Path

Question 1

Ozone

Answer 1

Sunlight + car exhaust

Makes free radicals that injure the lungs

Question 2

Air particles - threat

Answer 2

Particles <10micro grams get deep into lungs, are phagocytosed leading to inflammation

Question 3

Effects of lead on the brain (adults and kids)

Answer 3

Adult - headaches, memory loss

Kids - encephalopathy, mental retardation

Question 4

Signs of lead poisoning in the blood

Answer 4

Anemia, basophilic stippling, zinc protoporphyrin accumulation

Question 5

Why does lead cause anemia

Answer 5

Impaired iron incorporation into heme, increased fragility of red cells

Question 6

Lead effects on bones

Answer 6

Competes with calcium
Forms radio dense deposits at epiphyseal plates in kids
Inhibits fracture healing

Question 7

Source of peripheral nerve damage in lead toxicity

Answer 7

Demylination

Question 8

Results of heavy mercury poisoning in utero

Answer 8

Cerebral palsy, deafness, blindness

Question 9

Most toxic forms of arsenic are _________.

Answer 9

Trivalent

Question 10

Cause of death in arsenic toxicity

Answer 10

Interference with mitochondrial oxidative phosphorylation –> GI, CV, CNS disturbances

Question 11

Result of chronic exposure to arsenic

Answer 11

Hyperpigmentation and keratosis

May be followed by basal cell or squamous cell carcinoma on palms and soles

Question 12

Cadmium exposure results in

Answer 12

Obstructive lung disease, renal toxicity, and skeletal abnormalities from calcium loss (ie osteoporosis)

Question 13

Source of fatty liver in chronic alcohol use

Answer 13

Toxic effects of alcohol metabolism: decrease NAD+ and increased NADH results in fat accumulation in liver because NAD+ is required for fatty acid oxidation.

Question 14

Features of fetal alcohol syndrome

Answer 14

Microcephaly, growth retardation, facial abnormalities, mental retardation

Question 15

Oral contraceptives are associated with this rare tumor

Answer 15

Hepatic adenoma

Question 16

Acetaminophen is metabolized to _________, which can cause _____________.

Answer 16

NAPQI

Centrilobular necrosis

Question 17

Mechanism of injury produced by NAPQI

Answer 17

1) Covalent binding to hepatic proteins

2) Depletion of reduced glutathione (GSH) which leaves cells susceptible to ROS

Question 18

Treatment for acetaminophen overdose

Answer 18

N-acetylcysteine

Question 19

Aspirin overdose results in

Answer 19

Respiratory alkalosis and metabolic acidosis

Question 20

Chronic use of aspirin is called?

Symptoms

Answer 20

Salicylism
Headache, dizziness, tinnitus, decreased hearing, confusion, drowsiness, nausea, vomiting, diarrhea
Ulceration and bleeding

Question 21

Cocaine overdose symptoms

Answer 21

Seizures, arrhythmias, respiratory arrest

Question 22

Cocaine toxicity

Answer 22

Tachycardia, HTN, peripheral vasoconstriction, myocardial ischemia
Hyperpyrexia

Question 23

Chronic cocaine use results in

Answer 23

Perforated septum, decreased lung diffusing capacity, dilated cardiomyopathy

Question 24

Cocaine metabolite in blood

Answer 24

Benzoylecgonine

Question 25

Pharmacologic effects of cocaine

Answer 25

Blocks reuptake of dopamine in CNS

At adrenergic endings, blocks reuptake of epinephrine and norepinephrine, also stimulates release or norepinephrine

Question 26

Heroine metabolites

Answer 26

6-MAM and morphine

Question 27

Renal problems caused by heroine

Answer 27

Amyloidosis and focal glomerulosclerosis

Question 28

Pathophysiology behind atherosclerosis and tobacco use

Answer 28

Increased platelet aggregation, decreased myocardial O2 supply and increased O2 demand

Question 29

Treatment of CO poisoning

Answer 29

100% O2 and/or hyperbaric chamber, which reduces the 1/2 life of CO in the blood

Question 30

CO causes necrosis of the ___________.

Answer 30

Globus pallidus - modulates motor movement, part of basal ganglia

Question 31

Appearance of full thickness burns vs partial thickness burns

Answer 31

Full thickness: White or charred, dry, not painful

Partial thickness: pink or mottled, blistered and painful