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MOD (Mechanisms of Disease) Exam 2 > Robbins Chapter 9 > Flashcards

Robbins Chapter 9 Flashcards

1
Q

What is the single leading global cause for health loss?

A

Undernutrition

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2
Q

What 3 global complications have increased and what 2 have decreased?

A

Inc. = CV disease, cancer, HIV/AIDS/TB

Dec. = neonatal conditions, diarrhea/lower respiratory infections

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3
Q

What environmental conditions inc. risk of:

  1. CV, cerebrovascular, respiratory diseases
  2. gastroenteritis, cholera
  3. vector-borne infectious diseases
A
  1. heatwaves and air pollution
  2. flood contamination and disrupted clean water supply
  3. inc. temp, crop failures
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4
Q

What decreases CYP activity?

A

fasting and starvation

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5
Q

Ozone (Outdoor Air Pollutant)

A

free radicals injure respiratory tract epi/type 1 alveolar

release inflammatory mediators

  • dangerous for asthma/emphysema pts
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6
Q

Sulfur Dioxide (Outdoor Air Pollutant)

A

“Witches Brew” –> combine w/ozone, particulate matter

from fossil fuel burning, copper smelting, paper mills

sulfuric acid/trioxide = burning sensation in nose/throat

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7
Q

Particulate Matter (Outdoor Air Pollutant)

A

pulmonary inflammation/secondary CV effects

particles < 10 um get into alveoli = inflammatory release

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8
Q

Carbon Monoxide and how it works on bodies

A

CNS depression (basal ganglia/lenticular nuclei); 200x greater affinity for Hb (60%-70% sat. = DEATH

rapid death = NO morphological changes
long term survival = edema, hemorrhages, neuronal changes

cherry-red skin and mucous membranes

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9
Q

Indoor Air Pollutants

  1. Wood Smoke
  2. Bioaerosols
  3. Radon
  4. Formaldehyde
  5. Sick Building Syndrome
A
  1. polycyclic hydrocarbons
  2. leginnaires dz, viral pneumonia
  3. radioactive gas = INC. LUNG CANCER RISK
  4. building material, poorly ventilated trailers
  5. black mold from damp homes
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10
Q

Where is Lead poisoning acquired and what changes can it cause in both KIDS and ADULTS?

A

KIDS: paint chips, contaminated soil

  • severe brain damage (low Pb lvls)
  • behavioral problems, hyperactivity, poor organizer

ADULTS: tin cans, battery maker, car radiators

  • peripheral neuropathies
  • foot drop and wrist drop

Lead Lines: gums and metaphyses, hypochromic microcytic anemia (MCV<80), basophilic stippling, ring sideroblasts (iron laden macrophages)

Lead Colic: severe, poorly localized abdominal pain

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11
Q

Mercury Poisoning and Minimata Disease

A
  • damages CNS and kidney
  • main source: contaminated FISH, mercury vapors (dental amalgams)

Minimata Disease: cerebral Palsy, blindness, CNS

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12
Q

Arsenic Poisoning

A

interfere w/cellular metabolism (GI TRACT, CNS, heart)

2-8 wks: sensorimotor neuropathy, paresthesia, numbness; MEES LINES on nails

hyperpigmentation/hyperkeratosis of palms/soles

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13
Q

Cadmium Poisoning and Itai-Itai

A

toxic to Kidneys and Lungs (batteries, soil, plants)

renal tubular damage, skeleton abnormalities

Itai-Itai: osteoporosis and osteomalacia w/renal dz

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14
Q

What 3 things can cause Respiratory Fibrosis? (SAC)

A

silica, asbestos, cobalt

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15
Q

What causes leukemia and liver angiosarcoma?

A

Leukemia = BENZENE (rubber workers)

  • marrow aplasia, acute myeloid leukemia
  • 30 yo with 80 yo bones

Liver Angiosarcoma = Vinyl Chloride

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16
Q

Where 2 cancers are Polycyclic Hydrocarbons associated with?

A

lung and bladder cancer (scrotal cancer in chimney sweeps)

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17
Q

Organochlorines and DDT

A

synthetic lipophilic product = no degradation

DDT –> disrupt hormonal balance (antiestrogenic and antiandrogenic activity)

18
Q

What problems arise from Mineral Dust exposure?

A

pneumonconioses (insulation and shipyards)

asbestosis –> MESOTHELIOMA, black lung
Ferruginous Bodies: iron coating on asbestos fibers

pork chop lung = mesothelioma

19
Q

Dioxin and PCB exposure

A

folliculits and dermatosis (CHLORACNE)

  • acne, cyst formation, hyperpigmentation, hyperkeratosis behind ears and face
20
Q

What does cessation of smoking within 5 years lead to?

A

dec. in mortality of CVD and 21% dec. in lung cancer mortality

21
Q

What are Nicotine/Phenol and Formaldehyde/Nitrogen Oxides related to in smoking?

A

N/P –> tumor promotion

F/N –> cilia toxicity, mucosal irritation
- “smokers cough”

22
Q

How does alcohol potentiate the effects of other substrates?

A

competitively binds to CYP2E1, delaying drug catabolism

  • potentiates the depressant effects of drugs in the CNS
23
Q

Alcohol and Hypertension

A

heavy EtOH use = liver damage, which decreases the production of HDL causing an increased likelihood of coronary artery disease

24
Q

Wernicke Encephalopathy and Korsakoff Syndrome

A

THIAMINE DEFICIENCY

WE: reversible, hemorrhage/necrosis of mammillary bodies

KS: irreversible, short term memory disturbance and confabulation

atrophy of anterior vermis = truncal ataxia

25
Q

Problems with Oral Contraceptive Use

A

inc. risk of cervical cancer, 3-6x risk of venous thrombosis/PE, 2x inc. risk of CAD in smokers

HEPATIC ADENOMA - rare; older prolonged OC use

26
Q

Acetaminophen Toxicity

A

CYP2E1 causes production of NAPQ

normally can conjugate with Glutathione, but when it can’t –> protein adducts and lipid peroxidation

ultimately: HEPATOCYTE NECROSIS, LIVER FAILURE

27
Q

Opiates, Meth, MDMA, Marijuana, Huffing, Bath Salts

A

O: profound respiratory depression, “foam cone”, infections (endocarditis right heart valve)

Meth: violent, confusion, hallucinations, paranoia

MDMA: spike other drugs to enhance CNS effects

Marijuana: inc. HR/BP, large # carcinogens in smoke

Huffing: MRI-brain damage –> severe dementia

Bath Salts: agitation, psychosis, MI, suicide

28
Q

Cocaines effects on the body (2)

A

tachycardia, HTN, peripheral vasoconstriction –> MI!

lethal arrythmias (NOT DOSE RELATED) –> dec. blood flow to placenta = spont. abortion and fetal hypoxia

29
Q

Burn Classification (1st-3rd degree)

A

1st = superficial, epidermis only

2nd = partial thickness, epidermis and dermis

3rd = full thickness, subQ tissue

30
Q

Hyperthermia (Malignant) vs Hypothermia

A

Hyper: “heat-stroke” rise in core body temp w/muscle contractures –> common anesthetics (RYR1 gene)

Hypo: body temp < 90F, bradycardia –> atrial fibrillation, no consciousness

31
Q

Marasmus vs Kwashiorkor

A

M: serum albumin lvl normal, emaciated extremities

K: hypoalbuminuria (edema), spare extremities, fatty liver

32
Q

Anorexia Nervosa vs Bulimia

A

A: self-induced starvation, highest death of any psychiatric disorder (amenorrhea, dec. thyroid, bone)

B: binge/purge; more common and better prognosis
- pulmonary aspiration of gastric contents

BOTH: susceptible to cardiac arrhythmia due to electrolyte imbalance = HYPOKALEMIA

33
Q

Acute vs Chronic Vitamin A toxicity

A

Acute: headache, dizziness, stupor

  • Pseudotumor cerebri: unexplained cranial pressure
  • eskimo eating polar bear livers

Chronic: wt loss, anorexia, bone/joint pain

34
Q

Vitamin D Deficiency

A
  • maintain adequate calcium/phosphate lvls
  • prevent rickets, osteomalacia, and Hypocalcemic Tetany –> tingling around mouth and finger twitch

loss of cartilage palisades in bone

35
Q

Importance of Vitamin K, B1, B3, and B6

A

K –> procoagulant (bleeding diasthesis)

B1 (thiamine) –> dry/wet Beriberi, Wernicke/Korsakoff

B3 (Niacin) –> NAD/NADP
- Pellagra = dementia, diarrhea, dermatitis

B6 (Pyridoxine) –> myelination of spinal cord
- dermatitis, peripheral neuropathy

36
Q

BMI Ranges (3)

A

Normal: 18.5 - 25 kg
Overweight: 25 - 30 kg
Obese > 30 kg

37
Q

Where are Leptin, PPY, and Ghrelin located and what do they bind to?

A

Leptin (adipose) –> POMC/CART –> NRG consumption

PYY (intestines) –> NPY/AgRP –> NRG consumption
- inhibitor

Ghrelin (stomach) –> NPY/AgRP –> Food Intake

38
Q

What is Pickwickian Syndrome and what is it related to?

A

hypoventilation syndrome associated w/obesity

  • hypersomnolence –> sleep apnea, polycythemia, right-sided heart failure (cor pulmonale)
39
Q

IGF-1, Obesity, and Cancer

A

IGF-1 inc. during hyperinsulinemia (due to obesity)

IGF-1 = inc. cell proliferation and dec. apoptosis (perfect environment for tumor development)

obesity itself is a pro-inflammatory state = may be carcinogenic itself

40
Q

Aflatoxin, Nitrosamines/Nitrosamides/High animal fat and low fiber on Cancer development

A

Aflatoxin - hepatocellular carcinoma

N/N - gastric carcinoma

High Animal/Low Fiber - colon cancer

total dietary fat = inc. risk of breast cancer

MOD (Mechanisms of Disease) Exam 2 (4 decks)

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