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Wrap up block > Robbins ch 7 > Flashcards

Robbins ch 7 Flashcards

1
Q

what aspects of climate change causes increases in CV, cerebrovascular, and respiratory dz

A

heat waves & pollution

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2
Q

contaminated/disrupted water supplies (flood, heavy rain, environmental disaster) increase the the incidence of ….

A

gastroenteritis, cholera, other food/water-borne infectious dz

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3
Q

inc temperature, crop failures and other extreme weather cause an increase in what type of dz

A

vector borne infectious dz (b/c inc vector numbers)

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4
Q

Increased temperatures can destroy crops. what is the effect of this and where is it most likely to occur?

A

Malnutrition, tropical regions

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5
Q

which countries yield the heaviest burden of climate change

A

developing countries

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6
Q

what defines a poison

A

everything can be a poison at the right dose

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7
Q

What is a xenobiotic

A

an exogenous chemical in the environment

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8
Q

What are phase I reactions

A

hydrolysis, oxidation, or reduction

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9
Q

What are phase II reactions

A

conjugation

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10
Q

What is CCl4 converted to in the body and what does it cause

A

converted to trichloromethyl free radical and causes fatty change in the liver (THINK DRY CLEANER)

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11
Q

What chemical from cigarette smoke can be metabolized into a DNA binding molecule

A

Benzo[a]pyrene

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12
Q

which 6 chemicals produce smog

A

SO2, CO, O3, NO2, Pb, particulate matter

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13
Q

What is released by burning coal and oil

A

sulfur dioxide, particles, & acid aerosols

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14
Q

what is the main cause of morbidity and mortality when burning coal and oil

A

the particles

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15
Q

How is CO produced

A

incomplete oxidation during burning

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16
Q

what are 4 characteristics of CO

A

non-irritating, colorless, odorless, tasteless

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17
Q

What are 3 things you should think of when you hear CO

A

working in tunnels, underground garages, or suicide

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18
Q

which has a higher affinity for Hb: CO or O2? and by how much

A

CO has 200X more affinity to Hb than O2

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19
Q

What happens to the blood gases when you have CO tox

A

dec O2 sat; arterial partial pressure of O2 stays the same

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20
Q

what is the progression of CO tox

A

hypoxia–>eventual death
20-30% of Hb saturated w/ CO = systemic hypoxia
60-70% of Hb saturated w/ CO = comma and death

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21
Q

what regions of the brain are most susceptible to damage of long term CO exposure

A

basal ganglia and striatum

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22
Q

Cherry-red discoloration of skin and mucus membranes

A

Acute CO tox

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23
Q

if death by CO happens slowly what would you see on autopsy

A

slightly edematous brain w/punctate hemorrhages, hypoxia induced neuronal changes … (these are aspects of systemic hypoxia)

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24
Q

What is the most common pollutant

A

Tobacco smoke

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25
Q

what does wood smoke lead to

A

lung infections (b/c of carcinogenic polycyclic hydrocarbons)

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26
Q

Uranium miners

A

radon

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27
Q

how can Radon predispose to cancer

A

only if you are a smoker. it normally does not pose a cancer risk

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28
Q

what do bioaerosols predispose to

A

microbial infections (legionella, viruses, allergen) b/c they contain the bugs

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29
Q

What are the 4 MC environmental pollutants (metals)

A

Pb, Hg, As, Cd

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30
Q

places you can get lead poisoning from

A

paint, gas, mines, foundries, batteries, spray paint

Kids: eating paint off walls, soil contamination

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31
Q

How long is the half life of Pb

A

LONG 20-30 yrs

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32
Q

Who absorbs more lead kids or adults?

A

Kids

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33
Q

Where is most of the lead taken up in the body

A

bone/teeth

34
Q

effects of lead in adults

A

peripheral neuropathy (stops w/ stopping exposure)

35
Q

effects of lead in kids

A

CNS effects (low IQ, hyperactivity, poor organization skills)

36
Q

effects of lead in kids are reversible or irreversible

A

irreversible

37
Q

hyper pigmentation lines in gums/plain film

A

Lead poisoning

38
Q

which organ can be effected by Pb other than the brain

A

Kidney, damages proximal tubule when excreted

39
Q

How does Pb cause tox (2)

A
  • binds -SH groups and interferes w/ 2 enzymes in Heme synth –> ANEMIA
  • inhibits Na/K ATPase –> hemolysis
40
Q

microcytic hypochromic anemia w/ basophilic stipling in RBCs

A

Lead poisoning

41
Q

increased RBC free protoporphyrin

A

lead poisoning

42
Q

inc Zn-protoporphyrin

A

lead poisoning

43
Q

first gets wrist drop then develops foot drop

A

lead poisoning

44
Q

extremely severe poorly localized abdominal pain (GI colic) can be seen w/

A

lead poisoning

45
Q

tremor, gingivitis, bizarre behavior

A

Hg poisoning

46
Q

what ares sources of mercury

A

fish, dental amalgams, gold mining

47
Q

cerebral palsy, deafness, blindnes

A

minamata dz (mercury poisoning)

48
Q

where is arsenic found

A

soil, water, wood preservatives, herbicides, mining, smelting

49
Q

anyone in bangladesh chile or china drinking water

A

arsenic poisoning

50
Q

How does arsenic cause tox

A

interferes w/ oxidative phosphorylation

51
Q

chronic exposure of arsenic predisposes to what cancers

A

BCC & SqCC of skin on palms and soles

lung cancer

52
Q

severe GI, CV, CNS problems that lead to death

A

acute arsenic tox

53
Q

where do you find cadmium

A

nickel-cadmium batteries, but MC is food

54
Q

obstructive lung dz, renal tox, skeletal abnormalities, inc Ca in urine

A

acute cadmium tox

55
Q

osteoporosis, osteomalacia, renal dz

A

Itai-itai (cadmium poisoning)

56
Q

Rice fields in japan

A

cadmium poisoning

57
Q

when you see bone and kidney problems think….

A

cadmium poisoning

58
Q

dizziness, confusion —> possible coma

A

organic solvents (chloroform, CCl4, paint removers)

59
Q

Rubber workers .. what do they get and from what

A

leukemia (marrow aplasia & AML) from the benzene & 1,3-butadiene

60
Q

polycyclic hydrocarbons come from what and cause what

A

from combustion of coal/gas, also in tar and soot –> lung and bladder cancer

61
Q

name 4 pesticides

A

DDT, lindane, aldrin, dieldrin

62
Q

name 2 non-pesticides

A

PCBs, dioxin

63
Q

What does acute DDT poisoning cause

A

Neuro tox

64
Q

what is DDT used for

A

Malaria prevention (kills the mosquitos)

65
Q

what can dioxins and PCBs cause

A

skin disorders like folliculitis and acne (maybe som liver and CNS involvement)

66
Q

BPA is found in

A

food and plastic (bottles)

67
Q

What are the effects of BPA exposure in adults and kids

A

Adults –> heart dz

Kids –> endocrine defects

68
Q

vinyl chloride leads to

A

angiosarcoma of liver

69
Q

Remember all the pneumoconiosis???

A

coal dust, silica, asbestos, beryllium

70
Q

MC exogenous cause of cancer?

A

tobacco smoke

71
Q

3 MC dz caused by smoking

A

emphysema, COPD, lung cancer

72
Q

what are the direct effects of cig smoke

A

inflammation and increased mucus production

73
Q

how does cig smoke produce emphysema

A

inc WBC => inc elastase prod -> emphysema

74
Q

does smoking increase the risk of other cancer risks

A

yes it has a multiplicative effect on other exposures w/ predisposing risk

75
Q

why is atherosclerosis and MI increased in smokers

A

inc platelet aggregation, dec myocardial O2 supply, inc O2 demand, dec threshold for arrhythmias (VFib)

76
Q

what kind of risk is associated when smoking is combined w/ HTN and high cholesterol; multiplicative, additive, or no risk

A

multiplicative

77
Q

what other cancers other than lung are associated w/ smoking

A

laryngeal, esophageal, pancratic, bladder, oral

78
Q

Smoking and EtOH use predisposes to

A

oral, laryngeal, and esophageal cancer (multiplicative effect)

79
Q

smoking during pregnancy leads to

A

spontaneous abortion, IUGR, and preterm birth

80
Q

Kids living w/ smoker (2nd hand)

A

respiratory illness, asthma

81
Q

how do you estimate 2nd hand smoke exposure

A

cotine levels in blood

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