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Chapter 9 Part 1 Flashcards

1
Q

Definition of global disease burden

A

estimates burden imposed by environmental diseases including communicable and nutritional diseases

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2
Q

Disability adjusted life year

A

sum of years of life lost due to premature mortality and disability

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3
Q

What is the leading global cause of health loss?

A

Undernutrition

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4
Q

What is the leading cause of death in developed countries?

A

Ischemic heart diseases and cerebral vascular disease

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5
Q

What is the leading cause of death in developing countries?

A

Infectious disease

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6
Q

What are the three preventable conditions attributed to nearly 50% of all deaths in kids <5?

A

pneumonia, malaria, diarrheal dz

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7
Q

Key trends in the changing burden of disease?

A

Increase in CV, cancer, HIV/AIDS related deaths, Decrease in neonatal conditions and infectious disease deaths

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8
Q

Definition of emerging infectious disease

A

Infectious disorder whose incidence has recently increased or is expected to increase in the future

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9
Q

Categories of emerging infectious diseases

A

Newly evolved strains, pathogens endemic to other species that have passed to humans, diseases that have been present but are recently increasing

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10
Q

Key ways climate change impacts CV and resp diseases

A

worsened by heatwaves and air polution

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11
Q

Key ways climate change impacts gastroenteritis, cholera, other food and waterborne dzs

A

contamination from flood and disruption of clean water supply

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12
Q

Key way vector-borne infectious dzs are impacted by climate change

A

increase temp, crop failure and more extreme variations in weather increase malaria and Dengue fever

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13
Q

Key way malnutrition impacted by climate change

A

disrupted crop production

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14
Q

Definition of toxicology

A

“science of poisons”, distribution, effects, and mechanisms of toxic agents

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15
Q

Definition of poison

A

quantitative concept dependent on dosage

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16
Q

Definition of xenobiotics

A

exogenous chemicals in environment that may be absorbed into body

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17
Q

What is a key property of solvents and drugs that facilitates their transport in the blood and through plasma membrane?

A

lipophilicity

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18
Q

Phase I reactions of CYPs

A

hydrolysis, oxidation, reduction; make compound water soluble

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19
Q

Phase II reactions of CYPs

A

glucuronidation, sulfation, methylation, conjugation

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20
Q

Primary location of CYP450 enzymes

A

ER of liver, skin, lungs, GI mucosa, and other organs

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21
Q

Main action of P-450 system

A

catalyze reactions to detoxify xenobiotics or to make it into an active metabolite

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22
Q

Factors that decrease CYP activity

A

fasting and starvation

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23
Q

Major pollutants monitored by the EPA

A

sulfur dioxide, carbon monoxide, ozone, nitrogen dioxide, lead, and particulate matter

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24
Q

How is ozone produced?

A

Interaction of UV radiation and oxygen in the atmosphere

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25
What is ground level ozone?
gas formed by reaction of nitrogen oxides and volatile organic presents in sunlight, chemicals injure epithelial cells in resp tract and type 1 alveolar cells and release inflammatory mediators
26
Populations at risk for ozone effects
Healthy adults and children (decreased lung fxn and increased airway reactivity), athletes, outdoor works and asthmatics (decreased exercise capacity and increased hospitalizations)
27
What makes up the "witches' brew"?
ozone and particulate matter/sulfur dioxide
28
Where is sulfur dioxide released from?
power plants that use fossil fuels, copper smelting, and byproduct of paper mills
29
Clinical symptoms of sulfuric acid and sulfuric trioxide
burning in nose and throat, difficulty breathing, asthma attacks
30
Populations at risk for health effects of sulfur dioxide and effects
Healthy adults: increased resp sxs Individuals with chronic lung disease: increased mortality Asthmatics: increased hospitalizations, decreased lung functions
31
What are the main effects of particulate matter inhalation?
pulmonary inflammation and secondary CV effects
32
Carbon monoxide
nonirritating, colorless, tasteless, odorless gas produced when there is incomplete oxidation of hydrocarbons
33
What is the most important environmental source of CO?
automotive engines, furnaces, cigarettes
34
Who is at risk for chronic CO poisoning?
People who work in tunnels, underground garages, highway toll booths with high exposures to automobile fumes
35
Who is at risk for acute CO toxicity?
someone in a small, closed garage with a running car or those who use gas-powered generators improperly
36
How does CO kill?
Induces CNS depression and causes widespread ischemic changes esp in basal ganglia and lenticular nuclei
37
How much Hgb saturation with CO is needed to develop systemic hypoxia?
20-30%
38
How much Hgb saturation with CO is needed to cause unconsciousness and death?
60-70%
39
Permanent neurological sequelae caused by CO?
impaired memory, vision, hearing, and speech
40
Characteristic color change in acute CO poisoning?
cherry-red color of skin and mucous membranes
41
Morphological changes in rapidly occurring death due to CO poisoning
NONE
42
Morphological changes in longer survival in CO poisoning
edematous brain, punctate hemorrhages, hypoxia-induced neuronal changes
43
Common sources of CO in home
furnace, water heater, dryer, BB!, stove, car, blocked vents
44
Common symptoms of CO poisoning>
headache, dizziness, fatigue, confusion, blurry or double vision, SOB, chest pain, N/V
45
Carcinogen in wood smoke
polycyclic hydrocarbons
46
Examples of bioaerosols
Legionnaires Dz, viral pneumonia, pet dander, fungi, molds
47
Radon derivative and risk
derived from uranium, increases lung CA risk
48
Where is formaldehyde typically found?
building materials, esp poorly ventilated trailers
49
What is sick building syndrome and what may cause it?
HA, chest infection, chest congestion, nasal congestion; caused by common mold, damp homes
50
How does lead effect the body?
binds to sulfhydryl groups in proteins and interferes with calcium metabolism; hematologic, skeletal, neuro, GI, and renal toxicities
51
Common means of Pb exposure?
flaking led paint and soil, occupational exposure
52
Where is Pb commonly absorbed?
bone and developing teeth, competes with Ca
53
Effects of low levels of Pb
subtle deficits in intellect, behavioral problems, hyperactivity, poor organizational skills in kids, brain damage
54
Effects of CNS disturbances due to Pb poisoning in adults?
peripheral neuropathies--wrist drop, foot drop
55
Clinical anomalies that occur due to Pb poisoning
lead lines, hypochromic mycrocytic anemia, basophilic stippling, and ring sideroblast (Fe laden mt), lead "colic" (poorly localized abd pain), proximal tubule damage and possible failure
56
Level of lead required to decrease Hgb synthesis
40 ug/mL
57
Level of lead required for death
150 ug/mL
58
Level of lead to see developmental toxicity?
10 ug/mL
59
What enzymes does Pb interfere with?
delta-ALA dehydratase, ferrochelatase
60
How does mercury effect the body?
binds sulfhydryl groups, damage CNS and kidney
61
Main sources of mercury
contaminated fish, mercury fapors
62
Minamata disease sxs and cause
CP, deafness, blindness, mental retardation, and major CNS defects; caused by methyl mercury in fish
63
Sxs of mercury poisoning
gingivitis, tremor, bizarre behavior; muscle weakness, poor coordination, numbness in hands and feet, skin rashes, anxiety, memory problems, trouble speaking
64
How does arsenic effect the body?
Interferes with cellular metabolism, toxicities are most prominent in GI tract, nervous system, skin, and heart
65
Main environmental sources of arsenic
soil, water, wood preservatives, herbicides, herbal medicines
66
Common sx 2-8 weeks post arsenic exposure
sensorimotor neuropathy resulting in paresthesia, numbness, pain
67
Skin changes due to arsenic exposure
hyperpigmentation, hyperkertaosis
68
Common CAs from arsenic exposure
lungs, bladder, skin (palms and soles)
69
How does cadmium effect the body?
Preferentially toxic to kidneys and lungs via mechanisms that cause increased ROS
70
Common sources of cadmium
mining, electroplating, production of nickel-cadmium batteries, soil-> food
71
Principle toxic effects of cadmium excess
obstructive lung disease, renal tubular damage, skeletal abnormalities
72
Itai-Itai
Dz in postmenopausal women in japan due to cadmium-containing water, osteoporosis and osteomalacia associated with renal disease
73
Diseases associated with CO toxicity
heart disease
74
Diseases associated with lead toxicity
peripheral neuropathies, heart disease, infertility
75
Diseases associated with asbestos
lung CA, fibrosis
76
Diseases associated with mercury
peripheral neuropathies, ataxic gate, renal toxicity, teratogenesis, female infertility
77
Diseases associated with benzene toxicity
leukemia
78
Disease associated with vinyl chloride toxicity
liver angiosarcoma
79
Health risks of organic solvents
chloroform and carbon tetrachloride in decreasing and dry cleaning agents cause dizziness and confusion, CNS depression and coma
80
Effect of benzene on body
broken down by CYP2E1 to toxic metabolites that disrupt differentiation of hematopoietic differentiation, increasing risk of leukemia
81
Polycyclic hydrocarbons
come from the combustion of fossil fuels and are implicated in lung, scrotal, and bladder cancers
82
Organochlorines
lipophilic products often used as pesticides, disrupt hormone balance
83
Dioxins and PCBs
folliculitis and chloracne, characterized by hyperpigmentation, hyperkeratosis and abnormalities in liver and CNS
84
Mineral dusts
pneumonconioses, asbestosis, mesothelioma, ferruginous bodies (asbestos coated with iron and Ca
85
BPA
potential endocrine disruptor
86
Leading exogenous cause of human cancer
tobacco
87
Pack-years = ?
ppd x number years smoking
88
Nicotine
alkaloid substance in tobacco responsible for addictive properties of tobacco, binds to nAchR in brain stimulates release of catecholamines; responsible for increase HR and BP
89
AE of smoking
CA of oral cavity, larynx, esophagus, lungs, pancreas, bladder; chronic bronchitis, atherosclerosis, MI, peptic ulcer
90
Substance in tobacco that cause toxicity to cilia
formaldehyde, nitrogen oxides
91
Main effects of agents in smoke
inflammation and increased mucus production, leukocyte recruitment
92
Polycyclic hydrocarbons and nitrosamines
potent carcinogens involved in development of lung CA
93
Lung CA has a higher incidence in what 2 populations of workers
Asbestos and uranium miners (10x higher)
94
Multiplicative interaction of tobacco and alcohol
increase risk of laryngeal and oral CAs
95
Effect of tobacco intermediates during CYP reaction
may form DNA adducts that cause mutations in oncogenes and tumor supressors
96
Most common diseases caused by cigarette smoking
emphysema, chronic vronchitis, COPD
97
Factors that greatly increase MI risk in smokers
HTN and hypercholesterolemia
98
Risks associated with maternal smoking
spontaneous abortions, preterm births, intrauterine growth retardation
99
Risk of lung CA in exposed nonsmoker compared to unexposed nonsmoker
1.3x

MOD (34 decks)

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