VIII - Environmental and Nutritional Diseases

Question 1

A gas formed by sunlight-driven reactions involving nitrogen oxides. Together with oxides and fine particulate matter, it forms “smog”.

Answer 1

Ozone(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282

Question 2

A nonirritating , colorless, tasteless, odorless gas produced bu the imperfect oxidation of carbonaceous materials. Binds to hemoglobin with high affinity causing systemic asphyxiation and CNS depression.

Answer 2

Carbon monoxide(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282

Question 3

Carbon monoxide in the blood is called _______.

Answer 3

Carboxyhemoglobin(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282

Question 4

Acute poisoning of carbon monoxide produces this characteristic color of the skin and mucous membranes.

Answer 4

Cherry red color(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 283

Question 5

Microcytic, hypochromic anemia, with basophilic stippling of erythrocytes, peripheral demyelinating neuropathy which manifests as footdrop and wristdrop, colic characterized by extremely severe, poorly localized abdominal pain, and chronic renal damage are the features of poisoning with this heavy metal.

Answer 5

Lead(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 283

Question 6

Main source of exposure to this heavy metal are contamintaed fish and dental amalgams, causing tremor, gingivitis and bizarre behavior.

Answer 6

Mercury(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285

Question 7

Consumption of fish contaminated with methyl mercury causing cerebral palsy, deafness, blindness, and major CNS defects in children exposed in utero.

Answer 7

Minamata disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285

Question 8

Antidote for mercury poisoning.

Answer 8

Thimerosal(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285

Question 9

Chronic exposure with this heavy metal results in hyperpigmentation and hyperkeratosis which may develop into basal or squamous cell carcinomas.

Answer 9

Arsenic(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285

Question 10

This heavy metal is used mainly in batteries and fertilizers, which can contaminate soil. Can cause obstructive lung disease and kidney damage.

Answer 10

Cadmium(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285

Question 11

Disease caused by cadmium in Japan, presenting as a combination of osteoporosis and osteomalacia, associated with renal disease.

Answer 11

Itai-itai disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285

Question 12

May be released from combustion of fossil fuels, burning of coal and gas, and also present in tar and soot. Among the most potent carcinogens, implicated in lung and bladder cancer.

Answer 12

Polycyclic hydrocarbons(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287

Question 13

Synthetic products that resist degradation and are lipophilic, typically used as pesticides, with anti-estrogenic and anti-androgenic activity, and causes neurologic toxicity.

Answer 13

Organochlorines (e.g. DDT)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287

Question 14

These can cause skin disorders such as folliculitis and chloracne, consisting of acne, cyst formation, hyperpigmentation, and hyperkeratosis, around the face and behind the ears.

Answer 14

Dioxins and Polychlorinatedbiphenyls (PCB)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287

Question 15

It is the most preventable cause of human death.

Answer 15

Smoking(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287

Question 16

Components of cigarette smoke that are potent carcinogens in animals and are most likely involved in the causation of lung carcinomas in humans.

Answer 16

Polycyclic hydrocarbons and nitrosamines(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 288

Question 17

A long acting tetracycline which can cause a diffuse blue-gray pigmentation of the skin.

Answer 17

Minocycline(TOPNOTCH)

Question 18

Chronic alcoholics are at an increased risk of developing this type of cancer as a result of liver injury.

Answer 18

Hepatocellular carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 290

Question 19

These refer to untoward effects of drugs that are given in conventional therapeutic settings.

Answer 19

Adverse drug reactions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 291

Question 20

A long acting tetracycline which can cause a diffuse blue-gray pigmentation of the skin.

Answer 20

Minocycline(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 293

Question 21

Oral contraceptives have a protective effect against these cancers.

Answer 21

Endometrial and ovarian CA(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294

Question 22

Oral contraceptives may increase the risk of developing this type of cancer in women.

Answer 22

Cervical CA(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294

Question 23

Prolonged use of oral contraceptives is associated with the development of this rare benign tumor especially in older women.

Answer 23

Hepatic adenoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294

Question 24

Toxic metabolite of paracetamol or acetaminophen.

Answer 24

NAPQI (N-acetyl-p-benzoquinoneimine)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294

Question 25

Toxic dose for acetaminophen.

Answer 25

15-25 grams/day(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294

Question 26

Antidote for acetaminophen poisoning.

Answer 26

N-acetylcysteine(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 294

Question 27

Manifested by headache, dizziness, tinnitus, difficulty of hearing, mental confusion, drowsiness, nausea, vomiting, and diarrhea, with CNS changes that can progress to convulsions and coma.

Answer 27

Salicylism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294

Question 28

Adult toxic dose of aspirin.

Answer 28

10-30 grams(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294

Question 29

Mixtures of aspirin and phenacetin, or its active metabolite acetaminophen, when taken over several years can cause tubulointerstitial nephritis and renal papillary necrosis called _______.

Answer 29

Analgesic nephropathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294

Question 30

This drug of abuse can precipitate lethal arrythmias, hyperpyrexia, seizures, amd respiratory arrest during acute overdose. Causes nasal septal perforation, decrease in lung diffusing capacity in those who inhale smoke and dilated cardiomyopathy during chronic use.

Answer 30

Cocaine or “crack” (cocaine derivative)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 295

Question 31

Addictive opiod derived from the poppy plant which can cause euphoria, hallucinations, somnolence, sedation, and increased risk of sudden death.

Answer 31

Heroin(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 296

Question 32

Drug made from the leaves of Cannabis sativa plant which can cause distortion of sensory perception and impairs motor coordination.

Answer 32

Marijuana(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 297

Question 33

Psychoactive substance found in marijuana.

Answer 33

Delta 9- Tetrahydrocannabinol (THC)(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 297

Question 34

Mechanism of action of aspirin.

Answer 34

Irreversibly blocks the enzyme cyclooxygenase.(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 297

Question 35

A wound produced by scraping or rubbing resulting in removal of superficial layer of the skin.

Answer 35

Abrasion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 36

A wound usually produced by a blunt object, characterized by damage to blood vessels and extravasation of blood into tissues.

Answer 36

Contusion (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 37

A tear or disruptive stretching of tissue caused by the application of force by a blunt object, causing jagged and irregular edges to the skin.

Answer 37

Laceration(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 38

A wound inflicted by a sharp instrument, wherein bridging blood vessels are severed.

Answer 38

Incision(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 39

A wound caused by a long, narrow instrument.

Answer 39

Puncture wound(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 40

Burn classification which involves total destruction of the epidermis and dermis, with loss of thermal appendages.

Answer 40

Full thickness burn (3rd and 4th degree)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 41

Burn classification wherein the thermal appendages are spared but involves at least the deeper portions of the skin.

Answer 41

Partial thickness burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 42

Partial thickness burn that involves both the epidermis and superficial dermis.

Answer 42

Second degree burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 43

Partial thickness burn that involves the epidermis only.

Answer 43

First degree burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 44

Grossly, these burns are white or charred and anesthetic due to nerve ending destruction.

Answer 44

Full thickness burns(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 45

These burns are pink or mottled with blisters and are painful.

Answer 45

Second degree burn (partial thickness)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 46

Histologic change in the skin during burns.

Answer 46

Coagulative necrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298

Question 47

Leading cause of death in burn patients.

Answer 47

Organ system failure secondary to burn sepsis.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299

Question 48

Cramping of voluntary muscles in association with vigorous exercise as a result of electrolyte loss via sweating.

Answer 48

Heat cramps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299

Question 49

Most common hyperthermic syndrome. A sudden onset of prostration and collapse, resulting from failure of the cardiovascular system to compensate for hypovolemia, secondary to water depletion.

Answer 49

Heat exhaustion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299

Question 50

Associated with high ambient temperatures and high humidity. Thermoregulatory mechanisms fail, sweating ceases and core body temperature rises. Due to marked generalized peripheral vasodilation with peripheral pooling of blood and decreased effective circulating volume.

Answer 50

Heat stroke(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299

Question 51

Two types of injuries caused by electricity.

Answer 51

BurnsVFib or cardiac and respiratory center failure(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299

Question 52

This may injure cells directly or indirectly by generating free radicals from water or molecular oxygen, damages DNA and rapidly dividing cells. Exposure may predispose to neoplastic transformation, vascular damage, sclerosis and tissue fibrosis.

Answer 52

Ionizing radiation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 300

Question 53

Malnutrition caused by lack of nutrients from the diet.

Answer 53

Primary malnutrition(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 304

Question 54

Malnutrition caused by malabsorption, impaired nutrient utilization or storage, excess losses or increased nutrient needs.

Answer 54

Secondary or conditioned malnutrition(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 304

Question 55

Protein energy malnutrition which occurs when protein deprivation is relatively greater than reduction in total calories. Associated with generalized edema, flaky paint appearance of the skin, alternating bands of pale and dark hair, enlarged fatty liver, apathy, listlessness and loss of appetite.

Answer 55

Kwashiorkor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 305

Question 56

Protein energy malnutrition caused by a decrease in both protein and calorie intake, and weight falls below 60% of normal for sex, height and age. Serum albumin is normal or slightly reduced.

Answer 56

Marasmus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 305

Question 57

Self-induced starvation, resulting in marked weight loss.

Answer 57

Anorexia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 306

Question 58

A condition wherein a patient binges on food and then induces vomiting.

Answer 58

Bulimia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 306

Question 59

Deficiency of this vitamin causes night blindness, xerophthalmia, keratomalacia, Bitot spots and eventually corneal ulceration.

Answer 59

Vitamin A(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 307

Question 60

Condition in children as result of vitamin D deficiency causing the following signs and symptoms: frontal bossing of the head, rachitic rosary, pigeon breast deformity, lumbar lordosis and bow legs.

Answer 60

Rickets (children)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 309

Question 61

Deficieny of this vitamin causes impaired collagen formation, leading to gum bleeding, easy bruisability, and impaired wound healing.

Answer 61

Vitamin C (Scurvy)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 312

Question 62

Symptoms of cheilosis, stomatitis, glossitis, dermatitis and corneal vascularization results from deficiency of this vitamin.

Answer 62

Vitamin B2 (Riboflavin)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 314

Question 63

Symptoms of cheilosis, glossitis, dermatitis, and peripheral neuropathy.

Answer 63

Vitamin B6 (Pyridoxine)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 314