VIII - Environmental and Nutritional Diseases Flashcards
Ozone(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282
Gas formed by sunlight-driven reactions involving nitrogen oxides. Together with oxides and fine particulate matter, it forms “smog”.
Carbon monoxide(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282
A nonirritating , colorless, tasteless, odorless gas produced by imperfect oxidation of carbonaceous materials. Binds to hemoglobin with high affinity causing systemic asphyxiation and CNS depression.
Carboxyhemoglobin(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 282
Carbon monoxide in the blood is called _______.
Cherry red color(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 283
Acute poisoning of carbon monoxide produces this characteristic color of the skin and mucous membranes.
Lead(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 283
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. SEE SLIDE 8.1
Mercury(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
Main source of exposure to this heavy metal are contamintaed fish and dental amalgams, causing tremor, gingivitis and bizarre behavior.
Minamata disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
Consumption of fish contaminated with methyl mercury causing cerebral palsy, deafness, blindness, and major CNS defects in children exposed in utero.
Thimerosal(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
Antidote for mercury poisoning.
Arsenic(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
Chronic exposure with this heavy metal results in hyperpigmentation and hyperkeratosis, which may develop into basal or squamous cell carcinomas.
Cadmium(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
This heavy metal is used mainly in batteries and fertilizers, which can contaminate soil. Can cause obstructive lung disease and kidney damage.
Itai-itai disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
Disease caused by cadmium in Japan, presenting as a combination of osteoporosis and osteomalacia, associated with renal disease.
Polycyclic hydrocarbons(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
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.
Organochlorines (e.g. DDT)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
Synthetic products that resist degradation and are lipophilic, typically used as pesticides, with anti-estrogenic and anti-androgenic activity, and causes neurologic toxicity.
Dioxins and Polychlorinatedbiphenyls (PCB)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
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.
Smoking(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
It is the most preventable cause of human death.
Polycyclic hydrocarbons and nitrosamines(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 288
Components of cigarette smoke that are potent carcinogens in animals and are most likely involved in the causation of lung carcinomas in humans.
Hepatocellular carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 290
Chronic alcoholics are at an increased risk of developing this type of cancer as a result of liver injury.
Adverse drug reactions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 291
These refer to untoward effects of drugs that are given in conventional therapeutic settings.
Minocycline(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 293
A long acting tetracycline which can cause a diffuse blue-gray pigmentation of the skin.
Endometrial and ovarian CA(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
Oral contraceptives have a protective effect against these cancers.
Cervical CA(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
Oral contraceptives may increase the risk of developing this type of cancer in women.
Hepatic adenoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
Prolonged use of oral contraceptives is associated with the development of this rare benign tumor especially in older women.
NAPQI (N-acetyl-p-benzoquinoneimine)(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 422
Toxic metabolite of paracetamol or acetaminophen causing centrilobular necrosis that may progress to liver failure.
15-25 grams/day(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
Toxic dose for acetaminophen.
N-acetylcysteine(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 294
Antidote for acetaminophen poisoning.
Salicylism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
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.
10-30 grams(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
Adult toxic dose of aspirin.
Analgesic nephropathy(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
Mixtures of aspirin and phenacetin, or its active metabolite acetaminophen, when taken over several years can cause tubulointerstitial nephritis and renal papillary necrosis called _______.
Cocaine or “crack” (cocaine derivative)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 295
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.
Heroin(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 296
Addictive opiod derived from the poppy plant which can cause euphoria, hallucinations, somnolence, sedation, and increased risk of sudden death.
Marijuana(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 297
Drug made from the leaves of Cannabis sativa plant which can cause distortion of sensory perception and impairs motor coordination.
Delta 9- Tetrahydrocannabinol (THC)(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 297
Psychoactive substance found in marijuana.
Irreversibly blocks the enzyme cyclooxygenase.(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 297
Mechanism of action of aspirin.
Abrasion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
A wound produced by scraping or rubbing resulting in removal of superficial layer of the skin.
Contusion (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
A wound usually produced by a blunt object, characterized by damage to blood vessels and extravasation of blood into tissues.
Laceration(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
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.
Incision(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
A wound inflicted by a sharp instrument, wherein bridging blood vessels are severed.
Puncture wound(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
A wound caused by a long, narrow instrument.
Full thickness burn (3rd and 4th degree)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
Burn classification which involves total destruction of the epidermis and dermis, with loss of thermal appendages.
Partial thickness burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
Burn classification wherein the thermal appendages are spared but involves at least the deeper portions of the skin.
Second degree burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
Partial thickness burn that involves both the epidermis and superficial dermis.
First degree burn(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
Partial thickness burn that involves the epidermis only.
Second degree burn (partial thickness)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
These burns are pink or mottled with blisters and are painful.
Coagulative necrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 298
Histologic change in the skin during burns.
Organ system failure secondary to burn sepsis. Most common offender is the opportunist Pseudomonas aeruginosa. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
Leading cause of death in burn patients.
Heat cramps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
Cramping of voluntary muscles in association with vigorous exercise as a result of electrolyte loss via sweating.
Heat exhaustion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
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.
Heat stroke(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
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.
BurnsVFib or cardiac and respiratory center failure(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 299
Two types of injuries caused by electricity.
Ionizing radiation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 300
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.
Primary malnutrition(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 304
Malnutrition caused by lack of nutrients from the diet.
Secondary or conditioned malnutrition(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 304
Malnutrition caused by malabsorption, impaired nutrient utilization or storage, excess losses or increased nutrient needs.
Kwashiorkor. SEE SLIDE 8.2 (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 305
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. There is also mucosal atrophy and loss of villi in the small bowel (Making them lactate intolerant initially)
Marasmus. SEE SLIDE 8.2 (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 305
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.
Anorexia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 306
Self-induced starvation, resulting in marked weight loss.
Bulimia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 306
A condition wherein a patient binges on food and then induces vomiting.
Vitamin A(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 307
Deficiency of this vitamin causes night blindness, xerophthalmia, keratomalacia, Bitot spots and eventually corneal ulceration.
Rickets (children)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 309
Condition in children as result of vitamin D deficiency causing the following signs and symptoms: Craniotabes (parietal bones buckle inward with pressure), frontal bossing of the head, rachitic rosary, pigeon breast deformity, lumbar lordosis and bow legs. SEE SLIDE 8.3
Vitamin C (Scurvy)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 312
Deficieny of this vitamin causes impaired collagen formation, leading to gum bleeding, easy bruisability, and impaired wound healing. SEE SLIDE 8.4
Vitamin B2 (Riboflavin)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 314
Symptoms of cheilosis, stomatitis, glossitis, dermatitis and corneal vascularization results from deficiency of this vitamin.
Vitamin B6 (Pyridoxine)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 314
Symptoms of cheilosis, glossitis, dermatitis, and peripheral neuropathy.
Ischemic heart disease and cerebrovascular disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 405
Leading causes of death in developed countries
Cytochrome P-450 enxyme system (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 407
The most important catalyst of phase I reactions; detoxify xenobiotics
Carbon monoxide poisoning (TOPNOTCH)
A 55 y/o male presented to the ER following a house fire. He was lethargic, tachycardic, tachypneic and displayed memory disturbance. Skin was noted to be cherry red. What is the most likely cause?
Lead poisoning (TOPNOTCH)
A 5 y/o boy presented to the clinic due to hyperactivity and impulsiveness. Hearing acuity was below normal, and speech and language were slightly delayed. History reveals that the boy lives in an old house in the community. PBS showed hypochromia and microcytosis. What is the most likely diagnosis?
Mercury (TOPNOTCH)
Toxic effects of this heavy metal include cerebral palsy, deafness, blindness, and kidney damage. Cause of Minamata disease.
Trivalent compounds of arsenic(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 412
Most toxic form of arsenic
Arsenic (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 412
The most serious consequence of chronic exposure to this heavy metal is the increased risk for the development of cancers, particularly of the lungs, bladder, and skin.
Cadmium (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 413
The principal toxic effects of toxicity to this heavy metal are obstructive lung disease and renal tubular damage that may progress to ESRD.
Leukemia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 413
Exposure to benzene increases risk of what hematologic condition
Angiosarcoma of the liver (TOPNOTCH) Robbins Basic Pathology, 9th ed.,p.414
Exposure to vinyl chloride used in the synthesis of polyvinyl resins leads to the development of what tumor?
Alcohol dehydrogenase(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 417
Main enzyme system involved in alcohol metabolism
Kwashiorkor(TOPNOTCH)
Enlarged and fatty liver is seen in kwashiorkor or marasmus?
Cardiac arrythmia and sudden death due to hypokalemia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 435
A major complication of anorexia nervosa and bulimia
Vitamin A(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 438
Symptos of acute toxicity to these vitamin include headache, diziness, vomiting, stupor, and blurred vission, which may be confused with those of a brain tumor (pseudotumor cerebri)
Vitamin D(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 441
Toxicity of this vitamin may cause calcification of soft tissue and bone pain.
Zinc(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 443
Rash around the eyes, mouth (SEE SLIDE 8.5) ,and nose, anorexia, diarrhea, growth retardation, depressed wound healing and impaired night vision are associated with ____ deficiency
Copper(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 443
Muscle weakness, neurologic defects and abnormal collagen cross-linking are associated with ___ deficiency.
Scurvy(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 443
Disease characterized by bone disease in growing children and by hemorrhages and healing defects in both children and adults.
Hypoventilation syndrome/pickwickian syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 448
Syndrome composed of respiratory abnromalities in very obese persons.
Leptin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 448
Hormone synthesized by fat cells which regulates food intake an energy expenditure. Its binding to its receptors in the hypothalamus increases energy consumption by stimulating POMC/CART neurons.
Hepatocellular carcinoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 449
Aflatoxin is implicated in what type of cancer?
True (TOPNOTCH)
True or False. High animal intake and low fiber has been imlicated in colon cancer.
a more permeable blood-brain barrier (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 283
Lead has a more damaging effect on the brains of children than in adults because of (A) a more permeable blood-brain barrier (B) immature lenticular nuclei (C) less microglia and astrocytes(D) greater proportion of fetal hemoglobin in the blood
mucoepidermoid carcinoma of the salivary glands (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 285
Chronic exposure to arsenic is associated with the development of the following malignancies EXCEPT (A) squamous cell carcinoma of the skin (B) mucoepidermoid carcinoma of the salivary glands (C) lung carcinoma (D) basal cell carcinoma
hepatic angiosarcoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 287
Exposure to vinyl chloride has been found to cause (A) multiple uterine leiomyomas (B) hepatic angiosarcoma (C) squamous cell carcinoma of the skin (D) transitional carcinoma of the bladder
alcohol (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 289
Tobacco smoke, when combined with this, is known to have a multiplicative effect on the risk of developing laryngeal cancer (A) alcohol (B) diet rich in animal fat (C) dietary nitrates (D) oral sex
endometrial cancer (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 293
Progestin is added to estrogen in hormone replacement therapy for menopausal women to reduce the risk of (A) breast cancer (B) endometrial cancer (C) thromboembolism (D) all of the above
benign-looking hepatocytes in cords and sheets, absent portal tracts, and prominent vessels (hepatic adenoma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294, p664)
During a routine ultrasound, a 38 year old G1P0 was found to have a solitary, 4 cm diameter, hepatic mass in the right lobe, beneath the capsule. She has a history of regular oral contraceptive use since 18 years old, and stopped 1 year ago. She has never been infected by HBV or HCV. She does not drink alcohol. If the mass is excised, it would most likely show (A) benign-looking hepatocytes in cords and sheets, absent portal tracts, and prominent blood vessels (B) proliferation of endothelial cells some containing lumens with RBCs (C) portal tracts with chronic inflammation and bile duct proliferation (D) pleomorphic cells, bizarre giant cells, atypical mitoses, and necrosis
centrilobular necrosis (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294
Liver damage in acetaminophen overdose is characterized histologically by (A) brisk neutrophilic infiltration of portal tracts (B) hepatocytes with extensively vacuolated cytoplasm (C) centrilobular necrosis (D) bile duct proliferation
all of the above (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 294, 564
A 65 year old man has been regularly taking aspirin and acetaminophen for 20 years. This predisposes him to developing (A) chronic interstitial nephritis (B) renal papillary necrosis (C) transitional cell carcinoma of the renal pelvis (D) all of the above
vitamin D (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 309-312
An 4 year old orphan boy with a scar on his forehead was found locked in a small room under the stairs by his abusive uncle and aunt. He has been kept there and fed crackers and milk since he was 1 year old. He has a squared appearance of the head, a pigeon breast deformity, lumbar lordosis, and bowing of the legs. These physical findings are due to deficiency of (A) calcium (B) vitamin A (C) vitamin C (D) vitamin D
Excess of unmineralized bone matrix. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 300
Basic derangement in both rickets and osteomalacia
