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PATHPROS > ENVIRONMENTAL & NUTRITIONAL PATHOLOGY > Flashcards

ENVIRONMENTAL & NUTRITIONAL PATHOLOGY Flashcards

1
Q

How does benzene cause marrow aplasia and increase risk of acute myeloid leukemia?

A

Benzene is oxidized by hepatic CYP2E1 to toxic metabolites that disrupt differentiation of hematopoietic cells in the bone marrow

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2
Q

Bitot’s spots that develop in Vitamin A deficiency are associated with which type of metaplasia

A

Squamous metalpasia

(goblet/columnar epithelium undergoes metaplasia to keratinizing squamous epithelium)

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3
Q

List sources of arsenic

A

ground water

wood preservers and herbicides

mines and smelting industries

Herbal medicine

Vineyard workers

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4
Q

Identify the deficient micronutrient

  • Rash around eyes, mouth, nose, and anus called acrodermatitis enteropathica
  • Anorexia and diarrhea
  • Depressed wound healing and immune response
  • Impaired night vision
  • Infertility
A

Zinc

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5
Q

List the common causes of death due to electrical injuries

A

burns

ventricular fibrillation or cardiac and respiratory center failure

asphyxia due to chest wall spasms

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6
Q

Is this Kwashiorkor/Marasmus?

Hypoalbuminemia

Edema - generalized or dependent

Flaky paint dermatoses

alternating bands of pale and darker hair.

A

Kwashirokor

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7
Q

List the acute effects of alcohol

A

CNS- depressant effect, respiratory arrest

GI- acute gastritis, ulceration, fatty change

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8
Q

Clinical features of Vitamin C deficiency

A
  1. Scorbutic gums
  2. Poor wound healing
  3. Corkscrew hairs
  4. Bone changes- faliure to form osteoid, classic subperiosteal hemorrhages at ends of long bones
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9
Q

Sources of environmental exposure to mercury

A

a. contaminated fish (methyl mercury)- swordfish, shark, and bluefish, tuna fish
b. dental amalgams
c. contaminated rivers and streams

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10
Q

What is the mechanism of injury in Acetaminophen toxicity?

A
  1. covalent binding to hepatic protein- forming proetin adducts
  2. depletion of GSH
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11
Q

Which form of Vitamin A is a constituent of visual pigments?

A

Retinal

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12
Q

Clinical manifestations of acute aspirin toxicity

A

Increased anion gap metabolic acidosis

Hyperthermia

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13
Q

Which agent used to treat constipation may also cause fat-soluble vitamin deficiencies?

A

Mineral oil

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14
Q

List the clinical features of Rickets

A

Craniotabes

Frontal bossing

Rachitic rosary

Harrison’s sulcus

Bowing of the legs

Lumbar lordosis

Genu valgum, genu varum

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15
Q

Why is a millet based diet pellagrogenic?

A

Although this grain contains adequate tryptophan, it also contains high levels of leucine, another amino acid that interferes with the enzymatic conversion of tryptophan to niacin.

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16
Q

List the adverse effects of anabolic steroids

A

Stunted growth in adolescents

Acne

Gynecomastia

Testicular atrophy in males

Growth of facial hair

Menstrual changes in women.

Psychiatric problems

Premature heart attacks

Hepatic cholestasis - orally administered anabolic steroids

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17
Q

Type of hypothermic injury characterized by:

Direct damage to tissue caused by ice crystallization in cells

occurs when tissue is exposed to temperatures less than 0° C

A

Frostbite

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18
Q
  1. List the sources of radon exposure
  2. What’s the health risk assoc with radon exposure?
A
  1. Sources:
    a. radioactive gas derived from uranium
    b. present in soil and in homes
  2. Lung Cancer
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19
Q

List 3 effects of chronic alcohol abuse

A

fatty change

alcoholic hepatitis

cirrhosis- portal hypertension , hepatocellular carcinoma

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20
Q

The formulation of Viamin A that is used to treat Acute promyelocytic leukemia

A

All-trans-retinoic acid (vitamin A)

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21
Q

Clinical consequences of Chronic aspirin toxicity (salicylism)

A

Dizziness

tinnitus

Bleeding tendencies

Analgesic nephropathy - tubulointerstitial nephritis with renal papillary necrosis

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22
Q

Why must alcohol not be mixed with narcotic, sedative, and psychoactive CNS drugs?

A

When alcohol is present in the blood at high concentrations, it competes with other CYP2E1 substrates and delays drug catabolism, potentiating the depressant effects of narcotic, sedative, and psychoactive drugs in the CNS

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23
Q

Least radiosensitive tissues

A

bone (least sensitive), brain, muscle, and skin

24
Q

List 5 complications of burns

A
  1. Hypovolemic shock
  2. Pseudomonas aeruginosa -infection of burn wounds
  3. Curling ulcers - proximal duodenum
  4. Hypermetabolic syndrome- increased basal metabolic rate
  5. Smoke inhalation- carbon monoxide/cyanide poisoning
25
Q

What condition is the attached imaging finding associated with?

A

Wernicke’s encephalopathy (triad of ataxia, ophthalmoplegia/nystagmus and confusion)

The image shown is bilateral symmetrical hyperintensity involving the mammillary bodies

26
Q

List 3 food items assoc with carcinomas

A

Aflatoxin - hepatocellular carcinoma (causes mutation in codon 249 of the p53 gene )

Nitrosamines & nitrosamides - gastric carcinoma

Artifical sweeteners - bladder cancers

27
Q

List 3 conditions assoc with OCP use

A

Thromboembolism

Cardiovascular disease

Hepatic adenoma

28
Q

Is this heat cramps/ heat exhaustion/heat stroke?

>40° C (>104° F)

Hot and dry (anhidrosis)

Impaired consciousness
CNS dysfunction

athletes and military recruits,

Lactic acidosis, Rhabdomyolysis (↑CK), myoglobinuria, ↑serum BUN, creatinine, Hypocalcemia

A

Heat Stroke

29
Q

Why are diets based on corn pellagrogenic?

A

Diets based on unfortified maize (corn) are pellagrogenic for the following two reasons:

a. low in tryptophan, the amino acid precursor of niacin, which can be used to offset a diet low in niacin
b. any endogenous niacin in untreated corn is bound in a nonbioavailable form

30
Q

Which vitamin is employed in the treatment of cystic acne?

A

Oral isotretinoin (vitamin A)

31
Q

Is this heat cramps/ heat exhaustion/heat stroke?

37° C (98.6° F)

Skin - Moist and cool

Mental status- Normal

Painful, involuntary spasmodic contractions of muscle that occur after exercise

A

Heat cramps

32
Q

Is this heat cramps/ heat exhaustion/heat stroke?

<40° C (<104° F)

Skin- Profuse sweating

Mental status - Normal

Hypotension, nausea, vomiting

A

Heat Exhaustion

33
Q

List 4 causes for Vitamin K deficiency

A

Parenchymal liver diseases

Biliary disease

Fat malabsorption syndromes

Dietary deficiency

Drugs – cholestyramine, coumadin

34
Q

List 2 biochemical effects of arsenic

A
  1. interferes with mitochondrial oxidative phosphorylation
  2. inhibits pyruvate dehydrogenase which requires lipoic acid as a cofactor. Arsenite forms a stable complex with the thiol (SH-) groups of lipoic acid
35
Q

What best accounts for the changes in the brain following acute exposure to CO poisoning?

A

Hypoxic neuronal change

36
Q

large, solitary, and well-encapsulated mass

Benign

Susceptible to hemorrhage

assoc with OCP use

A

Hepatic adenoma

37
Q

List 3 Cancers associated with ionizing radiation

A

AML, CML

Papillary thyroid carcinoma

Lung, breast and bone cancers(Osteosarcoma)

38
Q

Causes for acute CO poisoning

A

Running car in a closed garage

Improper use of gasoline-powered generators (e.g., during power outages)

Mine fires

39
Q

List the clinical features of pyridoxine deficiency

A

Oral:

Glossitis

Cheilosis

Neurologic :

Distal limb numbness and weakness

Impaired vibration and proprioception

Preserved pain and temperature

Sensory ataxia

Generalized seizures

40
Q

Identify the deficient micronutrient

Dental caries

41
Q

What are the bone changes assoc with scurvy?

A
  1. Osteoblasts fail to form osteoid (bone matrix)
  2. classic subperiosteal hemorrhage at the ends of the long bones
42
Q

Consequences of homozygosity for the ALDH2*2 allele

A

unable to oxidize acetaldehyde

nausea, flushing, tachycardia, and hyperventilation after its ingestion.

Intolerance to alcohol

43
Q

List 2 biochemical consequences of alcohol consumption

A
  1. Deficiency of NAD - main cause of the accumulation of fat in the liver of alcoholics
  2. increase in the NADH/NAD ratio in alcoholics - lactic acidosis
44
Q

List one important cancer caused by arsenic exposure

A

liver angiosarcoma

45
Q

List the hormonal derangements assoc with anorexia nervosa

A

Decreased GnRH

Decreased LH, FSH

Decreased estrogen

Decreased thyroid hormone release

46
Q

Clinical features of Vitamin B3 deficiency

A

Pellagra- diarrhea, dermatitis(Cassal’s necklace) and dementia

47
Q

Mechanism of damage by UV radiation (UV-B)

A

Produces pyrimidine dimers that distort DNA structure

Inactivate p53

Activate RAS proto oncogene

48
Q

List 2 morphologic changes assoc with Kwashiorkor

A

Liver- enlarged, fatty change

Small bowel - loss of villi and microvilli

49
Q

Clinical signs of arsenic poisoning

A

Severe headaches

abdominal pain

Diarrhea

Delirium

Convulsions

50
Q

Morphologic finding in the liver in acetaminophen toxicity

A

Marked hepatocellular necrosis is present in a zonal, centrilobular pattern

51
Q

Identify the deficient micronutrient

52
Q

List the features of thiamine deficiency

A

Dry beriberi - Nervous system involvement

Wet beriberi – CVS involvement

Infantile beriberi

Wernicke encephalopathy

Korsakoff syndrome

53
Q

Clinical features of chronic CO poisoning

A

CNS- widespread ischemic change- basal ganglia; lenticular nuclei

Permanent neurologic sequelae - impairment of memory, vision, hearing, and speech.

54
Q

Signs of acute vitamin A toxicity

A
  1. Headache, dizziness
  2. Vomiting
  3. Stupor
  4. Blurred vision
55
Q

Clinical features of mercury exposure

A

a. developing brain is extremely sensitive to methyl mercury

b.

Diarrhea

constricted visual fields

nephrotoxicity in proximal tubule, tachycardia

hyperhidrosis (↑sweating)

peripheral neuropathy

hypertension

PATHPROS (36 decks)

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