environmental pathology Flashcards by asw asw

Children account for over 60% of injuries from _________

chemicals

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what does CLADME stand for? (in relation to chemical injury)

Concentration
Liberation
Absorption
Distribution
Metabolism
Excretion

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what are “major” adverse drug reactions?

anaphylaxis (penicillin), blood clots, arrhythmias, hematologic (anemia, thrombocytopenia, leukopenia)

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Adverse drug reactions are also related to _______

potency

which is why ARD’s are common with anti-cancer meds

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what happens if someone overdoses on acetaminophen?

OD of 15 to 20 grams– causes liver damage, may result in liver failure/death

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long term use of _________ is associated with elevated risk of breast ca, strokes & blood clots

exogenous estrogen

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85% of Lead is taken up by ________ and ___________

bones & developing teeth

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what is Gingival hyperpigmentation ?

“lead line” of soft tissue

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how does lead effect red blood cells?

Pb blocks or hinders incorporation of Fe++ into hemoglobin

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what types of anemia are caused by lead poisoning

microcytic

hypochromic

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what is the CDC threshold for lead exposure?

Pb threshold blood level for concern > 5 micro-grams/dL

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when is chelation therapy used for lead poisoning?

initiated when lead concentration > 45 micro-grams/dL

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what dental-related side effect is seen during the use of ecstasy?

bruxism- grinding teeth

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what are the 4 types of physical agents that cause injury?

1) mechanical injury
2) thermal injuries
3) hypothermia
4) hyperthermia

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____________ causes over 5,000 deaths per year in the US

hyperthermia (burns)

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what is the “rule of 9’s” in relation to burn severity?

% body surface area involved:

Head & neck 9%
Trunk front 18%, trunk back 18%
Arms 9% each (hands: 1% each)
Legs 18% each
Perineum 1 %

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what factors are important in determining burn severity?

1) % of body surface involved
2) depth of burn
3) potential for inhalation damage of smoke/heat
4) age of patient
5) speed & quality of treatment

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If more than ____% of the body surface is burned, the patient has a grave prognosis

50%

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when is shock common in burn victims?

when > 20% of the body is burned

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Acute respiratory distress syndrome (ARDS) is a result of what?

inhalation of smoke or hot gases during a fire

at what temperature do most heat strokes occur?

happen above 40 degrees Celsius

what are the symptoms of heat stroke?

peripheral vasodilation, confusion, coma, ischemia, muscle necrosis, DIC: high mortality rate

what body temperature is mild hypothermia? moderate? severe?

Mild (core temp =) 32-35 C (89-95 F)

Moderate= 28-32 C (82-89 F)

Severe= < 28 C (< 82 F)

the symptoms of severe hypothermia include what?

Bradycardia, atrial fibrillation, loss of consciousness

how can radiation damage cells?

1) Direct damage to DNA | 2) Indirect – production of free radicals that can damage membranes, nucleic acids and enzymes

Occupational exposures to radiation should not exceed ______ mSv/yr

what types of tissues are most sensitive to radiation?

1) Hematopoietic/lymphoid tissues 2) gonads 3) lungs- due to vascularity 4) GI tract- VERY sensitive 5) blood vessels

when are patients susceptible to infection following radiation exposure?

PMN’s decrease over 1-2 weeks, rebound in 2-3 months patients are weakened WEEKS after exposure- not immediately

what is the range for lethal doses of radiation?

- Lethal range begins about 2 Sv | - at 7 Sv death is certain w/o treatment

what are the effects of acute Hematopoietic radiation syndrome?

- 2-10 Sv - drop in WBC’s, hair loss, infections, sepsis & bleeding - death 2-6 weeks

what are the characteristics of acute GI radiation syndrome?

- 10-20 Sv - vomiting, bloody diarrhea, shock, sepsis - death 5-14 days

cerebral acute radiation syndrome is characterized by what?

- more than 50 Sv - listlessness, drowsiness, seizures, coma - death 1-4 hrs

what is the difference between primary and secondary malnutrition

Primary – diet deficient in 1 or more components Secondary – supply is OK, problem w absorption, storage, utilization, excessive losses or drug effects

during what form of protein-energy malnutrition is somatic muscle most severely effected?

marasmus

during what form of protein-energy malnutrition is the liver most severely effected?

kwashiorkor

When weight falls to < 60% of normal, the child has _______

marasmus

what are the physical characteristics of children suffering from marasmus?

Extremities appear emaciated, head looks out-of-proportion (too large)

children with marasmus are especially prone to infections. what part of their immune system is most effected? what common infection is seen in them?

- T cell defects are common | - thrush is commonly seen

Serum _______ concentrations are relatively normal during marasmus

albumin

how does Kwashiorkor syndrome differ from marasmus?

Greater deficiency of protein than total calories, more severe than marasmus

what are the characteristics of Kwashiorkor syndrome?

- Low albumin - generalized edema **Weight is between 60-80% of normal but this is misleading because of the edema

_________ is a form of protein-energy malnutrition seen in cancer patients

Cachexia

why is cachexia seen in cancer patients?

Partly due to decreased appetite Increased catabolism – cytokine-mediated (IL-1, IL-6 and TNF)

what conditions will decrease the bodies ability to absorb fat-soluble vitamins?

Inflammatory bowel disease (Crohn) Cystic fibrosis Alcoholic liver disease

what are the 3 forms of Vitamin A?

retinol, retinal, and retinoic acid

what is the physiological roll of vitamin A?

Maintain vision in reduced light Augments differentiation of specialized epithelial cells (mucus secreting epithelium) Enhances immunity to infections

what are the severe effects of vitamin A deficiencies?

Squamous metaplasia of respiratory & urinary tracts | - increases risk for infections and stones

Squamous metaplasia of respiratory & urinary tracts is the RESULT of what condition?

vitamin A deficiency

a deficiency of Vitamin A can predispose people to what types of infections?

measles, pneumonia and infectious diarrhea | all caused by weakened immune system