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SP15 Pathology > Exam 1; Environmental Pathology > Flashcards

Exam 1; Environmental Pathology Flashcards

1
Q

What are the factors that affect chemical injuries

A 
CLADME
Concentration
Liberation
absorption
distribution
metabolism
excretion
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2
Q

True or False

Adverse drug reactions are common

A

True (2%)

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3
Q

An overdose of this may be accidental in kids or even intentional in adults

A

aspirin

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4
Q

An overdose of this may cause liver damage

A

acetaminophen

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5
Q

85% of this compound found in the air, soil, water, etc. is taken up by bones and developing teeth; it competes with Ca and interferes with the remodeling process

A

lead

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6
Q

What can be seen on the x-ray on something exposed to lead

A

lead lines (hyperdensity/hyperpigmentation)

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7
Q

Lead blocks or hinder the incorporation of this into hemoglobin

A

iron

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8
Q

Since lead blocks iron incorporation into hemoglobin, what can develop

A

anemia
neurologic disturbances
“wrist drop and foot drop” - peripheral neuropathies

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9
Q

What kind of problems can lead cause with the GI tract

A

colicky pain - severe, not localized

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10
Q

What kind of problems can lead cause wit the kidneys

A

damages tubules, fibrosis, even renal failure

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11
Q

What are the CDC guidelines of the lead threshold in blood

A

level of concern ≥5µg/dL

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12
Q

Chelation therapy of lead is initiated when

A

blood levels of lead are ≥45µg/dL

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13
Q

What is the range of temperature the body operates at

A

89-106℉ (31-41℃)

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14
Q

What is the rule regarding burns

A

rule of 9’s; % body surface area

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15
Q

What is the rule of 9’s

A 
head and neck - 9%
trunk front and back each - 18%
arms - 9% (hands 1%)
legs each - 18%
perineum - 1%
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16
Q

What are four important factors regarding burns on a patient

A

depth of the burn (full or partial thickness)
potential for internal injuries from inhalation of fumes or hot gasses
age of the patient
speed and quality of treatment

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17
Q

What percentage of BSA burned leads to a grave prognosis

A

> 50%

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18
Q

Shock is common when what percentage of BSA is burned

A

> 30-40%

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19
Q

When BSA burned reaches shock levels, what three things can occur

A

massive fluid shift causing hypovolemic shock
sepsis/infections
other problems like electrolyte and nutritional imbalance

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20
Q

Internal thermal injuries like inhalation can cause what two things to occur

A

damages to the URT and LRT

acute respiratory distress syndrome (ARDS)

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21
Q

What are three variances of hyperthermia

A

heat cramps
heat exhaustion
heat stroke

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22
Q

What occurs during a heat stroke

A

elevation of body temperature above 40℃ causes regulatory mechanisms to fail; perisperhal vasodilation results in pooling and decrease blood volume leading to ischemic and necrosing tissues - DIC

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23
Q

What occurs during hypothermia

A

bradycardia
atrial fibrillation
loss of consciousness
cell damage due to crystallization of water

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24
Q

What are the two forms of radiation injuries

A

electromagnetic waves; x and gamma rays

high energy neutrons and charged particles; alpha and beta particles and protons

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25
Q

Radiation interacts with atoms and molecules by what

A

excitation and ionization

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26
Q

In which ways does radiation interact with biological systems

A

directly on DNA; causing mutations

indirectly causing the production of free radicals

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27
Q

What can be the result of radiation injury to the cell

A

may be reversible, induce apoptosis or mitotic arrest
nuclear abnormalities or DNA strand breaks
cytoplasm is affected via swelling, membrane changes, and mito/ER changes

28
Q

What is the level of radiation that occupational exposures should not exceed

A

20mSv/year

a single oral find has 0.005mSv

29
Q

What happens over time to the skin exposed to radiation damage

A

erythema at 2-3 days
edema at 2-3 weeks
blistering/desquamification at 4-6 weeks
atrophy/fibrosis/neoplasia at months/years/decades

30
Q

How does radiation affect the lymphocytes

A

decreases levels over hours, but they rebound in weeks/months

31
Q

How does radiation affect the lymph nodes and spleen

A

shrinks in size

32
Q

How does radiation affect the PMNs

A

decrease in levels over 1-2 weeks, but levels rebound in 2-3 months
patients are susceptible to infection at this time!

33
Q

These cellular components also decrease due to radiation, and take a longer time to rebound

A

erythrocytes and platelets

34
Q

How does radiation affect the gonads

A

both sexes are sensitive to radiation - sterility

35
Q

How does radiation affect the lungs

A

sensitive due to the rich vascularity; pulmonary congestion and edema; ARDS

36
Q

How does radiation affect the GI tract

A

very sensitive; ulcers, strictures (narrowing) and later possible carcinomas

37
Q

How does radiation affect the blood vessels

A

endothelial cell injury then fibrosis and narrowing

38
Q

What is the lethal range of radiation

A

2Sv, at 7Sv, death is certain without medical care

39
Q

What are the fatal acute radiation syndromes and level os Svs

A

hematopoietic; 2-10Sv
gastrointestional; 10-20 Sv
cerebral; >50Sv

40
Q

What occurs during the hematopoietic radiation syndrome

A 
decrease WBCs
hair loss
infections
sepsis and bleeding
death 2-6 weeks
41
Q

What occurs during the gastrointestinal radiation syndrome

A 
vomiting
bloody diarrhea
shock
sepsis
death 5-14 days
42
Q

What occurs during the cerebral radiation syndrome

A 
listlessness
drowsiness
seizures
coma
death 1-4 hours
43
Q

What is the difference between primary and secondary malnutrition

A

primary - diet is deficient

secondary - diet is fine, there is a problem with absorption, etc.

44
Q

This protein compartment is found in the skeletal muscle and you can assess the loss of this compartment by measuring skin fold thickness

A

somatic protein compartment

45
Q

This protein compartment is mainly found in the liver and you can assess this compartment by measuring serum proteins

A

visceral protein compartment

46
Q

In this disorder, there is a deficiency of caloric intake

A

marasmus

47
Q

What does marasmus cause in the body

A 
growth retardation
loss of muscle mass
the body catabolized proteins as a source of energy, depleting the somatic compartment
extremities appear emaciated
head looks too large
48
Q

What are some manifestations of marasmus in the body

A 
anemia
vitamin deficiencies
immune deficiency, especially T cells - infections are coming (thrush)
bradycardia
low body temperature
49
Q

In this disorder, there is a greater deficiency of protein that total calories; common form of PEM found in africa

A

kwashiorkor

50
Q

What does kwashiorkor cause in the body

A

depletion of the visceral protein compartment leading to a loss of vascular oncotic pressure (and low serum proteins) leading to fluid retention and edema

51
Q

What are some manifestations of kwashiorkor

A

skin changes; hyper pigmentation, desquamation, hypo pigmentation
hair changes
fatty liver
vitamine and immune deficiencies

52
Q

Which is worse, marasmus or kwashiorkor

A

kwashiorkor

53
Q

Why may it be difficult to diagnose kwashiorkor

A

the weight is between 60-80% of normal, but is misleading due to the edema

54
Q

This is a form of PEM found in cancer patients, most likely due to loss of appetite and increase catabolism (cytokine mediated)

A

cachexia

55
Q

What are the three biologically active forms in vitamin A

A

retinol
retinal
retinoic acid

56
Q

Where is over 90% of vitamin A stored

A

in the liver

57
Q

What are the three functions of vitamin A

A

maintain normal vision in reduced light
augments differentiation of specialized epithelial cells (mucus secreting)
enhance immunity to infections

58
Q

True or False

Vitamin A deficiency is common worldwide

A

True

59
Q

What are the ocular changes of a vitamin A deficiency

A

impaired night vision (early)
dry eyes leading to corneal damage
total blindness

60
Q

What are the non-ocular changes associated with a vitamin A deficiency

A

squamous metaplasia of the respiratory and urinary tracts; increase infections and stones
impaired immunity - measles, pneumonia, infectious diarrhea

61
Q

What are some symptoms of vitamin toxicity

A

nausea and vomitting
blurred vision
hair loss
dry skin

62
Q

What results from a vitamin C deficiency

A

scurvy; found in the elderly, alcoholics, pirates, dialysis patients

63
Q

What is the function of vitamin C

A

formation and stabilization of collagen
conversion of tyrosine to catecholamines
role as an antioxidant

64
Q

Scurvy is a disease of what

A

impaired collagen synthesis; the weakened collagen cannot support capillaries or venues therefore causing hemorrhage (especially in the skin and gingival mucosa)
poor wound healing

65
Q

What symptoms are common with scurvy

A

gingival bleeding
swelling
periodontal infections

66
Q

What are some symptoms of vitamin C toxicity

A

enhancement of iron absorption
acidic urine - stone formation
rebound scurvy if suddenly stop taking large amounts

SP15 Pathology (17 decks)

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