Etiology - Environmental Pathology (I)

Question 1

What are environmental diseases?

Answer 1

Conditions caused by exposure to chemical and physical agents (includes diseases of nutritional origin)

Question 1

Expected human health effects of climate change

Answer 1

Gastroenteritis
Cardiovascular, cerebrovascular and respiratory diseases
Vector-borne infectious diseases
Malnutrition

Question 2

What can be poison?

Answer 2

Any agent of chemical and biological nature can have toxic effects dependant on level of exposure (dosage) and exposure time

Question 3

What are drug and xenobiotics metabolised from?

Answer 3

“inactive” water-soluble products (detoxification)

Question 4

Is the sensitivity towards chlorpyrifos the same in everyone?

Answer 4

No it varys from person to person due to variable activity of CYPs

Question 5

3 inhibitors if CYP activity

Answer 5

Starvation
Fasting
Malnutrition

Question 6

4 inducers of CYP activity

Answer 6

Drugs
Smoking
alcohol
Hormones

Question 7

3 sources of outdoor air pollution

Answer 7

Industrial activity
Heating system
Motor vehicles

Question 8

2 types of pollutants according to concentration

Answer 8

Micropollutants
Macropollutants

Question 9

2 types of pollutants according to origin

Answer 9

Primary
Secondary

Question 10

What is TSD?

Answer 10

Total suspended dust

Question 11

What is SD?

Answer 11

Suspended dust

Question 12

What is PM?

Answer 12

Particulate matter

Question 13

What is particulate matter?

Answer 13

Part of total suspended dust

Question 14

What size of particles stops the upper respiratory tract?

Answer 14

Diameter greater then 10micrometer

Question 15

What can a particle with a diameter smaller than 10micrometer reach?

Answer 15

Treachea
bronchi
Pulmonary alveoli

Question 16

Health risks of pollution (4)

Answer 16

Pregnancy, foetuses and birth effects
Cardiovascular disease
Respiratory disease
Cognitive hazards

Question 17

Personal habits that could cause disease (3)

Answer 17

Tobacco use
Alcohol ingestion
Recreational drug consumption

Question 18

How much is survival reduced at 75 years when smoking?

Answer 18

25%

Question 19

How do you calculate the survival rate based on smoking?

Answer 19

Number of packs per day * number of years

Question 20

What does nicotine bind to?

Answer 20

Nicotinic acetylcholine receptors

Question 21

What acute effects does nicotine binding to nicotinic acetylcholine receptors have?

Answer 21

Increase heart rate
Increase blood pressure
Elevation of cardiac contractility and output

Question 22

What does nicotine stimulate when binding to the nicotinic acetylcholine receptors?

Answer 22

Catecholamines

Question 23

What are the chronic effects of nicotine?

Answer 23

Fetal brain development
Preterm birth and stillbirth
Cancer

Question 24

What is polycyclic hydrocarbons and nitrosamines directly involved with?

Answer 24

Development of lung cancer

Question 25

What is polycyclic hydrocarbons and nitrosamines activated by?

Answer 25

Cytochromes P-450

Question 26

How does combination of smoking and alcohol affect the risk of developing oral and laryngeal cancers?

Answer 26

Increases the risk

Question 27

Kinds of cancer smoking is associated with (8)

Answer 27

Esophagus Pancreas Bladder Kidney Cervix Bone marrow Liver Colon

Question 28

How does smoking effect the tracheobronchial mucosa?

Answer 28

Irritant effect

Question 29

Smoking increases the risk of (5)

Answer 29

Type 2 diabetes Rheumatoid arthritis Age-related macular degeneration Ectopic pregnancy Erectile dysfunction

Question 30

What is alcohol abuse disorder (AUD)?

Answer 30

Chronic relapsing brain disease characterised by an impaired ability to stop or control alcohol use

Question 31

What is the legal alcohol level?

Answer 31

80mg/dL (0.008%)

Question 32

What is ethanols effect on CNS?

Answer 32

Its a CNS depressor

Question 33

Where is alcohol mainly metabolised?

Answer 33

In the liver

Question 34

Most important toxic derived from alcohol metabolism

Answer 34

Acetaldehyde

Question 35

Which effects of alcohol is acetaldehyde responsible for?

Answer 35

Acute effects

Question 36

Chronic effects of the liver (4)

Answer 36

Lipid accumulation Inflamation Fibrosis Carciogenises

Question 37

What does lipid accumulation caused by alcohol cause?

Answer 37

Alcohol fatty liver

Question 38

What does inflammation caused by alcohol cause?

Answer 38

Alcoholic steatohepatitis

Question 39

What does fibrosis cause my alcohol cause?

Answer 39

Alcoholic fibrosis/cirrhosis

Question 40

What does carcinogenisis cause my alcohol cause?

Answer 40

Hepatocellular carcinoma

Question 41

What does alcohol oxidation require a lot of?

Answer 41

NAD+

Question 42

What does the increase in the NADH/NAD ratio in alcoholics cause?

Answer 42

Lactic acidosis

Question 43

What are some toxic effects which are a result of ethanol metabolism?

Answer 43

Alcohol oxidation ROS generation Acute alcoholism Chronic alcoholism

Question 44

Which 2 anticoagulant drugs cause adverse reactions most frequently?

Answer 44

Warfarin Dabigatran

Question 45

What does Warren block?

Answer 45

Vitamin K reductase

Question 46

Is warfarin selective?

Answer 46

No it affect all vitamin dependant factors in coagulation

Question 47

Risks of using menopausal hormone therapy

Answer 47

Breast cancer Stroke Venous thromboembolism (VTE) (After 5 years of treatment)

Question 48

What does the risks of using menopausal hormone therapy depend on?

Answer 48

Type hormonal therapy used Age of patient when treatment was started Duration of treatment Hormone dosage, formulation and route of administration

Question 49

What are some benefits of menopausal hormone therapy?

Answer 49

Protects against the development of atherosclerosis and coronary disease in women younger than 60 years

Question 50

What does oral contraceptives increase the risk of?

Answer 50

Onset of pathologic conditions Cervical cancer 8in women infected with human papilloma virus) Thromboembolism (real risk is controversial) Cardiovascular disease in smokers Hepatic adenoma

Question 51

Does oral contraceptives increase the risk of breast carcinoma?

Answer 51

No

Question 52

What are some risk of acetaminophen (paracetamol)?

Answer 52

Liver failure Mortality Only with very large usage

Question 53

Negative effects of Asprin

Answer 53

CNS change s(impaired hearing, mental confusion, drowsiness) Nausea VOmiting Diarrhea Erosive gastritis (gastrointestinal bleeding and ulceration) Bleeding

Question 54

What does cocaine block?

Answer 54

The dopamine transporters

Question 55

Why is euphoria experienced when on coke?

Answer 55

Enhancement of brain dopamine activity

Question 56

What is cardiovascular effects of cocaine use caused by?

Answer 56

Blockade of uptake of epinephrine and norepinephrine at adrenergic nerve ending which causes accumulation of neurotransmitters in synapse

Question 57

Cardiovascular effects of cocaine (6)

Answer 57

Tachycardia Hypertension Peripheral vasoconstriction Coronary artery vasorestriction Platelet aggregation Myocardial ischemia

Question 58

Positive feelings associated with use of cocaine (6)

Answer 58

Increased alertness Well being Euphoria Increased energy and motor activity Increased feelings of competence Increased sexuality

Question 59

What kind of drug is heroin?

Answer 59

Opioid

Question 60

Effects of heroin on the CNS

Answer 60

Euphoria Hallucinations Somnolence Sedation Rapid addiction

Question 61

What is heroin derived from?

Answer 61

Morphine (poppy plant)

Question 62

Most important adverse effect of heroin

Answer 62

Sudden death

Question 63

Pulmonary injury caused by heroin

Answer 63

Edema Septic embolism from endocarditis Lung abscess Opportunistic infections Foreign body granulomas

Question 64

Where does heroine often cause infection?

Answer 64

Skin Heart valves Liver Lungs

Question 65

What is the nost common infection spread by heroin?

Answer 65

HIV

Question 66

Effects of heroin on kidneys

Answer 66

Amyloidosis Glomerulosclerosis Proteinuria Nephrotic syndrome

Question 67

How does methamphetamine work?

Answer 67

Releases dopamine in the brain which inhibits presynaptic neurotransmission at corticostriatal synapses altering glutamatergic transmission

Question 68

Effects of marijuana

Answer 68

Euphoria Sense of relaxation Lower nausea Decrease pain

Question 69

3 Major environmental determinants

Answer 69

Air pollutants Food and water (toxic agents) Occupational exposure

Question 70

What are xenobiotics?

Answer 70

All molecules that can be acquired by the environment

Question 71

What happens when a reactive metabolite formed from a xenobiotic interacts with cellular molecules (DNA, enzymes, receptors, so on)?

Answer 71

Cellular damage (which can either be repaired or lead to toxicity

Question 72

What is the catalyst of the phase 1 of reactions in xenobiotic detoxification and activation?

Answer 72

Cytochrome P-450 enzyme system