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Flashcards in environmental pathology Deck (49):
1

Children account for over 60% of injuries from _________

chemicals

2

what does CLADME stand for? (in relation to chemical injury)

Concentration
Liberation
Absorption
Distribution
Metabolism
Excretion

3

what are "major" adverse drug reactions?

anaphylaxis (penicillin), blood clots, arrhythmias, hematologic (anemia, thrombocytopenia, leukopenia)

4

Adverse drug reactions are also related to _______

potency

(which is why ARD's are common with anti-cancer meds)

5

what happens if someone overdoses on acetaminophen?

OD of 15 to 20 grams– causes liver damage, may result in liver failure/death

6

long term use of _________ is associated with elevated risk of breast ca, strokes & blood clots

exogenous estrogen

7

85% of Lead is taken up by ________ and ___________

bones & developing teeth

8

what is Gingival hyperpigmentation ?

“lead line” of soft tissue

9

how does lead effect red blood cells?

Pb blocks or hinders incorporation of Fe++ into hemoglobin

10

what types of anemia are caused by lead poisoning

microcytic

hypochromic

11

what is the CDC threshold for lead exposure?

Pb threshold blood level for concern > 5 micro-grams/dL

12

when is chelation therapy used for lead poisoning?

initiated when lead concentration > 45 micro-grams/dL

13

what dental-related side effect is seen during the use of ecstasy?

bruxism- grinding teeth

14

what are the 4 types of physical agents that cause injury?

1) mechanical injury
2) thermal injuries
3) hypothermia
4) hyperthermia

15

____________ causes over 5,000 deaths per year in the US

hyperthermia (burns)

16

what is the "rule of 9's" in relation to burn severity?

% body surface area involved:

Head & neck 9%
Trunk front 18%, trunk back 18%
Arms 9% each (hands: 1% each)
Legs 18% each
Perineum 1 %

17

what factors are important in determining burn severity?

1) % of body surface involved
2) depth of burn
3) potential for inhalation damage of smoke/heat
4) age of patient
5) speed & quality of treatment

18

If more than ____% of the body surface is burned, the patient has a grave prognosis

50%

19

when is shock common in burn victims?

when > 20% of the body is burned

20

Acute respiratory distress syndrome (ARDS) is a result of what?

inhalation of smoke or hot gases during a fire

21

at what temperature do most heat strokes occur?

- happen above 40 degrees Celsius

22

what are the symptoms of heat stroke?

peripheral vasodilation, confusion, coma, ischemia, muscle necrosis, DIC: high mortality rate

23

what body temperature is mild hypothermia? moderate? severe?

Mild (core temp =) 32-35 C (89-95 F)

Moderate= 28-32 C (82-89 F)

Severe= < 28 C (< 82 F)

24

the symptoms of severe hypothermia include what?

Bradycardia, atrial fibrillation, loss of consciousness

25

how can radiation damage cells?

1) Direct damage to DNA

2) Indirect – production of free radicals that can damage membranes, nucleic acids and enzymes

26

Occupational exposures to radiation should not exceed ______ mSv/yr

20

27

what types of tissues are most sensitive to radiation?

1) Hematopoietic/lymphoid tissues

2) gonads

3) lungs- due to vascularity

4) GI tract- VERY sensitive

5) blood vessels

28

when are patients susceptible to infection following radiation exposure?

PMN’s decrease over 1-2 weeks, rebound in 2-3 months


patients are weakened WEEKS after exposure- not immediately

29

what is the range for lethal doses of radiation?

- Lethal range begins about 2 Sv

- at 7 Sv death is certain w/o treatment

30

what are the effects of acute Hematopoietic radiation syndrome?

- 2-10 Sv

- drop in WBC’s, hair loss, infections, sepsis & bleeding

- death 2-6 weeks

31

what are the characteristics of acute GI radiation syndrome?

- 10-20 Sv

- vomiting, bloody diarrhea, shock, sepsis

- death 5-14 days

32

cerebral acute radiation syndrome is characterized by what?

- more than 50 Sv

- listlessness, drowsiness, seizures, coma

- death 1-4 hrs

33

what is the difference between primary and secondary malnutrition

Primary – diet deficient in 1 or more components

Secondary – supply is OK, problem w absorption, storage, utilization, excessive losses or drug effects

34

during what form of protein-energy malnutrition is somatic muscle most severely effected?

marasmus

35

during what form of protein-energy malnutrition is the liver most severely effected?

kwashiorkor

36

When weight falls to < 60% of normal, the child has _______

marasmus

37

what are the physical characteristics of children suffering from marasmus?

Extremities appear emaciated, head looks out-of-proportion (too large)

38

children with marasmus are especially prone to infections. what part of their immune system is most effected? what common infection is seen in them?

- T cell defects are common

- thrush is commonly seen

39

Serum _______ concentrations are relatively normal during marasmus

albumin

40

how does Kwashiorkor syndrome differ from marasmus?

Greater deficiency of protein than total calories, more severe than marasmus

41

what are the characteristics of Kwashiorkor syndrome?

- Low albumin
- generalized edema

**Weight is between 60-80% of normal but this is misleading because of the edema

42

_________ is a form of protein-energy malnutrition seen in cancer patients

Cachexia

43

why is cachexia seen in cancer patients?

Partly due to decreased appetite

Increased catabolism – cytokine-mediated (IL-1, IL-6 and TNF)

44

what conditions will decrease the bodies ability to absorb fat-soluble vitamins?

Inflammatory bowel disease (Crohn)

Cystic fibrosis

Alcoholic liver disease

45

what are the 3 forms of Vitamin A?

retinol, retinal, and retinoic acid

46

what is the physiological roll of vitamin A?

Maintain vision in reduced light

Augments differentiation of specialized epithelial cells (mucus secreting epithelium)

Enhances immunity to infections

47

what are the severe effects of vitamin A deficiencies?

Squamous metaplasia of respiratory & urinary tracts
- increases risk for infections and stones

48

Squamous metaplasia of respiratory & urinary tracts is the RESULT of what condition?

vitamin A deficiency

49

a deficiency of Vitamin A can predispose people to what types of infections?

measles, pneumonia and infectious diarrhea

(all caused by weakened immune system)