Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mechanisms of Disease Exam #2 > Environmental and Nutritional Disorders > Flashcards

Environmental and Nutritional Disorders Flashcards

1
Q

Global disease burden (GDB)

A

Estimates the burden imposed by environmental diseases, including those caused by communicable and nutritional diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Disability adjusted life year (DALY)

A

Sum of years of life lost due to premature mortality and disability in a population.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some major diseases that affected GDB from 1990-2010? (5)

A 
HIV/AIDS
Undernutrition
Ischemic heart disease and cerebral vascular disease
Infectious disease
Post-natal diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Categories of emerging infectious diseases:

  1. Newly evolved strains/organisms
  2. Pathogens endemic to other organisms that now affect humans
  3. Pathogens that have previously been present in humans, but show an increase in incidence
A
  1. Newly evolved strains/organisms: multidrug resistant TB
  2. Pathogens endemic to other organisms that now affect humans: HIV
  3. Pathogens that have previously been present in humans, but show an increase in incidence: dengue fever, due to warming and spread into southern US.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which diseases/conditions have been negatively impacted by climate change?

A

CV disease, cerebrovascular disease, respiratory diseases - worsened by heatwaves and air pollution.

Gastroenteritis, cholera, foodborne and waterborne infectious diseases - contamination from floods and changes in clean water supply.

Vector-borne diseases - malaria, dengue fever - due to increased temp., crop failures, and extreme weather variations.

Malnutrition - disrupted crop production.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most solvents and drugs are:

How is that clinically important?

A

Lipophilic.

They can cross membranes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 phase I reactions?

A

Hydrolysis
Reduction
Oxidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 4 phase II reactions?

A

Glucoronidation
Sulfation
Methylation
Conjugation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where are cytochrome p450s located?

A

ER of liver, but also skin, lungs, GI mucosa and others.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cytochrome p450 reactions can either:

A

Detoxify xenobiotics orless commonly convert them into active compounds that cause cell injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the effect of fasting and starvation on CYP activity?

A

Decreases CYP activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Air pollution is especially hazardous to which patients? (2)

A

Patients w/ pre-existing pulmonary or cardiac diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the EPA limit in outdoor air pollution? (6)

A 
SO2
CO
O3
NO2
Lead
Particulate matter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Effects of ozone on:

Healthy adults and children: (3)

Athletes, outdoor workers, asthmatics: (2)

A

Healthy adults and children: decreased lung function, increased airway reactivity, lung inflammation.

Athletes, outdoor workers, asthmatics: decreased exercise capacity, increased hospitalizations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Effects of SO2 on:

Healthy adults: (1)

People with chronic lung disease: (1)

Asthmatics: (2)

A

Healthy adults: respiratory symptoms.

People with chronic lung disease: increased mortality.

Asthmatics: increased hospitalizations, decreased lung function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ozone toxicity is due to:

What do they damage?

A

Free radicals.

Respiratory tract epithelial cells and type I alveolar cells and release inflammatory mediators.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is “witches’ brew”?

What produces it?

What symptoms ensue?

A

SO2 + O3 + particulate matter.

Power plants burning fossil fuels, copper smelting and byproduct of papermills.

Burning sensations in nose and throat, trouble breathing and asthma attacks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Particulate matter (soot) has what effects? (2)

What size particulate is most harmful?

A

Pulm inflammation, secondary CV effects.

Fine or ultrafine particles less than 10 um in diameter.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CO toxicity can occur in which 2 scenarios?

A

Chronically working in tunnels, garages, highway toll booths with lots of exposure to car fumes.

Acutely by being trapped in a garage within approx 5 min.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does CO do physiologically?

What are its effects with longer survival?

What are the symptoms if the patient recovers?

What is a hallmark sign of CO poisoning?

A

Inducing CNS depression leading to ischemic changes to basal ganglia and lenticular nuclei. Also, outcompetes Hb for O2

Longer survival in the brain may be slightly edematous w/ punctate hemorrhages and hypoxia-induced neuronal changes.

Memory, vision, hearing and speech problems.

Generalized cherry-red color of skin and mucous membranes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Systemic hypoxia shows how much saturation of Hb with CO?

How much saturation is associated with death and unconsciousness?

A

20-30%.

60-70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Wood smoke produces ______ which are carcinogenic.

A

Polycyclic hydrocarbons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bioaerosols examples: (3)

Diseases caused by bioaerosols? (2)

A

Pet dander, fungi, mold.

Legionnaires disease, viral pneumonia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Formaldehyde is a carcinogen. Where does it come from? (2)

A

Building materials

Poorly ventilated trailers following disasters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What causes sick building syndrome?

A

Indoor pollutants, poor ventilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Lead as a pollutant

A

It is readily absorbed and binds to sulfhydryl groups in proteins that interfere with Ca++ metabolism, effects that lead to hematologic, skeletal, neurological, GI and renal toxicities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where can lead be found?

A

Paint
Soil
Occupational exposure: batteries, pigments, radiators and tin cans.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where does most of the absorbed lead get incorporated?

A

Bone and developing teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Low level Pb can have what effects in kids?

A

Intellectual, behavioral, hyperactivity and poor organizational skills in kids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does Pb do the baby while mom’s pregnant?

A

Impairs brain development.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

CNS disturbances from lead poisoning in adults include:

A

Peripheral neuropathies leading to wrist drop, followed by foot drop.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are lead lines?

A

Radiodense deposits on metaphyses which interfere with cartilage remodeling.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Lead “colic”

A

Severe, poorly organized abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What effects can Pb have on the kidneys?

A

Proximal tubule damage; chronic damage -> interstitial fibrosis and possible renal failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Ringed sideroblast

A

Associated w/ siderblastic anemia, due to excess iron in mitochondria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Mercury’s toxicity

Main 2 sources:

What is Minamata disease?

A

Binds sulfhydryl groups and damages CNA (developing brain) and kidneys.

Contaminated fish, mercury vapors from dental amalgams.

Includes cerebral palsy, deafness, blindness, MR and major CNS defects in children exposed in utero.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Arsenic toxicity

Where is it found?

A

Interferes with cellular metabolism -> toxicities most common in GI tract, nervous system, skin and heart (Borgia and Medici poisonings).

Soil and water naturally. Wood preservatives, herbacides, herbal meds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What happens when large quantities of arsenic are ingested?

2-8 wks post exposure?

A

GI, CV and CNS toxicities.

Sensorimotor neuropathy; paresthesias, numbness, pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What chronic skin changes occur in arsenic poisoning?

A

Hyperpigmentation and hyperkeratosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which cancers are at a higher risk for people with arsenic poisoning?

A

Lung, bladder and skin (palms and soles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Cadmium toxicity

Where is it found?

What diseases can ensue?

Increased risk for?

A

Preferentially toxic to kidneys and lungs via uncertain mechanisms that may increase ROS.

Nickel-cadmium batteries, soil, plants = food.

Obstructive lung disease, renal tubular damage, skeletal abnormalities from Ca++ loss.

Increased risk for lung cancer.

42
Q

Chloroform and carbon tetrachloride can lead to:

A

Dizziness and confusion -> CNS depression and coma.

Lower levels toxic to liver and kidneys.

43
Q

What molecules, when rubber workers are exposed, can increase risk of leukemia?

How can this lead to acute myeloid leukemia? (AML)

A

Benzene and 1,3-butadiene

Dose-dependent marrow aplasia

44
Q

Polycyclic hydrocarbons can cause which cancers? (3)

A

Scrotal cancer, lung and bladder cancers

45
Q

What are some examples of organochlorides?

What is their toxicity?

A

DDT, PBs, dioxin.

Disrupt hormonal balance due to antiestrogenic or antiandrogenic activity.

46
Q

Effects of Dioxins and PCBs

A

Chloracne (acne, cysts, hyperpigmentation and hyperkeratosis of face and ears).
Abnormalities in liver and CNS.

47
Q

Mineral dusts cause:

A

Pneumonconioses

48
Q

What are ferruginous bodies?

A

Asbestos fibers coated in iron

49
Q

Vinyl chloride can cause:

A

Angiosarcomas in the liver

50
Q

BPA (bisphenol A) has what effects?

Where is it found?

A

Endocrine disruption.

Lines almost all food bottles and cans

51
Q

Nicotene does what?

A

Binds nAChRs in the brain and releases catecholamines from SNS neurons -> increased HR, BP and CO.

52
Q

Agents in smoke lead to: (2)

A

Inflammation and increased mucous production

53
Q

How does emphysema occur in smoking?

A

WBC recruitment which increases local elastase production and injury to lung tissue.

54
Q

Which cancers is smoking associated with?

A 
Lung
Esophagus
Pancreas
Bladdr
Kidney
Cervix
Bone marrow
55
Q

How is the amount of alcohol absorbed in the stomach and SI related to blood level?

A

Directly proportional

56
Q

Legal limit of alcohol in blood

Drowsiness

Stupor

Coma

A

80mg/dl (after 3 drinks)

200mg/dl

300mg/dl

> 300mg/dl

57
Q

What is EtOH metabolized to? By what?

Who utilizes it?

What does it compete with?

What does it potentiate?

A

Acetaldehyde by ADH.

Mitochondrial respiratory chian.

CYP2E1 to potentiate depressant effects of narcotic, sedative and psychoactive drugs in the CNS.

58
Q

Atrophy of the superior part of the vermis is known as:

A

Alcoholic cerebellar degeneration

59
Q

Acute alcoholism effects:

Chronic alcohol effects:

A

CNS depressant, but also hepatic steatosis, acite gastritis and ulceration.

Shortened lifespan of liver, GI tract, CNS, CVS and pancreas.

60
Q

Thiamine deficiency from alcoholism leads to:

A

Peripheral neuropathies and Kernicke-Worsakoff syndrome; cerebral atrophy, cerebellar degeneration and optic neuropathy.

61
Q

Alcoholic cardiomyopathy

A

Dilated congestive cardiomyopathy, HTN.

Leads to low HDL which increases risk of CAD.

62
Q

Fetal alcohol syndrome sx

A

Microcephaly, growth retardation, facial anomalies.

63
Q

What are some positives of drinking moderate amounts of alcohol? (3)

A

Increased HDL
Inhibit platelet aggregation
Low fibrinogen levels may protect against CHD

64
Q

Anticoagulants s/e (2)

A

Bleeding; thrombosis due to insufficient dosage.

65
Q

Oral contraceptives s/e

A

Increased risk for cervical cancer
Increased risk for VT
Hepatic adenoma

66
Q

Anabolic steroids s/e

A

Stunted growth, acne, gynecomastia, testicular atrophy; facial hair & menstrual changes in females; psychiatric issues; ↑risk MI

67
Q

Acetaminophen s/e (2)

A

Acute liver failure

Centrilobular necrosis

68
Q

Aspirin s/e

A

Acute salicylate poisoning effects the brain →nausea →coma; chronic (salicylism) HA, dizziness, tinnitus, bleeding, coma; analgesic nephropathy

69
Q

Opiates s/e

A

Profound respiratory depression, arrhythmia, cardiac arrest, and pulmonary edema

70
Q

Methamphetamine s/e

A

Violent behavior, confusion, psychotic sx

71
Q

Huffing/glue sniffing s/e

A

MRI-detectable brain damage ranging from mild to severe dementia

72
Q

Bath salts s/e

A

Agitation, psychosis, MI, & suicide

73
Q

Cocaine s/e

A

Tachycardia, HTN, peripheral vasoconstriction.

74
Q

1st
2nd
3rd
Degree burns

A

1st: superficial, epidermis only.
2nd: partial thickness; epidermis and dermis.
3rd: full thickness; extends into subcutaneous tissues.

75
Q

How does shock ensue from a burn?

A

When approx >20% of body surface is burnt -> rapid shift of fluid into interstitium -> shock

76
Q

How does a burn lead to sepsis?

A

Virtually all burns can be colonized by pseudomonas aeruginoa, MRSA and candida.

77
Q

4 outcomes of severe burns

A

Shock
Sepsis
Respiratory insufficiency
Hypertrophic scars

78
Q

Malignant hyperthermia

What gene is associated?

A

“Heat stroke like” rise in core body temp and muscle contractures in response to anesthetics. Associated with RYR1 gene.

79
Q

Sx of hypothermia (3)

A

Body temp <90 -> loss of consciousness, bradycardia and AFib.

80
Q

Morphology of cells exposed to radiation

What are the cancer risks for these cells?

A

Similar to cancer cells.
Nuclear swelling, giants cells, many nuclei, etc.

Leukemias and solid tumors of the thyroid, breast and lungs.

81
Q

What is subintimal fibrosis?

A

It is fibrosis that occludes the lumen from radiation injury

82
Q

Primary vs secondary malnutrition

A

Primary is missing from diet.

Secondary is malabsorption, storage disease, etc.

83
Q

Protein-energy malnutrition (PEM) is a major cause of death for which patients?

A

Infants/children and elderly people in nursing homes.

84
Q

Signs of PEM (3)

A

(1) depletion of subcutaneous fat in the arms, chest wall, shoulders, or metacarpal regions; (2) wasting of the quadriceps and deltoid muscles; (3) ankle or sacral edema

85
Q

Marasmus

A

wt <60% NL for sex, ht and age; growth retardation and muscle loss.
Serum albumin NL; anemia; immune deficiency.
Muscle proteins & subQ fat used as fuel → emaciated extremities

86
Q

Kwashiorkor

A

↓protein more severe > ↓ in total calories
Hypoalbuminemia→ generalized or dependent edema; vit def, immune def & secondary infections
Depletion of visceral protein compartment; fatty liver; sparing of subQ fat and muscle
Weaned too early, and fed carbohydrate diet (Ghana & Southeast Asia)
Chronic diarrhea, protein losing enteropathies, nephrotic syndrome, extensive burns, fad diets or replacement of milk with rice-based beverages

87
Q

Cachexia

A

PEM complication in AIDS or advanced cancers
•50% of cancer pts; GI, pancreatic and lung cancers
•Extreme wt loss, fatigue, muscle atrophy, anemia, anorexia, and edema
•Mortality from atrophy of the diaphragm and other respiratory muscles

88
Q

What is the mechanism for cachexia?

A

Tumor and host secrete TNF and PIF which activate NF-kB which activate transcription of ubiquitin ligases which breaks down muscle proteins (myosin).

89
Q

Anorexia nervose

A

Self-induced starvation →mkd wt loss
•Highest death rate of any psychiatric DO
•Amenorrhea, ↓thyroid hormone, ↓ bone density

90
Q

Bulimia

A

Binge/purge; more common than anorexia and better prognosis
•Electrolyte imbalance (hypokalemia) → cardiac arrhythmia
•Pulmonary aspiration of gastric contents
•Esophageal and gastric rupture

91
Q

What are the 2 major risks for anorexia nervosa and bulimia?

A

Susceptibility to cardiac arrhythmia and sudden death due to hypokalemia

92
Q

Radon increases risk for:

A

Increased risk for lung cancer

93
Q

Pb leads to a heme deficiency. What does this cause? (3)

A

Hypochromic microcytic anemia, basophilic stipping and ring sideroblasts

94
Q

What is Itai-Itai?

A

Osteoporosis and osteomalacia with renal disease from cadmium poisoning.

95
Q

Defects associated with Vit A deficiency (4)

A

Night blindness
Epithelial/squamous metaplasia and keratinization
Bitot spots in the eyes
Immune deficiency

96
Q

Acute Vit A toxicity

Chronic Vit A toxicity

A

Acute - headache, dizziness, stupor, blurred vision; confused w/ pseudotumor cerebri.

Chronic - wt loss, anorexia, bone and joint pain.

97
Q

What is secondary Vit A deficiency associated with?

What diseases cause it?

A

Fat malabsorption.

Celiac dz, Crohns dz, CF, bariatric surgery.

98
Q

Normal BMI range

Overweight range

A

18.5 to 25 kg/m2

25 kg/m2 to 30 kg/m2

99
Q

Consequences of obesity

A 
Metabolic syndrome
Hypertriglyceridemia and low HDL
Nonalcoholic fatty liver dz
Hypoventilation syndrome
Sleep apnea
Cor pulmonale (right heart failure)
Osteoarthritis
100
Q

Aflatoxin ->

Nitrosamines and nitrosamides ->

High animal fat and low fiber ->

High total dietary fat ->

A

Aflatoxin -> hepatocellular carcinoma

Nitrosamines and nitrosamides -> gastric carcinomas

High animal fat and low fiber -> colon cancer

High total dietary fat -> breast cancer

101
Q

Anticarcinogens (4)

A

Vit C
Vit E
beta-carotenes
Selenium

Mechanisms of Disease Exam #2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions