Chapter 8 Flashcards
- 65 yo woman with history of smoking has 3 wk history of chest pain and bloody sputum; CXR shows hilar lung mass; also squamous cell carcinoma growing within lumen of bronchus; what chemical agent could be causing cancer?
Aromatic hydrocarbons (potent experimental carcinogens)
- 75 yo man in a shipyard for 25 years dies of thoracic tumor; autopsy shows pleural tumor; interstitial pulmonary fibrosis and multiple pleural plaques; we see brown beaded ferruginous bodies in lungs; what caused this?
Asbestos, leading to development of pleural tumor termed malignant mesothelioma. We see interstitial fibrosis of lungs and pleural plaques with dense CT; asbestos bodies with fibers are coated with protein and iron
- 47 yo man with 6 week history of increasing fatigue and drak-colored stools; CBC with Hg of 8.6 g/dL and microcytic, hypochromic RBC’s; peptic ulcer along lesser curvature of stomach; why the anemia?
Iron
- 49 yo woman with 2-mo history of yellow discoloration of eyes, abdo pain, weight loss, low-grade fever; PE with distended abdo, RUQ tenderness, palpable liver below costal margin; alcoholic hepatitis; with antifreeze and ethylene glycol present, which organ fails?
Kidney; acute tubular necrosis of kidney, leading to renal failure
- Neonate noted to have mild growth retardation and facial dysmorphology; mother an abuser of several substances. Why?
Alcohol; fetal alcohol syndrome with the listed symptoms, neurologic impairment, other congenital anomalies
- 10 yo boy with irritability and ataxia; has anemia, basophilic stippling of erythrocytes, dark-gray pigmentation of gums
Chronic lead poisoning; inhibits delta-aminolevulinic acid dehydratase and ferrochelatase, leading to to microcytic hypochroic anemia; we inhibit heme synthesis
- 50 yo man has enlarged liver; getting chronic exposure to vinyl chloride; what is he at risk for with respect to cancer of liver?
Angiosarcoma; malignant tumor of endothelial cells in liver; it’s associated with exposure to arsenic and Thorotrast
- Severely depressed 32-yo man commits suicide by running his car motor in his closed garage for several hours; CO poisoning happens how?
Displacement of O2 on Hg by CO
- Japanese fisherman lives in vicinity of plastics factory; has constriction of visual fields, paresthesias, ataxia, dysarthira, hearing loss; why the neurologic disease?
Mercury; organic mercurials can damage the brain, whereas inorganic mercury toxic to kidneys
- 12 yo boy has gangrene of fingers and toes; what mediates necrosis in fingers and toes of the patient after being stuck in the woods?
Membrane disruption by water crystals; crystallization of tissue water, causes cellular disruption and vascular changes resulting in frostbite; mech disruption of cellular membranes by ice crystasl occurs during both freezing and thawing
- 35 yo man hospitalized with 3-degree burns after being rescued from house fire. Suffers from shock and oligura, but renal function returns to normal; most likely cause of death?
Sepsis; the burned skin
- Adult running marathon in summer has hot dry skin, cessation of sweating, lactic acidosis, hypocalcemia, muscle necrosis (rhabdomyolysis); diagnosis?
Heat stroke; happens during unusually vigorous exercise; done on exertion espeically with ambient temp is high
- 26 yo electrician found unconscious in backyard beside metal ladder and exposed electrical wire and deep burn on right hand; what was cause of death?
Cardiac arrhythmia; electrical energy disrupts system within heart and causes death through v fib
- Sailor seen after breach in reactor containment system of sub; has pancytopenia, Hg 7.8 g/dL, WBC count 900/uL, platelets low; how many rads of acute total-body radiation?
300 rads: depression of bone marrow, symptoms related to granulocytopenia and thrombocytopenia within two weeks; anemia comes more slowly
- Sailor on that same sub dies 10 days after accident with severe diarrhea and dehydration; how many rads?
1000; destruction of tissues composed of proliferating cells; damage to GI tract most serious consequence
- 66 yo woman with 6-mo history of scaling and abnormal pigmentation of skin; treated for thyroid cancer 1 yr ago; atrophy of epidermis and dense fibrosis of dermis, and dilated superficial bv’s; what was the exposure?
Radiation therapy; consider that the treatment of cancer traverses first the skin and you get radiation dermatitis
- 28 yo radar technician on aircraft carrier subjected to intense microwave radiation for 7 years; elevated risk for developing what?
Not associated with ANY health risks!
- 15 yo African boy with history of tooth loss, gingivitis, skin heorrhages, multiple infections, poor wound healing; also bad height and weight; why?
Scurvy; need Vit C for collagen syntehsis; deficiency is poor wound healing; perifollicular hemorrhages, also gingivitis, alveolar bone resorption
- 24 yo woman has dermatitis, diarrhea, dementia; condition?
Pellagra
- 45 yo woman with longstanding Crohn disease and fat malabsorption has fracture of femoral neck after contusion; what vit is deficient?
Vit D (see problem with vit D absorption with lipid malabsorption, and also osteomalacia)
- Alcoholic with peripheral neuropathy, difficulty balancing and dementia; has arrhythmia and lesions in mamillary bodies; what is the deficiency?
Vit B1
- 40 yo malnourished woman with 6 mo history of night blindness; keratomalacia and corneal ulceration; what to suspect?
Vit A
- 26 yo woman with fever and shaking chills; pulse 120/min, BP 140/80; PE with harsh systolic murmur; then headache and coma; what leads to the bloody aortic valve?
IV drug abuse; introducing bacteria that leads to bacterial endocarditis, like with Staph aureus; the photo shows adherent vegetations on aortic valve, and vegetations with platelets, fibrin, cell debris, masses of organisms
- 50 yo woman with easy fatigability, smooth sore tongue, numbness and tingling of feet, weakness of legs; CBS with megaloblastic anemia not reversed by folate theraphy; Hg is low, WBC count low, platelets lows; deficiency?
Vit B12
