Environmental Pathology Flashcards Preview

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Flashcards in Environmental Pathology Deck (82):
1

Most xenobiotics are

Lipophilic

2

Lipophilic toxicants are metabolized to hydrophilic metabolites in two steps;

Phase 1: adding a polar group

Phase 2: conjugation products

3

There are __ in the level of activity of the xenobiotic metabolizing enzymes.

Genetic variations

4

Phase I reactions generate

Oxygen free radicals as byproducts.

All of the reactions occur in the SER.

5

Most important phase I reactions

Cytochrome P-450- dependent monooxygenase system

Flavin containing monooxygenase system

Peroxidase dependent cooxidation

6

Examples of phase II reactions

Glucuronidation

Biomethylation

Glutathione conjugation

7

Systemic diseases caused by tobacco use

Cancer

Ischemic heard disease

COPD

8

Tobacco use can lead to risk factors for

Hypocholesterolemia/hypertension

Myocardial infarction in women who take oral contraceptives

9

Maternal smoking can cause

Fetal hypoxia

10

Passive smoking causes increased risk for

Respiratory/ear infections in children

Asthma in children

11

Ingestion of methanol/ethylene glycol (anti-freeze) can cause:

Initial: dizziness, blindness, respiratory depression

Days after: acute renal failure.

It is treated with ethanol

12

Alcohol abuse: acute and chronic abuse causes

Acute: drowsiness, euphoria

Chronic: cirrhosis, vitamin deficiency, ulcers, cardiomyopathy

13

Fatty change, actue hepatitis and cirrhosis in the liver is caused by

Toxicity

14

Nervous system disorders are caused by

Thiamine deficiency/nutritional deficiency

15

Cardiovascular system lesions cause cardiomyopathy and hypertension. They are caused by

Toxicity and vasopressor

16

GI tract, skeletal, reproductive and fetal alcohol syndrome are all caused by

Toxicity

17

Depressors (ethanol and barbituates) induce

Sedation and decrease anxiety, but tolerance develops rapidly.

18

Stimulants such as amphetamines and cocain cause

Cardiac arrhythmias, ischemia and respiratory arrest. In a fetus, it can cause placental abruption.

19

Opioid narcotics (heroin, codeine) can cause

Endocarditis
Viral hepatitis
Convulsions, cardiorespiratory arrest (overdose)

20

Cannabinoids and hallucinogens cause

Nystagmus
Visual illusions
Altered perception

21

Acetaminophen can cause toxicity due to overdose. The adverse effect is

Liver necrosis and failure

22

NSAIDs can have a side effect of

Peptic ulcers

23

A deficiency of tiopurine S-methyltransferase and azathiprine can cause

Bone marrow failure

24

Cytocrome P-450 CYP2C9 and anicoagulants can cause

Bleeding

25

Cytochrome P-450 and CYP2D6 and some antipsychotic drugs can cause

Sedation and prakinsonism

26

N-actyltransferase and hydralazine can cause

Lupus

27

Chloramphenicol can cause

Aplastic anemia

28

Benefits and side effects of oral contraceptive pills

Benefit: decrease risk of endometrial and ovarian cancers.

Adverse effects: deep vein thrombosis, MI, stroke, benign hepatic ademonas

29

Hormone replacement therapy benefits and adverse effects

Benefits: improve menopause symptoms and prevent osteoperotic fractures.

Effects: increased risk of breast cancer, venous thrombosis, and cholecystitis

30

Long term effect of Acetaminophen and NSAIDs

Analgesic nephropathy

31

Radon and asbestos cause

Lung cancer

32

Bioaerosols cause

Allergic rhinitis, asthma

33

Volatile organic compounds can cause

Headache, dizziness and liver or kidney toxicity

34

Cadmium can cause

Chronic proteinuria

35

Nickel can cause

Contact dermatitis

36

Lead is most commonly inhaled. Some adverse effects are

Hand/foot drops

Basophilic stippling of erythrocytes (KIDS)

Damage to proximal tubules

Gout, renal failure

37

A single dose of external radiation administered to the whole body is ___ than regional doses with shielding.

More letahal

38

Cells in the ___ phases of the cell cycle are most sensiitive to ionizing radiation

G2 and mitotic phase

39

Cell injury induced by x rays and gamma rays is enhanced by

Hyperbaric oxygen

40

Sublinical radiation: dose, symptoms, prognosis

Dose: <200

Symptoms: mild nausea, vomiting, lymphocytes <1500

Prognosis: 100% survival

41

Hematopoietic radiation: dose, symptoms, prognosis

Dose: 200 - 600

Symptoms: intermittent nausea and vomiting, petechiae, hemorrhage, neutrophil/platelet depression, lymphocytes <1000

Prognosis: infections, possible bone marrow transplant

42

Gastrointestinal radiation: dose, symptoms, prognosis

Dose: 600 - 100 rem

Symptoms: nausea, vomiting, diarrhea, hemorrhage, infection, severe neutrophil and platelet depression, lymphocytes <500

Prognosis: shock and death in 10 - 14 days

43

Central nervous system radiation: dose, symptoms, prognosis

Dose: >1000 rem

Symptoms: nausea, vomiting, confusion, somnolence, convulsions, coma, lymphocytes absent

Death: 14 - 36 hours

44

The most susceptible period of radiation injury to a fetus is

From implantation to 9 weeks gestation.

From 9 weeks gestation to birth, there are underdeveloped reproductive organs, mental retardation and childhood leukemia.

Postnatal: retarded bone growth and maturation, perturbed CNS

45

Delayed radiation injury causes fibrosis. Some areas affected are

Blood vessels: fibrosis of blood vessels

Skin: radiation dermatitis and skin cancer

Heart: fibrosis of pericardium

Lungs: intra-alveolar and intersitial fibrosis

Kidneys/bladder: moderately susceptible

46

The spermatogonia are ____ to irradiation.

Are extremely sensitive to irradiation.

The eyes and CNS are also sensitive to ionizing radiation.

47

UV causes degenerative cahnges in

Elastin and collagen

48

Burns, depth of the burn in 1-3 degrees

1: epithelium
2: epidermis and superficial dermis
3 & 4: epidermis and dermis, dermal appendanges.

49

50% of burnt skin is fatal. 20% causes

Hypovolemic shock

50

Heat cramps result from loss of

Electrolytes through sweating

51

The most common head syndrome

Heat exhaustion.

It is sudden and is caused by a failure of the CV system to compensate for hypovolemia.

52

Heat stroke results from

High temperatures and humidity.

Thermoregulatory mechanisms fail, sweating ceases and core body temperature rises.

53

Marasmus is

Malnutrition caused by severe reduction in caloric intake.

Albumin levels are normal, extremities are emaciated and there is an immune deficiency.

54

Kwashiorkor protein deprivation is relatively greater than the reduction in total calories. Its signs are

Albumin levels low
Poorer prognosis than marasmus
Skin lesions
Enlarged, fatty liver
Defects in immunity
Secondary infections

55

Functions and deficiency of vitamin A

Functions: component of visual pigment, maintenance of specialized epithelia, maintenance of resistance to infection.

Deficiency: night blindness, squamous metaplasia, vulnerability to infection.

56

Function and deficiency of vitamin D

Function: facilitates internal absorption of calcium and phosphorus and mineralization of bone

Deficiency: rickets (children), osteomalacia (adults)

57

Vitamine E: function and deficiency

Function: major antioxidant; scavenges free radicals

Deficiency: spinocerebellar degeneration

58

Vitamin K: function and definciency

Cofactor in procoagulants.

Deficiency: bleeding diathesis

59

Vitamin B1: functions, deficiency

Function: coenzyme in decarboxylation reactions

Deficiency: wernicke, korsakoff

60

Vitamin B2 (riboflavin): function and deficiency

Function: converted to flavin coenzymes, cofactors for intermediary metabolism

Deficiency: glossitis, dermatitis, corneal vascularization

61

Vitamin B6 (pyridoxine): function and deficiency

Function: serves as coenzymes

Deficiency: glossitis, dermatitis, peripheral neuropathy

62

Vitamin B12: function and deficiency

Function: folate metabolism and DNA synthesis, myelinization of spinal cord

Deficiency: anemia, degeneration of posterolateral spinal cord tracts.

63

Niacin: function and deficiency

Function: incorporated into NAD

Deficiency: dementia, dermatitis, diarrhea

64

Vitamin C: function and deficciency

Function: redox reactions

Deficiency: scurvy

65

Folate: function and deficiency

Function: essential for transfer and use of 1-carbon units of DNA synthesis

Disease: megaloblastic anemia, neural tube defects

66

Pantothenic acid: function

Incorportated in coenzyme A; no syndromes due to deficiencies

67

Biotin: function

Cofactor in carboxylation reactions; no clearly defined deficiency

68

The most important form of vitamin A is

Retinol; it is stored in the liver.

Toxicity causes headache, vomiting, papilledema

69

The most active form of vitamin D is

1,25(OH)2 D

It stimulates intestial absorption of calcium and phosphorus and collaborates with PTH in the mobilization of calcium from the bone.

70

Rickets presentations:

Frontal bossing, square appearance to the head

Rachitic rosary

Pigeon breast deformity
Harrison's groove
Lymbar lordosis/bowing of the legs.

71

Osteomalacia presentations:

Affects the vertebral bodies and femoral necks

72

Deficiencies of vitamin K cause

Fat malabsorption

Small liver in neonates

Diffuse liver disease

73

Cause of thiamine deficiences are

Chronic alcoholism, pernicious vomiting

It presents as: polyneuropathy, cardiovascular syndrome, wernicke and korsakoff syndromes

74

Deficiency of vitamin B 6 can occur with the use of

Isoniazid, estrogens and penicillamine

75

Presentations of vitamin C deficiency

Hemorrhages

Skeletal changes

Gingival sweeling, hemorrhages, periodontal infection

76

Vitamin B 12 occurs in

Atrophic gastritis, vegetarianism and bacterial overgrowth.

Presentations of deficiency include megaloblastic anemia and myelin degeneration.

77

Iron deficiency presents as

Hypochromic microcytic anemia

78

Iodine deficiency presents as

Goiter and hypothyroidism

79

Manganese deficiency presents as

Hypocalcemia

80

Fluoride deficiency presents as

Dental caries

81

Associated disease risk is associated with BMIs of

Underweight <18.5

Overweight 25 - 29.9

82

Central or visceral obesity in which fat accumulates in the trunk and in the abdominal cavity are at much __ risk than excess fat in subcutaneous tissue

Higher risk