Path: Chapter 7: Environmental and Nutritional Disease

Question 1

Leading cause of global health loss?

Answer 1

undernutrition

Question 2

Most important catalyst in Phase I drug rxns?

Answer 2

CYP450

Question 3

Effects of fasting on CYP activity?

Answer 3

decrease

Question 4

How long does excess risk of lung cancer last after you stop smoking?

Answer 4

30 years

Question 5

Passive smoke inhalation by nonsmokers can be estimate how?

Answer 5

by measuring plasma cotinine, a metabolite of nicotine

Question 6

A blood alcohol concentration of ________ is legally intoxicated.

Answer 6

80 mg/dL

Question 7

Most common cause of acetominophen toxicity in U.S.?

Answer 7

unintentional overdose

Question 8

Most common bug that infects burns?

Answer 8

Pseudomonas

Question 9

What is marasmus?

Answer 9

a child is said to have marasmus when weight falls to 60% of normal for sex, height, and age

lab values include a normal serum albumin (vs. Kwashiorkor)

muscle is broken down for energy and protein as is fat

Question 10

How does damage due to radiation change w/ tissue vascularity?

Answer 10

highly vascular tissue has more oxygen, so radiation can cause more free radical formation there

thus, at the center of rapidly growing tumors (a hypoxic area), radiation won’t have quite the same effect

Question 11

Which air pollutants can increase mortality in pts w/ chronic lung disease?

Answer 11

particulates and sulfur dioxide

Question 12

Of the pollutants released by coal- and oil-fired power plants and industrial processes, which one appears to be the main cause of morbidity and death?

Answer 12

particulates (especially those less than 10 micrometers in diameter since they can travel all the way down the airways)

Question 13

What is Minamata disease?

Answer 13

a form of mercury poisoning causing:

cerebral palsy, deafness, blindness, and major CNS defects in children exposed in utero

named after Minamata Bay in Japan where methyl mercury (made by bacteria) is in high conc. in the fish.

pregnant women shouldn’t eat fish

Question 14

Large concentrations of ________ are present in ground water in countries such as Bangladesh, Chile, and China.

Answer 14

inorganic arsenic

Question 15

Chronic skin exposure to arsenic can cause…

Answer 15

hyperpigmentation and hyperkeratosis of the skin, possibly followed by development of basal and squamous cell carcinoma (but not melanoma)

Question 16

How to distinguish skin cancer caused by Arsenic vs. caused by sunlight?

Answer 16

Arsenic - palms and soles. also generally multiple

Question 17

What is “itai-itai”?

Answer 17

“ouch-ouch”. seen in postmenopausal rice farmers in Japan exposed to Cadmium in water

it’s a combination of osteoporosis and osteomalacia associated w/ renal dz

Question 18

Exposure to what mineral dust causes an increased risk of cancer even to family members?

Answer 18

asbestos

Question 19

Alcohol is metabolized where?

Answer 19

most is metabolized to acetaldehyde in liver by 3 enzymes systems:

1) alcohol dehydrogenase (cytosol)
2) CYP2E1 (microsomes)
3) catalase (peroxisomes)

the main enzyme is alcohol dehydrogenase, but at high BAC, the microsomal (CYP) also has an important role

Question 20

‘lung granuloma showing talc crystals under polarized light’

Answer 20

heroin

Question 21

Most common infection among heroin addicts?

Answer 21

hepatitis

Question 22

Most common forms of kidney disease in heroin addicts?

Answer 22

1) amyloidosis (usually secondary to skin infxns)

2) FSGS

Question 23

Leading cause of death in burn patients?

Answer 23

organ system failure from sepsis (such as Pneumonia or septic shock + renal failure)

(classically Pseudomonas, but S. aureus and candida are possible)

Question 24

Carcinogens in cigarette smoke?

Answer 24

tar, polycyclic aromatic hydrocarbons, benzopyrene, nitrosamines

(polycyclic aromatic hydrocarbons and nitrosamines are cited as probably being the cause of lung cancer)