[B] 1.11 Autointoxication Flashcards
(46 cards)
1
Q
Autotoxication AKA =
A
Autotoxaemia
2
Q
Define autointoxication
A
- Poisoning of the body with endogen toxins
- Toxins are produced during the process in different diseases
3
Q
Causes of autointoxication
A
- Normal metabolism gets stuck - accumulation of metabolites
- Normal metabolites not excreted
- Abnormal metabolism
- Decreased function of an organ
- Histolysis/heterolysis by gangrene
- Enterogenic autointoxication
- Absorbed metabolites from special cases
4
Q
Diabetic autointoxication
A
- “Diabetic toxins”: Ketone bodies
- Ketone bodies produced during:
- Fasting
- Carb. restrictive diets
- Starvation
- Prolonged exercise
- Type-1 diabetes mellitus
5
Q
List the ketone bodies
A
- Acetoacetate
- B-hydroxybutyrate
- Acetone
6
Q
Ketosis
A
Metabolic state where most of the body’s energy comes from ketone bodies in the blood
7
Q
Diabetic ketoacidosis (DKA) symptoms
A
- Nausea + vomiting
- Thirst + excessive urine production
- Abdominal pain
- Dehydration
- Tachycardia
- Low BP
- Cerebral oedema
8
Q
What is shown?
A
Pancreas fibrosis
9
Q
List the pathological findings from diabetic autointoxication
A
- Pancreas fibrosis
- Lipidosis in the liver
- Brain oedema
10
Q
What is shown?
A
Lipidosis of the liver
11
Q
What is shown?
A
Brain oedema
12
Q
Retention autointoxication
A
- Develops with excretory organs
- Accompanied by a delay in metabolic product removal
- Kidney failure = Uraemia
- Uricosis
- Icterus (hepatopathy)
13
Q
Uraemic autointoxication is characterised by…
A
Retention of various solutes that would normally be excreted by the kidneys
14
Q
List some uremic toxins/retention solutes
A
- Creatine
- Creatinine
- Urea
- Uric acid
15
Q
List the classifications of uremic toxins
A
- Low-molecular-weight water-soluble uremic toxins
- Protein-bound solutes
- Middle-molecular-weight molecules
16
Q
Complications of uremic toxins
A
- Seizure, coma, cardiac arrest, death
- Spontaneous bleeding
- Subdural hematoma
- Electrolyte abnormalities (hyperkalaemia, metabolic acidosis)
17
Q
What is shown?
A
Uremia (Kidney fibrosis, Dog)
18
Q
Hepatic autointoxication examples
A
- Hepatitis
- Hepatosis
- Tumour
- Fibrosis
- Cirrhosis
19
Q
Hepatosis
A
Degeneration of the liver
20
Q
Hepatic fibrosis
A
Necrosis, scar formation
21
Q
Cirrhosis
A
- Generalised formation of scar tissue associated with liver cell nercrosis
- Ineffective regenerative liver cell nodules
22
Q
Give the effect of cirrhosis
A
- Retention of the bilirubin
- Decreased detoxification of the GI toxins (enterogen autointoxication)
23
Q
Impaired hepatic detoxification refers to…
A
- Decreased phase I and/or phase II enzyme activity
- Levels of hepatic detoxification enzymes decreased
24
Q
Phase one of detoxification consists of…
A
- Oxidation
- Reduction
- Hydrolysis
25
Phase I detoxification is catalysed by enzymes referred to as...
Cytochrome P450 enzyme group/Mixed Function Oxidase enzymes (MFO)
* Located in the membrane of the liver
26
Phase II of detoxification
Conjugation pathway
* Liver cells at substances to a toxic chemical/drug
* Renders the chemical less harmful
* Excreted from the body via bile/urine
27
Toxic effect of bilirubin
Inhibition of :
* Enzyme systems
* Cell regulatory reactions
28
Toxic effect of bilirubin in the brain
1. If serum bilirubin \> albumin binding capacity
2. Bilirubin → CNS
3. Permanent neurological damage/death
## Footnote
*Bilirubin encephalopathy with kernicterus*
29
Kernicterus: Etymology
"Yellow Kern"
## Footnote
*Refers to an anatomic diagnosis made at autopsy*
30
BIND
Bilirubin-induced neurologic dysfunction
* Clinical signs associated with bilirubin toxicity
31
Give some clinical signs associated with BIND
* Hypotonia → Hypertonia
* Opisthotonus
* Retrocollis
32
Impaired hepatic detoxification can result from...
* Exposure to food additives/solvents/pesticides/heavy metals
* Viral infections
* Restricted bile flow
* Old age
* Affects phase I enzymes
* Decreased blood flow to liver
33
Hepatic autointoxication - Complications
* Presence of chronic fatigue
* Depression
* Headaches, digestive disturbances
* Mental confusion
* Mental ilness
34
Histolysis by gangrene =
Putrid intoxication
35
Gangrene
A variety of necrosis
| (Ichorous inflammation)
36
Give the varieties of gangrene
* Dry
* Wet
* Gas
* Internal
37
Dry gangrene
* Develops in ischemic tissue - Low blood supply
* ↓ Oxygen = limited putrefaction/bacterial growth
* The affected part is dry and shrunken
* Leads to autoamputation of affected area
38
Wet/infected gangrene
* Thriving bacteria
* Poor prognosis
* Free communication between: Infected fluid ⇔ circulation
* Can lead to sepsis
39
In wet gangrene, the tissue is affected by...
Saprogenic microorganisms
## Footnote
*Causes tissues to swell and emit a smell*
40
Give the fate of the toxins produced by the wet gangrene bacteria
1. Necrotoxins are absorbed
2. The systemic manifestation of sepsis
3. Death
41
Describe clinical signs of wet gangrene
Affected part:
* Edematous
* Soft
* Putrid
* Rotten
* Dark
42
What is Porphyria/porphyrias?
A group of rare diseases in which porphyrins accumulate with high metabolism
43
Enterogenic autointoxication, enterotoxaemia
Absorbed decomposition products from GI system
*E.g Grass fever; Grass sickness: C. botulinum*
44
Intestinal autointoxication/Toxic colon
* Colon's main role is toxin elimination via faeces
* Faecal toxins: Indol, skatol, phenol, urobilin
* **Constipation → Intestinal autointoxication**
45
Absorbed metabolites from special cases: Examples
* Arrodated stomach
* Ruptures
* Perforations
46
Autotoxaemia example
DIC (Disseminated intravascular coagulopathy)
