old quizzes Flashcards
1
Q
source of new car smell
A
vinyl chloride
2
Q
main ingredient in mothballs
A
naphthalene
3
Q
major component of tar from charred/grilled foods and tobacco smoke
A
benzo(a)pyrene
4
Q
PAH stands for
A
polycyclic aromatic hydrocarbons
5
Q
primary metabolite of nicotine can be used to asses tobacco exposure
A
cotinine
6
Q
condition pathognomic for asbestos exposure
A
mesothelioma
7
Q
2 plastics together the are considered the safest are
A
2 & #4
8
Q
these are used as plasticizers and are of partcular concern because they leech very easily
A
phthalates
9
Q
A substance that is often found in packaging and in the metal coatings of cans
A
bisphenol A
10
Q
this species is considered “black mold”
A
staphybotrys chartarum
11
Q
what is the major severe health effect of vinyl chloride
A
hepatic angiosarcoma
12
Q
6 criteria air pollutants
A
ozone, nitrogen oxides, carbon monoxide, particulate matter, sulfur dioxide, lead
13
Q
a xenobiotic is
A
any substance that is foreign to the body, or to an entire biological system
14
Q
primary routes of absorption of toxins are
A
inhalation, ingestion, dermal absorption
15
Q
primary routes of excretion of toxins are
A
urine, bile, breath
16
Q
what is the predominant CYP in liver
A
3A4
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
18
Q
EPA limits for amounts of pesticides that can remain on food, which is called
A
MRLs: Maximum residue limits
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
20
Q
two pollutants combine to form ground level ozone, which are they?
A
Nitrogen oxides and VOCs
21
Q
VOC is abbreviation for
A
volatile organic compounds
22
Q
how can we be exposed to VOCs
A
ingestion, inhalation, topical (all of the above)
23
Q
main systems affected by VOCs are
A
hematologic, nervous, and immune
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
25
component of non-stick or teflon we are concerned about
PTFE (polytetrafluorethylene)
26
the water-solubility of this toxic substance prevents its access to lower respiratory tract
formaldehyde
27
those who huff glue are mostly after this specific VOC that is 25x more reactive than benzene
toluene
28
drycleaned clothes that are brought into the home contain elevated levels of this VOC
tetrachloroethylene (perchloroethylene PERCs)
29
this voc is a precursor to many medications and is also found as an oral anesthetic in chloraseptic and carmex
phenol
30
the most common VOC that is a potential occupational hazard for persons working in a histology lab and performing tissue processing is
xylene
31
these immune responses are often associated with eosinophilic responses and atopy
TH2
32
many toxic exposures can cause hypersensitivity reactions, AI, or suppression of immune function: T or F?
True
33
these 2 metal exposures can lead to an inability to kill candida
mercury and lead
34
which of the following is the primary component of smog
ground level ozone
35
what is the main health effect, if any, of carbon monoxide?
RBCs pick up CO quicker than O2, which causes tissue necrosis and cell death
36
which particulate matter size is of most concern because they can penetrate from blood into other organs?
0.1 microns
37
the form of mercury bioaccumulates in fish and is of most concern to humans consuming fish
methylmercury
38
DDT is an example of this type of pesticide
organochlorine
39
Methemoglobinemia is a serious results of
nitrate fertilizer exposure
40
bioaccumulation is defined as
accrual of toxic chemicals in the tissue of a particular organism
41
who was the first woman to gain a medical degree (MD) in the US?
Elizabeth Blackwell, MD
42
Common chemicals in fabric softener
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
additive in childhood vaccines that is concering
aluminum/thimerosol (mercury based preservative)
44
OSHA
occupational safety and Health Administration
45
new car smell that is highly hepatotoxic and carcinogenic, linked to hepatic angiosarcoma
vinyl chloride and PVC
46
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
formaldehyde
47
Vinyl chloride dz
raynauds, acroosteolysis (dissolution of terminal phlalanges and SI joints), scleroderma-like skin changes
48
what is an HCA
heterocyclic amine that can be formed from benzo (A) pyrene, which is from carbon combustion.
49
To protect oneself from PAHs, do these things:
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
3 health effects of asbestos exposure
mesothelioma, asbestosis, lung cancer
51
plastics that are just "okay"
```
#1 polyethylene terephthalates (soda bottles & polyester)
#5polypropylene (clothing and tupperware)
```
52
plastics that are unsafe
```
#3 PVC
#6 polystyrene (styrofoam)
#7 other (fiberglass, nylon, etc)
```
53
what plastic is found in IV bags and tubing with DEHP (phthalate) to make it pliable?
#3 PVC
54
What # is in transvaginal mesh and diapers?
#5 polypropylene (just "okay" plastic)
55
What are phthalates health risks?
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
Polystyrene health effects
acute: mucous memb and resp irritation
chronic: dizziness, fatigue, N&V; cognitive and perceptual loss; neural toxicity and possibly renal and hepatic toxicity
57
AQI stands for?
Air Quality Index - coded from green to maroon and has 6 levels. Has additional numeric scale of 0-500
58
major sources of outdoor pollution
power plants, refineries, transportation, fuel consumption as stationary sources, forest fires, solid waste disposal, chemical dumps, aerial spraying on farms, active volcanos
59
Smaller sources of outdoor pollution
nail salons, dry cleaners, auto body shops
60
PM10 is what?
all particles equal to or less than 10 microns. Particles bigger than this are generally not deposited in the lungs
61
PM10-2.5 is what?
Particulate matter: coarse fraction particles
| Tends to deposit to the earth within minutes to hours and within tens of kilometers from emission source
62
PM2.5 is what?
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
Ultrafine PM (particulate matter) is what size and the concerns are?
less than 0.1 microns
| Concern because may leave the lung and travel through the blood to other organs, including the heart
64
What pH is acid rain and what is it's primary cause?
wet precipitate that has a pH lower than 5.6
| Sulfur dioxide is primary cause
65
What is Smog, what PM size is it and where is it from?
mixture of particles and gasses that form a haze
Main cause of haze is PM2.5
Directly emitted from combustion sources
66
there are 5 components of smog, what are they?
Ground level Ozone, particulate matter, Nitrous oxides, sulfur dioxide, VOC
67
6 criteria pollutants are:
ground level ozone, Nitrogen oxides, carbon monoxide, particulate matter, lead, and sulfur dioxide
68
What was used as a refrigerant, solvent, and foal blowing agent and what is used as a replacement today (slightly better)?
CFCs (chlorofluorocarbons)
69
which pesticides were removed from the market dt there health and environmental effects and their persistence?
organochlorines (ex: DDT)
70
What do Organophosphates (used in WW2 as nerve agent), carbamates, and nitrate containing fertilizers (methemoglobinemia) have in common?
They are all acetylcholinesterase inhibitors
71
what are the routes of exposure of heavy metals?
skin, ingestion, inhalation, ocular
72
What is LD50?
the amt of material given at once that will cause death in 50% of a test group.
73
Is a lower or higher LD50 more toxic?
lower
74
Mech of toxicity of heavy metals?
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
Potential sources of heavy metal exposure:
```
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
Some occupations and hobbies that involve lead might be:
```
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
Products where lead is still found:
```
Computers
Solder
Pewter
Ceramic glazes
Jewelry
Automotive batteries
Imported or older pre-regulation products
```
78
Who are most at risk for lead exposure?
Children living in an older house and Pregnant women (risk to fetus)
79
Why is there a risk to the fetus in a pregnant women, or to children with lead exposure?
Crosses the placental barrier and affects fetal viability. Neurologic effects on children documented below 10mcg/dL.
80
What are some Sx of lead toxicity?
```
Irritability
Anorexia
Malaise
Headache
Constipation
Abdominal pain (“lead colic”)
Renal toxicity
Acute lead encephalopathy
```
81
What is the best test for lead exposure and what are the testing guidelines for kids?
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
What are the "normal" levels of lead for adults and children?
And when does CDC say to treat?
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
What might imaging reveal with lead exposure?
Lead lines in bones, or lead object the child swallowed (fishing sinker, anyone?)
84
What are the three types of mercury?
elemental, organic (methylmercury), and inorganic
85
Where is elemental mercury found and how exposed?
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
Where is organic mercury found and how are we exposed?
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
What are the health risks associated with organic/methylmercury exposure?
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
Where is inorganic mercury found?
Batteries, cosmetics. Workplace exp and using skin lightening cosmetics
89
difference between bioaccumulation and biomagnification
Bioaccumulation-one organism accumulates Biomagnification- increasing levels of a toxin as you move up the food chain
90
what type of mercury crosses BBB and how does it do it?
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
And why might the use of NAC be controversial in mercury detox?
N acetyl cysteine (NAC) might provide methyl-mercury with cysteine needed to cross the BBB more efficiently.
92
What are sources of cadmium use/exposure?
battery manufacture (predominant use), cigarette smoking.
93
What increases risk of cadmium absorption?
iron deficiency (F>M dt common issue for F)
94
Where does cadmium accumulate in body?
liver and kidneys (causes renal tubular & glomerular dmg- leads to irrev proteinuria & reduced GFR)
95
what is the risk for chelation in a patient with cadmium exposure?
mobilizing more cadmium for excretion through kidneys (that may already be dmg'd by cadmium), increases harm to kidneys.
96
What two conditions of the bone are caused by cadmium exposure and why?
osteomalacia & osteoporosis dt incr'd urinary excretion of Ca+ & phosphorus, & dec'd hydroxylation of vit. D metabolites.
97
Inhalation of cadmium can cause:
lung emphysema and lung CA
