Environmental Pollution 2 Flashcards
(22 cards)
GUNSHOT WOUND – MECHANICAL INJURY
Contact gun wound over skull or areas of skin close to bone
usually stellate - due to gases from gun undermining skin
Contact wounds may have burning around margin
Close range wounds (20 inches or less) have unburned powder particles and soot
= tattooing/stippling**
Abrasion
Contusion
Laceration
Incised Wound
Puncture Wound
Scratch
Bruise (Leakage of tissue under the skin)
Tear of the skin (There is regular edge) tissue bridging
No tissue strand blood coming out the edge is clean and sharp straight line borders
ELECTRICAL INJURY
all depend on strength (amp), duration and path of current Death from – cardiac arrhythmias **, respiratory or cardiac arrest
** Ventricular fibrillation
DETERMINANTS OF BIOLOGIC EFFECTS OF RADIATION
Hematopoietic cells • GI tract epithelium
Note:
Radiation changes in cells =
Cellular pleomorphism, giant-cell transformation, nuclei changes with abnormal mitoses
= same types of changes seen in cancer cells
Gunshot
Close range: Stipples around the wound
Distance range: Abrasion collar no gunpowder stipples
Contact: There is a stellate coz it pieced the skin and exit wound will be clean
Strangulation
Asphyxia
Homicide assault
Petechial hemorrhage
Arrythmia as they are struggling
Thermal Injury
Burn injury*** Excessive heat
Ist degree: epidermis burn
2nd degree: Dermis
A) Partial papillary dermis
B) Full Reticular dermis
3rd degree: subcutaneous
4th degree: muscle tissue under the subcutaneous tissue
Fire Death
Soot in the Airway (Smoke inhalation)
If the person has no soot in the fire burn he died early before it started
Complication if Thermal Injury
Shift of plasma into interstitial space at burn site- Hypovolemic shock, Hypoproteinemia general edema
Inhalation of heated air and toxic materials - Airway injury diffuse alveolar damage (ARDS)
Loss of skin amd mucosal barriers - infection and sepsis
Hypovolemic and septic shock - Acute renal tubular necrosis
Heat Cramps
Heat exhaustion
Heat Stroke
Loss of electrolytes no loss of conciousness
Dehydration (no loss of conciousness) less than 40 centigrade and 104 farenheit
Shock
Prevent heat exhaustion with only water and heat cramp with water and suppliment and electrolytes
PHYSICAL CONSEQUENCES OF RADIATION
Early and large impact due to constant cell production/turnover ***
High effect on the liver cells
Damages the DNA
Malignant Hyperthermia
Hypothermia
Ryanodine Receptor type 1
Nitrosylation of ryanodine receptor type 1
Muscle is contracting**
Crystallization of Intracellular and Extracellular water with physical disruptions of the cells by high salt concentration
Circulatory failure - Trench foot, immersion foot
ALCOHOL and Variants
Metabolism of ethanol in liver leads to…
Reactive oxygen species
Lipid peroxidation of cell membranes
Alcoholic liver disease
ALDH21 is normal allele • ALDH22 allele cannot metabolize toxic acetaldehyde
ACUTE ALCOHOLISM and
CHRONIC ALCOHOLISM
High levels = ** respiratory depression ** cause of death
** Increased risk of acute/chronic pancreatitis **
Thiamine (vitamin B1) deficiency
• Peripheral neuropathy • Wernicke-Korsakoff Syndrome = “alcoholic encephalopathy”
Hemorrhage and necrosis of mamillary bodies
- Wernicke Encephalopathy: Sudden onset psychosis - Korsakoff Syndrome: ** Memory disturbances and confabulation * - Cerebral atrophy, cerebellar degeneration, and optic neuropathy
Delirium tremens (DTs): Severe ethanol withdrawal
• 3-10 days after last drink • Global confusion • Sympathetic overdrive (autonomic hyperactivity)
FETAL ALCOHOL SYNDROME
Growth retardation – Microcephaly – Abnormal face
• Smooth philtrum (probably easiest thing to notice)
• Short palpebral fissures (small eye opening)
• Thin upper lip
• Maxillary hypoplasia – Decreased mental function as child grows
“Dysmorphic Facial Features”
ACETAMINOPHEN OVERDOSE
In overdose NAPQI** accumulates and 1.Depletes glutathione (GSH)
jaundice in few days
Treat within 12 hours with N-acetylcysteine to restore glutathione (GSH)
ACETAMINOPHEN LIVER TOXICITY HEPATOCELLULAR AND CENTRILOBULAR NECROSIS***
ASPIRIN (ASA) – SALICYLATES ACUTE OVERDOSE
• Respiratory alkalosis followed by metabolic acidosis (lactate and pyruvate)
- fatal before anatomic changes occur
- Initial respiratory alkalosis: ** Respiratory center stimulation ** Mechanism : Dysfunctional Krebs cycle
*** Dysfunctional oxidative phosphorylation **
ACETYLSALICYLIC ACID (ASA)
Analgesic nephropathy: Kidney injury from use of over-the-counter pain medicines in combination (ASA, acetaminophen, ibuprofen, naproxen)
– Tubulointerstitial nephritis
– Renal papillary necrosis
COCAINE SIGNS
Tachycardia
– Vasoconstriction (coronary arteries) + Impair blood flow to placenta
– Hypertension
– MI
– Arrhythmias
– Dilated Cardiomyopathy
– Increased platelet aggregation and thrombus formation
Hyperpyrexia – increased body temperature
– Seizures
– Mydriasis (dilated pupils)
– Euphoria and paranoia
*** Perforated nasal septum with saddle nose from inhalation Note: Cocaine with alcohol 18x-25x higher risk of cardiac complications
OPIATES
μ-opioid receptor (Mu opioid receptor)
METHAMPHETAMINE (“MET”, “SPEED”)
Serotonin receptors (toxic)
Releases dopamine, norepinephrine and serotonin and inhibits reuptake
MARIJUANA
Molecular target: CB1 and CB2 cannabinoid receptors
