[P] Week 5: Environmental and Nutritional Disease - Part 1 Flashcards

1
Q

What are the two dieatary Insufficiency?

A
  1. Primary Malnutrition
  2. Secondary Malnutrition
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2
Q

DIETARY INSUFFICIENCY

  • It is commonly seen in chronically ill patients, elderly, or bed-ridden patients.
  • Bed-ridden or hospitalized malnourished patients have an increased risk of infection, sepsis, impaired wound healing, and death after surgery
A

Secondary Malnutrition

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3
Q

DIETARY INSUFFICIENCY

What are the most obvious signs of secondary malnutrition?

A
  • Depletion of subcutaneous fat in the arms, chest wall, shoulders, or metacarpal regions.
  • Wasting of the quadriceps and deltoid muscles.
  • Ankle or sacral edema.
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4
Q

Condition that lead to primary ort secondary malnutrition

A
  1. Poverty
  2. Acute and chronic illnesses with increased catabolism.
  3. Chronic alcoholism
  4. Ignorance and failure of diet supplementation
  5. Self-imposed dietary restrictions
  6. Other causes may also be GIT diseases and malabsorption syndromes, genetic diseases, and inadequate total parenteral nutrition (TPN).
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5
Q

Malnutrition is defined as the consequence of inadequate intake of protein and calories to meet the body’s needs.

A

Severe Acute Malnutrition (SAM)

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6
Q

SAM is formerly known as the?

A

Protein Energy Malnutrition

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7
Q

The WHO defines severe acute malnutrition (SAM) as a state characterized by a weight for height ratio that is ____ standard deviations below the normal range

A

three (3)

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8
Q

What are the Determination of State of Malnourishment

A
  1. Body Mass Index (BMI)
  2. Skinfold Thickness
  3. Measurement of Serum Proteins
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9
Q

DETERMINATION OF STATE OF MALNOURISHMENT

Computed using both the height and weight of person and then comparing it to a standardized chart

A

Body Mass Index (BMI)

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10
Q

DETERMINATION OF STATE OF MALNOURISHMENT

Classification:

  1. underweight
  2. Normal
  3. Overweight
  4. Obese

A. Below 18.5
B. 18.5 to 24.9
C. 25 to 29.9
D. Above 30

A

ABCD

In/de -crement of 5

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11
Q

DETERMINATION OF STATE OF MALNOURISHMENT

Measures fat stores and muscle mass.

A

Skinfold thickness

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12
Q

DETERMINATION OF STATE OF MALNOURISHMENT

Measurement of serum proteins (albumin, transferrin, and others) can provide an estimate of the adequacy of the visceral protein compartment.

A

Measurement of serum protein

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13
Q

What are the type of Severe Acute Malnutrition

A
  1. Marasmus
  2. Kwashiorkor
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14
Q

TYPES OF SEVERE ACUTE MALNUTRITION

  • Develops when the diet is severely lacking in calories.
  • Weight falls to 60% of normal for sex, height, and age.
  • Growth retardation and loss of muscle mass and subcutaneous fat as a result of catabolism and depletion of the somatic protein compartment
A

Marasmus

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15
Q

TYPES OF SEVERE ACUTE MALNUTRITION

Manifestations include:
- Emaciated extremities
- Head appearing too large for the body
- Anemia
- Multivitamin deficiencies
- Defects in T cell immunity making them prone to infections

A

Marasmus

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16
Q

TYPES OF SEVERE ACUTE MALNUTRITION

  • Occurs when protein deprivation is relatively greater than
    the reduction in total calories.
  • Marked protein deprivation is associated with severe loss of the visceral protein compartment, and the resultant hypoalbuminemia gives rise to generalized or dependent
    EDEMA.
A

Kwashiorkor

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17
Q

TYPES OF SEVERE ACUTE MALNUTRITION

  • Characteristic skin lesions with alternating zones of hyperpigmentation, desquamation, and hypopigmentation, giving a “flaky paint” appearance.
  • Hair changes includes loss of color or alternating bands of pale and darker colors, straightening, fine texture, and loss of firm attachment to the scalp.
A

Kwashiorkor

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18
Q

TYPES OF SEVERE ACUTE MALNUTRITION

  • Other findings include:
    o enlarged fatty liver
    o apathy
    o listlessness
    o loss of appetite
  • This is the most common form of severe acute malnutrition among African children who have been fed a carbohydrate-rich diet.
A

Kwashiorkor

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19
Q

Enumerate the Eating Disorders

A
  1. Anorexia Nervosa
  2. Bulimia
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20
Q

EATING DISORDERS

  • self-induced starvation, resulting in marked weight loss.
  • It has the highest death rate of any psychiatric disorder.
A

Anorexia Nervosa

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21
Q

EATING DISORDERS

  • Binge eating is the norm.
  • They eat large amounts of food, principally carbohydrates, which are ingested, followed by induced vomiting.
  • The problem here is that the stomach acid can go up to the esophagus and teeth, which can cause an injury.
A

Bulimia

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22
Q

VITAMIN DEFICIENCIES

important to maintain normal vision, regulation of cell growth an ddifferentiation, and regulation of life and metabolism

A

Vitamin A

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23
Q

VITAMIN DEFICIENCIES

name given to a group of related compounds that include retinol, retinal, and retinoic acid, which have similar biologic activities

A

Vitamin A

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24
Q

VITAMIN DEFICIENCIES

Sources of this vitamins comprise of:
- dairy
- oats
- carrots
- bread
- sweet potatoes.

Greatest sources include
- beef kidneys
- liver
- cod liver oil
- chicken liver

A

Vitamin A

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25
Q

VITAMIN DEFICIENCIES

Vitamin A deficiency occurs worldwide either as a
consequence of?

A

primary malnutrition or secondary to conditions that cause malabsorption of fats

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26
Q

VITAMIN DEFICIENCIES

Vitamin A deficiency manifestation:

  1. Xeropthalmia
  2. Xerosis conjunctiva
  3. Bitot spots
  4. Keratomalacia

A. dryness of the conjunctiva
B. buildup of keratin debris in small
opaque plaques
C. dry eyes - most devastating change
D. softening & destruction of the
cornea

A
  1. C
  2. A
  3. B
  4. D
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27
Q

VITAMIN DEFICIENCIES

Vitamin A is also good for skin. However, excessive use, such as using too many ____ and ____ treatments can lead to toxicity.

A

retinol products and isotretinoin

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28
Q

VITAMIN DEFICIENCIES

  • Made from sunlight exposure.
  • The major function is the maintenance of adequate levels of calcium and phosphorus to support metabolic functions.
A

Vitamin D

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29
Q

VITAMIN DEFICIENCIES

Vitamin D deficiency is called what in children and adult?

A

Children - Rickets
Adults - Osteomalacia

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30
Q

VITAMIN DEFICIENCIES

Vitamin D Deficiency

A

Manifestations include:
- Craniotabes (infants)
- Frontal bossing, squared appearance to the head (infants)
- Rachitic rosary (beading of the ribs)
- Pigeon breast deformity
- Lumbar lordosis
- Bowing of legs

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31
Q

VITAMIN DEFICIENCIES

In children, hypervitaminosis D may take the form?

A

metastatic calcifications of soft tissues such as the kidney

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32
Q

VITAMIN DEFICIENCIES

In adults, hypervitaminosis D it causes?

A

bone pain and hypercalcemia

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33
Q

VITAMIN DEFICIENCIES

The toxic potential of vitamin D is so great that in sufficiently large doses, it is a?

A

potent rodenticide

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34
Q

VITAMIN DEFICIENCIES

Prolonged exposure to normal sunlight does not produce
an excess of vitamin D, but ____ of orally administered vitamin can lead to hypervitaminosis

A

Megadoses

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35
Q

VITAMIN DEFICIENCIES

Vitamin C is also known as?

A

Ascorbic Acid

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36
Q

VITAMIN DEFICIENCIES

A deficiency of water soluble vitamin C leads to the development of?

A

Scurvy

characterized principally by bone disease in growing children and by hemorrhages and and healing defects in children & adults.

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37
Q

VITAMIN DEFICIENCIES

A person who has scurvy will have ____ when they brush their teeth

A

bleeding gums

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38
Q

VITAMIN DEFICIENCIES

TOF

The popular notion that megadoses of vitamin C protect against the common cold, or at least allay the symptoms, has not been borne out by controlled clinical studies

A

T

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39
Q

familliarize the table for virtamins and trace elements thank yew

A

facts

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40
Q

defined as an accumulation of adipose tissue that is of sufficient magnitude to impair health

A

Obesity

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41
Q

Obesity is associated with several of the most important diseases of humans, including ?

A
  • Type 2 diabetes,
  • dyslipidemia
  • cardiovascular disease
  • hypertension
  • cancer
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42
Q

CLINICAL CONSEQUENCES OF OBESITY

A
  • Insulin resistance & hyperinsulinemia
  • Hypertriglycidemia & low HDL cholesterol levels
  • Nonalcoholic fatty liver disease
  • Cholelithiasis (gallstones)
  • Obstructive sleep apnea
  • Predisposing factor for osteoarthritis
  • Increased incidence of certain cancers in overweight people, including cancers of the esophagus, thyroid, colon, and kidney in men and cancers of the esophagus, endometrium, gallbladder, and kidney in women
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43
Q

TOF

Diet is linked to cancer

A

TRUE

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44
Q

With respect to carcinogenesis, three aspects of the diet are of major concern, what are those?

A
  1. The context of exogenous carcinogens
  2. The endougenous syntehesis of carinigens from dietary components
  3. The lack of protective factors like vitamins C & E, betacarotene, and selenium
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45
Q

DIET AND CANCER

The context of exogenous carcinogens

It is involved in the development of hepatocellular carcinoma.

A

Aflatoxin

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46
Q

DIET AND CANCER

The endogenous synthesis of carcinogens from dietary components

Implicated in the generation
of gastric carcinomas.

A

Nitrosamines & nitrosamides

47
Q

DIET AND SYSTEMIC DISEASES

Restricting sodium intake reduces?

A

Hypertension

48
Q

DIET AND SYSTEMIC DISEASES

resulting in increased fecal bulk, is thought by some investigators to provide a preventive effect against diverticulosis of the colon

A

Dietary fiber or roughage

49
Q

DIET AND SYSTEMIC DISEASES

n touted to protect against heart disease (and also against devils, werewolves, vampires, and, alas, kisses), although research has yet to prove this effect unequivocally

A

Lowly garlic

50
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Drug abuse generally involves the ____ beyond therapeutic or social norms, and may lead to drug addiction and overdose, both serious public health problems.

A

repeated or chronic use of mind-altering substances,

51
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Cocaine is extracted from the leaves of the coca plant and is usually prepared as what water-soluble powder,

A

cocaine hydrochloride

52
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

what are the way cocain can be induced

A

snorted or dissolved in water and injected subcutaneously

producing intense euphoria and neurologic stimulation, making it one of the most addictive drugs

53
Q
A
54
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

TOF

It can precipitate arrhythmias, induce myocardial infarction, and cause hypopyrexia.

A

F

Myocardial Ischemia; Hyperpyrexia

55
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

In pregnant women, cocaine may cause

A

Acute decreases in blood flow to the placenta

56
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

In pregnant women, cocaine may cause acute decreases in blood flow to the placenta, resulting in?

A

fetal hypoxia and spontaneous abortion

Neurologic development may be impaired in the fetus of a pregnant woman who is a chronic drug user

57
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

With chronic cocaine users, it can eventually lead to?

A

perforation of the nasal septum, aside from decreased lung diffusing capacity and related cardiomyopathy.

58
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

OPIOIDS AND OPIATES

Opioid drugs of abuse include prescription drugs such as ?

A
  • heroin
  • oxycodone
  • hydrocodone
  • fentanyl
  • tramadol
  • methadone
59
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

a street drug derived from a poppy plant that is close to morphine

A

Heroin

60
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

The effects of heroin addiction on the CNS include?

A
  • euphoria
  • hallucinations
  • somnolence
  • sedation
61
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Most important adverse effects of heroin

A
  • Sudden death
  • Pulmonary injury
  • Infections - skin, heart, liver, and lungs
  • Skin lesions - most frequent telltale sign
    ▪ When injected, scarring occurs.
  • Kidney disease
62
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Methamphetamine produces a feeling of euphoria, which is followed by a?

A

crash

63
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Methamphetamine Long-term use leads to violent behaviors, confusion, and psychosis marked by

A

paranoia and hallucinations

64
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

This is also known as ____ or ____ and is closely related to amphetamines, but has a stronger effect in the CNS

A

speed or meth

65
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

this mental illness is linked to marijuana?

A

Schizophrenia

66
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Marijuana use causes

A

euphoria and a sense of relaxation

67
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Causes a heightened sensory perception (e.g., brighter colors/lights), laughter, altered perception of time, and increased appetite

A

Marijuana

68
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Marijuana is made from the leaves of the

A

Cannabis sativa plant

69
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Cannabis sativa plant, which contains the psychoactive substance known as

A

tetrahydrocannabinol (Δ9-THC)

70
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

About what percent of tetrahydrocannabinol (Δ9-THC) is absorbed when marijuana is smoked in a hand-rolled joint.

A

5 to 10%

71
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

TOF

Marijuana has the potential to treat nausea and can decrease pain. In other countries, if pain relievers are ineffective, it’s legal to use marijuana. However, this is still legal in the Philippines

A

F
illegal in PH

72
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

It is said that marijuana cigarettes contain a large number of carcinogens that are also present in?

A

tobacco

73
Q

INJURY BY NONTHERAPEUTIC AND DRUGS OF ABUSE

Smoking marijuana cigarettes compared with tobacco cigarettes is associated with a?

A

3-fold increase in the amount of carcinogen inhaled and retained in the lungs

74
Q
  • Refers to conditions caused by exposure to chemical or physical agents in the ambient, workplace, and personal environment, including diseases of nutritional origin.
  • Most diseases are caused or influenced by this
A

Environmental Diseases

75
Q
  • According to WHO, this can be defined as the increased interconnectedness and interdependence of people and countries to encourage economic growth. As a result, there is an increase in industrialization and
    population.
  • Eventually, this leads to climate change.
A

Globalization

76
Q

HEALTH EFFECTS OF CLIMATE CHANGE

Cardiovascular, cerebrovascular, and respiratory diseases, all of which will be exacerbated by?

A

heat waves and air pollution

77
Q

HEALTH EFFECTS OF CLIMATE CHANGE

Gastroenteritis, cholera, and other foodborne and waterborne infectious diseases (causing diarrhea), caused by?

A

contamination

78
Q

HEALTH EFFECTS OF CLIMATE CHANGE

TOF

Vector-borne infectious diseases resulting from changes in vector number and geographic distribution
related to increased temperatures, crop failures, and more less weather variation

A

F

extreme not less

79
Q

HEALTH EFFECTS OF CLIMATE CHANGE

Malnutrition caused by changes in local climate that disrupt?

A

Crop production

80
Q
  • Toxicology is defined as?
A

The science of poisons

81
Q

It studies the distribution, effects, and mechanisms of action of toxic agents. More broadly, it also includes the study of the effects of physical agents such as radiation and heat.

A

Toxicology

82
Q

ENVIRONMENTAL POLLUTION

significant cause of morbidity and mortality worldwide, particularly among at-risk individuals with preexisting pulmonary or cardiac disease.

A

Air pollution

83
Q

AIR POLLUTION

The ambient air in industrialized nations is contaminated with an unsavory mixture of gaseous and particulate pollutants, more heavily in cities and in proximity to heavy
industry.

A

Outdoor Air Pollution

84
Q

AIR POLLUTION

outdoor air pollution In industrialized nations, it is more heavy / dense especially
in areas with

A

Heavy industry

85
Q

Outdoor Air Pollution

In the United States, the Environmental Protection Agency
monitors and sets allowable upper limits for six pollutants:

A
  • sulfur dioxide
  • CO
  • ozone
  • nitrogen dioxide
  • lead
  • particulate matter
86
Q

Air pollution is a significant cause of mortality and morbidity worldwide. The effects of air pollution are drastic among those with?

A

pulmonary / lung problems (asthma, pulmonary pneumonia, COPD)

87
Q

HEALTH EFFECTS OF AIR POLLUTION

Short or Long Term Effects

✓ Affects Central Nervous System
✓ Cardiovascular diseases
✓ Respiratory diseases
✓ Impacts on liver
✓ Impacts on reproductive system

A

Long term effects

88
Q

HEALTH EFFECTS OF AIR POLLUTION

Short or Long Term Effects
✓ Headache
✓ Ice inflammation
✓ Coughing
✓ Painful
✓ Pneumonia
✓ Breathing
✓ Bronchitis
✓ Skin irritation

A

Short term effects

89
Q

HEALTH EFFECTS OF OUTDOOR AIR POLLUTANTS

Identify the pollutant

Populations at Risk: Healthy adults and children, Athletes, outdoor workers, Asthmatic

Effects:
✓ Decreased lung function Increased airway reactivity - Lung inflammation
✓ Decreased exercise capacity Increased hospitalizations

A

Ozone

90
Q

HEALTH EFFECTS OF OUTDOOR AIR POLLUTANTS

Identify the Polutants

Population at Risk:
✓ Healthy adults
✓ Asthmatics
✓ Children

Effects:
✓ Increased airway reactivity
✓ Decreased lung function
✓ Increased respiratory infections

A

Nitrogen Dioxide

91
Q

HEALTH EFFECTS OF OUTDOOR AIR POLLUTANTS

Identify the Polutants

Population at Risk:
✓ Healthy adults
✓ Individuals with chronic lung disease
✓ Asthmatics

Effects:
✓ Increased respiratory symptoms
✓ Increased mortality
✓ Increased hospitalization ✓Decreased lung function

A

Sulfur dioxide

92
Q

HEALTH EFFECTS OF OUTDOOR AIR POLLUTANTS

Identify the Polutants

Population at Risk:
✓ Healthy adults
✓ Children
✓ Asthmatics

Effects:
✓ Altered mucociliary clearance
✓ Increased respiratory infections
✓ Decreased lung function
✓ Increased hospitalizations

A

Acid aerosols

93
Q

HEALTH EFFECTS OF OUTDOOR AIR POLLUTANTS

Identify the Polutants

Population at Risk:
✓ Children
✓ Individuals with chronic lung or heart disease
✓ Asthmatics

Effects:
✓ Increased respiratory infections
✓ Decreased lung function
✓ Excess mortality Increased attacks

A

Particulates

94
Q

GROUND LEVEL OZONE (O3)

  • Ozone accumulates in the ____ (ground-level ozone) is one of the most pernicious air pollutants.
A

lower atmosphere

95
Q

gas formed by the reaction of
nitrogen oxides and volatile organic compounds in the presence of sunlight. These chemicals are released by industrial emissions and motor vehicle exhaust.

A

Ground level ozone

96
Q

GROUND LEVEL OZONE (O3)

a particularly important cause of morbidity and mortality related to pulmonary inflammation and secondary cardiovascular effects

A

Particulate matter (known as “soot”)

97
Q

GROUND LEVEL OZONE (O3)

Black powdering or gray substance consisting largely amorphous carbon produce by incomplete burning of organic matte

A

SOOT

98
Q

AIR POLLUTION

  • a systemic asphyxiant that is an important cause of accidental and suicidal death.
  • Victims are often unaware that they are undergoing poisoning already
A

Carbon Monoxide (CO)

99
Q

AIR POLLUTION

can’t be seen (colorless), smelled (odorless), heard, tasteless gas, and
can be stopped.

A

Carbon monoxide (CO)

100
Q

AIR POLLUTION

  • The diagnosis is made by measuring carboxyhemoglobin levels in the blood.

o It will alarm when there is an increased level

A

Carbon monoxide (CO)

101
Q

CARBON MONOXIDE (CO)

Acute or Chronic poisoning
* Generally, a consequence of accidental exposure or suicide attempt.
* In light-skinned individuals, acute
poisoning is marked by a characteristic generalized cherry-red
color of the skin and mucous membranes, which results from high
levels of carboxyhemoglobin.

A

Acute poisoning by CO

102
Q

CARBON MONOXIDE (CO)

Acute or Chronic poisoning

  • It develops because carboxyhemoglobin, once formed, is remarkably stable
  • Even with low-level, but persistent, exposure to CO, carboxyhemoglobin may rise to life- threatening levels in
    the blood.
  • The slowly developing hypoxia can insidiously evoke widespread ischemic changes in the CNS; these are particularly marked in the basal ganglia and lenticular nuclei
A

Chronic poisoning by CO

103
Q

The most common pollutant is tobacco smoke, but additional offenders are CO, nitrogen dioxide, and asbestos.

A

Indoor Air Pollution

104
Q

Indoor Air Pollution

containing polycyclic aromatic hydrocarbons generated by cooking oils and coal burning are important indoor pollutants in lower income parts of the world, particularly parts of Asia.

A

Volatile substances

105
Q

Indoor Air Pollution

containing various oxides of nitrogen and carbon particulates, is an irritant that predisposes exposed persons to lung infections and may contain carcinogenic polycyclic hydrocarbons

A

Smoke from burning of organic materials

106
Q

Indoor Air Pollution

range from microbiologic agents capable of causing infectious diseases such as legionnaires’disease, viral pneumonia, and the common cold to less threatening but nonetheless distressing allergens derived from pet dander, dust mites, fungi, and molds that are variously responsible for rhinitis, eye irritation, and asthma.

A

Bioaerosols

107
Q

Indoor Air Pollution

a radioactive gas derived from uranium widely present in soil and in homes, can cause lung cancer in
uranium miners.

A

Radon

It is also suspected that low-level chronic exposures in the home increase lung cancer risk, particularly in those who smoke tobacco.

108
Q

Indoor Air Pollution

number one cause of lung cancer among nonsmokers, according to EPA estimates

A

Radon

109
Q

Indoor Air Pollution

second leading cause of lung cancer.

A

Radon

110
Q

Indoor Air Pollution

s used in the manufacture of building materials (e.g., cabinetry, furniture, adhesives) and mayaccumulate in the air in poorly ventilated housing

A

Formaldehyde

111
Q

Indoor Air Pollution

at what concentration of formaldehydh causes breathing difficulties and a burning sensation in the eyes and throat and can trigger asthma attacks

A

Formaldehyde

112
Q

Indoor Air Pollution

TOF

Formaldehyde is classified as a car for humans and animals.

A

False

Carcinogen

113
Q

Indoor Air Pollution

TOF

Exposure to formaldehyde in the home can irritate eyes, nose, throat, and skin

A

T

114
Q

Indoor Air Pollution

TOF
formaldehyde can also increase breathing problems for people with health conditions like asthma, Acute obstructive pulmonary disorder (AOPD)

A

False

Chronic Obstructive Pulmonary Disorder