Environmental And Nutritional Diseases - Martin Flashcards
(184 cards)
1
Q
most deaths in children under 5yo
A
- pneumonia
- diarrhea
- malaria
2
Q
what 3 diseases are increasing and what 2 are decreasing
A
- cardivascular d, cancer, HIV/AIDS/ TB
2. neonatal conditions, D or lower Resp infections
3
Q
how does climate change affect cardi + resp
A
heatwaves and air pollution
4
Q
how does climate change affect GI, cholera, food and water spreading infections
A
contamination from flooding, disrupting clean waters
5
Q
how does climate change affect Vector-borne infections
A
malaria, Dengue fever happen when temperature increases = crop failures, which also leads to more extreme weather variations
6
Q
how does climate change affect malnutruition
A
disruption of crop growth
7
Q
xenobiotics
A
chemicals in environment like water, soil, food, air, absorbed through skin or inhaled
8
Q
what detoxifies xenobiotics
A
CYP, Cytochrome P-450
9
Q
CYP is located + function
A
liver, and also skin, lung, GI mucosa
- inside the ER
they detoxify or activate xenobiotics, can make ROS
10
Q
what changes CYP activity
A
fasting and starving can lower it
11
Q
what compounds are found in pollution
A
sulfur dioxide CO ozone NO lead particles of matter
12
Q
ozone causes what in healthy people
A
decreases lung function, lung inflammation increased airway reactivity chest discomfort (free radicals injuring type 1 cells and epithelium -> inflammtation)
13
Q
ozone causes what in athletes, outdoor workers, asthmatics, emphysema
A
higher hospitalizations, decreased exercise capacity
14
Q
sulfur dioxide does what to healthy adults and COPD and Asthma
A
healthy : higher respiratory symptoms
COPD : higher mortality
Asthma : decreased lung function, higher hospitalizations
15
Q
witches brew
A
surfure dioxide when combined with ozone and particles of matter
= from power plants burning fossil fules, paper mills
(burning nose and throat, SOB, asthma attack if susceptible)
16
Q
particles of matter
A
SOOT
pulmonary inflammation
secondary cardiovascular effects
* most dangerous are smaller then 10um going to alveoli
17
Q
CO chronic poisoning from
A
working in tunnels, underground garages, highway toll booths can do this (generator Heater, automobile fumes)
18
Q
CO acute poisoning from
A
small closed garage with running car, in 5 min you die, or during power outage using gasoline powered generators, mine fires
19
Q
CO poisoning happens due to
A
CNS depression = ischemic changes
(Basal ganglia + lenticular nuclei)
can cause edematous, punctuate hemorrhages, hypoxia-induced neuronal changes -> sommer’s sector in hippocampus
20
Q
SX : CO poisoning
A
RED COLOR of skin and mucous membranes, V, dizzy
AFTER: loss of memory, vision changes, hearing and speech changes
21
Q
CO poisoning can cause what in the brain
A
hemorrhage in pallidum
22
Q
Wood smoke
A
polycyclic hydrocarbons are carcinogens
can give lung infections
23
Q
Bioaerosols
A
can caused from Legionnaires disease (from cooling towers for AC), viral pneumonia, pet dnader, fungi, molds
SX: asthma, rhinitis, eye irritaiton
24
Q
Radon
A
gas from uranium , (soil, well water, cracks, drains, windows)
HIGH lung cancer risk
25
Formaldehyde
building materials, after disasters in poorly ventilated trailers
= carcinogen
26
sick building syndrome
indoor pollutants, poor ventilation (fungi, molds)
27
Lead poisoning causes what and interferes with
causes hematologic, skeletal , GI and renal toxisity
= looks like low Fe+3
interferes with CA+2 metabolism
28
lead can be found
batteries, paint, car radiators, tin cans
29
children SX of lead poisoning
CNS changes, affects intellect, behavior problems, hyperactive, poor organization, = looks like ADHD
severe can be blindness, psychomotor problems, psychoses, seizures, coma
30
adults SX of lead poisoning
peripheral neuropathy
1. EXTENSOR muscles of wrist and fingers = wrist drop
2. if continued, PERONEAL muscles = foot drop
31
SX of lead poisoning form both adults and children
1. lead lines : radiodense in metaphyses (bones) and gums
2. hypochromic microcytic anemia (as in low Fe+), basophilic stippling, ring sideroblasts (Fe+ mitochondria)
3. Lead colic : extremely sever, abd pain all over
4. renal damage
32
ringed sideroblast
iron in mitochondria
33
how to determine if someone has microcytic and hypochromic anemia
MCV < 80fL
| MCG < 27pg
34
Mercury causes
damage CNA + KIDNEY
| -cerebral palsy, deafness, blindness, mental problems, especially inutero exposure
35
Arsenic causes
1. GI , cardio, CNS toxicities
2. sensorimotor neuropathy, paresthesias, numbness, pain
3. hyperpigmentation + hyperkeratosis
4. many cancers on soles and palms , lung and bladder
36
Arsenic comes from
soil, water, wood preservatives, herbicides, herbal medicine
37
mercury comes from
fish, mercury vapor from dental metallic amalgams
38
Cadmium comes from
high ROS from nickel-cadmium batteries, soil, plants , FOOD (contaminated rice)
39
Cadmium causes
LUNG + KIDNEY toxicity
CA +2 LOSS : osteoporosis and osteomalacia with renal disease = ITAI-ITAI
high lung cancer risk
40
what causes lung cancer
Radon, asbestos, silica, arsenic
41
what causes lung fibrosis
silica
asbestos
cobalt
42
what causes (hematopoietic) leukemia
Benzene
43
what causes liver angiosarcomas
Vinyl chloride
44
what causes heart disease
CO, lead, cadmium, cobalt
45
what causes COPD
cadmium
46
what causes ataxic gait
mercury, toluene
47
what causes renal toxicity
mercury, lead, cadmium
48
what causes male infertility
lead, cadmium, phthalate plasticizers
49
what causes female infertility
lead, mercury
50
what causes tetratogenesis
mercury, polychlorinated biphenyls
51
what causes peripheral neuropathies
lead, mercury, arsenic , DDT
52
chloroform + carbon tetrachloride causes what
dizzy, confusion, DEPRESS CNS, coma, toxic ot liver and kidney
53
chloroform + carbon tetrachloride from what
dry cleaning agents, paint removers, vapors, rubber that has benzene and 1,3-butadiene ----> can cause marrow aplasia and AML
54
Polycyclic hydrocarbons causes
scrotal cancer, very potent carcinogen, lung and bladder cancer
55
Polycyclic hydrocarbons form
fossil fuels, chimney sweeps
56
Organochlorines causes
hormonal imbalance like antiestrogenic or acntiandrogenic activity
57
Organochlorines from what
lipophilic products not degrading, pesticides, DDT, , PCBs, dioxin
58
Dioxins and PCBs cause what specifically
folliculitis and dermatosis, chloracne (acne and cycts, hyperpigmentation, hyper keratosis) - face and behind ears
59
Mineral dust causes what
1. pneumonioses
2. mesothelioma - outside of lung turns thick and black "pork-chop lung"
3. asbestos fibers coated in FE+3 (FERRUNGINOUS BODIES)
60
Mineral dust comes from
coal dust, silica, asbestos, beryllium
61
Vinyl chloride causes , and from what
angiosarcoma of liver +endocrine effects in infants
| from Bisphenol A (BPA) - food bottles and cans
62
Tobacco smoking quitting decreases death by how much
21% decrease 5 years from cardiovascular diseases and lung cancer
63
nicotine effect
increase HR and BP, increase cardiac contractility and output
CNS depressor, tumor promotor
64
formaldehyde and NO cuases
cilia toxicity and mucosal irritation (smokers cough in the morning)
65
what 2 things increaseee lung cancer or laryngeal + oral cancer with smoking
lung cancer with asbestos or uranium miners
| oral + laryngyal cancer with alcohol
66
tobacco causes what to lungs
leukocytes to lung, = high elastase production, injury to lung, = emphysema + inflammation causing bronchitis
67
what is the thing that CAUSES lung cancer in smokers
polycyclic hydrocarbons and nitrosamines
68
Alcohol testing for chronic use
test vitrous fluid from eye
69
alcohol amount for drunk, drowsiness, coma
80mg/dL
200mg/dL
300mg/dL
70
what makes asians red with alcohol
X ALDH*2
71
what is alcohol in blood
acetaldehyde from ADH (alcohol dehydrogenase) in liver,
| also makes it acetate
72
alcohol inhibits
CYP2E1, metabolism of other drugs or compounds
73
alcohol increases what for liver issues
NADH + lactic acid = steatosis
74
liver cirrhosis can cause
esophageal varices, due to blood in vein congestions
75
alcohol affects what part of the brain
cerbellum, SUPERIOR VERMIS
76
alcohol does what to HDL and what deficiency
```
low HDL (unless it is wine low amounts in increases HDL)
Thiamine (B1) deficiency
```
77
what does low B1 cause from alcohol
peripheral neuropathies
| Wernicke- Korsakoff syndrome
78
alcohol and fetus
microcephaly, low growth, facial anomalies, low mental function (esp 1st trimester)
79
wine effects in moderation
high HDL
low platelet aggregation
low fibrinogen levels
80
wernicke encephalopathy
low thiamine
= reversible
= TX: thiamine
= mamillary bodies hemorrhage and necrosis
81
Korsakoff syndrome
irreverible worse form of wernickes encephalopathy
= short term memory loss confabulation
= trunctal ataxia, nystagmus
= Affects ANTERIOR VERMIS of cerebellum--> atrophy
82
minocycline drug adverse effect
- it is an AB with adverse effect of darkened skin discoloration rash looking like Lupus, hemolytic anemia, immune thrombocytopenia
83
anticoagulant warfarin can cause
is also rat poisoning (VIT K antagonist) = bleeding
84
anticoagulant pradaxa can cause
inhibits thrombin , so it can cause A-Fib, bleeding
85
Menopausal hormone therapy
estrogens with progesterones (only fine in early menopause)
- high breast cancer, high stroke
- lowers ASCVD if under 60yo
86
oral contraceptives
- increases cervical cancer (especially from HPV)
- protects against ovarian and endometrial cancers
- high venous thrombosis
- high CAD in women who smoke over >35yo
- chronic use and old pt can get hepatic adenoma
87
anabolic steroids cause
acne, stunt growth, testicular atrophy, facial hair, menstrual changes, high MI risk, gynecomastia, psychiatric issues
88
Acetaminophen can cause
acute liver failure = centrilobular necrosis, will need liver transplant
89
toxic level of acetaminophen
| TX:
NORMAL : 0.5g
TOXIC : 15-25g
TX: N-acetylcysteine within 12hrs
90
Asprin (acetylsalicylic acid) can cause
alkalosis due to medulla respiratory center stimulation
ACUTE : N, coma
CHRONIC : dizzy, tinnitus**, bleeding, coma, analgesic nephropathy (PHENACETIN ----> renal necrosis and analgesic nephropathy)
91
Asprin toxic level
Child : 2g-4g
ADULT : 10-30g
(also found in wintergreen oil, methyl salicylate)
92
how does actetominophen cause damage to liver
1. activated CYP2E2 activity
2. NAPQ1 activated
3. lowers GSH (X conjugation) = high ROS, potentiated by alcohol
3. covalent binding to hepatic cells= damage cells= mito dysfunction
93
cocain causes what
tachycardia, HTN, peripheral vasoconstriction
- platelet aggregation + vasoconstriction = MI *
- lethal arrhythmias * (disrupt ion transport in myocardium)
- LOW BF to PLACENTA* (fetal hypoxia and spontaneous abortion)
- fever, seizures
94
Opiates cause what
- respiratory depression
- arrhythmia
- cardiac arrest
- pulmonary edema**
- injected with IV = ENDOCARDITIS* of RIGHT HEART****
95
opiates SX:
bubbles coming out from mouth, nose, ears from pulmonary edema
96
Metamphetamines cause
violent behavior, confusion, psychotic (paranoia, hallucinations)
97
MDMA (Ecstasy) causes
sleep disorder, depression, anxiety, aggressive behavior, usually spiked with other CNS effective drugs
98
Marijuana
- high HR
- low or high BP
- angina if pt has CAD
- high carcinogens
- psychomotor dysfunction
99
Huffing and glue sniffing
brain damage on MRI of dementia
100
Bath salts
agitation, psychosis, MI, suicide
101
internal burn can be caused by
skin burn can cause
% of body surface that is burned is
- intubation
- electrolyte disfunction, give a lot of fluids
- rule of 9
102
1st degree burn
epidermis
103
2nd degree burn
epidermis and dermis
104
3rd degree burn
epidermis, dermis, subcutaneous tissue
105
4th degree burn
epidermis, dermis, subcutaneous tissue, muscle underneath
106
thermal injury causing shock
when more then 20% body surface involved, fluids go to intestines + PULMONARY EDEMA, hyper metabolic state needing more nutritional support
107
thermal injury causing sepsis
due to pseudomas aeruginosa, MRSA, Candida species colonization at burn site
108
thermal injury cuasing respiratory insufficiency
direct heat on upper airway and inhaling noxious gases
109
hypertrophic scars
original burn + donor graft , a lot of collagen deposition for healing (EX: Tilapia grafts of skin)
110
pugilistic stance
how burned victims shape their body positioning
111
heat cramps
| heat exaustion
- electrolyte dysregulation
| - hypovolemia from dehydration --> no cardiac compensation , collapse
112
heat stroke
NO SWEATING, vasodilation = pooling of blood
hyperkalemia
rhabomyolysis , RYR1 ----> CA release causing muscel contractions
113
Malignant Hyperthermia
muscle contractures and body temperature rises from normal anesthetics due to RYR1 gene , TX : with muscle relaxer (not common however deadly)
114
Hypothermia causes what
| what makes it worse
bradycardia ----> a fib
loss of consciousness
vasoconstriction and increased vascular permeability
- alcohol
115
paradoxical undressing
person experiencing hypothermia and before they die they have an extreme burst of heat
116
electrical burns do what to eyes
star shaped cataracts
117
electrical burns do what to the heart
V fib, cardiac-respiratory failure
118
low voltage burns cause
tetanic muscle spasm, irreversible grasps
| chest wall spasm = asphyxia
119
high voltage burns cause
medullary centers paralysis, EX: lighting
120
curie
radiation amount emitted
121
Gray
energy absorbed thats radiation
122
sievert (Sv)
absorbed radiation x effectiveness of radiation
123
what determines if radiation will have bad effects
1. Rate of delivery
2. Field size
3. Cell proliferation
4. O2 effects (hypoxia)
5. Vascular damage
124
Sv of 5
Lens of eye ----> cataracts
125
Sv of 0.15
Testes ----> Temporary steriliry
126
Sv of 2.5- 6
Ovaries ----> permanent sterility
127
Sv of 3-5
Skin ----> Temporary hair loss
128
Sv of 3.5
Testes ----> permanent sterility
129
what does ionizing radiation do
remove tightly bound electrons
130
cell morphology of radiation
looks like cancer * hard to see if cancer is there
- nuclear swelling, collagenous hyalinization, intima thickens of BVs,
- high collagen (fibrosis, sclerosis)
- mitotic figures, abnormal
- high fat in cell stains
131
radiation on lymophoid and hematopoietic system
aplastic anemia (low marrow in bone)
132
places getting fibrosis after radiation
abd, lungs, salivary glands
133
radiation on dna
can cause double stranded breaks
134
radiation can cause high risk of what cancer
leukemia (AML) , solid tumor in thyroid, breast, lungs, MDS (myelodysplastic syndrome)
135
chronic radiation effect on skin
dermititis = dermal fibrosis
136
radiation can cause a lot of
fibrosis
137
0-1 Sv causes
nothing
138
1-2 Sv causes
Lymphocytes ----> Moderate granulocytopenia Lymphopenia (if exposed 1 day to 1 week)
139
2-10 Sv causes
Bone marrow ----> Leukopenia, hemorrhage, hair loss, vomiting (if exposed 2-6 weeks)
140
10-20 Sv causes
SI -----> D, Fever, electrolyte imbalance, V (if exposed 5-14 days)
141
greater then 50 Sv causes
Brain ----> ataxia, coma, convulsions, V (if exposed 1-4hrs)
142
primary malnutrition
| secondary malnuttrition
- not eating in diet something
| - malabsorption, impaired utilization or storage, Gut microbe*
143
iodine in found in
where sea life has been
| NOT himalayan sea salt
144
infant feed on formulas can miss what
iron
145
only eating rice can cause what deficiency
thiamine (B1)
146
scientific name for malutrition
Severe Acute Malnutrition (esp. low calories or proteins)
| Protein-energy malnutrition
147
SX: of SAM
- low subcutaneous fat
- wasting quads and deltoid
- edema of ankles and sacrum
148
somatic SAM
| visceral SAM
- marasums
| - kwashiorkor
149
Marasmus hallmarks
muscels loss, anemia, small, normal albumin
| EXTREME : cachexia
150
Kwashiokor hallmarks
edema, hypoalbuminemia, fatty liver, hyperpigmented area
151
anorexia causes
```
Gelatinous transformation (fat in BM, mucinous matrix)
HYPOKALEMIA, risk of arrhythmia and sudden death
```
152
bulimia
electrolyte imbalance
HYPOKALEMIA (arrhythmia, sudden death)
pulmonary aspiration of gastric contents
esophageal and gastric rupture
153
gelatinous transformation of BM looks like
high fat, very little hemopoietic tissue
154
Vit A function
maintain normal vision (rhodopsin)
| regulation of lipid metabolisms,
155
Vit A can be from
- X fat absorption (Celiac, crohns, CF)
| - kids during infections
156
VIT A deficiency
- night blindness
- epithelial to squamous metaplasia + keritinization (Bitot spots on eye, Xerophthalmia = dry eye, corneal destruction), pulmonary infections, stones in urinary tract
- low immune system
157
VIT A toxicity
| acute
headache, dizzy, V, stupor, blurred vision, *pseudotumor cerebri (high intracranial P, only no tumor)
158
VIT A toxicity
| chronic
weight loss, anorexia, N,V, bone joint pain, high osteoclast activity
**** people from Canada, Alaska, Artic (polar bears, shark, tuna, whale)
159
VIT D function
absorb CA+2 and P
| bone mineralization, neuromuscular transmission
160
VIT deficiency children
RICKETS : epiphyses has not closed (frontal bossing, squared face, rachitic rosary, pigeon breast, lumbar lordosis, bowing of legs)
161
VIT deficiency adults
OSTEOMALACIA : hypocalcemic tetany, weak bone
162
low vit D risk for what infection
TB
163
Hypervitaminosis D
metastatic calcification of soft tissues
| - bone pain, hypercalcemia
164
low iron leads to
Hypochromic microcytic anemia
165
VIT C function
collagen, synthesis of NTs, antioxidant, regulate immune system, absorb FE+3
166
VIT C found in
animal liver and fish, milk, fruits, veggies
167
VIT C deficiency
SCURVY
hemorrhages, healing defects
(chronic alcoholics, bad eating habits, elderly living alone, dialysis)
168
VIT C toxicity
rare, need megadose
| FE overload, hemolytic anemia, calcium oxalate kidney stones, G6PD deficiency
169
normal BMI
18.5-25
170
anabolic
EAT, low energy usage
171
catabolic
DONT eat, high energy expenditure
172
Arcuate nucleus that
1. for eating
2. for not eating
1. NYP/AgRP
| 2. POMC/CART
173
Pickwickian syndrome
hypoventilation syndrome, form obesity
174
obesity can cause
- gallstones
- NASH (non-alcoholic fatty liver)
- Hypersomnolence (sleep apnea)
- high inflammation ---> procarcinogenic state
- right heart failure
175
obesity cancer risk in men
esophagus, thyroid, colon, kidney
176
obesity cancer risk in women
esophagus, endometrium, gallbladder, kidney
177
Aflatoxin
hepatocellular carcinoma (toxin from fungi in crops of humid environments)
178
Nitrosamines and nitrosamides in food cause
gastric carcinomas (preservative, in veggies)
179
high animal fat and low fiber diet causes
colon cancer
180
breask cancer is correlated with
total fat in diet
181
antioxidant vitamines
C, E, B-carotene, selenium
182
garlic helps
prevent heart disease
183
high fibers in diet helps
prevent diverticulosis
184
low cholesterol and animal saturated fat (egg, butter, beef) helps to
prevent atherosclerosis
