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gen path- exam 1 > environmental pathology > Flashcards

environmental pathology Flashcards

1
Q

Children account for over 60% of injuries from _________

A

chemicals

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2
Q

what does CLADME stand for? (in relation to chemical injury)

A 
Concentration
Liberation
Absorption
Distribution
Metabolism
Excretion
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3
Q

what are “major” adverse drug reactions?

A

anaphylaxis (penicillin), blood clots, arrhythmias, hematologic (anemia, thrombocytopenia, leukopenia)

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4
Q

Adverse drug reactions are also related to _______

A

potency

which is why ARD’s are common with anti-cancer meds

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5
Q

what happens if someone overdoses on acetaminophen?

A

OD of 15 to 20 grams– causes liver damage, may result in liver failure/death

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6
Q

long term use of _________ is associated with elevated risk of breast ca, strokes & blood clots

A

exogenous estrogen

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7
Q

85% of Lead is taken up by ________ and ___________

A

bones & developing teeth

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8
Q

what is Gingival hyperpigmentation ?

A

“lead line” of soft tissue

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9
Q

how does lead effect red blood cells?

A

Pb blocks or hinders incorporation of Fe++ into hemoglobin

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10
Q

what types of anemia are caused by lead poisoning

A

microcytic

hypochromic

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11
Q

what is the CDC threshold for lead exposure?

A

Pb threshold blood level for concern > 5 micro-grams/dL

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12
Q

when is chelation therapy used for lead poisoning?

A

initiated when lead concentration > 45 micro-grams/dL

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13
Q

what dental-related side effect is seen during the use of ecstasy?

A

bruxism- grinding teeth

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14
Q

what are the 4 types of physical agents that cause injury?

A

1) mechanical injury
2) thermal injuries
3) hypothermia
4) hyperthermia

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15
Q

____________ causes over 5,000 deaths per year in the US

A

hyperthermia (burns)

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16
Q

what is the “rule of 9’s” in relation to burn severity?

A

% body surface area involved:

Head & neck 9%
Trunk front 18%, trunk back 18%
Arms 9% each (hands: 1% each)
Legs 18% each
Perineum 1 %
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17
Q

what factors are important in determining burn severity?

A

1) % of body surface involved
2) depth of burn
3) potential for inhalation damage of smoke/heat
4) age of patient
5) speed & quality of treatment

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18
Q

If more than ____% of the body surface is burned, the patient has a grave prognosis

A

50%

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19
Q

when is shock common in burn victims?

A

when > 20% of the body is burned

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20
Q

Acute respiratory distress syndrome (ARDS) is a result of what?

A

inhalation of smoke or hot gases during a fire

21
Q

at what temperature do most heat strokes occur?

A
  • happen above 40 degrees Celsius
22
Q

what are the symptoms of heat stroke?

A

peripheral vasodilation, confusion, coma, ischemia, muscle necrosis, DIC: high mortality rate

23
Q

what body temperature is mild hypothermia? moderate? severe?

A

Mild (core temp =) 32-35 C (89-95 F)

Moderate= 28-32 C (82-89 F)

Severe= < 28 C (< 82 F)

24
Q

the symptoms of severe hypothermia include what?

A

Bradycardia, atrial fibrillation, loss of consciousness

25
Q

how can radiation damage cells?

A

1) Direct damage to DNA

2) Indirect – production of free radicals that can damage membranes, nucleic acids and enzymes

26
Q

Occupational exposures to radiation should not exceed ______ mSv/yr

A

20

27
Q

what types of tissues are most sensitive to radiation?

A

1) Hematopoietic/lymphoid tissues
2) gonads
3) lungs- due to vascularity
4) GI tract- VERY sensitive
5) blood vessels

28
Q

when are patients susceptible to infection following radiation exposure?

A

PMN’s decrease over 1-2 weeks, rebound in 2-3 months

patients are weakened WEEKS after exposure- not immediately

29
Q

what is the range for lethal doses of radiation?

A
  • Lethal range begins about 2 Sv

- at 7 Sv death is certain w/o treatment

30
Q

what are the effects of acute Hematopoietic radiation syndrome?

A
  • 2-10 Sv
  • drop in WBC’s, hair loss, infections, sepsis & bleeding
  • death 2-6 weeks
31
Q

what are the characteristics of acute GI radiation syndrome?

A
  • 10-20 Sv
  • vomiting, bloody diarrhea, shock, sepsis
  • death 5-14 days
32
Q

cerebral acute radiation syndrome is characterized by what?

A
  • more than 50 Sv
  • listlessness, drowsiness, seizures, coma
  • death 1-4 hrs
33
Q

what is the difference between primary and secondary malnutrition

A

Primary – diet deficient in 1 or more components

Secondary – supply is OK, problem w absorption, storage, utilization, excessive losses or drug effects

34
Q

during what form of protein-energy malnutrition is somatic muscle most severely effected?

A

marasmus

35
Q

during what form of protein-energy malnutrition is the liver most severely effected?

A

kwashiorkor

36
Q

When weight falls to < 60% of normal, the child has _______

A

marasmus

37
Q

what are the physical characteristics of children suffering from marasmus?

A

Extremities appear emaciated, head looks out-of-proportion (too large)

38
Q

children with marasmus are especially prone to infections. what part of their immune system is most effected? what common infection is seen in them?

A
  • T cell defects are common

- thrush is commonly seen

39
Q

Serum _______ concentrations are relatively normal during marasmus

A

albumin

40
Q

how does Kwashiorkor syndrome differ from marasmus?

A

Greater deficiency of protein than total calories, more severe than marasmus

41
Q

what are the characteristics of Kwashiorkor syndrome?

A
  • Low albumin
  • generalized edema

**Weight is between 60-80% of normal but this is misleading because of the edema

42
Q

_________ is a form of protein-energy malnutrition seen in cancer patients

A

Cachexia

43
Q

why is cachexia seen in cancer patients?

A

Partly due to decreased appetite

Increased catabolism – cytokine-mediated (IL-1, IL-6 and TNF)

44
Q

what conditions will decrease the bodies ability to absorb fat-soluble vitamins?

A

Inflammatory bowel disease (Crohn)

Cystic fibrosis

Alcoholic liver disease

45
Q

what are the 3 forms of Vitamin A?

A

retinol, retinal, and retinoic acid

46
Q

what is the physiological roll of vitamin A?

A

Maintain vision in reduced light

Augments differentiation of specialized epithelial cells (mucus secreting epithelium)

Enhances immunity to infections

47
Q

what are the severe effects of vitamin A deficiencies?

A

Squamous metaplasia of respiratory & urinary tracts

- increases risk for infections and stones

48
Q

Squamous metaplasia of respiratory & urinary tracts is the RESULT of what condition?

A

vitamin A deficiency

49
Q

a deficiency of Vitamin A can predispose people to what types of infections?

A

measles, pneumonia and infectious diarrhea

all caused by weakened immune system

gen path- exam 1 (10 decks)

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