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CMBM exam 6 > Environmental Pathology > Flashcards

Environmental Pathology Flashcards

1
Q

What does environmental disease refer to?

A

Lesions and conditions cause by chemical and physical agents resulting from where, what and how we live

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2
Q

Before an autopsy what is needed?

A

Family consent is necessary

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3
Q

What is the addiction from tobacco use caused from?

A

Dopamine receptors in the brain

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4
Q

Cigarette smoking is high in ____ and ____.

A

Mortality and Morbidity

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5
Q

What is cigarette smoking associated with in excess mortality?

A

Chronic bronchitis and emphysema
Coronary heart disease
Bronchogenic carcinoma

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6
Q

If a pregnant lady smokes as little as 10 cigarettes a day what could occur?

A

Inc rate of spontaneous abortion
Low birth weight
Inc perinatal mortality
Inc sudden infant death syndrome SIDS

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7
Q

Smoking in the house around an infant can cause;

A

Sudden infant death syndrome
Asthma
Acute illness
Respiratory illness later in life

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8
Q

2nd had smoke is the equivalence of smoking ___ cigs a day.

A

3

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9
Q

What are some lung injuries related to air pollution?

A

Acute and chronic inflammation - direct cell injury
Emphysema-enhanced proteolysis
Asthma-allergic or irritant effect
Hypersensitivity pneumonitis - immunologic injury related to organic dusts
Pneumoconiosis-cytokines
Neoplasia -mutagenic/promoting effects

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10
Q

What are the main constituents of smog?

A 
SO2	- respiratory irritant (acid rain)
NO2*, NO - respiratory irritant (xs O2)
CO - carboxyhemoglobin (O2)
O3*	- respiratory irritant
Pb binds sulfhydryl groups
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11
Q

Oxidant pollutants

mostly produced by;

A

Combustion of fossil fuels

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12
Q

What could occur in someone who works with toxins that may be inhaled (like a miner)?

A

Pneumoconiosis

Characterized by cytokine mediated, progressive fibrotic scarring

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13
Q

What is pneumoconiosis?

A

“Dust in the lungs”
Non-neoplastic lung reaction to inhalation of mineral, organic or inorganic dust particulates
Includes chemical fume (vapor) induced lung disease

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14
Q

What are the different pathogens which can cause pneumoconiosis?

A 
Asbestosis
Silicosis
Beryllium
Cotton
Heavy Dust
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15
Q

What is the simple/uncomplicated phase of coal-worker’s pneumoconiosis?

A

Macule composed of dust-containing macrophages in a mesh of collagen fibers

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16
Q

What is the complicated stage of coal-worker’s pneumoconiosis?

A

Nodules can coalesce
“Progressive massive fibrosis”
Centrilobular (centriacinar) emphysema
Chronic bronchitis, bronchiectasis

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17
Q

What causes black lung disease?

A

Carbon particles which are weakly fibrogenic (anthracosis)

Other coal components cause more issues - silica and trace metals

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18
Q

What is brown lung disease

A

Cotton weakly fibrogenic

Endotoxin from the gram negative bacteria within the cotton

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19
Q

What does silicon contamination cause?

A

Silicosis

20
Q

What is silicosis?

A

A chronic, nodular, densely fibrosing pneumoconiosis
Acellular fibrous nodules in upper zones of lungs containing birefringent particles of silica and silicates
“Honeycomb” lung

21
Q

What is asbestosis?

A

Parenchymal interstitial fibrosis
Predisposes to bronchogenic carcinoma
Causes pleural effusions, localized fibrous plaques, diffuse pleral fibrosis
Possible laryngeal cancer

22
Q

What are the two types of asbestos?

A

Serpentine
Amphibole
Progressive massive fibrosis

23
Q

What is serpentine asbestos?

A

Curly and flexible fibrogebic fibers

Not pathogenic

24
Q

What is amphibole asbestos?

A

Straight, stiff and brittle
Align parallel to airway, deep impact
Spear epithelial cell and enter interstitium
Very pathogenic

25
Q

What is progressive massive fibrosis asbestos?

A

Gross, small, firm, dark brown lungs
Honeycomb lung
Seen via light microscopy

26
Q

What would be seen pathologically in pleura plaques?

A

Gross: gray-white to ivory white, posterolateral thorac and dome of diaphragm
Light micro: acellular basket-weave collagen

27
Q

What would be seen pathologically in bronchogenic carcinoma (adeno) and malignant mesothelioma?

A

Gross: encasing and arising from the pleura

28
Q

Si + Fe =

A

Ferruginous body

29
Q

Adverse drug events (ADE)

A

Injury due to medical treatment

4% of hospitalized pts

30
Q

What are some common reasons for ADEs

A

Lack of drug knowedlge, lack of pt info, rule violations, slip ups, memory lapses

31
Q

What causes mesothelioma?

A

Asbestosis

32
Q

What is the definition of an Adverse Drug Reactions (ADR)?

A

Any noxious, unintended and undesired effect of a drug which occurs at doses used in humans for prophylaxis, diagnosis or therapy

33
Q

What does an ADR exclude?

A 
Therapeutic failure
Poisoning, accidental or intentional 
Drug abuse
Non-compliance
Errors in administration
34
Q

How can an ADR be predicted ?

A 
Age, dose, route of entry 
Ability to metabolize or excrete
Underlying disease
Genetic factors (CYP450)
Concurrent treatment
35
Q

What are the ADRs of aspirin?

A 
Acute overdose
Fatal to children - 2-4 grams
Fatal adults - 10-30 grams
Respiratory alkalosis, metabolic acidosis
Acute papillary necrosis
36
Q

What are the ADRs of acetominophen?

A

Adult toxic dose 7.5-10gm, normal 0.5gm
Acute: N&V, diarrhar, shock, jaundice
Severe: liver necrosis

37
Q

What is the antidote for acetominophen overdose?

A

N-acetylcysteine within 8 hours

38
Q

What is the major substance that in non-therapeutic that causes an ADR?

A

Ethyl alcohol

39
Q

Widmark equation

A 
C = A/ (W x r) 
C = conc of EtOH
A = mass of alcohol ingested in grams 
W = body weight in grams
r = widmark distribution
40
Q

What can occur when alcohol in taken in excess?

A

Fatty change
Alcohol hepatitis
Alcoholic cirrhosis

41
Q

What are some acute alcoholic changes?

A 
Neurological
Diminished coordination
Peripheral vision dec
Night vision dec
Mood variable
42
Q

When is death most likely going to occur in CO posioning?

A

60% Hgb saturated

43
Q

What are the clinical significance of burn severity?

A

% of body surface involved
Depth of burn
Possible internal injuries
Post-burn therapy

44
Q

What are the early consequences of burns?

A

Early - neurologic shock, hypovolemic shock, plasma protein loss
Late - infection and sepsis, pseudomonas and candida, DIC

45
Q

What does radiation tissue injury depend on?

A

Dose
Linear energy transfer of radiation
Vulnerability to radiation effect

CMBM exam 6 (16 decks)

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