VIII - Environmental and Nutritional Diseases

Question 2

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

Answer 2

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

Question 3

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 3

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

Question 4

Carbon monoxide in the blood is called _______.

Answer 4

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

Question 5

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

Answer 5

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

Question 6

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 6

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

Question 7

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

Answer 7

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

Question 8

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

Answer 8

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

Question 9

Antidote for mercury poisoning.

Answer 9

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

Question 10

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

Answer 10

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

Question 11

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

Answer 11

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

Question 12

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

Answer 12

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

Question 13

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 13

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

Question 14

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

Answer 14

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

Question 15

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 15

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

Question 16

It is the most preventable cause of human death.

Answer 16

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

Question 17

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

Answer 17

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

Question 18

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

Answer 18

Minocycline(TOPNOTCH)

Question 19

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

Answer 19

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

Question 20

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

Answer 20

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

Question 21

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

Answer 21

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

Question 22

Oral contraceptives have a protective effect against these cancers.

Answer 22

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

Question 23

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

Answer 23

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

Question 24

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

Answer 24

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

Question 25

Toxic metabolite of paracetamol or acetaminophen.

Answer 25

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

Question 26

Toxic dose for acetaminophen.

Answer 26

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

Question 27

Antidote for acetaminophen poisoning.

Answer 27

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

Question 28

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 28

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

Question 29

Adult toxic dose of aspirin.

Answer 29

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

Question 30

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 30

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

Question 31

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 31

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

Question 32

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

Answer 32

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

Question 33

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

Answer 33

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

Question 34

Psychoactive substance found in marijuana.

Answer 34

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

Question 35

Mechanism of action of aspirin.

Answer 35

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

Question 36

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

Answer 36

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

Question 37

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

Answer 37

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

Question 38

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 38

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

Question 39

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

Answer 39

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

Question 40

A wound caused by a long, narrow instrument.

Answer 40

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

Question 41

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

Answer 41

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

Question 42

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

Answer 42

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

Question 43

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

Answer 43

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

Question 44

Partial thickness burn that involves the epidermis only.

Answer 44

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

Question 45

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

Answer 45

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

Question 46

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

Answer 46

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

Question 47

Histologic change in the skin during burns.

Answer 47

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

Question 48

Leading cause of death in burn patients.

Answer 48

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

Question 49

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

Answer 49

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

Question 50

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 50

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

Question 51

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 51

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

Question 52

Two types of injuries caused by electricity.

Answer 52

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

Question 53

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 53

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

Question 54

Malnutrition caused by lack of nutrients from the diet.

Answer 54

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

Question 55

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

Answer 55

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

Question 56

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 56

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

Question 57

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 57

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

Question 58

Self-induced starvation, resulting in marked weight loss.

Answer 58

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

Question 59

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

Answer 59

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

Question 60

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

Answer 60

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

Question 61

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 61

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

Question 62

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

Answer 62

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

Question 63

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

Answer 63

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

Question 64

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

Answer 64

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