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Flashcards in Environmental Path 2 Deck (58):
1

what are 2 main maternal smoking risks?

1) increased risk of spontaneous abortions & preterm births
2) fetal hypoxia with Intra-uterine growth retardation

2

what are the effects of smoking on respiratory system?

1) bronchitis
2) emphysema
3) lung cancer

3

which 2 groups of people have a 10 fold higher incidence of lung carcinomas?

1) asbestos workers
2) uranium miners

4

smoking and alcohol increases the risk of what cancer?

laryngeal

5

what is the mechanism of action that links atherosclerosis to MI?

increased plt aggregation --> decreased oxygen supply to heart --> increased oxygen demand --> decreased threshold for v-fib

6

What 2 cases result in a multiplicative effect on incidence of MI?

1) HTN + hypercholesterolemia
2) smoking + oral contraception in women > 35

7

What 2 types of lung cancer are associated with smoking?

small cell carcinoma,
squamous cell carcinomas

8

What type of laryngeal cancer is associated with smoking?

squamous cell carcinoma

9

What type of bladder cancer is associated smoking?

urothelial carcinoma

10

what type of oropharyngeal cancer is associated with smoking?

squamous cell carcinoma

11

what type of esophageal cancer is associated with smoking?

squamous cell carcinoma

12

What type of pancreatic cancer is associated with smoking?

adenocarcinoma

13

what type of kidney cancer is associated with smoking?

renal cell carcinoma

14

what type of cervical cancer is associated with smoking?

squamous cell carcinoma

15

what type of hematopoietic cancer is associated with smoking?

acute myeloid leukemia

16

What are some non-neoplastic conditions associated with smoking?

1-GIT
2- Bones
3- Thyroid
4- Eyes
5- Menopause

1- GIT = GERD, PUD
2- Osteoporosis exacerbated by tobacco
3- Graves Disease
4- Macular degeneration and cataracts
5- earlier menopause in females (estradiol is hydroxylated to estrone in liver)

17

Acetaldehyde

causes acute effects of alcohol metabolism and development of oral cancer.

Efficiency of alcohol metabolism varries b/w populations -- asians have low to no ALDH activity and cannot tolerate alcohol.

18

At high blood alcohol levels, what enzyme in addition to ADH metabolizes ethanol to acetaldehyde?

What is generated during this reaction?

CYP2E1
= MEOS (microsomal ethanol oxidizing system)

ROS, lipid peroxidation of cell membranes

19

Step 2 in Ethanol metabolism:
Acetaldehyde is converted to acetate by what enzyme?

ALDH (hepatic acetaldehyde DH)

20

Overall breakdown of Ethanol:

Ethanol --> [ADH or CYP2E1] --> Acetaldehyde --> [ALDH] --> Acetate

21

Step 1 in ethanol metabolism: What enzyme oxidizes Ethanol --> acetaldehyde?

ADH

22

Effects of ADH during oxidation of alcohol

& importance of NAD

-Causes REduction of NAD to NADH (thus depletes NAD)

NAD is required for fatty acid oxidation and in alcohols, this is depleted and is the main cause of fat accumulation in Liver

23

Chronic alcoholism results in what Liver pathologies? (3 main ones)

1) Chronic injury-
i) Fatty change (steatosis)
ii) alcoholic hepatitis
iii) cirrhosis

2) portal HTN

3) increased risk of hepatocellular carcinoma

24

Steatosis/Fatty change results in accumulation of what in hepatocytes?

triglycerides

25

Chronic alcoholism results in deficiency of what vitamin and what does this result in clinically?

Thiamine (b1)

peripheral neuropathy, wernicke-korsakoff (hemorrhage and necrosis of mammillary bodies) resulting in ataia, confabulation, nystagmus

26

What 2 diseases are a chronic alcholic at risk for in the CVS?

1) dilated congestive cardiomyopathy (alcoholic cardiomyopathy)
2) HTN

27

What type of anemia is an alcoholic susceptible to?

megaloblastic anemia (due to folate deficiency)

28

infective endocarditis from IV drug use affects which heart valves and is caused by which bacteria?

tricuspid/aortic

S. Aureus

29

Cocaine's AE's on CNS, CVS, and other

CVS:
MI, sudden death

CNS:
seizures

Other:
perforated nasal septum

30

What type of pulmonary injury results from heroin use?

Edema, foreign body granuloma from talc

31

What infection results from heroin use?

endocarditis (R- tricuspid valve, s. aureus), viral hepatitis, AIDs

32

what are 2 Renal problems from heroin?

amyloidosis

heroin nephropathy = focal segmental glomerulosclerosis

33

Abrasion

wound produced by scraping or rubbing

removal of superficial layer

34

contusion

produced by blunt object

damage to blood vessels and extravastion of blood into tissues

35

laceration

tear or disruptive stretching of tissue caused by applicaiton of force by a blunt object

intact bridging blood vessels and jagged irregular edges

36

incised wound

by sharp instrument

bridging blood vessels severed

37

puncture wound
(penetrating v perforating)

caused by along, narrow instrument

penetrating: when instrument pierces tissue

Perforating: when instrument traverses tissue to create exit wound

38

Superficial Burn

first degree
confined to epidermis

39

partial thickness burn

second degree
involves dermis

40

full thickness burn (3rd v 4th)

third degree- extends to subcutaneous tissue

fourth degree- may also involve damage to muscle tissue

41

Hypovolemic shock:
1) what percentage of body surface is burned?
2) mechanism?
3) most common bacteria?

1) >20%
2) rapid shift of body fluids into interstitial compartment. Excess head loss and increased need for nutritional support.
3) Pseudomonas aeruginosa (MOST!), s. aureus, candida

42

What internal injury can result when water-soluble gas is inhaled?

inflammation and swelling causing partial or complete airway obstruction esp. in upper airways

(chlorine, sulfur oxides, ammonia)

43

what internal injury can result when lipid-soluble gases are inhaled?

reach deep airways producing pneumonitis

(NO, burning plastics)

44

What is a long-term consequence of burn injury?

Hypertrophic scars

45

What causes a hypertrophic scar?

continuous angiogensis in wound due to excess neuropeptide released from injured nerve endings (i.e. substance P)

46

How does Hypothermia cause injury? (direct. v indirect)

Direct: crystallization of intra and extracellular water --> physical disruption within cells

Indirect: circulatory changes -- i.e. trench food (slowly developing chill results in edema and hypoxia, gangrene)

47

Electrical injury produces what 2 types of injury?

1) burns (at site of entry and exit, in internal organs)

2) V-fib

48

what cell types are more vulnerable to ionizing radiation injury? What types of tissue are most vulnerable?

Rapidly dividing cells

Gonads
Bone marrow
Mucosa of GI

49

What type of vascular damage is produced from injury due to ionizing radiation?

damage to endothelial cells, occlusion/narrowing of blood vessels, impaired healing --> fibrosis and chronic ischemic atrophy!

50

0-1 Sv irradiation causes:
1) injury where?
2) signs & symptoms
3) time of development
4) lethality

none.

51

1-2 Sv irradiation causes:
1) injury where?
2) signs & symptoms
3) time of development
4) lethality

1)lymphocytes
2)lymphopenia, granulocytopenia
3) 1-7 days
4) none

52

2-10 Sv irradiation causes:
1) injury where?
2) signs & symptoms
3) time of development
4) lethality

1) bone marrow
2) leukopenia, hemorrhage, hair loss, vomiting
3) 2-6 weeks
4) variable

53

10-20 Sv irradiation causes:
1) injury where?
2) signs & symptoms
3) time of development
4) lethality

1)small bowel
2) diarrhea, fever, electrolyte imbalance, vomiting
3) 5-14 days
4) 100%

54

>50 Sv irradiation causes:
1) injury where?
2) signs & symptoms
3) time of development
4) lethality

1) brain
2) ataxia, coma, convulsions, vomiting
3) 1 to 4 hours
4) 100%

55

what are pathological features of tissue that has had persistent exposure to radiation?

1) arterioles-- endothelial swelling, collagen deposition
2) small arteries -- fragramentation of IEL, fibrosis
3) bizarre fibroblasts with large hyperchromatic nuclei

56

what are 4 clinical conditions that result from chronic radiation?

1) interstitial fibrosis in heart and lungs, constrictive pericarditis
2) radiation dermatitis
3) cataracts
4) atrophy of testes and ovaries

57

what are features of radiation-induced fibrosis?
1) what tissues affected?
2) Timeframe?
3) DNA damage?

1) all tissues included in irradiation
2) after weeks or months
3) DNA mutations that can inititate carcinogenesis if repair mechanisms fail

58

What 2nd cancers can individuals get who received radiation therapy for childhood cancers?

AML
MDS
HL (Hodgkins Lymphoma)