Robbins ch 7 Flashcards
what aspects of climate change causes increases in CV, cerebrovascular, and respiratory dz
heat waves & pollution
contaminated/disrupted water supplies (flood, heavy rain, environmental disaster) increase the the incidence of ….
gastroenteritis, cholera, other food/water-borne infectious dz
inc temperature, crop failures and other extreme weather cause an increase in what type of dz
vector borne infectious dz (b/c inc vector numbers)
Increased temperatures can destroy crops. what is the effect of this and where is it most likely to occur?
Malnutrition, tropical regions
which countries yield the heaviest burden of climate change
developing countries
what defines a poison
everything can be a poison at the right dose
What is a xenobiotic
an exogenous chemical in the environment
What are phase I reactions
hydrolysis, oxidation, or reduction
What are phase II reactions
conjugation
What is CCl4 converted to in the body and what does it cause
converted to trichloromethyl free radical and causes fatty change in the liver (THINK DRY CLEANER)
What chemical from cigarette smoke can be metabolized into a DNA binding molecule
Benzo[a]pyrene
which 6 chemicals produce smog
SO2, CO, O3, NO2, Pb, particulate matter
What is released by burning coal and oil
sulfur dioxide, particles, & acid aerosols
what is the main cause of morbidity and mortality when burning coal and oil
the particles
How is CO produced
incomplete oxidation during burning
what are 4 characteristics of CO
non-irritating, colorless, odorless, tasteless
What are 3 things you should think of when you hear CO
working in tunnels, underground garages, or suicide
which has a higher affinity for Hb: CO or O2? and by how much
CO has 200X more affinity to Hb than O2
What happens to the blood gases when you have CO tox
dec O2 sat; arterial partial pressure of O2 stays the same
what is the progression of CO tox
hypoxia–>eventual death
20-30% of Hb saturated w/ CO = systemic hypoxia
60-70% of Hb saturated w/ CO = comma and death
what regions of the brain are most susceptible to damage of long term CO exposure
basal ganglia and striatum
Cherry-red discoloration of skin and mucus membranes
Acute CO tox
if death by CO happens slowly what would you see on autopsy
slightly edematous brain w/punctate hemorrhages, hypoxia induced neuronal changes … (these are aspects of systemic hypoxia)
What is the most common pollutant
Tobacco smoke
what does wood smoke lead to
lung infections (b/c of carcinogenic polycyclic hydrocarbons)
Uranium miners
radon
how can Radon predispose to cancer
only if you are a smoker. it normally does not pose a cancer risk
what do bioaerosols predispose to
microbial infections (legionella, viruses, allergen) b/c they contain the bugs
What are the 4 MC environmental pollutants (metals)
Pb, Hg, As, Cd
places you can get lead poisoning from
paint, gas, mines, foundries, batteries, spray paint
Kids: eating paint off walls, soil contamination
How long is the half life of Pb
LONG 20-30 yrs
Who absorbs more lead kids or adults?
Kids
Where is most of the lead taken up in the body
bone/teeth
effects of lead in adults
peripheral neuropathy (stops w/ stopping exposure)
effects of lead in kids
CNS effects (low IQ, hyperactivity, poor organization skills)
effects of lead in kids are reversible or irreversible
irreversible
hyper pigmentation lines in gums/plain film
Lead poisoning
which organ can be effected by Pb other than the brain
Kidney, damages proximal tubule when excreted
How does Pb cause tox (2)
- binds -SH groups and interferes w/ 2 enzymes in Heme synth –> ANEMIA
- inhibits Na/K ATPase –> hemolysis
microcytic hypochromic anemia w/ basophilic stipling in RBCs
Lead poisoning
increased RBC free protoporphyrin
lead poisoning
inc Zn-protoporphyrin
lead poisoning
first gets wrist drop then develops foot drop
lead poisoning
extremely severe poorly localized abdominal pain (GI colic) can be seen w/
lead poisoning
tremor, gingivitis, bizarre behavior
Hg poisoning
what ares sources of mercury
fish, dental amalgams, gold mining
cerebral palsy, deafness, blindnes
minamata dz (mercury poisoning)
where is arsenic found
soil, water, wood preservatives, herbicides, mining, smelting
anyone in bangladesh chile or china drinking water
arsenic poisoning
How does arsenic cause tox
interferes w/ oxidative phosphorylation
chronic exposure of arsenic predisposes to what cancers
BCC & SqCC of skin on palms and soles
lung cancer
severe GI, CV, CNS problems that lead to death
acute arsenic tox
where do you find cadmium
nickel-cadmium batteries, but MC is food
obstructive lung dz, renal tox, skeletal abnormalities, inc Ca in urine
acute cadmium tox
osteoporosis, osteomalacia, renal dz
Itai-itai (cadmium poisoning)
Rice fields in japan
cadmium poisoning
when you see bone and kidney problems think….
cadmium poisoning
dizziness, confusion —> possible coma
organic solvents (chloroform, CCl4, paint removers)
Rubber workers .. what do they get and from what
leukemia (marrow aplasia & AML) from the benzene & 1,3-butadiene
polycyclic hydrocarbons come from what and cause what
from combustion of coal/gas, also in tar and soot –> lung and bladder cancer
name 4 pesticides
DDT, lindane, aldrin, dieldrin
name 2 non-pesticides
PCBs, dioxin
What does acute DDT poisoning cause
Neuro tox
what is DDT used for
Malaria prevention (kills the mosquitos)
what can dioxins and PCBs cause
skin disorders like folliculitis and acne (maybe som liver and CNS involvement)
BPA is found in
food and plastic (bottles)
What are the effects of BPA exposure in adults and kids
Adults –> heart dz
Kids –> endocrine defects
vinyl chloride leads to
angiosarcoma of liver
Remember all the pneumoconiosis???
coal dust, silica, asbestos, beryllium
MC exogenous cause of cancer?
tobacco smoke
3 MC dz caused by smoking
emphysema, COPD, lung cancer
what are the direct effects of cig smoke
inflammation and increased mucus production
how does cig smoke produce emphysema
inc WBC => inc elastase prod -> emphysema
does smoking increase the risk of other cancer risks
yes it has a multiplicative effect on other exposures w/ predisposing risk
why is atherosclerosis and MI increased in smokers
inc platelet aggregation, dec myocardial O2 supply, inc O2 demand, dec threshold for arrhythmias (VFib)
what kind of risk is associated when smoking is combined w/ HTN and high cholesterol; multiplicative, additive, or no risk
multiplicative
what other cancers other than lung are associated w/ smoking
laryngeal, esophageal, pancratic, bladder, oral
Smoking and EtOH use predisposes to
oral, laryngeal, and esophageal cancer (multiplicative effect)
smoking during pregnancy leads to
spontaneous abortion, IUGR, and preterm birth
Kids living w/ smoker (2nd hand)
respiratory illness, asthma
how do you estimate 2nd hand smoke exposure
cotine levels in blood
