L 8: Acute effects of TBI

Question 1

Important chart

Answer 1

Question 2

GI syndrome

Answer 2

• 10-50 Gy of exposure
• Death by 3-10 days
• Death is due to depopulation of epithelial lining of gut loss of dividing cells in intestinal crypts villi shorten, not replaced.

Question 3

Hematopoietic Syndrome

Answer 3

• 2.5 – 10 Gy – death of precursors for RBC, WBC, platelets.
• Most ppl beleive threshold is 6Gy
• Mature cells still circulate, but no stem cells to repopulate
• LD50 = dose at which 50% will die
• Death at 30days for animals – 60 days for human – LD50 at 60 d. = LD50/60

Exposure -> chills, fatigue -> no BM regeneration

-> death by infection, hemorrhage, anemia

Question 4

Prodromal syndrome
Important tables, both

Board question

Answer 4

• drop in lymphocytes First thing to drop
• lymphocyte numbers tells us the dose received.
• Hospitalization post 4Gy is required

Question 5

G-CSF

Answer 5

Neupogen
Filgrastim

Question 6

2Gy -8Gy

Answer 6

People survive with ABs and nursing

Question 7

8Gy - 10Gy

Answer 7

Can benifit from bone marrow transplant

Question 8

> 10Gy

Answer 8

People will die mainly from GI symptoms

Question 9

Acute radiation syndrom paradigm

Answer 9

Question 10

MODS
Multi organ dysfunction syndrome

Answer 10

• A clinical syndrome with the development of progressive and potentially reversible physiological dysfunction in 2 or more organs or organ systems induced by a variety of acute insults.
• Gradual and sequential failure of virtually all organs. It is a process rather than an event
• Occurring after a wide spectrum of noxious stimuli ( trauma, thermal burns, chemical burns, infection, pancreatitis, others)
• Developing not as a consequence of the insult itself but the host’s response to the insult
• Closely tied to the phenomenon recognized clinically as “inflammation”
• Mechanisms: unknown (when productions of biochemical mediators escaped physiologic control)