Environmental Flashcards by joseph dizon

Q

Carbon monoxide can cause coma within

A

5 minutes

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Q

Hemoglobin has a greater affinity of CO than oxygen

A

200 fold

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Q

Effects of carbon monoxide

A

Systemic hypoxia

Unconsciousness and death

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Q

Chronic poisoning of CO

A

Ischemic changes in the CNS

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Q

Acute poisoning of CO

A

Cherry red color of the skin and
Mucous membrane

Brain may be slightly edematous

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Q

Polycyclic aromatic hydrocarbons

A

Volatile substances

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Q

Contain oxides of nitrogen and carbon participate

A

Wood smoke

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Q

Indoor air pollution

Radio active gas derived from uranium
Occupational hazard that can cause lung cancer

A

Radon

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Q

Indoor air pollution

Legionnaires disease
Viral pneumonia
Common colds

A

Bioaerosols

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Q

Metals as environmental pollutants

A

Lead
Mercury
Arsenic
Cadmium

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Q

Exposure occurs through contaminated air and food

A

Lead

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Q

Sources of lead

A

House paints
Gasoline
Mines
Foundries
Batteries
Spray paints

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Q

Maximal allowable level of lead

A

> 10

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Q

Sub clinical lead poisoning cause

A

Low intellectual capacity
Hyperactivity
Poor organizational skill

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Q

Effects of lead poisoning in children related to blood levels

10

A

Decrease IQ level
Decreased hearing
Decrease growth
Impaired peripheral nerve function

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Q

Effects of lead poisoning in children related to blood levels

20

A

Decrease vitamin D metabolism
Decreased calcium homeostasis
Increased level of erythrocyte proto porphyria
Increased nerve conduction velocity

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Q

Effects of lead poisoning in children related to blood levels

40

A

Decrease hemoglobin synthesis

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Q

Effects of lead poisoning in children related to blood levels

100

A

Encephalopathy
Nephropathy
Frank anemia
Colic

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Q

Effects of lead poisoning in children related to blood levels

150

A

Death

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Q

Lead is 80-85% taken up by

A

Bone and developing teeth

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Q

Leads compete with

A

Calcium and binds with phosphate

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Q

Lead 5-10%

A

Remain in blood

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Q

Lead inhibits heme synthesis

A

Microcytic hypochromic anemia
Aminolevulinic acid dehydratase
Ferrochelatase

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Q

Children absorb more than ____ of ingested lead

A

50%

Can lead to high susceptibility of brain damage

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Lead neurotoxic effects

Inhibition of neuro transmitters

GIT effect of lead

Colic | A severe poorly localized abdominal pain

Kidney effects of lead

Proximal tubular damage Chronic renal damage Saturnine gout

Lead interferes with the normal remodeling of cartilage

Lead lines Which inhibit the healing of fractures

Diagnosis of lead poisoning

Increase protoporphyrin levels | Increase zinc protoporphyrin

Mercury is found in

Cave painting Cosmetic Remedy for syphilis Component of diuretics

Forms of mercury Metallic Inorganic Organic

Elemental Mercuric cholride Methyl mercury

Sources of methyl mercury

Contaminated fish

Sources of metallic mercury

Dental amalgams

Effects of mercury

``` Minamata disease Cerebral palsy Deafness Blindness Mental retardation Major CNS defects ```

Arsenic naturally found in

Soil and water

Uses of arsenic

Wood preservative Herbicides Agricultural products

Toxic forms of arsenic

Arsenic trioxide Sodium arsenite Arsenic tricholride

Acute effects of arsenic

Disturbance of GIT Cardiovascular CNS

Arsenic attributed to interfere with

Mitochondrial oxidative phophorylation

Chronic effects of arsenic

Lung and skin cancer such as basal and squamous carcinoma

Arsenic mechanism of carcinogenesis

Defects in nucleotide excision repair

Occupational and environmental pollutant

Cadmium

Cadmium

Mining Electroplating Nickel cadmium batteries

Cadmium source of exposure

Food

Toxic effect of cadmium Obstructive lung disease due to

Necrosis of alveolar macrophages

Toxic effect of cadmium

``` Obstructive lung disease Kidney damage ESRD Skeletal abnormalities Itai-itai (outch2x) Osteoporosis and osteomalacia Increase lung cancer ```

Occupational exposures

13% COPD 9% lung cancer 2% leukemias

Organic solvent that cause dizziness and confusion, leading to CNS depression and coma

Chloroform and carbon tetracholride

Lower level of chloroform and carbon tetra cholride

Toxic for the kidney and liver

Organic solvents that increase risk of leukemia

Benzene and 1,3 butadiene

Implicated in lung and bladder cancer

Polycyclic hydrocarbon

Organochlorines Pesticides

DDT Lindane Aldrin Dieldrin

Organochlorines Non pesticides

Polychorinated biphenyls Dioxin PBDE

Most organochlorines are

Endocrine disruptors with anti estrogenic | Anti androgenic activity

Folliculitis and chloracne

Dioxin and PCB's

Inhalation of mineral dust

Pneumoconiosis

Exposure to vinyl chloride

Liver angiosarcoma

Exposure to phthalates

Endocrine disruption and | testicular dygenesis syndrome

Most common exogenous cause of human cancer- 90% of lung cancers

Tobacco

Main culprit

Cigarette smoking

Oral cancer

Smokeless tobacco

Effects of tobacco

Bronchitis | Emphysema

Components of cigarette smoke

Polycyclic hydrocarbons | Nitrosamines

Produced intermediate mutations of K-RAS and P53

CPY P-450

Cigarette smoking and alcohol consumption

Larnygeal cancer

Relative risk of lung cancer in passive smoke inhalation

1.3%

Drunk driving

80mg/DL in the blood

Drunk | Consumption of 3 standards drink

3 bottles of beer 15 ounces of wine 4-5 ounce of 89 proof distilled spirits

Alcohol effect Decreased inhibition Slight feeling of intoxication

20

Alcohol effect Decrease in complex cognitive functions and motor performance

80

Alcohol effect Obvious slurred speech, motor in coordination, irritability and poor judgement

200

Alcohol effect Light coma and depress vital signs

300

Alcohol effect Death

400

MEOS is located in

SER

MEOS involves

CYP2E1

Alcohol competes with other CYP2E1 substrates that

Delays drug catabolism

NAD is required for fatty acid oxidation in the liver Deficient result to

Fatty liver

NAD is required for fatty acid oxidation in the liver Increase NADH/NAD ratio

Metabolic acidosis

About 50% of individuals of Asia have deficiency in ALDH result to

Flushing Tachycardia Hyperventialtion

Acute toxic effects of alcohol produces reactive oxygen species and causes lipid peroxidation of cell membrane via

CPYE2 metabolism of alcohol

Chronic effects of excess alcohol

Liver GI Tracy CVS Acute and chronic pancreatitis

Microcephaly, growth retardation and facial abnormalities in new born

Fetal alcohol syndrome

Incidence of cancer | Oral, esophagus, liver and breast

Acetaldehyde

Damage of mammillary bodies, cerebullum and periaqueductal gray matter of the midbrain

Wernicke syndrome

Wernicke syndrome due to

Thiamine deficiency

Memory loss and confabulation

Korsakoff syndrome

Korsakoff syndrome results from

Thiamine deficiency and direct toxicity

Beneficial effects of Hormonal replacement therapy

Distress menopausal symptoms Prevent osteoporosis Reduce MI

Main Adverse effect of HRT

Ovarian cancer Endometrial carcinoma Breast cancer

Adverse effects of HRT

Increase venous thromboembolism - two folds Increase HDL Decrease LDL Protect against atherosclerosis

Oral contraceptives contains

Estradiol | Progestin

OC associated with this conditions

``` Venous thrombosis MI Endometrial and ovarian CA Hepatic adenoma Pulmonary thromboembolism ```

Therapeutic acetaminophen

0.5grams

Toxic level of acetaminophen

15-25 grams

Acetaminophen 95% detoxification by

Phase 2 reactions

Acetaminophen 95% excreted in urine as

Glucoronate or sulfate conjugated

Acetaminophen 5% or less

Activity of CYP | Glutathione

Hepatocellular necrosis

Acetaminophen.

Serious overdose of Acetaminophen

Centrilobular necrosis | Renal damage

Aspirin Fatal ingestion

Children - 2-4grams | Adult- 10-30

Aspirin Source of poisoning

methyl salicylate

Aspirin Chronic salicylism

>3 gram daily for long periods of time

Adverse effect of aspirin

Respiratory alkalosis followed by metabolic acidosis | Accumulation of pyruvate and lactate

Aspirin Petechiae

Acetylates platelets Cycloxygenase Thromboxane A2

Cocaine Acute overdose can produce

Seizures | Cardiorespiratory arrest

Cocaine When heated to produce vapors that are inhaled

Crack

Cocaine Cardio effect

MI Coronary artery vasoconstriction Thrombus formation

Cocaine CNS effect

Hyperpyrexia | Seizures

Cocaine | Chronic use

Perforation of nasal septum Decrease lung capacity Cardiomyopathy

Cocaine Cardiovascular effect

Symphatomimeti | Disrupting normal ion transport

Related to morphine, more harmful than cocaine

Heroin

Heroin administered

IV and subcu

Heroin effects

Euphoria Hallucinations Somnolence Sedation

Heroin adverse effects

``` Sudden death Pulmonary injury Infections (s, aureus) Skin Renal ```

Speed or meth

Methamphetamine

Methamphetamine Acts by releasing _____ in the brain which inhibits ____________ transmission

Dopamine | Neuro sympathetic

Methamphetamine Produces a feeling of euphoria followed by a

Crash

Methamphetamine Long term use

Violent behavior Confusion Psychotic features

MDMA ecstasy

``` Oral Euphoria 4-6 hours Serotonin synthesis Decrease serotogenic axon Decrease peripheral effects of dopamine ```

Marijuana

Pot Tetrahdrocannabinol Effects clear 4-5 hours

Marijuana allergic reactions due to

Contaminants

Beneficial effects of marijuana

Decrease intraocular pressure | Combat intractable nausea cancer

Produced by scrapping or rubbing, resulting from the removal of the superficial layer

Abrasion

Produced by a blunt object and is characterized by damage to blood vessels and extra austin of blood into tissues

Contusion | Bruise

Tear or disruptive stretching

Laceration

Inflicted by sharp instrument

Incised wound

Caused by a long narrow instrument

Puncture wound Perforating Penetrating Gunshot wound

A noniritating, colorless, tasteless, odorless gas From carbonaceous materials

Carbon monoxide Sources are automotive engines, cigarette smoking