Ch 9 Flashcards
(49 cards)
What is GBD?
global disease burden: estimates burden imposed by environmental disease, including those caused by communicable and nutritional disease
what is the leading cause of health loss globally?
undernutrition
what is the leading cause of death in developed countries?
ischemic heart disease and cerebral vascular disease
what are the three conditions that 50% of childhood deaths are linked to?
pneumonia, diarrheal disease, malaria
what are the changing trends in disease from 1990-2010?
- cardiovascular and circulatory disease
- cancer
- diarrhea, lower respiratory infection, other common infections
- HIV/AIDS, tuberculosis
- neonatal conditions
- increased
- increased
- decreased
- increased
- decreased
what stands to become the preeminent global cause of environmental disease in the 21st century?
what are the possible negative impacts?
climate change
increased incidence of:
- CV, cerebrovascular and respiratory diseases
- gastroenteritis, cholera, other foodborn/waterborn illnesses
- vector-born infectious diseases
- malnutrition
what are xenobiotics?
exogenous chemicals in environment that may be absorbed into the body through the basement membrane
note: most solvents/drugs/xenobiotics are metabolized to inactive water-soluble product (detoxification) or activated to form toxic metabolites
where is cytochrome P-450 located?
what does it do?
primarily in ER or liver, also present in lungs, GI mucosa, other organs
is catalyzed rxns that either detoxify xenobiotics, or less commonly converts xenobiotics into active compounds that cause cellular injury
note: both rxns may produce ROS as byproduct, which cause cellular damage
what effect can fasting and starvation have on CYP activity?
they can both decrease activity
air pollution is especially hazardous to whom?
people with preexisting pulmonary or cardiac disease
ozone:
what are the populations at risk? and the effects?
healthy adults and children: decreased lung function, increased airway reactivity, lung inflammation
athletes, outdoor workers, asthmatics: decreased exercise capacity increased hospitalizations
sulfur dioxide:
what are the populations at risk? and the effects?
healthy adults: increased respiratory symptoms
individuals with chronic lung disease: increased mortality
asthmatics: increased hospitalizations, decreased lung function
what effect does ozone have on the body?
free radicals injure the respiratory tract epithelial cells and type I alveolar cells, by releasing inflammatory mediators
mild symptoms: decreased lung function and chest discomfort
what effect does sulfur dioxide have on the body?
- combines with ozone and particulate matter -> witches brew
- is produced by power plants burning fossil fuels, copper smelting, byproduct of paper mills
- sulfuric acid and sulfuric trioxide: burning sensation in nose and throat, difficulty breathing, asthma attacks in those susceptible
what effect does particulate matter (soot) have on the body?
- soot causes pulmonary inflammation and secondary CV effects
- fine or ultrafine particles less than 10um in diameter are the most harmful! they are readily inhaled into the alveoli, releasing a number of inflammatory mediators
how is ozone produced?
interaction of UV radiations and O2 in the stratosphere, naturally accumulates in the ozone layer
how do acute and chronic CO poisoning occur?
chronic poisoning: working in tunnels, underground garages, highway toll booths with high exposure to automobile fumes
acute toxicity: small, closed garages, average car can produce sufficient CO to induce coma or death in 5 minutes
note: HB has 200-fold higher affinity for CO than oxygen
what effect does carbon monoxide have on the body?
CO kills by inducing CNS depression, widespread ischemic changes
- basal ganglia and lenticular nuclei
- if pt recovers, impaired memory, vision, hearing and speech
- generalized cherry-red color of the skin and mucous membranes***
signs of first few hours of CO poisoning vs 24-48 hours
first few hours brain is swollen, congested and cherry red
after 24-48 hours of survival, scattered petechial hemorrhages may be see in white matter with larger hemorrhages in the pellucidum
what are the most common causes of indoor air pollution?
wood smoke (polycyclic hydrocarbons=carcinogens), bioaerosis (Legionnaires disease, viral pnu, pet dander, fungal molds), radon (lung cancer), formaldehyde (building materials, poor ventilation)
what is the danger of lead?
it is readily absorbed, and binds to sulfhydryl groups in proteins and interferes with calcium metabolism
leads to hematologic, skeletal neurologic, GI and renal toxicity
where is most of the absorbed lead incorporated in the body?
bone and developing teeth, competes with calcium, half life in bone is 20-30 years!
what are the effects of lead poisoning in children?
- sensory, motor, intellectual and psychologic impairments including decreased IQ, retarded psychomotor dvlpment, blindness, radiodense deposits in epiphyses
- severe cases: psychoses, seizures, coma
note: lead toxicity in mother may impair brain development in prenatal infant
what are the effects of lead poisoning in adults?
- peripheral neuropathies: extensor muscles of the wrist and fingers often first (wrist-drop), followed by paralysis of peroneal muscles (foot-drop)
- headache, memory loss, anemia, red cell basophilic stipping
- lead lines: radiodense deposits in metaphyses, also in the gums
- lead colic: extremely severe, poorly localized abdominal pain
