Etiology - Environmental Pathology (I) Flashcards
What are environmental diseases?
Conditions caused by exposure to chemical and physical agents (includes diseases of nutritional origin)
Expected human health effects of climate change
Gastroenteritis
Cardiovascular, cerebrovascular and respiratory diseases
Vector-borne infectious diseases
Malnutrition
What can be poison?
Any agent of chemical and biological nature can have toxic effects dependant on level of exposure (dosage) and exposure time
What are drug and xenobiotics metabolised from?
“inactive” water-soluble products (detoxification)
Is the sensitivity towards chlorpyrifos the same in everyone?
No it varys from person to person due to variable activity of CYPs
3 inhibitors if CYP activity
Starvation
Fasting
Malnutrition
4 inducers of CYP activity
Drugs
Smoking
alcohol
Hormones
3 sources of outdoor air pollution
Industrial activity
Heating system
Motor vehicles
2 types of pollutants according to concentration
Micropollutants
Macropollutants
2 types of pollutants according to origin
Primary
Secondary
What is TSD?
Total suspended dust
What is SD?
Suspended dust
What is PM?
Particulate matter
What is particulate matter?
Part of total suspended dust
What size of particles stops the upper respiratory tract?
Diameter greater then 10micrometer
What can a particle with a diameter smaller than 10micrometer reach?
Treachea
bronchi
Pulmonary alveoli
Health risks of pollution (4)
Pregnancy, foetuses and birth effects
Cardiovascular disease
Respiratory disease
Cognitive hazards
Personal habits that could cause disease (3)
Tobacco use
Alcohol ingestion
Recreational drug consumption
How much is survival reduced at 75 years when smoking?
25%
How do you calculate the survival rate based on smoking?
Number of packs per day * number of years
What does nicotine bind to?
Nicotinic acetylcholine receptors
What acute effects does nicotine binding to nicotinic acetylcholine receptors have?
Increase heart rate
Increase blood pressure
Elevation of cardiac contractility and output
What does nicotine stimulate when binding to the nicotinic acetylcholine receptors?
Catecholamines
What are the chronic effects of nicotine?
Fetal brain development
Preterm birth and stillbirth
Cancer
What is polycyclic hydrocarbons and nitrosamines directly involved with?
Development of lung cancer
What is polycyclic hydrocarbons and nitrosamines activated by?
Cytochromes P-450
How does combination of smoking and alcohol affect the risk of developing oral and laryngeal cancers?
Increases the risk
Kinds of cancer smoking is associated with (8)
Esophagus
Pancreas
Bladder
Kidney
Cervix
Bone marrow
Liver
Colon
How does smoking effect the tracheobronchial mucosa?
Irritant effect
Smoking increases the risk of (5)
Type 2 diabetes
Rheumatoid arthritis
Age-related macular degeneration
Ectopic pregnancy
Erectile dysfunction
What is alcohol abuse disorder (AUD)?
Chronic relapsing brain disease characterised by an impaired ability to stop or control alcohol use
What is the legal alcohol level?
80mg/dL (0.008%)
What is ethanols effect on CNS?
Its a CNS depressor
Where is alcohol mainly metabolised?
In the liver
Most important toxic derived from alcohol metabolism
Acetaldehyde
Which effects of alcohol is acetaldehyde responsible for?
Acute effects
Chronic effects of the liver (4)
Lipid accumulation
Inflamation
Fibrosis
Carciogenises
What does lipid accumulation caused by alcohol cause?
Alcohol fatty liver
What does inflammation caused by alcohol cause?
Alcoholic steatohepatitis
What does fibrosis cause my alcohol cause?
Alcoholic fibrosis/cirrhosis
What does carcinogenisis cause my alcohol cause?
Hepatocellular carcinoma
What does alcohol oxidation require a lot of?
NAD+
What does the increase in the NADH/NAD ratio in alcoholics cause?
Lactic acidosis
What are some toxic effects which are a result of ethanol metabolism?
Alcohol oxidation
ROS generation
Acute alcoholism
Chronic alcoholism
Which 2 anticoagulant drugs cause adverse reactions most frequently?
Warfarin
Dabigatran
What does Warren block?
Vitamin K reductase
Is warfarin selective?
No it affect all vitamin dependant factors in coagulation
Risks of using menopausal hormone therapy
Breast cancer
Stroke
Venous thromboembolism (VTE)
(After 5 years of treatment)
What does the risks of using menopausal hormone therapy depend on?
Type hormonal therapy used
Age of patient when treatment was started
Duration of treatment
Hormone dosage, formulation and route of administration
What are some benefits of menopausal hormone therapy?
Protects against the development of atherosclerosis and coronary disease in women younger than 60 years
What does oral contraceptives increase the risk of?
Onset of pathologic conditions
Cervical cancer 8in women infected with human papilloma virus)
Thromboembolism (real risk is controversial)
Cardiovascular disease in smokers
Hepatic adenoma
Does oral contraceptives increase the risk of breast carcinoma?
No
What are some risk of acetaminophen (paracetamol)?
Liver failure
Mortality
Only with very large usage
Negative effects of Asprin
CNS change s(impaired hearing, mental confusion, drowsiness)
Nausea
VOmiting
Diarrhea
Erosive gastritis (gastrointestinal bleeding and ulceration)
Bleeding
What does cocaine block?
The dopamine transporters
Why is euphoria experienced when on coke?
Enhancement of brain dopamine activity
What is cardiovascular effects of cocaine use caused by?
Blockade of uptake of epinephrine and norepinephrine at adrenergic nerve ending which causes accumulation of neurotransmitters in synapse
Cardiovascular effects of cocaine (6)
Tachycardia
Hypertension
Peripheral vasoconstriction
Coronary artery vasorestriction
Platelet aggregation
Myocardial ischemia
Positive feelings associated with use of cocaine (6)
Increased alertness
Well being
Euphoria
Increased energy and motor activity
Increased feelings of competence
Increased sexuality
What kind of drug is heroin?
Opioid
Effects of heroin on the CNS
Euphoria
Hallucinations
Somnolence
Sedation
Rapid addiction
What is heroin derived from?
Morphine (poppy plant)
Most important adverse effect of heroin
Sudden death
Pulmonary injury caused by heroin
Edema
Septic embolism from endocarditis
Lung abscess
Opportunistic infections
Foreign body granulomas
Where does heroine often cause infection?
Skin
Heart valves
Liver
Lungs
What is the nost common infection spread by heroin?
HIV
Effects of heroin on kidneys
Amyloidosis
Glomerulosclerosis
Proteinuria
Nephrotic syndrome
How does methamphetamine work?
Releases dopamine in the brain which inhibits presynaptic neurotransmission at corticostriatal synapses altering glutamatergic transmission
Effects of marijuana
Euphoria
Sense of relaxation
Lower nausea
Decrease pain
3 Major environmental determinants
Air pollutants
Food and water (toxic agents)
Occupational exposure
What are xenobiotics?
All molecules that can be acquired by the environment
What happens when a reactive metabolite formed from a xenobiotic interacts with cellular molecules (DNA, enzymes, receptors, so on)?
Cellular damage (which can either be repaired or lead to toxicity
What is the catalyst of the phase 1 of reactions in xenobiotic detoxification and activation?
Cytochrome P-450 enzyme system
