Environmental & Nutritional Pathology

Question 1

Which chemical causes skin cancer that affects the palms and soles as opposed to UV-induced skin cancer that affects sun-exposed areas?

Answer 1

Arsenic

Question 2

What are the two hematologic findings that can be seen in cases of lead poisoning?

Answer 2

1. Ring sideroblasts
2. Microcytic, Hypochromic anemia with basophilic stippling of RBCs.

Question 3

Going on multiple fad diets will most likely result in?

Answer 3

Vitamin deficiencies

Question 4

Cadmium poisoning causes which disease that is characterized by osteoporosis and osteomalacia with renal disease seen in postmenopausal women of a certain East Asian country?

Answer 4

Itai-itai ( seen in post-manopausal japanese women)

Question 5

What is the guardian angel against obesity?

Answer 5

Adiponectin

Question 6

34/ M with history of sleeping in the car with windows closed presented with decrease in sensorium and cherry red discoloration of the skin and mucosal membranes. What is the most likely diagnosis ?

Answer 6

CO poisoning

Question 7

6/M with pica presented with poorly localized abdominal pain, poor school performance, and decreased play activity. PBS shows microcytic, hypochromic red cells with basophilic stippling. X-ray shows opacities occupying the epiphyseal plates. What is the diagnosis?

Answer 7

Lead poisoning

Question 8

Carbon monoxide saturation level that causes systemic hypoxia?

Answer 8

20-30%

Question 9

Nerve involved in claw hand?

Answer 9

Ulnar

Question 10

38/M production worker at a battery manufacturing plant develops wrist drop and foot drop . What is the implicated exposure?

Answer 10

Lead

Question 11

50/ M, Bangladeshi with a history of arrhythmia presents with an ulcerating palm mass on a background of yellowish plaques on his palms and soles. Biopsy of the mass shows squamous cell carcinoma. What is the implicated exposure?

Answer 11

Arsenic

Question 12

Radiation effect in bone marrow?

Answer 12

Myelosuppression ( dose dependent marrow aplasia)

Question 13

Wart-like new growth on the hands and feet of patient with history of exposure to their town river where Marcopper Mining drainage would usually pass?

Answer 13

Arsenic keratosis

Question 14

Diagnostic tool to confirm the arsenic keratosis?

Answer 14

Excision biopsy

Question 15

Complication that may arise from arsenic keratosis?

Answer 15

Develops into squamous carcinoma

Question 16

Etiologic factor in an elderly factory worker presenting with increasing dyspnea and decreased breath sounds in all fields of the left lung without cough and sputum production with pleural biopsy findings of spindle & cuboidal cells invading adipose tissue.

Answer 16

Asbestosis

Question 17

Which component of cigarette smoke is a potent carcinogen?

Answer 17

Benzopyrene

Question 18

Risk factor for development of esophageal adenocarcinoma?

Answer 18

Multiple exposure to radiation

Question 19

Mechanism of cadmium toxicity?

Answer 19

1. Acts on mitochondria by inducing oxidative stress and generating reactive oxygen species (ROS).
2. Activating apoptosis , mutating mtDNA
3. Altering gene expression
4. Inhibiting respiratory chain complexes
5. Reducing ATP synthesis
6. Altering the inner mitochondrial permeability

Question 20

Papillary Thyroid CA morphology?

Answer 20

Orphan Annie Nuclei

Question 21

CA more common in iodine sufficient areas?

Answer 21

Papillary Thyroid CA

Question 22

CA more common in iodine deficient areas?

Answer 22

Follicular Thyroid CA