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gen path lec > Environmental And Nutritional Disease > Flashcards

Environmental And Nutritional Disease Flashcards

1
Q

Indoor,, outdoor and occupation setting in which human beings live and work

A

Environmental

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2
Q

Conditions caused by exposure to chemical or physical agents in th ambient, workplace and personal environment

A

Environmental disease

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3
Q

Studies the distribution effects and MOA of toxic agents

A

Toxicology

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4
Q

Exogenous chemicals in the environment that may be absorbed into the body

A

Xenobiotics

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5
Q

Responsible for the catalyzation of xenobiotics that either detoxify or convert xenobiotics into active compound

A

P-450 enzyme

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6
Q

Phase 1 reaction os xenobiotics

A

Hydrolysis
Reduction
Oxidation

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7
Q

Phase 2 reactions of xenobiotics

A

Glucorinidation
Sulfation
Methylation
Conjugation

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8
Q

Significant cause of morbidity and mortality worldwide

A

Air pollution

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9
Q

Sulfur dioxide, CO, ozone, nitrogen dioxide, lead and particulate matter

A

Smog

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10
Q

Produced by the interaction of UV rad and oxygen in the stratosphere

A

Ozone

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11
Q

What destroys ozone layer

A

Chlorofluorocarbon

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12
Q

Protects life by absorbing UV rad emitted by the sun

A

Ozone

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13
Q

Formed by reaction of nitrogen oxides and volatile organic compounds

A

Ozone

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14
Q

Produces free radicals which injures epithelial cells of the respiratory tract

A

Ozone

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15
Q

Emitted by burning coal, oil-fired and diesel exhaust

A

Particulate matter - soot

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16
Q

Systemic asphyxiant that is an important cause of accidental and suicidal death

A

Carbon monoxide

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17
Q

Produced during any process that results in the incomplete oxidation of hydrocarbons

A

Carbon monoxide

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18
Q

Chronic carbon monoxide poisoning in individuals usually occurs in workplaces such as?

A

Tunnels
Underground garages
Highway toll booths

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19
Q

Signs of carbon monoxide poisining

A

Fatigue
Dizziness
Tightness in chest
Headache
Nausea

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20
Q

Ischemic changes in ___ and ___ are seen in patients who are chronically exposed to CO

A

Basal ganglia and lenticular nuclei

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21
Q

Most common indoor air pollution

A

Tobacco smoke

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22
Q

No.1 cause of lung cancer in non-smokers

A

Radon

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23
Q

Indoor air pollution

Formaldehyde —- ???

A

Carcinogen

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24
Q

Metals as environmental pollutants

A

Heavy metals, lead, mercury, cadmium and arsenic

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25
Q

Binds to sulfhydryl groups in proteins and interferes with calcium metabolism

A

Lead Pb

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26
Q

Absorbed lead is taken into developing teeth and bone where it competes with ___ and binds ___

A

Calcium
Phosphates

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27
Q

Is lead susceptible to brain damage?

A

Yes, due to more permeable BBB

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28
Q

Results in microcytosis and anemia

A

Lead

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29
Q

interferes with delta-aminolevulinic acid dehydratase and ferrochelatase

A

Lead

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30
Q

Binds to sulfhydryl groups in proteins with high affinity - leads to damage in the CNS and kidneys

A

Mercury

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31
Q

Main source of exposure to mercury

A

Contaminated fish
Mercury vapors
Dental amalgams

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32
Q

Three forms of mercury

A

Elemental mercury
Inorganic mercury
Organic mercury

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33
Q

inorganic mercury is converted to ___ by bacteria

A

Methyl mercury

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34
Q

Mercury toxicity:

____ - cerebral palsy, deafness, blindness, intellectual disability, major CNS defects in children exposed in utero

A

Minamata disease

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35
Q

Interferes with mitochondrial oxidative phosphorylation

A

Arsenic

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36
Q

Most toxic form of arsenic

A

Trivaleny compounds arsenic trioxide
Sodium arsenite
Arsenic trichloride

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37
Q

Neurologic effects of arsenic

A

Sensorimotor neuropathies

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38
Q

Cardiovascular effects of arsenic

A

Prolonged Q-c interval with ventricular arrhythmias

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39
Q

Skin changes in arsenic

A

Hyperpigmentation and hyperkeratosis

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40
Q

Risk in malignancies in arsenic

A

Lung, bladder and skin

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41
Q

Preferentially toxic to the kidneys and lungs

A

Cadmium

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42
Q

The most important source of cadmium exposure in the general population

A

Food

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43
Q

Cadmium is acquired from?

A

Mining, electroplating and production of batteries

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44
Q

Cadmium causes _____ by necrosis of alveolar epitherlial cells

A

Obstructive lung disease

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45
Q

Osteoporosis and osteomalacia associated with renal disease - “___” in cadmium

A

Itai-itai

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46
Q

Agent
Chloroform and carbon tetrachloride

Disease?

A

CNS effects, liver and kidney toxicity

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47
Q

Agent
Benzene and 1,3 butadiene

Disease?

A

Leukemias

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48
Q

Agent
Polycyclic hydrocarbons

Disease

A

Lung and bladder cancer

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49
Q

Agent
Organochlorines

Disease

A

Neurologic toxicity, endocrine disruptor

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50
Q

Agent:
Dioxin and PCB

Disease??

A

Folliculitis and acneiform dermatosis

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51
Q

Agent: vinyl chloride

Disease??

A

Hepatic angiosarcoma

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52
Q

Agent: bisphenol A

Disease??

A

Endocrine disruptor

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53
Q

Agent: mineral dusts

Disease??

A

Pneumoconioses

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54
Q

What is the most readily preventable cause of death in humans

A

Smoking

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55
Q

Chewing tobacco is associated with __ disease

A

Oral cancer

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56
Q

Average number of cigarette packs smoked each day multiplied by the number of years of smoking

A

Pack-years

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57
Q

Stimulates release of catecholamines from sympathetic neurons

A

Nicotine

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58
Q

The effect of tobacco that has direct irritant effect on the _____ mucosa

A

Tracheobronchial mucosa

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59
Q

Tobacco is strongly linked to development of ??

A

Atherosclerosis, MI and stroke

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60
Q

Chronic relapsing brain disease characterized by an impaired ability to stop of control alcohol use despite adverse, social, occupational, or health consequences

A

Alcohol use disorder (AUD)

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61
Q

Why breath test can determine alcohol consumption

A

Because amount exhaled is proportional to the blood level

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62
Q

___ is absorbed unaltered in the GI tract and then distributes throughout the body in direct proportion to the blood level

A

Ethanol

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63
Q

When taking alcohol, drowsiness occurs at ___ mg/dl

A

200 mg/dl

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64
Q

Individuals with low levels of _____ metabolize alcohol slowly

A

Acetaldehyde (ALDH)

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65
Q

Acute effects of alcohol

A

Hepatic steatosis
Acute gastritis and ulceration
CNS depression

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66
Q

Alcohol oxidation by ADH causes reduction of ___ to ____ Decrease ___ results in decrease FA oxidation in the ___ which results in _____ in the liver

A

NAD to NADH

NAD

Liver

Accumulation of fat

67
Q

Metabolism of ethanol in the liver by CYP2E1 produces ___ ?

A

ROS

68
Q

alcohol promotes release of ___ from intestinal flora

A

Endotoxin

69
Q

Chronic effects of alcohol

A

Alcoholic hepatitis and cirrhosis
Gastric bleeding and ulcer
Thiamine deficiency
Dilated congestive cardiomyopathy
Hypertension
Acute and chronic pancreatitis
Fetal alcohol syndrome
Oral cavity malignancies
Malnutrition

70
Q

Vitamin K antagonist

A

Warfarin

71
Q

Direct inhibitor of thrombin

A

Dabigatran

72
Q

Used to counteract menopausal symptoms

A

Menopausal hormone therapy

73
Q

Composed of either synthetic estradiol + variable amount of progestin or progestin only

A

Oral contraceptives

74
Q

Acts by inhibiting ovulation or preventing implantation

A

Oral contraceptives

75
Q

Have a protective effects against endometrial and ovarian cancers

A

Oral contraceptives

76
Q

A contraceptIncrease risk of hepatic adenoma

A

Oral contraceptive

77
Q

When taken in large dose, NAPQI accumulates which leads to hepatocellular injury

A

Acetaminophen

78
Q

Covalently binds to hepatic proteins and deletes GSH

A

Acetaminophen

79
Q

Extracted from the leaves of coca plant

A

Cocaine

80
Q

Produces intense euphoria and neurologic stimulation

A

Addictive

81
Q

Cocaine at the nerve endings blocks the reuptake of?

A

Epinephrine and norepinephrine

82
Q

Cocaine in neurotransmission in the CNS blocks reuptake of?

A

Dopamine

83
Q

Derived from poppy plant

A

Heroin

84
Q

Acts by releasing dopamine in the brain which inhibits presynaptic neurotransmission at corticostriatal synapses, slowing glutamate release

A

Methamphetamine

85
Q

Derived from leaves of cannabis sativa

A

Marijuana

86
Q

Psychoactive substance o marijuana is called?

A

Tetrahydrocannabinol

87
Q

Potential use to treat nausea secondary to cancer chemotheraphy

A

Marijuana

88
Q

Mechanical trauma

A

Abrasion
Contusion
Laceration
Incision
Puncture wound

89
Q

4 injuries by physical agents

A

Mechanical trauma
Thermal injury
Electrical injury
Radiation injury

90
Q

Damage by direct injury to tissue and by inhalation injury

A

Thermal burns

91
Q

Thermal burns that is confined to epidermis

A

Superficial burns

92
Q

thermal burn that dermis is involved

A

Partial thickness burns

93
Q

thermal burn that extends to the subcutaneous tissue

A

Fulll-thcknes burns

94
Q

Heat cramps

A

Hyperthermia

95
Q

Results from loss of electrolytes via sweating

A

Hyperthermia - heatcramps

96
Q

Hallmark of heat cramps

A

Cramping of muscles during exercise

97
Q

Most common hyperthermic syndrome

A

Hyperthermia - heat exhaustion

98
Q

Results from failure of the CVD system to compensate from hypovolemia caused by dehydration

A

Hyperthermia - heat exhaustion

99
Q

Associated with high ambient temperature, high humidity and exertion

A

Hyperthermia - heat stroke

100
Q

Failure of thermoregulatory mechanism which results in increased body temperature

A

Hyperthermia - heat stroke

101
Q

Receptors that regulates calcium release from sarcoplasm in heat stroke

A

RYR1

102
Q

Results in mutations in genes that encode RYR1

A

Hyperthermia - malignant hyperthermia

103
Q

Results from prolonged exposure to low ambient temperature

A

Hypothermia

104
Q

Direct injury is due to cell injury caused by crystallization of intracellular and extracellular water

A

Hypothermia

105
Q

Results in burns, and disruption of nerve impulse conduction

A

Electrial injury

106
Q

High voltage are more likely to produce paralysis in medullary centers

A

Electrical injury

107
Q

Energy that travels in the form of waves or high-speed particles

A

Radiation

108
Q

____ radiation has sufficient energy to remove tightly bound electrons

A

Ionizing radiation

109
Q

____ radiation can move atoms in a molecule but is not sufficient to displace electrons from atoms

A

Nonionizing radiation

110
Q

Radiation unit:

Expression of amount of radiation emitted by a source

A

Curie (Ci)

111
Q

radiation unit:

Unit that expresses the energy absorbed by the target tissue per mass unit

A

Gray (Gy)

112
Q

Radiation unit:

Unit of equivalent dose that depends on the biologic rather the physical effects of radiation

A

Sievert (Sv)

113
Q

Main determinants of biologic effect of ionizing radiation

A

Rate of delivery
Field size
Cell proliferation
Oxygen effects and hypoxia
Vascular damage

114
Q

normal cells repair radiation damage more quickly than neoplasic cells, fractionated doses only damages neoplastic cells in the long term

A

Rate of delivery

115
Q

Body can sustain higher radiation dosage when given to a smaller area: smaller doses in larger area may be lethal

A

Field size

116
Q

Rapidly dividing cells are more vulnerable to injury than quiescent cells

A

Cell proliferation

117
Q

ionizing radiation results in radiolysis of water which produces ROS; hypoxic tissues are more resistant to radiation

A

Oxygen effects and hypoxia

118
Q

Endothelial damage by radiation may result in narrowing of blood vessels

A

Vascular damage

119
Q

Injury produced by ionizing radiation

A

DNA damage
Cellular changes
Fibrosis of vessels

120
Q

A common side effect of radiation

A

Fibrosis

121
Q

replacement of dead cells by connective tissue

A

Fibrosis

122
Q

leads to scar formation and adhesion

A

Fibrosis

123
Q

Double stranded breaks and repaired either via ___ or ____ end joining

A

Homologous recombination

Non-homologous

124
Q

DNA repair via ___ often results in mutation - carcinogenesis

A

NHEJ

125
Q

One of the components are missing in the diet

A

Primary malnutrition

126
Q

Results from malabsorption, impaired utilization, excess loss or increase need for nutrients

A

Secondary malnutrition

127
Q

Previously called protein energy malnutrition

A

Severe acute malnutrition

128
Q

Severe acute malnutrition can affects the 2 compartments

A

Somatic and visceral compartment

129
Q

Develops when the diet is severely lacking in calories

A

Marasmus

130
Q

When does a child is considered to have a marasmus?

A

When weight falls o 60% of normal

131
Q

Extremities are emaciated due to loss of muscle and subcutaneous fat

A

Marasmus

132
Q

Occurs when protein deprivation is relatively greater than the reduction in total calories

A

Kwashiorkor

133
Q

Most common form of SAM seen in african children who are exclusively fed on a carbohydrate diet

A

Kwashiorkor

134
Q

Weight of children are typically 60 - 80% of normal

A

Kwashiorkor

135
Q

Often develops in chronically ill, older and bedridden patients

A

Malnutrition

136
Q

Self-induced starvation resulting in marked weight loss

A

Anorexia nervosa

137
Q

condition in which the patient binges on food and then induces vomiting

A

Bulimia

138
Q

Endocrine effects and symptoms of anorexia

A

Amenorrhea and hypothyroidism

139
Q

Maintenance of normal vision, regulation of cell growth and differentiation and regulation of lipid metabolism

A

Vitamin A

140
Q

Group of related compounds that include retinol, retinal and retinoic acid

A

Vitamin A

141
Q

Conversion of retinol occurs in the ____ ?

A

Intestine

142
Q

Maintenance of normal vision - light sensitive pigments

A

Vitamin A

143
Q

Cell growth and differentiation - binds to retinoic acid receptors and RXR - maintenance of cell growth and differentiation

A

Vitamin A

144
Q

Vitamin A deficiency

A

Bitot spots
Corneal ulcer
Keratomalacia

145
Q

What are the fat soluble vitamins

A

Vitamin A D E K

146
Q

Maintenance of adequate plasma levels of calcium and phosphorus

A

Vitamin D

147
Q

supports metabolic functions, bone mineralization and neuromuscular transmission

A

Vitamin D

148
Q

Major source in humans is the endogenous synthesis from 7-dehydrocholesterol

A

Vitamin D

149
Q

Reaction requires UV light which results in synthesis of cholecalciferol

A

Vitamin D

150
Q

Where does 25-hydroxycholecalciferol is being converted to?

A

In the liver

151
Q

Most active form of vitamin D

A

1,25 dihydroxyvitamin D

152
Q

Overgrowth of epiphyseal cartilge

Persistence of distorted, irregular masses of cartilage

Inadequate mineralization of osteoid matrix

A

Rickets

153
Q

Inadequate mineralization of bone matrix

Weak bones which are prone to fractures

A

Osteomalacia

154
Q

Not synthesized endogenously; supply is dependent on diet

Collagen synthesis - hydroxylation of procollagen
Antioxidant function, immune response

A

Vitamin C (ascorbic acid)

155
Q

Vitamin C deficiency

A

Scurvy

156
Q

defined as accumulation of adipose tisue that s of sufficient magnitude to impair health

A

Obesity

157
Q

Obesity, what circuit

= promotes food intake and reduced energy expenditure

A

Anabolic circuits

158
Q

obesity, what circuits

=reduces food intake and increases energy expenditure

A

Catabolic circuits

159
Q

The three afferent system

A

Leptin, adiponectin, gut hormone

160
Q

Secreted by fat cells

Reduces food intake by stimulating POMC/CART and inhibits NPY/AgRP neurons

Abundance of leptin stimulates physical activity, heat production and energy expenditure

A

Afferent system - leptin

161
Q

“Fat burning molecules” reduces fatty acid levels

Stimulates FA oxidation in skeletal muscle

Protects against metaboic syndrome in decreasing glucose production, increases insulin sensitivity

Has anti-inflammatory, antiatherogenic, antiproliferative and cardioprotective effects

A

Afferent system - adiponectin

162
Q

Increases food intake

A

Ghrelin

163
Q

Short term meal initiators and terminators

A

Ghrelin
PYY and GLP-1

164
Q

Decreases food intake

A

PYY and GLP-1

gen path lec (7 decks)

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