Environmental / Nutritional Pathology Flashcards
Anorexia Nervosa is what?
what do they present with?
what symptoms do they have?
self-induced starvation
marked weight loss
Amenorrhea, low thyroid hormone, low bone density.
Ozone:
how is ground level ozone toxicity mediated? what does it injure?
what does it lead to?
when is exposure more dangerous for people?
free radicals –> injury to respiratory tract epithelial cells, alveolar cells
inflammatory mediators –> mild sx
more dangerous for people with asthma or emphysema
why is cigarette smoke a direct irritant?
why is smoking associated with emphysema?
what is the importance of the constituents polycyclic hydrocarbons/nitrosamine?
it leads to inflammation and increased mucus production (bronchitis)
smoking –> recruits leukocytes to the lung –> increase elastase production an then injury to the lung –> emphysema
DIRECTLY linked to lung cancer
Acute Vitamin A toxicity:
Chronic Toxicity?
headache, vomiting, dizziness, stupor and blurred vision. confused.
wt loss, anorexia, N/V, bone and joint pain.
What toxicant is heavily associated with leukemia?
liver angiosarcoma?
Benzene
Vinyl Chloride
Vitamin D:
function
what is it required for in the prevention of?
maintenance of adequate plasma levels of calcium and phosphorus to support metabolic functions…. bone mineralization
Rickets, osteomalacia and hypocalcemia tetany
Arsenic:
where does it come from
1) what does it interfere with? when is toxicity most prominent?
2) you have a large quantity ingested, what parts of your body are most affected?
3) what do you get 2-8 weeks post exposure?
4) what about on your skin?
Contaminated Water / Food
cellular metabolism –> GI tradt, nervous system, skin and heart
GI, CNS, cardiovascular
sensorimotor neuropathy; parathesias, numbness, pain
chronic changes lead to hyperpigmentation and hyperkeratosis
Particulate matter (soot):
1) what effects does it have on us?
2) what is most harmful?
pulmonary inflammation and secondary cardiovascular effects
particulates less than 10um in diameter –> because it can be inhaled into the alveoli which leads to a release of a number of inflammatory mediators.
Adverse drug reactions:
Acetaminophin –> what happens to people that use to them when using this improperly. what pattern of necrosis is associated?
Aspirin –> acute vs chronic? what else can it damage?
unintentional overdose –> gives acute liver failure a week or two after OD with 30% mortality –> centrilobular necrosis
ACUTE salicylate poisoning effects the brain –> nausea –> coma…. CHRONIC (salicylism) leads to HA, dizziness, tinnitus, bleeding, coma;
can also damage the kidneys –> analgesic nephropathy
What happens when the body is burned more than 20%?
in this scenario, what can you generally get?
what about metabolism?
you get rapid shifts in body fluids into the INTERSTITIAL COMPARTMENT –> go into SHOCK
generalized edema, including pulmonary edema!
hyper metabolic state –> excess heat loss and increase need for nutritional support
What xenobiotic is responsible for free radical injury in the liver that may have worked in a laundromat?
CCL4 which uses Cytochrome P450 to create ROS as it goes from CCL4 to CCL3-.
A mother smokes, what does she have an increased risk of with her pregnancy? (3 things)
spontaneous abortions, preterm births, intrauterine growth retardation (IUGR)
What does Lead do to heme? (3 things)*****
what kind of problems would you see in kids with a lead level of 10 ug/mL?
what about 40?
we get a deficiency of it that gives us –> Hypochromic microcytic anemia, BASOPHILIC STIPPLING, and ring sideroblasts (red cell precursors with iron-laden mitochondria that are detected with a PRUSSIAN BLUE stain)
developmental toxicity –> decreased IQ, decreased hearing, decreased growth, impaired peripheral nerve function, fetal effects.
decreased hemoglobin synthesis
Bone Marrow signs and symptoms with radiation? 4)
again, what Sv would this be the main site of injury from total-body ionizing radiation?
how long does this take to develop?
is it lethal?
leukopenia, hemorrhage, hair loss, vomiting
2-10 Sv
2-6 weeks
variable (0-80%)
What is the main site of injury with total body ionizing radiation within the following Sv’s:
0-1Svs
1-2Sv
2-10Sv
10-20 Sv
> 50Sv
None
Lymphocytes
Bone Marrow
Small Bowel
Brain
Ozone:
What effects would it have on healthy adults and children? (3)
what effects would it have on athletes, outdoor workers, and asthmatics? (2)
decreased lung function, increased airway reactivity, lung inflammation
decreased exercise capacity, increased hospitalizations
Adverse Drug Reactions:
Oral Contraceptives: what 2 things do people on these have an increased risk of? what cancer is more prevalent and at what age?
Anabolic Steroids (in males, then in females)
increase risk of cervical cancer especially HPV. 3-6x higher risk of thrombosis and PE if you also smoke….. HEPATIC ADENOMA –> older patient with prolonged use
stunted growth, acne, gynecomastia, testicular atrophy, PSYCHIATRIC ISSUES (ROID RAGE)…. facial hair and menstrual changes in females… both increase risk of MI
Lead:
1) what does it bind to in our body, what does it interfere with?
2) when could this be exposed to kids? what about adults (be specific)?
3) what does most of the absorbed lead incorporate into? what’s the half life?
4) what do you see on Xray? (3 things)
it’s absorbed and binds to sulfhydryl groups –> interferes with CALCIUM metabolism
flaking lead paint and soil contamination for kids, occupational exposure (battery manufacturing, car radiators, pigment work, tin can stuff)
Bone and developing teeth because it competes with calcium. 20-30 years.. so lasts forever
Lead lines on the metaphyses and lead lines on the gums! Lead “colic” which is super severe and leads to people having poorly localized abdominal pain.
Normal BMI?
obese BMI?
Overweight BMI?
18.5 - 25
30+
25-30
Someone is an asbestos worker or a uranium miner and they smoke, what is their chances of lung carcinoma compared to someone who just smokes?
what has a multiplicative interaction with smoking? what does this give people?
10x higher
alcohol + tobacco –> laryngeal and oral cancers
Rickets, what are the presentations?
Frontal bossing, squared head, pigeon breast deformity, rachitic rosary (prominent bone at costochondral joints), lumbar lordosis, bowing of the legs
what is metabolic syndrome?
visceral/intraabdominal fat gives us insulin resistance and hyperinsulinemia
Complication of both anorexia and bulimia?
both susceptible to cardiac arrhythmia and sudden death due to hypokalemia.
Occupational Health Risks:
Mineral dusts: what is included in this?
what generally do all 4 of these give you?
What is specific with asbestos? what do you see on stains?
Coal dust, silica, asbestos, beryllium
Pneumoconiosis –> also called “BLACK LUNG”
Asbestosis (workers AND family members) –> mesothelioma. –> FERRUGINOUS BODIES Asbestos fibers coated in iron (can be seen with Prussian blue)
Occupational Health Risks:
Vinyl Chloride, what can this lead to?
Bisphenol A (BPA) –> where is this found? what is it possibly disrupting?
angiosarcomas in the liver
all food bottles and cans –> potential endocrine disruptor
role of obesity in cancer? (3 of them)
insulin resistance leading to hyperinsulinemia –> directly or indirectly contribute to cancer by increasing free IGF-1 which is A MITOGEN
obesity increases synthesis of estrogen –> higher risk of cancer stuff
the general proinflammatory state of obesity might be carcinogenic
What are 3 examples of emerging infectious diseases in our environment?
multidrug resistant TB
pathogens endemic to other species jumped to ours –> HIV
pathogens recently present but increased in incidence –> Dengue fever
What’s considered “indoor air pollution”? (4 things)
1) what kind of smoke indoors could be considered as indoor air pollution?
2) what includes pet dander, fungi, and molds and is a common cause of Legionnaires Dzviral pneumonia?
3) what is shown to have a higher risk of lung cancer and where does it come from?
4) What did FEMA trailers do that shed light on indoor air pollution?
Wood smoke –> polycyclic hydrocarbons are carcinogenic
Bioaerosols
Radon –> radioactive gas derived from uranium
Formaldehyde –> building materials that lead to cancer.
How do drugs and solvents enter cells?
they are lipophilic, facilitating their transport and penetration through the basement membrane!
what stance do patients show that are burned beyond recognition? what can be normal in this?
Pugilistic stance (contracts up and looks like a boxer)
internal organs are “normal”, just a little cooked
within 24-48 hours of a burn, what happens to breathing?
direct heat and inhalation of noxious gases affects the airway, so people end up with RESPIRATORY INSUFFICIENCY
what can lead to less cytochrome P450 activity?
fasting and starving
Bulimia is what?
what do they present with? (3 things)
binging then purging
electrolyte imbalance (hypokalemia) from throwing up so much –> leads to cardiac arrhythmia
Pulmonary aspiration of gastric contents
Esopaghageal and gastric rupture
Cadmium:
1) what is it preferentially toxic to?
2) where does it come from?
3) what three things does it lead to?
4) living next to zinc smelters gives you an increased risk of what?
kidneys and lungs
nickel-cadmium batteries, soil, plants –> so FOOD
obstructive lung dz, renal tubular damage, skeletal abnormal associated with calcium loss.
increased risk of lung cancer
Chronic alcoholism:
1) what happens if they want to have kids?
2) what kind of cancers are they more likely to have?
3) why might they have malnutrition?
4) what are the positive things to note about alcohol?
fetal alcohol syndrome –> microcephaly, growth and mental retardation, ABSENT PHILTRUM
oral, esophageal, liver, breast in women
malnutrition and nutritional deficiency, especially B vit.
moderate amounts INCREASES HDL, inhibits platelet aggregation and lowers fibrinogen levels protecting against CHD
What can happen if burns get colonized? (happens in almost all burns).
what are the 3 common ones?
Sepsis –> Pseudomonas aeruginosa, MRSA, Candida
What’s the difference between a primary and secondary dietary insufficiency?
what would diabetes be considered?
primary = missing from diet
secondary = malabsorption, impaired utilization or storage, excess loss, or increase need
secondary malabsorption
What is Cachexia?
1) what is it happening in?
2) what do people present with?
3) How do they die from it?
Malnutrition complication in AIDS or advanced cancers
extreme weight loss, fatigue, muscle atrophy, anemia, anorexia, edema
atrophy of the diaphragm and other respiratory muscles.
Drugs of Abuse:
Opiates –> what 4 things does it do to users? what do these lead to? what infections are they likely to have?
Methamphetamine –> what do people with this present with (3 things)
Marijuana does what to patients? what if someone with CAD uses marijuana? what about if they continue to use it? What’s to note about the smoke itself?
profound respiratory depression, arrhythmia, cardiac arrest, and pulmonary edema … (foam at the mouth)–> leads to sudden death UNRELATED to OD –> 10% right heart valve endocarditis
violent behavior, confusion, psychotic symptoms (paranoia + hallucinations)
increase HR, may increase/decrease BP. CAD pts may cause angina. cognitive and psychomotor impairment. TONS of carcinogens in the smoke.
What is the function of Cytochrome P-450 (CYP) as it relates to xenobiotics?
1) where is it primarily located
2) what does it do with xenobiotics? 2 possibilities
3) what do both of these possibilities produce as a byproduct?
primarily in the ER of the liver, but also in the skin, lungs, GI mucosa, and others.
detoxifies xenobiotics, or less commonly convert xenobiotics into active compounds that cause cellular injury
both can produce ROS which causes cellular damage.
Chronic Alcoholism:
1) what do they have wrong with their liver (3 things). what are they associated with and at a higher risk for?
2) GI system?
3) Any vitamin problems? what does this give you?
4) heart problems?
5) what are they more likely to get?
1) MAIN site of chronic injury –> steatosis, hepatitis, cirrhosis… –> associated with portal hypertension and increased risk for hepatocellular carcinoma
bleeding from gastritis or ulcers associated with cirrhosis
Thiamine –> peripheral neuropathy and WERNICKE KORSAKOFF –> MAMILLARY BODIES ARE SCREWED, degeneration and optic neuropathy
dilated congestive cardiomyopathy and hypertension… pretty much lowers your HDL leading to higher likelihood of coronary heart disease
acute and chronic pancreatitis
Vitamin K
Vitamin B1 (thiamine)
Niacin
Bitamin B6 (pyridoxine)
bleeding problems
wernicke Korsakoff syndrome, dry and wet beriberi
3 D’s, Dementia, dermatitis, diarrhea
Cheilosis, glossitis, peripheral neuropathy, maintenance of myelinization of spinal cord tracts.
What toxicants are associated with lung cancer? (5 ones)
radon, asbestos, silica, nickel, arsenic, chromium
What toxicants give heart disease?
Ataxic gait?
Renal Toxicity?
Female infertility/stillbirths?
CO and lead
Mercury
Mercury
Lead, Mercury
What is Sick Building Syndrome?
what specific groups of people are affected by this?
people living in damp homes with common molds, indoor pollutants and with poor ventilation –> sickness involving chest congestion, congestion of nose and around the eyes, headache, etc.
people living in flood-hit buildings.
What is Marasmus?
1) what categorizes someone with this?
2) what do they have generally?
3) what is being used as fuel for these kids? what does it lead to?
less than 60% normal weight for sex, height, and age
growth retardation and muscle loss.
subQ fat and muscle proteins –> leads to emaciated extremities
What are the EPA’s guidelines on what constitutes outdoor air pollution? (6 of them)
sulfur dioxide, CO2, Ozone, NO2, lead and particulate matter.
Mercury:
1) what does it bind to and what does it damage?
2) what are the 2 main sources that you can see this in?
3) what disease is it associated with and what are the problems associated with it?
sulfhydryl groups –> damage CNS (developing brain) and kidney
contaminated fish and mercury Vapors from metallic mercury in dental stuff
Minamata disease –> cerebral palsy, deafness, blindness, mental retardation, major CNS defects in children exposed in utero
What has climate change done with regards to health?
1) what has worsened because of the heatwaves and air pollution?
2) what about because of contamination from floods and disruption of clean water supplies?
3) what about infectious disease? why does this happen?
4) what general health problem is now more prevalent because of disrupted crop production?
Cardiovascular, cerebrovascular, respiratory diseases
Gastroenteritis, cholera, and other foodborne/waterborne infectious diseases.
malaria and dengue fever –> increase temperatures, crop failures and more extreme weather favoring different vectors
malnutrition
Malnutrion
1) what is this the consequence of? (2 things)
2) clinical presentation
it’s the consequence of inadequate intake of proteins or calories or deficiencies in the absorption of proteins
loss of fat and muscle tissue. weight loss, lethargy, muscle weakness
What is Kwashiorkor?
1) what defines it?
2) what do they have low levels of?
3) what do they use as fuel?
4) what is the main reason for this in Africa?
THIS is MUCH more severe than marasmus. way less protein.
Hypoalbuminemia –> this is why they have edema.
depletion of visceral protein compartment; FATTY LIVER; spares subQ fat and muscle.
they’re weaned too early and fed a carbohydrate diet.
what are the 3 most common diseases involving the lung and cigarette smoking?
emphysema, chronic bronchitis, COPD
Occupational health risks:
Organochlorines: what are they? what is ONE used for historically? how was this affecting an animal?
what are the other two to know? what does this give people? what is a famous story to know about this one?
synthetic lipophilic products that resist degradation
DDT –> pesticides, killing eagle eggs.
PCBs and Dioxins –> folliculitis and dermatosis called “CHLORACNE” characterized by acne, cyst formation, hyperpigmentation and hyperkeratosis all over the face. –> this was given to the president of Ukraine.
Carbon Monoxide:
1) why is it easy to die from this?
2) when would someone have chronic poisoning of this?
3) acute? (include time). What % saturation would you need to die from this?
4) what feature would they present with?
what about anatomy lab and seeing a brain, when would you consider it to have been involved with CO poisoning?
it’s non-irritating, non colorless, tasteless, odorless
working in tunnels, underground garages, highway toll booths with tons of automobile fumes
5 minutes in a closed garage with the car running, 60-70%
cherry red color of BOTH the skin and mucous membranes
it’s red despite the addition of formaldehyde
What does Cocaine do once ingested?
how might cocaine give us myocardial ischemia?
is it dose dependent?
what about using cocaine when you have a fetus?
when taken in high doses, what happens?
Tachycardia, HTN, and peripheral vasoconstriction
coronary artery vasoconstriction + platelet aggregation + thrombus formation –> myocardial ischemia
NOT DOSE DEPENDENT –> lethal arrhythmia
lowers blood flow to the placenta –> fetal hypoxia and spontaneous abortion
hyperpyrexia (high fever) and seizures
How is alcohol metabolized? what does it become and what uses it?
in high concentrations, what does it compete with? this is why on pill bottles it says what?
alcohol oxidized to acetaldehyde in the liver by Alcohol Dehydrogenase (ADH) –> becomes acetate through ALDH –> used by the mitochondrial respiratory chain
competes with other CYP2E1 substrates and delays drug catabolim, POTENTIATING the depressant effects of narcotics, sedative, and psychoactive drugs in the CNS –> don’t drink and take this at the same time.
Sulfur dioxide:
what effects would it have on healthy adults? (1)
individuals with chronic lung disease? (1)
asthmatics? (2)
increased airway reactivity
increased mortality
increased hospitalization and decreased lung function
How does CO kill you?
when would you see morphological changes? what changes would you see? (3)
what if the pt recovers from this?
what’s to note about CO and it’s relationship to hemoglobin?
induces DNS depression –> widespread ischemic changes to the BASAL GANGLIA and LENTICULAR NUCLEI (pallidum)
if death happened rapidly, no morphologic changes. if longer, brain is edematous, punctate hemorrhages, and hypoxia-induced neuronal changes
they have impaired memory, vision, hearing, and speech
200X GREATER AFFINITY FOR CO THAN OXYGEN
Vitamin A:
function
secondary deficiency of vitamin A is from what?
what would happen if you have vitamin A deficiency and the eye?
what about in the lungs?
maintenance of normal vision, regulation of cell growth and differentiation/regulation of lipid metabolism.
secondary deficiency = fat malabsorption
night blindness, epithelial/squamous metaplasia and keratinization, and Bitot spots
squamous metaplasia of respiratory epithelium –> increased pulmonary infections
What toxicants are associated with fibrosis? (3)
silica, asbestos, cobalt
what would you see on histo of rickets?
cartilage palisades are lost so instead of growing straight in bones (which normally happens), its abnormal and more squiggly than straight.
Cigarrete smoking is associated with cancers of what regions?
what are you more likely to develop because of smoking? what does this lead to?
what has a multiplicative effect on MIs?
esophagus, pancreas, bladder, kidney, cervix, bone marrow
Atherosclerosis –> MI
smoking with HTN and hypercholesterolemia
Clinical significance of a burn injury depends on what 3 things?
what is the treatment for burns?
depth of the burn
% of body surface covered by the burn
Internal injuries – including inhalation of toxic fumes and heat.
fluid and electrolyte management, along with infection control
Sulfur dioxide:
1) when does it become “witches’ brew”?
how is it produced? (3)
what would sulfuric acid and sulfuric trioxide do to someone if inhaled/ingested?
sulfur dioxide + ozone
power plants burning fossil fuels, copper smelting, paper mill byproduct
burning sensation in nose and throat, difficulty breathing, asthma attacks in those susceptible
What are the classifications of burns?
1st degree –> superficial; epidermis only
2nd degree –> partial thickness; epidermis and dermis
3rd degree = full thickness; extend into the subcutaneous tissue
Rubber workers are exposed to what that gives them an increased risk of LEUKEMIA?
depending on the dose, what happens?
Benzene and 1,3 butadiene
benzene is oxidized by hepatic CYP2E1 to toxic stuff that disrupts the differentiation of hematopoeitic cells in the bone marrow
dose dependent marrow aplasia and increased risk of AML (acute myeloid leukemia)
Lead:
1) what happens if lead levels are low, what subtle effects can it give kids? what about if the kid isn’t even born yet?
2) what CNS problems do adults get with lead poisoning? (2 things)
1) intellect, behavioral problems, hyperactivity, poor organizational skills; BRAIN DAMAGE……. mother can impair brain development if lead poisoned.
Adults get peripheral neuropathies –> Extensor muscles of the wrist and fingers often first –> Wrist- Drop
Followed by paralysis of the peroneal muscles (foot-drop)
Acute Alcoholism:
1) what is mostly affected? what three things do we se with this?
2) is it reversible?
1) mostly CNS effects (depressant) –> see fatty liver (steatosis), acute gastritis, and ulcers
yes, if you stop drinking
Lymphocyte signs and symptoms with radiation? (2)
again, what Sv would this be the main site of injury from total-body ionizing radiation?
how long does this take to develop?
is it lethal?
Moderate granulocytopenia and lymphopenia
1 day to 1 week
NO
Huffing/glue sniffing –> what happens if you do this?
Bath salts –> what does it cause (4 things)
MRI-detectable brain damage that ranges from MILD to SEVERE dementia.
agitation, psychosis, MI and suicide.
Brain signs and symptoms with radiation? (4)
again, what Sv would this be the main site of injury from total-body ionizing radiation?
how long does this take to develop?
is it lethal?
Ataxia, coma, convulsions, vomiting
> 50Sv
1-4 hours
100% yes
Global Disease Burden:
from 1990 to 2010, what has increased in mortality rate?
what is the leading cause of health loss?
what is the leading cause of death in developed countries?
5 of 10 leading causes of death are what?
50% of all deaths in kidless than 5 have what 3 conditions which are preventable?
HIV/AIDS, cardiovascular, and a bit of cancer
Undernutrition
Ischemic heart disease and cerebral vascular disease
infectious disease
Pneumonia, diarrheal disease, malaria
Cancer from radiation exposure:
1) what do they have increased incidence for?
2) what develops after they survive?
increase incidence of leukemias and solid tumors (due to destroying bone marrow hematopoiesis in radiation therapy), or from Chernobyl
SECOND cancers happen after radiation therapy for cancers such as Hodgkin
what syndrome is obesity associated with (not metabolic syndrome)?
hypoventilation syndrome/pickwinian –> intense sleepiness feeling at day and at night
leads to eventual right sided heart failure (cor pulmonate)
Adverse drug reactions:
Minocycline
Anticoagulants, what are the two common types and what happens with insufficient dosage or too much.
Menopausal Hormone Therapy… when is it okay to use them? not okay?
discoloration of the skin, like a bluish tinge from iron/melanin pigment deposits in the skin
warfarin (vit k antagonist) and dabigatran (inhibits thrombin) –> bleeding with too much; thrombosis due to insufficient dosage.
was Hormone replacement therapy: estrogens with progesterone.. okay early menopause, but not long term –> higher risk for cancer
despite al the attention for illicit drugs, what’s to note about alcohol?
what’s up with the police breath test, how does it work?
alcohol abuse is more widespread and claims more lives –> 100,000 deaths annually, 15,000 due to liver cirrhosis
ethanol that is unabsorbed goes to the tissues and fluids of the body. when you exhale its proportional to your blood level.
What is hyperthermia?
what is considered “heat-stroke like”? when does this happen? what is the gene usually associated with this?
heat stroke = Lack of sweating
malignant hyperthermia –> heat stroke like rise in core body temp and muscle contractors –> COMMON reaction to ANESTHETICS
RyR1 gene
What is the leading exogenous cause of human cancers? what is 90% of it?
how many deaths happen per year usually? how much of that is lung cancer?
what’s to note about how much tobacco you use?
What’s important to know about stopping smoking and risk of mortality? how much of a decrease is it for lung cancer? how long does this risk stay?
Tobacco –> 90% of lung cancers
400K, 1/3 lung cancer
lower overall survival through it’s dose-dependent effects –> more pack years, less likelihood of survival.
stopping smoking within 5 years decreases mortality and risk of death from CVD.
lung cancer mortality down 21% within 5 years, but the risk persists for 30 years
How is vitamin D metabolized?
when would you have a deficiency in vitamin D?
endogenous synthesis from a precursor 7-dehydrocholesterol in a photochemical reaction that requires solar or artificial UV light.
insufficient sunlight
Arsenic:
1) what do you have an increased risk of?
2) what do you see on fingernails?
cancers of the lung, bladder, skin (palm and soles)
MEES lines
Occupational Health Risks:
1) what organic solvents are considered health risks? what are they seen in? what happens to people if at high levels of vapors?
Chloroform and CCL4 –> found in degreasing agents, dry cleaning products, paint removers
exposure to high levels gives people dizziness and confusion –> CNS depression and coma.
Occupational Health Risks:
Polycyclic hydrocarbons, where do they come from?
what do chimney sweeps have a higher risk for?
what is polycyclic hydrocarbons considered as?***
industrial exposure to these are implicated in what?
combustion of fossil fuels
scrotal cancer
among the most POTENT CARCINOGENS
lung and bladder cancer
What’s the story behind Cadmium in Japan?
what does it give people?
Itai Itai disease –> Cadmium pollution due to mining activities –> got in the river basin and accumulated in the rice fields –> accumulated in people eating the contaminated rice.
Osteoporosis and osteomalacia with the renal problems.
Small Bowel signs and symptoms with radiation? (4)
again, what Sv would this be the main site of injury from total-body ionizing radiation?
how long does this take to develop?
is it lethal?
Diarrhea, fever, electrolyte imbalance, vomiting
10-20 Sv
5-14 days
100% yes
Vitamin C:
deficiency leads to what in kids? what about adults?
where do we get it?
when would someone have a secondary deficiency?
scurvy –> bone disease in kids, hemorrhage and healing problems in adults
entirely from diet
older individuals who live alone and are chronic alcoholics
What is Toxicology?
What is a “poison”? what is it dependent on?
what is a Xenobiotic?
Distribution, effects, and mechanisms of action of toxic agents
everything is a poison; the right dosage differentiates a poison from a remedy
exogenous chemicals in the environment (air, water, food, soil) that may be absorbed into the body via inhalation, ingestion, or skin contact
What’s the difference between Marasmus and Kwashiorkor?
Marasmus –> uses muscle proteins and subQ fat. Serum albumin normal
Kwashiorkor –> spares the subQ fat and muscle, instead uses visceral protein compartments. hypoalbuminemia + fatty liver
Consequences of obesity
(4)
increased risk of CAD from hypertriglyceridemia and low HDL
Nonalcoholic fatty liver disease
6x higher association of gallstones
degenerative bone disease (osteoarthritis)
Malnutrition:
1) who is susceptible to this?
what are signs of secondary malnutrition?
50% of deaths ininfants and childhood in developing countries OR older and debilitated patients in nursing homes and hospitals
depletion of fat, chest wall, arms or hands. Wasting of quads and deltoids, ANKLE OR SACRAL EDEMA
Passive smoke inhalation (environmental) has what risk of lung cancer?
what about kids in the home?
1.3X risk compared to unexposed non-smoker
increased risk of asthma and other respiratory problems in children exposed in the home
