Environmental Pathology Flashcards by Amanda Romeu

What does environmental disease refer to?

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

How well did you know this?

Not at all

Perfectly

Before an autopsy what is needed?

Family consent is necessary

How well did you know this?

Not at all

Perfectly

What is the addiction from tobacco use caused from?

Dopamine receptors in the brain

How well did you know this?

Not at all

Perfectly

Cigarette smoking is high in ____ and ____.

Mortality and Morbidity

How well did you know this?

Not at all

Perfectly

What is cigarette smoking associated with in excess mortality?

Chronic bronchitis and emphysema
Coronary heart disease
Bronchogenic carcinoma

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

Smoking in the house around an infant can cause;

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

What are some lung injuries related to air pollution?

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

How well did you know this?

Not at all

Perfectly

What are the main constituents of smog?

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

How well did you know this?

Not at all

Perfectly

Oxidant pollutants

mostly produced by;

Combustion of fossil fuels

How well did you know this?

Not at all

Perfectly

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

Pneumoconiosis

Characterized by cytokine mediated, progressive fibrotic scarring

How well did you know this?

Not at all

Perfectly

What is pneumoconiosis?

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

How well did you know this?

Not at all

Perfectly

What are the different pathogens which can cause pneumoconiosis?

Asbestosis
Silicosis
Beryllium
Cotton
Heavy Dust

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

What causes black lung disease?

Carbon particles which are weakly fibrogenic (anthracosis)

Other coal components cause more issues - silica and trace metals

How well did you know this?

Not at all

Perfectly

What is brown lung disease

Cotton weakly fibrogenic

Endotoxin from the gram negative bacteria within the cotton

How well did you know this?

Not at all

Perfectly

What does silicon contamination cause?

Silicosis

What is silicosis?

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

What is asbestosis?

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

What are the two types of asbestos?

Serpentine
Amphibole
Progressive massive fibrosis

What is serpentine asbestos?

Curly and flexible fibrogebic fibers

Not pathogenic

What is amphibole asbestos?

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

What is progressive massive fibrosis asbestos?

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

What would be seen pathologically in pleura plaques?

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

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

Gross: encasing and arising from the pleura

Si + Fe =

Ferruginous body

Adverse drug events (ADE)

Injury due to medical treatment | 4% of hospitalized pts

What are some common reasons for ADEs

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

What causes mesothelioma?

Asbestosis

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

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

What does an ADR exclude?

``` Therapeutic failure Poisoning, accidental or intentional Drug abuse Non-compliance Errors in administration ```

How can an ADR be predicted ?

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

What are the ADRs of aspirin?

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

What are the ADRs of acetominophen?

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

What is the antidote for acetominophen overdose?

N-acetylcysteine within 8 hours

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

Ethyl alcohol

Widmark equation

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

What can occur when alcohol in taken in excess?

Fatty change Alcohol hepatitis Alcoholic cirrhosis

What are some acute alcoholic changes?

``` Neurological Diminished coordination Peripheral vision dec Night vision dec Mood variable ```

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

60% Hgb saturated

What are the clinical significance of burn severity?

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

What are the early consequences of burns?

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

What does radiation tissue injury depend on?

Dose Linear energy transfer of radiation Vulnerability to radiation effect