Environmental Diseases

Question 1

Emphysema

Answer 1

Permanent enlargement of airspaces due to destruction of alveolar walls

Question 2

How does smoking cause thrombosis?

Answer 2

1. Toxins injury enothelial cells –> increased permeability of lipids into arteries
2. Induce procoagulant state
3. Increase HR, BP, and contractility
4. Decrease blood oxygen-carrying capacity

Question 3

Smokers macrophages

Answer 3

Macrophages in air spaces with brown pgiment inside –> look similair to hemophages with hemosiderin

Question 4

Carbon monoxide signs

Answer 4

“cherry red” discoloration of skin and mucous membranes

Question 5

Symptoms of CO poisoning

Answer 5

Headache and exertional dyspnea –> eventually coma and death

Question 6

Microscopic finding of lead poisoning

Answer 6

Basophilic stippling of red blood cells due to ribosomal clumping

Question 7

Manifestations of lead poisoning in children at low concentrations

Answer 7

1. Cognitive impairment
2. Hyperactivity
3. Hearing loss

Question 8

Manifestations of lead poisoning in children at high concentrations

Answer 8

1. Colicky abdominal pain
2. arthralgia
3. Renal insufficiency
4. Constipation

Question 9

Manifestations of lead poisoning in adults at low concentration

Answer 9

1. Short-term memory loss
2. Difficulty concentrating
3. Anxiety
4. Phobias

Question 10

Manifestations of lead poisoning in adults at high concentration

Answer 10

1. Peripheral demyelinating neuropathy
2. Myalgia
3. Arthralgia
4. Constipation

Question 11

How does lead cause stippling?

Answer 11

Inhibition of pyrimidine 5’ nucleotidase causing degradation of rRNA

Question 12

How does lead cause neurological problems?

Answer 12

Competes with Ca2+ in neurons

Question 13

Urothelial carcinoma from smoking

Answer 13

Carcinogens are excreted in urine and rest in the bladder

Question 14

How does smoking cause pneumonia

Answer 14

Loss of mucociliary elevator prevents removal of bacteria

Question 15

Signs and symptoms of arsenic exposure

Answer 15

Garlicy breath

Scaly (pigment changes) papular rash

Question 16

WTF is cotinine?

Answer 16

Cotinine is a breakdown product of nicotine detectable in the blood up to 7 days after smoking

Question 17

Main effects fo chronic alcoholism

Answer 17

1. Fatty liver
2. alcoholic hepatitis
3. cirrhosis

Question 18

What is steatosis?

Answer 18

Fatty liver deposits that give it a yellow-tan color instead of red-brown –> caused by alcohol, obesity, and diabetes

Question 19

Pathological mechanism of steatosis

Answer 19

1. Excess NADH produced in alcohol metabolism shunts toward lipid biosynthesis
2. Impaired assembly and secretion of lipoproteins
3. Increased peripheral catabolsim of fat

Question 20

What is steatohepatitis?

Answer 20

Steatosis with neutrophil inflammation and dying hepatocytes

Question 21

What causes steatophepatitis?

Answer 21

Acetaldehyde and alcohol affect cytoskeleton, ROS generated during EtOH breakdown, and cytokines/TNF

Question 22

What are Mallory-Denk bodies?

Answer 22

Broken down cytoskeleton filaments seen in cirrhosis and other conditions eliciting hepatic damage; hypereosinophilic braided rope appearance on H&E

Question 23

Microscopic pathology of liver cirrhosis

Answer 23

Round nodules of regenrating hepatocytes surrounded by fibrous tissue

Question 24

Fetal alcohol syndrome characteristics

Answer 24

1. Dysmorphic facial features
2. Growth retardation
3. CNS abnormalities

Question 25

Acetaminophen metabolite

Answer 25

NAPQI --\> accumulation leads to centrilobular hepatic necrosis

Question 26

Cocaine

Answer 26

Cardiovascular effects mediated by norepi and CNS effects mediated by dopamine

Question 27

Alcohol consumption and pancreatitis

Answer 27

Causes acute pancreatitis with coagulative necrosis, hemorrhage, degenerating polys, and fat necrosis

Question 28

First sign of radiation injury

Answer 28

Nausea

Question 29

First blood sign of radiation injury

Answer 29

Lymphopenia --\> within hours Neutropenia within several days Thrombocytopenia within a week Anemia 2 to 3 weeks