Enviro Final Flashcards
1
Q
How can we e exposed to VOCs?
A
Ingestion
Inhalation
Dermal Absorption
2
Q
What are the main systems affected by VOCs?
A
Hematologic, Nervous, Immune
3
Q
Benzene toxicity can cause what pathology?
A
Leukemia due to bone marrow suppression
4
Q
What is the component of teflon?
A
Polytetrafluorethelyne (PTFE)
5
Q
What water soluble substance prevents access to lower respiratory tracts?
A
formaldehyde
6
Q
The VOC is 25x more reactive that Benzene and is a commonly used “huffing” agent
A
Toluene
7
Q
This VOC is used in dry cleaning clothes
A
Tetrachloroethylene (PERC)
8
Q
What VOC is the precursor to medication and found in oral anesthetic agents like Carma and Chloraseptic?
A
Phenol
9
Q
What is the most common VOC that is potentially hazardous to people working in histology labs>
A
Xylene
10
Q
What is the source the new car smell
A
Vinyl Chloride and PVC
11
Q
What is the main ingredient in mothballs?
A
Napthalene
12
Q
What is the major component of tar from charred grilled foods?
A
Benzo-a-pyrene
13
Q
What does PAH stand for?
A
Polyvinyl aromatic hydrocarbon
14
Q
What is the most concerning pathology from Asbestos?
A
Mesothelioma
15
Q
Which #s are the safest plastics?
A
2 and #4
16
Q
What is used in plasticizers and are concerning due to leeching abilities?
A
Phthalates
17
Q
What is the substance in packaging and metal can coating?
A
Bisphenol A (BPA)
18
Q
What is the species of black mold?
A
Staphbotrys chartarum
19
Q
What is the major sever health effect of vinyl chloride exposure from off-gasing/ leeching?
A
Hepatic Angiosarcoma
20
Q
What are the 6 components of smog?
A
Ground level ozone Particulate matter CO NO sulfur dioxide lead
21
Q
What is a xenobiotic?
A
Any substance that is foreign to the body
22
Q
What are the 3 routes of toxin excretion?
A
Urine
Bile
Breath
23
Q
What are 3 route of toxin absorption?
A
Ingestion
Inhalation
Dermally
24
Q
What is the predominant CYP in the liver?
A
3A4
25
How does fasting affect biotransformation? Is fasting a good idea for biotransformation?
fasting is not a good idea because it requires energy that has to be spared in the fasting state at the expense of gluconeogenesis
26
What are MRLs?
limits set by the EPA to determine how much pesticide is in our food
27
Which heavy metal is common in organic form in shellfish and is the reason you should test someone with a weak immune system?
Arsenic
28
What are the 2 pollutants that form ground-level ozone?
NO and VOCs
29
What is the primary cause of acid rain?
SO2 and NO
30
What is the immune response associated with eosinophilic responses and atopy?
Th2
31
What are the 2 metal exposures that can lead to inability to kill candida?
Mercury and Lead
32
What is the main health effect of CO poisoning?
tissue necrosis and cell death
33
What particulate matter size is most concerning because of the ability to penetrate tissue from the blood?
0.1 microns
34
What form of mercury bioaccumulate in fish and is most concerning for humans?
methylmercury
35
What type of pesticide is DDT?
Organochlorine
36
Methylglobinemia is a result of exposure to what?
Nitrate fertilizers
37
Bioaccumulation definition:
accrual of toxic chemicals in tissue or a particular organism/ food chain
38
Who is the first female MD in the USA?
Elizabeth Blackwell
39
Sick building syndrome vs Building-related illness?
SBS: symptoms of illness when in a building but without specific known cause
BRI: illness from a building with an identifiable cause
40
What is the main chemical in Brazilian blow-outs?
Formaldehyde
41
What maternal occupation is at increase risk for cleft palate in their children?
preschool teachers
42
What are the components of natural gas?
fossil fuels, hydrocarbons
43
What are the health effects of natural gas?
hematologic changes with exposure to hydrogen sulfate High RBC, High HCT, HGB, PLT, LOW WBCs)
44
What exposure risk is there for a broken fluorescent bulb?
mercury
45
What is the common chemical in fabric softeners?
Phthalates
46
What is the agent added to vaccines to promote immune response?
Aluminum
47
What does OSHA stand for?
occupation safety and health administration
48
What is MSDS?
Material Safety Data Sheet
49
What is the 4th review?
study reporting the human exposure to environmental chemicals, updated regularly
50
Chemical found in forest fires, volcanoes, crude oil, exhaust and cigarettes?
Benzene
51
Chemical founding paint thinners, added to gasoline and adhesives?
Toluene
52
Chemical used in histology labs, found in coal, petroleum and wood tar
Xylene
53
Main effect of Xylene?
CNS depression
54
While volatile crystalline solid that is produced from petroleum?
Phenol
55
Used in plywood construction, automotive, appliance parts, a plastics precursor:
Phenol
56
Used adhesive glues, dyes, pressed wood, carpets, particle board:
Formaldehyde
57
What are health effects of Formaldehyde?
UPPER respiratory tract and mucus membranes symptoms
58
What is Acroosteolysis and what can cause it?
dissolution of terminal phalanges and SI joints0 caused by PVCs and vinyl chloride
59
From combustion of carbon-based fuels and contains multiple benzene rings:
PAH
60
What are the 2 forms of PAH?
Low molecular weight (eg. Naphthalene)
| High molecular weight( eg Benzo-A-pyrene)
61
From charred grilled foods and tar:
PAH, specifically Benzo-A-Pyrene (HMW)
62
What is the most carcinogenic component of tobacco smoke?
PAH, specifically Benzo-A-pyrene (HMW)
63
What is the first carcinogen to be discovered?
Benzo-A-pyrene
64
What is the metabolite found in 2nd and 3rd hand smoke?
Continine
65
This is found in electrical, heat, sound, brakes, clutch and tiles:
Asbestos
66
What are semi-safe plastic #s?
#1 and 5
67
Is polyvinyl chloride plastic safe?
Nope, made from #3 plastics
68
Are IV tubing and bags safe?
Nope, made from #3 plastics (PVC)
69
What are the health risks of PVC?
Increased CVD and Nervous diseases
70
What are plasticizers?
Phthalates that leech easily
71
What the health effects of phthalates?
endocrine disruption
72
What are the acute exposure sxs of polystyrene?
mucus membrane and respiratory irritaiton
73
What are the chronic exposure sxs of polystyrene?
N/V, fatigue, cognitive loss, neural toxicity, renal and hepatic pathologies. can affect iron absorption
74
What are BPAs and where are they used?
Bisphenol's found in food packaging, metal can coatings
75
What are side-effects of BPAs?
Endocrine disruption, xenoestrogens
76
What is the AQI?
Air Quality Index: developed by the EPA to indicate pollutant air quality
77
Whats the safe size of particular matter and why?
PM10 microns or greater, because it cannot get deposited in the lungs
78
What is the main component of haze?
particulate matter (PM 2.5)
79
What are the 2 classes of Acetylcholinesterase?
Organophosphates
| Carbamates
80
What type of Acetylcholinesterase was used as a nerve gas in WWII?
Organophosphate s- banned in 1970s
81
How do fertilizers affect our health?
Contains nitrates that alter iron in hemoglobin from ferrous state to ferris state. This then forms methemoglobin which cannot carry oxygen
82
What is LD50?
Median lethal dose that will cause 50% death of a test group. The lower the LD50, the higher the toxicity
83
What are some common mechanisms to heavy metal toxicity?
```
enzyme inhibnition,
disruption of membranes and transport,
disruption of mitochondria,
decreased neuronal function
binding of sulfa groups causing protein misfolding....
```
84
Where is lead commonly found?
dust, soil, paint
85
Who is at greatest risk of lead poisoning?
children, pregnant women
86
Where is lead most commonly found in the environment?
pre 1978 homes
87
What jobs have high lead exposures?
smelting, mining, auto repair, plumbing, military
88
What hobbies have high lead exposure?
painting, stained glass, pottery, shooting
89
What products still contain lead today?
computers, ceramics, pewter, jewelry, auto batteries
90
What are S/Sxs of lead toxicity?
usu asx, decreased learning, low IQ, impaired speech, impaired hearing, body pains, fatigue, HA, tremor, weight loss, constipation, paralysis, seizures, lead lined gums
91
What is the best test for lead toxicity?
blood
92
What are acceptable BLLs for adults and children?
Adults: <20mcg/ dL
Children: <5 mcg/dL
93
What is seen on imaging to reveal lead toxicity?
abdomen shows lead based items swallowed. Long bones show lead lines
94
What are 3 types of mercury?
elemental, organic, inorganic
95
What are 2 types of organic mercury?
methylmercury
| ethylmercury
96
Where is methyl mercury found?
fish (bioaccumulates)
97
Where is ethyl mercury found?
preservatives, vaccines
98
Where is elemental mercury found?
thermometers, barometers, dental amalgams, released from smelting, fossil fuels, mining
99
What are health risks of mercury exposure?
neurotoxicity, teratogenic
100
Bioaccumulation vs biomagnification
Bioaccumulation: substance builds up in one species
Biomagnification: eating animal that has accumulated substance
101
Where is cadmium found?
Battery manufacturing, pigmentation, coatings, plastic stabilizers, MOSTLY FROM CIG INHALATION
102
Where does cadmium accumulate?
Liver and Kidneys
103
What are health effects of cadmium?
Iron deficiency, kidney damage, lung cancer
104
Why is chelation of cadmium concerning?
it will need to be excreted through the kidneys, possibly doing further damage
105
Where is arsenic found?
medicine, cosmetics, paint, pigments, wood preservatives
106
What is the best test for acute heavy metal exposure?
blood
107
Why is hair testing not good?
can have falsely high level because hair heavy metals won't reabsorb into body and hair is exposed to dyes, shampoos, etc.
hair testing is good for methyl mercury only
108
What is depuration?
process of free body of impurities
109
What is detoxification?
process of making toxic substances more water soluble
110
What is nasal fatigue?
ability to stay in an area that originally irritates the nares but , after time, the smell is no longer detected
111
What are major storage sites in the body?
adipose tissue, bones, liver, kidney
112
What are routes of excretion of chemicals?
urine, bile, exhalation
113
what are the problems with the research surrounding xenoextrogens?
Mostly done on animals, and half-lives will differ in humans
114
What patient population is best for stool testing?
children
115
What are the best chelators for mercury?
DMPS
(DMSA is best for lead, then mercury)
(EDTA is mostly used for lead, although it does have greater affinity for mercury)
116
What administration method is best for chelation?
IV
117
Why avoid seafood 7 days before challenge testing?
to prevent falsely elevated arsenic or mercury
118
What is the best method for acetylcholinesterase testing?
whole blood and plasma
119
What is the theory behind hydrotherapy for treatment of heavy metals?
increased bile dumping?
120
Why is low temperature sauna beneficial for detoxification?
increases lipolysis and can increase excreting of heavy metals stored in adipose tissue
121
What supplements increase glutathione production?
(glutathione is not well absorbed orally)
NAC 1500-1800 mg/day
L-cystein
122
What are the most supportive supplements for heavy metal exposure (and dosages!)
C: 6-12 g/day (ROS scavenger)
Fiber (helps bind bile)
Selenium 2 mcg/day (increases metal excretion and phase 2 detox)
Zinc: 30mg BID-TID (give copper too) (mercury depletes zinc)
123
What are the diagnostic criteria for MCS?
1. Sxs reproducible with repeated chemical exposures
2. condition has persisted for significant time
3. low levels of exposure results in manifestations of syndrome (i.e. increased sensitivity)
4. Sxs improve when the triggering chemicals are removed
5. responses often occur to multiple chemically unrelated substances
6. Sxs involve multiple organ systems
124
This chemical can penetrate most clothing
Xylene
125
What is found in pipes, insulation, siding and shower curtains?
PVC, Vinyl Chloride
126
What is HCA?
Heterocyclic amines (from grilling foods) (from HMW benzo-a-pyrene)
127
What are some prevention strategies to protect against PAHs?
stop smoking, limit grilled meats
increase brassicas
increase antioxidants
marinade in acids
128
what plastic # is transvaginal mesh and diapers?
#5
129
What are the minor sources of air pollution?
nail salons, dry cleaners, auto and body shops
130
What are CFCs and what are their common use?
Chlorofluorocarbons and found in refrigerants, solvents and foam blowing agents
131
What soil pesticide was removed due to its biomagnification effects?
organochlorines (DDT)
132
How does mercury get through the BB?
its not fat soluble, transported by ending to sulfhydryl groups on cysteines
133
What is NAC use controversial in detox?
cysteine increase means more can get through the BB because methymercury binds to it to pass through the BBB
134
lead poisoning results on CBC:
microcytic hypochromic anemia with basophilic stippling
135
Reference range for whole blood mercury:
<5ug/L
136
What has increased absorption when there is iron deficiency?
Cadmium
137
How does cadmium contribute to osteomalacia/osteoporosis?
increased urinary excretion of calcium and phosphorous and decreased hydroxylation of Vit D metabolites
138
Where is arsenic absorbed in the body?
GI tract (small intestine)
139
What is biotransformation?
conversion of lipid soluble xenoestrogen into water soluble substance for excretion
140
What are some inhibitors?
heavy metals, trauma, obesity
141
circadian clock of glutathione production?
6pm GSH cycles between oxidation and cycled back to glutathione by glutathione reductase. If a heavy metal is present, then replenishment cannot occur, leading to GSH deficiency
142
Th1 vs Th2 cytokines:
Th1: IL-2, IFNg, M0 activity
Th2: IL-4, IL-5, IL-10
143
DS, Dioxin, DDT can cause atrophy of what glandular cells?
thymus
144
PCB exposure may make people prone to what?
increased allergic response
145
PAH exposure has decreased activity in what organs?
spleen and thymus
146
lead and mercury decrease ability to kill....
candida
147
What supplementation can be protective of immune function with cadmium exposure?
selenium
148
What is the main toxin causing concerns with reproductive problems in offspring?
DES
149
Half-life of genistein and daidzein (soy)
5-6 hours
150
what toxin affects the thyroid?
PCBs- bind thyroxine
151
What tests must you do before doing any specialty testing?
CBC, CMP, Lipids, complete UA, HCG, G6PD, TB
152
most accurate test for body burden of heavy metals:
none exists
153
What is DMPS best for, IV or oral and common SEs?
Mercury
IV best, oral is available
SEs: feeling happy, exhausted, N, dizzy, rash
dose: 3-5 mg/Kg body weight
154
what is DMSA best for? best route and SE?
```
lead
Oral best (20-30mg/kg body weight on empty stomach)
```
SE: GI dysfxn, rash, DEF of essential elements, mood changes
155
What is EDTA best for? best route and SE?
lead (even though mercury is high affinity)
IV best (50mg/kg body weight)
SE: hypotension, hypoglycemia, hypocalcemia
