Environmental health

Question 1

mechanism of smoking and caricnoma

Answer 1

o Direct DNA damage (oncogenic mutations, inter-individual variation in DNA repair capacity (explains why some people can smoke their whole life)

Question 2

types of mutation in smoking and carcinoma

Answer 2

o CT mutation (in p53) more common in people who smoke (polycyclic aromatic hydrocarbons association)
o KRAS mutation implications for therapy (present in more people who smoke and have adenocarcinoma)

Question 3

mechanisms of smoking and cardiovascular disease risk

Answer 3

o Development of atherosclerotic changes
♣ Chronic inflammation in smokers (raised WCC and acute phase reactants)
♣ Lipid abnormalities (higher and oxidised free radical production)
♣ Endothelial dysfunction (nitric oxide alters vasodilation (impaired function))
o Induction of hypercoagulable state due to intrinsic factors)
♣ (Acute thrombosis rapid decline in risk of myocardial infarction after smoking cessation)

Question 4

mechanism of asbestos and bad news

Answer 4

♣ Macrophages try and break down
♣ Ferruginous bodies are a surface where reactive oxygen species can be catalysed (macrophages ingesting these exacerbate this production of reactive oxygen species)
♣ Surface directly interacts with DNA and RNA by proteins absorbed on surface
♣

Chronic inflammation from these bodies

Question 5

results from asbestos sniffing

Answer 5

fibrosis, mesothelioma, adenocarcinoma, pleural plaques

Question 6

what is bad about lead

Answer 6

o Incorporates into bone and teeth (competes with Ca+)

Question 7

chronic expsorue of lead

Answer 7

• Decreased IQ (children), cognitive decline (adults), anaemia, renal dysfunction

Question 8

acute exposure of lead

Answer 8

neuropathies

Question 9

what are the results from UV radiation

Answer 9

o Chronic exposure solar keratosis (preinvasive neoplastic process)
o Squamous cell carcinoma produces keratin, invasive lesion.
o Basal cell carcinoma no propensity to mestastasised
o Melanoma

Question 10

what is hyperthermia and what are the outcomes

Answer 10

o Core 41-42 confusion, cardiac and respiratory dysfunction (denaturation of cell proteins)
o Vasodilation, oedma and clotting, acidosis

Question 11

what is hypothermia and what are the outcomes

Answer 11

o Core below 35, causes confusion, loss of shiver response (further drop in temp)
o Diuresis, cardiac arrhythmia, pulmonary oedema