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MOD > Chapter 9 Part 2 > Flashcards

Chapter 9 Part 2 Flashcards

1
Q

Deaths associated with alcohol use include…

A

drunken driving, alcohol-related homicides, suicide, cirrhosis of the liver

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2
Q

How is alcohol distributed throughout the body?

A

in direction proportion to the blood level!

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3
Q

Legal definition of drunk driving in US

A

80 mg/dL

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4
Q

BA level that causes drowsiness

A

200mg/dL

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5
Q

BA level that causes stupor

A

300 mg/dL

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6
Q

In what form is alcohol found in blood?

A

Acetaldehyde

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7
Q

Enzyme responsible for EtOH oxidation

A

alcohol dehydrogenase

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8
Q

CYP involved in alcohol breakdown

A

CYP2E1

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9
Q

Decrease in NAD causes…

A

fat accumulation in liver

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10
Q

Alcohol cerebellar degeneration

A

atrophy of superior part of vermis

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11
Q

acute alcoholism sxs

A

CNS depression, hepatic steatosis, acute gastritis, ulceration

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12
Q

Chronic alcoholism impact on liver

A

steatosis, alcoholic hepatitis, cirrhosis, portal hypertension, increased risk for hepatocellular carcinoma

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13
Q

Chronic alcoholism impact on GI

A

bleeding from gastritis, gastric ulcer, esophageal varices

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14
Q

Chronic alcoholism impact on Thiamine

A

peripheral neuropathy and wernicke-korsakoff due to deficiency, cerebral atrophy, cerebellar degeneration

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15
Q

Chronic alcoholism on alcoholic cardiomyopathy

A

dilated congestive cardiomyopathy, decrease HDL and increase in coronary heart dz

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16
Q

Positive effects of moderate amounts of alcohol

A

increase HDL, inhibit platelet aggregation, decrease levels of fibrinogen

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17
Q

Wernicke encephalopathy

A

occurs due to thiamine deficiency, acute psychotic symptoms and ophthalmoplegia, hemorrhage of mamillary bodies

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18
Q

Korsakoff syndrome

A

disturbances of short term memory and confabulation

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19
Q

Definition of adverse drug reaction

A

untoward effects of drugs given in therapeutic settings

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20
Q

Presentation of drug-induced hypersensitivity

A

skin rashes most common

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21
Q

Two drugs that most frequently cause adverse reactions

A

warfarin and dabigatran –excessive bleeding or thrombosis

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22
Q

Action of warfarin

A

Vitamin K antagonist

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23
Q

Action of dabigatran

A

inhibits thrombin

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24
Q

What is menopausal hormone theory?

A

Hormone replacement for post-menopausal women containing estrogens and progesterone

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25
Adverse reactions associated with MHT
increased risk of breast CA, VTE--should not be used long term
26
Oral Contraceptive AE conclusions
does not increase breast CA, increase risk of cervical CA, 3-6x increase in VTE, does not increase CAD in young women but increases 2x in smokers>35, hepatic adenoma
27
AR associated with anabolic steroids
stunted growth, acne, gynecomastia, testicular atrophy, facial hair and menstrual changes in females, psych issues, increased MI risk
28
AR associated with acetaminophen
centrilobular necrosis that may progress to liver failure
29
What enzyme breaks down acetaminophen?
CYP2E1
30
Acetaminophen breakdown metabolites
NAPQ, combines with glutathione
31
Injury produced by NAPQI
binding to hepatic proteins, depletion of GSH leading to increased risk of ROS damage
32
AR associated with aspirin
acts on brain (alkalosis by stimulating medulla) leading to metabolic acidosis, nausea, coma
33
Chronic aspirin toxicity
HA, dizziness, tinnitus, bleeding, coma, vomiting, diarrhea, gastric ulceration, analgesic nephropathy
34
Side affects of cocaine
intense euphoria and stimulation, HTN, tachycardia, arrhythmia, myocardial ischemia, hyperpyrexia, fetal hypoxia and spontaneous abortion, perforated nasal septum, decreased lung capacity
35
Neurotransmitters involved in cocaine usage
DA and NE
36
AE of opiates
resp depression, arrhythmia, cardiac arrest, pulmonary edema, endocarditis, lung abscess, foreign body granulomas, amyloidosis, glomerulosclerosis
37
Effects of opiates on CNS
euphoria, hallucination, somnolence, sedation
38
AE of methamphetamine
violent behavior, confusion, psychotic sx
39
AE of MDMA
increase in serotonin, euphoria; decreases 5HT receptors and synthesis, increase adrenergic and DA effects
40
Marijuana AE
increased heart rate, possible change in BP causing angina in CAD pt, cognitive and psychomotor impairment, carcinogens
41
AE of glue sniffing
cognitive abnormalities, MRI-detectable brain damage, violence, aggressive behavior
42
AE of bath salts
agitation, psychosis, MI, suicide
43
What does the clinical significance of a burn injury depend on?
depth of burn, percent of body covered by burn, internal injuries, promptness and efficacy of treatment
44
First degree burn
superficial, epidermis only
45
second degree burn
partial thickness, epidermis and dermis (blistering
46
third degree burn
full thickness, extending to subcutaneous tissue
47
Pathogenesis of shock in burn victims
burns>20% body surface causes rapid shift of body fluids to interstitial compartment; generalized edema and pulm edema can be severe, develops a hypermetabolic state causing increased heat loss and increased need for nutritional support
48
Pathogenesis of sepsis in burn victims
burn site ideal for microorganism so most will be colonized, most commonly with P. aeruginosa, MRSA, candida
49
Pathogenesis of respiratory insufficiency in burn victims
within 24-48 hours, direct heat effects upper airway and noxious gas inhalation can lead to inhalation and airway obstruction
50
Pathogenesis of hypertrophic scars in burn victims
original bone and site of graft may have excessive collagen deposition
51
Heat cramps result from... and cause...
Result from loss of electrolytes and cause cramping of muscles
52
Heat exhaustion results from... and causes...
Results from hypovolemia caused by dehydration and causes collapse
53
Heat stroke caused by... and leads to...
lack of sweating leads to multiorgan dysfunction, hyperkalemia, tachycardia, arrhythmia, RYR1 stimulation causing muscle contraction
54
Malignant hyperthermia
RYR1 mutation characterized by "heat-stroke-like" rise in body temp and muscle contractures following exposure to anesthetics
55
Pathogenesis of hypothermia
physical disruptions within cells caused by water crystallization; vasoconstriction and increased vascular permeability leading to edema and hypoxia
56
Clinical symptoms of hypothermia
loss of consciousness, bradycardia, afib
57
Types of electrical injuries
Burns, vfib or cardiac resp failure
58
Sources of ionizing radiation
x-rays, gamma rays, high energy neutrons, alpha and beta particles
59
AE of ionizing radiation
fibrosis, mutagenesis, carcinogenesis, teratogenesis
60
Curie (Ci)
radiation emitted
61
Gray (Gy)
energy absorbed by target tissue
62
Sievert (Sv)
equivalent dose that responds to absorbed dose multiplied by relative biologic effectiveness of radiation
63
Determinants of radiation effect
rate of delivery, field size, cell proliferation, oxygen effects and hypoxia, vascular damage
64
Morphology of ionizing radiation
nuclear swelling, giant cells, polymorphic nuclei, multinucleated, cytoplasmic swelling, endothelial cell proliferation and collagenous hyalinization, scarring and contractions
65
Acute effects of radiation to hematopoietic and lymphoid systems
marrow aplasia, neutropenia, lymphopenia, thrombocytopenia, aplastic anemia
66
Common sites of fibrosis after radiation treatment
lungs, salivary glands, colorectal and pelvic areas
67
Major morphologic consequences of radiation injury
erythema, edema, hyperpigmentation, acute tissue loss, interstitial fibrosis, mucosal injury, ulceration, ovary and testes destruction, anemia
68
CA risk from radiation exposure
increased risk of leukemia and solid tumors in hiroshima, thyroid CA in Chernobyl, "second cancer" development from radiation treatments

MOD (34 decks)

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