results from decreased intake and increased catabolism.

A

cachexia

70
Q

Name the fat-soluble vitamins.

A

A, D, E, K

71
Q

This vitamin prevents night blindness and is made up of 3 biologically active forms. Also, name the active forms.

A

Vitamin A

retinol, retinal, retinoic acid

72
Q

Over __% of vitamin A is stored in the _____ where there are reserves for __-__ months.
When retinol is released from the liver, it must be bound to _______-_______ protein.

A

90
liver
6-12
retinol-binding

73
Q

Name the 3 functions of vitamin A.

A
  • maintain normal vision in reduced light
  • augment differentiation of specialized epithelial cells (mucus-secreting)
  • enhance immunity to infections (especially in children)
74
Q

An early sign of vitamin A deficiency is…

If the deficiency persists, then there will be…

A

impaired vision at night

dryness of the conjunctiva (xerosis)

75
Q

T/F
In vitamin A deficiency, the epithelium of the respiratory and urinary tracts may undergo metaplasia (predisposing patients to infection).

A

True

76
Q

T/F
Vitamin A deficiency affects the immune system and may result in infections such as measles, pneumonia, and infectious diarrhea.

A

True

77
Q

Vitamin A toxicity refers to excessive ingestion of ______ IU or more daily.

A

25,000

78
Q

_____ are especially susceptible to vitamin A toxicity.

A

Infants

79
Q

Name 3 conditions that result in decreased absorption of fat-soluble vitamins.

A

Crohn’s disease (inflammatory bowel disease)
cystic fibrosis
alcoholic liver disease

80
Q

What are the symptoms of acute vitamin A toxicity?

A
  • nausea
  • vomiting
  • irritability
  • headache
  • blurred vision (papilledema)
81
Q

What are the symptoms of chronic vitamin A toxicity?

A
  • anorexia
  • hair loss
  • dry skin
  • pruritis
  • dry mucous membranes
  • fissured lips
  • fatigue
  • weight loss
  • bone and joint pain
82
Q

Vitamin C is _____-soluble and is _________ (we cannot synthesize it)

A

water

essential

83
Q

Deficiency of vitamin C leads to _______.

A

scurvy

84
Q

What are the 3 functions of vitamin C?

A
  • formation and stabilization of collagen (hydroxylation of proline and lysine)
  • conversion of tyrosine to catecholamines
  • role as an antioxidant
85
Q

Scurvy is a disease of impaired _______ synthesis.

A

collagen

86
Q

What are 3 common oral conditions resulting from scurvy?

A

gingival bleeding
gingival swelling
periodontal infections

87
Q

T/F

Vitamin C toxicity may result from excessive ingestion of >2g/day.

A

True

General Pathology (9 decks)

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