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old quizzes Flashcards

1
Q

source of new car smell

A

vinyl chloride

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2
Q

main ingredient in mothballs

A

naphthalene

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3
Q

major component of tar from charred/grilled foods and tobacco smoke

A

benzo(a)pyrene

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4
Q

PAH stands for

A

polycyclic aromatic hydrocarbons

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5
Q

primary metabolite of nicotine can be used to asses tobacco exposure

A

cotinine

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6
Q

condition pathognomic for asbestos exposure

A

mesothelioma

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7
Q

2 plastics together the are considered the safest are

A

2 & #4

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8
Q

these are used as plasticizers and are of partcular concern because they leech very easily

A

phthalates

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9
Q

A substance that is often found in packaging and in the metal coatings of cans

A

bisphenol A

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10
Q

this species is considered “black mold”

A

staphybotrys chartarum

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11
Q

what is the major severe health effect of vinyl chloride

A

hepatic angiosarcoma

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12
Q

6 criteria air pollutants

A

ozone, nitrogen oxides, carbon monoxide, particulate matter, sulfur dioxide, lead

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13
Q

a xenobiotic is

A

any substance that is foreign to the body, or to an entire biological system

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14
Q

primary routes of absorption of toxins are

A

inhalation, ingestion, dermal absorption

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15
Q

primary routes of excretion of toxins are

A

urine, bile, breath

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16
Q

what is the predominant CYP in liver

A

3A4

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17
Q

what effect does fasting have on biotransformation?

A

fasting is bad because biotransformation requires energy that in a fasting state could only be spared at the expense of gluconeogensis

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18
Q

EPA limits for amounts of pesticides that can remain on food, which is called

A

MRLs: Maximum residue limits

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19
Q

which heavy metal is common in its organic form in shellfish and is one of the reasons you want your patients to avoid seafood the week prior to testing?

A

arsenic

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20
Q

two pollutants combine to form ground level ozone, which are they?

A

Nitrogen oxides and VOCs

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21
Q

VOC is abbreviation for

A

volatile organic compounds

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22
Q

how can we be exposed to VOCs

A

ingestion, inhalation, topical (all of the above)

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23
Q

main systems affected by VOCs are

A

hematologic, nervous, and immune

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24
Q

one of most serious health consequences of exposure to this VOC is leukemia as it basically causes cells to not work effectively, esp those of bone marrow:

A

benzene

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25
Q

component of non-stick or teflon we are concerned about

A

PTFE (polytetrafluorethylene)

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26
Q

the water-solubility of this toxic substance prevents its access to lower respiratory tract

A

formaldehyde

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27
Q

those who huff glue are mostly after this specific VOC that is 25x more reactive than benzene

A

toluene

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28
Q

drycleaned clothes that are brought into the home contain elevated levels of this VOC

A

tetrachloroethylene (perchloroethylene PERCs)

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29
Q

this voc is a precursor to many medications and is also found as an oral anesthetic in chloraseptic and carmex

A

phenol

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30
Q

the most common VOC that is a potential occupational hazard for persons working in a histology lab and performing tissue processing is

A

xylene

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31
Q

these immune responses are often associated with eosinophilic responses and atopy

A

TH2

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32
Q

many toxic exposures can cause hypersensitivity reactions, AI, or suppression of immune function: T or F?

A

True

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33
Q

these 2 metal exposures can lead to an inability to kill candida

A

mercury and lead

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34
Q

which of the following is the primary component of smog

A

ground level ozone

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35
Q

what is the main health effect, if any, of carbon monoxide?

A

RBCs pick up CO quicker than O2, which causes tissue necrosis and cell death

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36
Q

which particulate matter size is of most concern because they can penetrate from blood into other organs?

A

0.1 microns

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37
Q

the form of mercury bioaccumulates in fish and is of most concern to humans consuming fish

A

methylmercury

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38
Q

DDT is an example of this type of pesticide

A

organochlorine

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39
Q

Methemoglobinemia is a serious results of

A

nitrate fertilizer exposure

40
Q

bioaccumulation is defined as

A

accrual of toxic chemicals in the tissue of a particular organism

41
Q

who was the first woman to gain a medical degree (MD) in the US?

A

Elizabeth Blackwell, MD

42
Q

Common chemicals in fabric softener

A
  1. quaternary ammonium cation compounds (QUATs) - considered an asthmagen
  2. phthalates
  3. synthetic musks
    all causes sensory irritation, pulm irritation and airflow limitation in mice
43
Q

additive in childhood vaccines that is concering

A

aluminum/thimerosol (mercury based preservative)

44
Q

OSHA

A

occupational safety and Health Administration

45
Q

new car smell that is highly hepatotoxic and carcinogenic, linked to hepatic angiosarcoma

A

vinyl chloride and PVC

46
Q

This is extremely common in adhesives, glues, dyes, wrinkle free clothing, carpets, particle board and has URT (upper resp tract) affects but cannot reach LRT dt its water solubility

A

formaldehyde

47
Q

Vinyl chloride dz

A

raynauds, acroosteolysis (dissolution of terminal phlalanges and SI joints), scleroderma-like skin changes

48
Q

what is an HCA

A

heterocyclic amine that can be formed from benzo (A) pyrene, which is from carbon combustion.

49
Q

To protect oneself from PAHs, do these things:

A

avoid high temp grilled meats
avoid grains/cereals/breads that are charred/burnt
avoid tobacco smoke
eat brassicas as they are protective
take AOs like vit C and E
Marinate foods in acidic base (vinegar or lemon), helps to protect against BenzoApryrene

50
Q

3 health effects of asbestos exposure

A

mesothelioma, asbestosis, lung cancer

51
Q

plastics that are just “okay”

A 
#1 polyethylene terephthalates (soda bottles & polyester)
#5polypropylene (clothing and tupperware)
52
Q

plastics that are unsafe

A 
#3 PVC
#6 polystyrene (styrofoam)
#7 other (fiberglass, nylon, etc)
53
Q

what plastic is found in IV bags and tubing with DEHP (phthalate) to make it pliable?

A

3 PVC

54
Q

What # is in transvaginal mesh and diapers?

A

5 polypropylene (just “okay” plastic)

55
Q

What are phthalates health risks?

A

they are “plasticizers” and can leech easily. They cause endocrine disruption: breast CA, endometriosis, adenomyosis, leiomyosis, thyroid disruption, dev issue in males with lower testosterone, decreased genital size and undescended testes, obesogen.

56
Q

Polystyrene health effects

A

acute: mucous memb and resp irritation
chronic: dizziness, fatigue, N&V; cognitive and perceptual loss; neural toxicity and possibly renal and hepatic toxicity

57
Q

AQI stands for?

A

Air Quality Index - coded from green to maroon and has 6 levels. Has additional numeric scale of 0-500

58
Q

major sources of outdoor pollution

A

power plants, refineries, transportation, fuel consumption as stationary sources, forest fires, solid waste disposal, chemical dumps, aerial spraying on farms, active volcanos

59
Q

Smaller sources of outdoor pollution

A

nail salons, dry cleaners, auto body shops

60
Q

PM10 is what?

A

all particles equal to or less than 10 microns. Particles bigger than this are generally not deposited in the lungs

61
Q

PM10-2.5 is what?

A

Particulate matter: coarse fraction particles

Tends to deposit to the earth within minutes to hours and within tens of kilometers from emission source

62
Q

PM2.5 is what?

A

Particulate matter: fine fraction particles

  • Directly emitted from combustion sources
  • Also formed secondarily from gaseous precursors of sulfur dioxide, nitrogen oxides, or organic compounds
  • Can remain in the atmosphere days to weeks and travel through the atmosphere hundreds and thousands of kilometers
  • The main cause of reduced visibility (haze) in the U.S.
63
Q

Ultrafine PM (particulate matter) is what size and the concerns are?

A

less than 0.1 microns

Concern because may leave the lung and travel through the blood to other organs, including the heart

64
Q

What pH is acid rain and what is it’s primary cause?

A

wet precipitate that has a pH lower than 5.6

Sulfur dioxide is primary cause

65
Q

What is Smog, what PM size is it and where is it from?

A

mixture of particles and gasses that form a haze
Main cause of haze is PM2.5
Directly emitted from combustion sources

66
Q

there are 5 components of smog, what are they?

A

Ground level Ozone, particulate matter, Nitrous oxides, sulfur dioxide, VOC

67
Q

6 criteria pollutants are:

A

ground level ozone, Nitrogen oxides, carbon monoxide, particulate matter, lead, and sulfur dioxide

68
Q

What was used as a refrigerant, solvent, and foal blowing agent and what is used as a replacement today (slightly better)?

A

CFCs (chlorofluorocarbons)

69
Q

which pesticides were removed from the market dt there health and environmental effects and their persistence?

A

organochlorines (ex: DDT)

70
Q

What do Organophosphates (used in WW2 as nerve agent), carbamates, and nitrate containing fertilizers (methemoglobinemia) have in common?

A

They are all acetylcholinesterase inhibitors

71
Q

what are the routes of exposure of heavy metals?

A

skin, ingestion, inhalation, ocular

72
Q

What is LD50?

A

the amt of material given at once that will cause death in 50% of a test group.

73
Q

Is a lower or higher LD50 more toxic?

A

lower

74
Q

Mech of toxicity of heavy metals?

A

i. Enzyme/cofactor inhibition or potentiation
ii. Disruption of membrane and other transport processes
iii. Disrupt mitochondrial function -> fatigue
iv. Decreased neuronal function and nerve conduction
v. Bind sulfhydryl groups on proteins and amino acids

75
Q

Potential sources of heavy metal exposure:

A 
pre-1978 homes - in dust, soil, paint
Imported remedies
Some cosmetics
Miniblinds
Metal wicked candles
Drinking water (Boiling does not get rid of lead. Running cold water before use may reduce exposure.)
76
Q

Some occupations and hobbies that involve lead might be:

A 
Lead smelting and mining
 Construction/remodeling
 Automobile repair
Plumbing
Police officers/military
Car repair
 Artistic painting 
 Stained glass
 Pottery glazing
 Soldering
Target shooting
 Making bullets, slugs, or fishing sinkers
77
Q

Products where lead is still found:

A 
Computers
 Solder
Pewter
Ceramic glazes
Jewelry
Automotive batteries
 Imported or older pre-regulation products
78
Q

Who are most at risk for lead exposure?

A

Children living in an older house and Pregnant women (risk to fetus)

79
Q

Why is there a risk to the fetus in a pregnant women, or to children with lead exposure?

A

Crosses the placental barrier and affects fetal viability. Neurologic effects on children documented below 10mcg/dL.

80
Q

What are some Sx of lead toxicity?

A 
—Irritability
 —Anorexia
   Malaise
  Headache
Constipation
Abdominal pain (“lead colic”)
 Renal toxicity
  Acute lead encephalopathy
81
Q

What is the best test for lead exposure and what are the testing guidelines for kids?

A

Blood lead test
CDC guidelines: Test children at ages 1 and 2.
Test annually to age 6 if high risk
Report any excess test results
CBC may show basophilic stippling with extended exposure

82
Q

What are the “normal” levels of lead for adults and children?
And when does CDC say to treat?

A

Adult <20mcg/dL
Child <5mcg/dl (this is different than what is originally in your notes as the CDC recommendation was updated, however it is not treated until >45 mcg!

83
Q

What might imaging reveal with lead exposure?

A

Lead lines in bones, or lead object the child swallowed (fishing sinker, anyone?)

84
Q

What are the three types of mercury?

A

elemental, organic (methylmercury), and inorganic

85
Q

Where is elemental mercury found and how exposed?

A

Used in amalgam, liquid at room temperature. Dentist, smelters at risk.
Inhalation of elemental mercury volatilized from dental amalgams is a major source of exposure for the general population

86
Q

Where is organic mercury found and how are we exposed?

A

Methylmercury in fish. Primary exposure is when you eat big fish, because they ate other fish who have methylmecury in them. This bioaccumulates/ biomagnifies in aquatic and terrestrial food chains.

87
Q

What are the health risks associated with organic/methylmercury exposure?

A

Neurotoxin and teratogen.
Large amts of fish eaten over wks to mos can cause dmg to nervous system. Infants born w/cerebral palsy.
High uptake to brain, ½ life is 20+ years.

88
Q

Where is inorganic mercury found?

A

Batteries, cosmetics. Workplace exp and using skin lightening cosmetics

89
Q

difference between bioaccumulation and biomagnification

A

Bioaccumulation-one organism accumulates Biomagnification- increasing levels of a toxin as you move up the food chain

90
Q

what type of mercury crosses BBB and how does it do it?

A

Methyl form easily absorbed in GI. Readily crosses BBB by binding sulfhydryl group on amino acid cysteine. Mimics methionine & uses the same membrane transport system.

91
Q

And why might the use of NAC be controversial in mercury detox?

A

N acetyl cysteine (NAC) might provide methyl-mercury with cysteine needed to cross the BBB more efficiently.

92
Q

What are sources of cadmium use/exposure?

A

battery manufacture (predominant use), cigarette smoking.

93
Q

What increases risk of cadmium absorption?

A

iron deficiency (F>M dt common issue for F)

94
Q

Where does cadmium accumulate in body?

A

liver and kidneys (causes renal tubular & glomerular dmg- leads to irrev proteinuria & reduced GFR)

95
Q

what is the risk for chelation in a patient with cadmium exposure?

A

mobilizing more cadmium for excretion through kidneys (that may already be dmg’d by cadmium), increases harm to kidneys.

96
Q

What two conditions of the bone are caused by cadmium exposure and why?

A

osteomalacia & osteoporosis dt incr’d urinary excretion of Ca+ & phosphorus, & dec’d hydroxylation of vit. D metabolites.

97
Q

Inhalation of cadmium can cause:

A

lung emphysema and lung CA

env Med (1 decks)

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