Environmental Path 2

Question 1

What kind of organic solvents cause some serious issues with dizziness, confusion, CNS depression, and coma

Answer 1

Chloroform and carbon tetrachloride. You find this in degreasing and dry cleaning agents and paint removers

Question 2

What organic solvent do we get concerned about for increased risk of leukemia?

Answer 2

Benzene, 1,3-butadiene

These are chemicals used by rubber workers

Question 3

What’s so bad about Organophosphates/ organochlorines

Answer 3

These are synthetic lipophilic products that resist degradation

They disrupt hormone balance due to antiestrogenic or antiandrogenic activity

Question 4

What’s so bad about Polycyclic hydrocarbons?

Answer 4

These are products of combustion of fossil fuels, specifically coal and gas at high temperatures. They are present in tar and soot.

Known carcinogen that cause bladder and lung cancer

Question 5

What do Dioxins and PCBs cause?

Answer 5

Skin disorders such as folliculitis and a dermatosis known as chloracne that is characterized by acne, cyst formation, hyperpigmentation, and hyperkeratosis, generally around the face and behind the ears

Question 6

Mineral dusts seen harmless, yes?

Answer 6

No. Causes nonneoplastic buildup of particulates = Pneumoconioses

Question 7

Sources of mineral dust?

Answer 7

1. coal dust (e.g.,mining of hard coal)
2. silica (e.g., and blasting, stone cutting)
3. asbestos (e.g., mining, fabrication, insulation work)
4. beryllium (e.g, mining, fabrication).

Question 8

What does vinyl chloride cause?

Answer 8

Causes angiosarcomas of the liver, which is usually very uncommon otherwise.

Source: synthesis of polyvinyl resins

Question 9

Bisphenol A (BPA) (the stuff in your water bottle!) What does this cause?

Answer 9

Heart disease in adults, endocrine effects in infants

Question 10

Name the top 9 List of Chemicals (Out of 2000-4000 substances) that you find in cigarettes

Answer 10

Carcinogenic (4): Tar, polycyclic aromatic hydrocarbons, benzoapyrene, Nitrosamine

Mucosal irritant (3): Phenol (also tumor promoter), Formaldehyde and Nitrogen Oxides (also both toxic to cillia)

Impaired Oxygen Transport (1): Carbon Monoxide

Ganglionic Stimulant/Depressant/ Releases Catecholamines (1): Nicotine (also tumor promoter)

Question 11

What is the pathophys involved in the bronchitis you get with smoking?

Answer 11

Increased mucus production and inflammation

Question 12

What’s the pathophys behind the emphysema you get from smoking?

Answer 12

Recruitment of leukocytes to the lung, increasing local production of elastase and injury to lung tissue leading to inability to expel air

Question 13

What’s the pathophys being the cancer you get from smoking?

Answer 13

CYPs make carcinogens more water soluble to excrete them faster, but some intermediates made by this pathway are electrophilic and result in DNA adduct (piece of DNA bound to cancer causing chemical) formation, which can mutate oncogenes and tumor suppressors.

Question 14

Basic pathophys involved with smoking induced COPD?

Answer 14

Bronchitis + Emphysema = Obstructive = Can’t get air out

Question 15

Pathophys behidn the lovely cardiovascular disease you’ll get from smoking?

Answer 15

Atherosclerosis from platelet aggregation, decreased myocardial oxygen supply (lung disease + increased CO), decreased threshold for ventricular fibrillation. Multiplicative if HTN and high cholest. present

Question 16

What happens when pregnant mom smokes?

Answer 16

IUGR unless mom stops smoking during pregnancy

Question 17

What’s the deal with second hand smoke/environmental tobacco smoke? Not so bad?

Answer 17

NOPE, STILL BAD. For at least 3 reasons:

1. 1.3x increase in lung cancer compared to no exposure
2. Increased chance of atherosclerosis
3. Measured via blood levels of cotinine, a nicotine metabolite