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Gen Path > Exam 2 - Environmental Diseases > Flashcards

Exam 2 - Environmental Diseases Flashcards

1
Q

What are environmental diseases?

A

injuries or disorders caused by chemical or physical agents

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2
Q

What is occupational medicine?

A

field focusing on workplace related injuries from chemical or physical agents

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3
Q

How much more do work related injuries occur than home injuries?

A

2 times more

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4
Q

What US agencies are involved in regulating environmental hazards?

A

Environmental Protection Agency
Food and Drug Administration
Occupational and Safety Health Administration
Consumer Products Safety Commission

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5
Q

What are the categories of environmental diseases?

A 
air pollution
industrial exposures
tobacco smoke
chemical agents
physical agents
electrical injury
radiation injury
nutritional diseases
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6
Q

What subsections of chemical agents that cause environmental disease are there?

A

general
therapeutic
nontherapeutic

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7
Q

How do general chemical injuries occur?

A

inhalation, ingestion, injection or absorption through the skin

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8
Q

What percentage of chemical exposures are oral intake?

A

73%

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9
Q

What percentage of chemical exposures are in children less than 6 yrs old?

A

61%

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10
Q

What are the most common household chemical agents?

A

cleaning agents
analgesics (pain reliever)
cosmetics
plants or cold preparations

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11
Q

What factors affect chemical injuries?

A 
Concentration
Liberation
Absorption
Distribution
Metabolism
Excretion

“CLADME”

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12
Q

True or False:

2% of chemical injuries are adverse events

A

True

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13
Q

What percentage of therapeutic agent injuries are adverse drug reactions?

A

7-8% are ADRs

10% of these are fatal

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14
Q

When does anaphylaxis occur?

A

with any medication, but often associated with antibiotics (PCN)

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15
Q

True or False:

The more potent a drug, the less likely it will cause an adverse reaction.

A

False: the more potent a drug the more likely an ADR.

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16
Q

What are other examples of ADRs?

A

anti-cancer drugs
aspirin
acetaminophen
Exogenous Estrogens & Oral Contraceptives (OCP)

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17
Q

What is the fatal amount of aspirin when ingested?

A

2-4 grams (kids)

10-30 grams (adults)

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18
Q

What is the mechanism for aspirin injury?

A 
respiratory alkalosis (acute)
metabolic acidosis (acute)
Chronic ingestion: headaches, dizziness, ringing ears, drowsiness, mental status changes, gastritis, GI bleeding, nausea, vomiting 
Can lead to seizures and coma
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19
Q

How much acetaminophen is ingested for overdose?

A

15-20 grams

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20
Q

How quickly can liver toxicity occur from an acetaminophen overdose?

A

several hours to days

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21
Q

What are symptoms of acetaminophen overdose?

A

Early: nonspecific, nausea, vomiting, diarrhea
Later: jaundice, shock (liver failure process)
heart, kidney damage

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22
Q

What are the risks of long term HRT (hormone replacement therapy), like estrogen?

A

increased risk of breast cancer
strokes
blood clots

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23
Q

Why are exogenous estrogens and oral contraceptives used?

A

postmenopausal syndrome
osteoporosis
contraceptive

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24
Q

With such a risk in long term use of exogenous estrogens, why would you continue to use it?

A

short term therapy outweighs the risk

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25
Q

What are risks of using oral contraceptives?

A 
blood clots
hypertension
hepatic adenoma (benign liver tumor)
cholecystitis
increase risk of breast cancer
26
Q

What are the benefits of oral contraceptives?

A

contraception
protective effect for endometrial
ovarian cancer protection

27
Q

Examples of nontherapeutic agents

A 
lead
carbon monoxide
cleaning agents
cyanide
ethylene glycol
organophosphates (pesticides)
mercury,
plants (mushrooms)
petroleum and PCBs
28
Q

Where is lead found?

A 
urban air
soil
water
food
house dust
gasoline
batteries
old paints
29
Q

Why is lead so poisonous to the body?

A

it has a high affinity for enzymes involved in hemoglobin synthesis. blocks iron
it also competes with calcium in teeth and in bone remodeling
effects neurological abilities

30
Q

What do patients develop if they have lead poisoning and it affects the hemoglobin synthesis?

A

microcytic hypochromic anemia

31
Q

What happens when lead toxicity occurs in the CNS?

A

mild sensory, motor, cognitive and psychologic deficits
reduced IQ
learning disabilities
peripheral neuropathies

32
Q

What occurs intraorally if a patient has lead poisoning?

A

gingival hyperpigmentation (kids)

33
Q

If you are looking at an x-ray of the arm, how would you be able to tell if a patient had lead poisoning?

A

Lead lines. bone becomes hyperdense

34
Q

What does lead poisoning look like in the GI tract?

A

severe, colicky pain

35
Q

Name 2 diseases that can occur with the renal system if lead poisoning occurs.

A

interstitial fibrosis
renal failure
(Lead is toxic to the renal tubules)

36
Q

Who is responsible for monitoring lead exposures?

A

It is a public health responsibility

37
Q

What is the maximum blood level of lead?

A

5 ug/dL

38
Q

How do you treat lead poisoning?

A

chelation therapy (45 ug/dL) and other supportive measures

39
Q

What are the 7 classes of drug abuse?

A 
sedative hypnotics
CNS stimulants
opioids
cannabinoids
hallucinogens
inhalants
nonprescription drugs
40
Q

Describe sedative hypnotics

A

alcohol, barbiturates, benzodiazepines

41
Q

Describe/name CNS stimulants.

A

cocaine, amphetamines, weight loss products

42
Q

Describe/name opioids.

A

heroin, morphine, methadone, codeine, fentanyl

43
Q

Name cannabinoids

A

marijuana

44
Q

Name/describe hallucinogens.

A

LSD, mescaline, phencyclidine (PCP), ketamine

45
Q

Describe some inhalants

A

glues, toluene, paint thinner, gasoline, amyl nitrate, nitrous oxide

46
Q

Describe nonprescription drugs of abuse.

A

atropine, scopolamine, antihistamines, weak analgesics.

47
Q

When did cocaine arise and what was it used for?

A

19th century

used to cure everything from exhaustion to depression

48
Q

What are club drugs?

A

substances that have become popular in dance clubs, bars, raves, trances.

49
Q

What is considered a club drug?

A

anything: methamphetamines (MDMA/ecstacy), hallucinogens, CNS depressants, benzodiazepeines

50
Q

What is a side effect of MDMAs (ecstacy)?

A

bruxism

51
Q

What are some environmental physical agents?

A

mechanical injury
thermal injury
radiation injury
nutritional diseases

52
Q

What are the different mechanical injuries one can have?

A

abrasion
contusion
laceration

53
Q

Define abrasion.

A

wound produced by scraping/rubbing

removal of superficial skin layer

54
Q

Define contusion

A

bruise; caused by blunted object.

55
Q

Describe laceration

A

tear in tissue

usually irregular edges

56
Q

What is normal temperature for the body to operate?

A

89-106 degrees F

31-41 degrees C

57
Q

What is hyperthermia?

A

high body temp/burns

5000 deaths/yr in US

58
Q

What is hypothermia?

A

prolonged exposure to low temps, body temp drops

59
Q

What factors affect clinical significance of burns?

A
  1. percentage of total body surface involved
  2. depth of the burn
  3. possible internal injuries from inhalation of hot gases and fumes
  4. the age of the pt
  5. how fast & well it is treated.
60
Q

What percentage of the body is involved in burns to be considered often fatal?

A

50%

61
Q

When does shock occur when someone has burns?

A

20% or more of the body is burned

62
Q

What occurs when a person goes into shock from burns?

A
  1. massive fluid shift causing hypovolemic shock
  2. sepsis/infections like Pseudomonas spp., Candida
  3. electrolyte/nutritional imbalances

Gen Path (7 decks)

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