Exam 1; Environmental Pathology Flashcards Preview

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Flashcards in Exam 1; Environmental Pathology Deck (66):
1

What are the factors that affect chemical injuries

CLADME
Concentration
Liberation
absorption
distribution
metabolism
excretion

2

True or False
Adverse drug reactions are common

True (2%)

3

An overdose of this may be accidental in kids or even intentional in adults

aspirin

4

An overdose of this may cause liver damage

acetaminophen

5

85% of this compound found in the air, soil, water, etc. is taken up by bones and developing teeth; it competes with Ca and interferes with the remodeling process

lead

6

What can be seen on the x-ray on something exposed to lead

lead lines (hyperdensity/hyperpigmentation)

7

Lead blocks or hinder the incorporation of this into hemoglobin

iron

8

Since lead blocks iron incorporation into hemoglobin, what can develop

anemia
neurologic disturbances
"wrist drop and foot drop" - peripheral neuropathies

9

What kind of problems can lead cause with the GI tract

colicky pain - severe, not localized

10

What kind of problems can lead cause wit the kidneys

damages tubules, fibrosis, even renal failure

11

What are the CDC guidelines of the lead threshold in blood

level of concern ≥5µg/dL

12

Chelation therapy of lead is initiated when

blood levels of lead are ≥45µg/dL

13

What is the range of temperature the body operates at

89-106℉ (31-41℃)

14

What is the rule regarding burns

rule of 9's; % body surface area

15

What is the rule of 9's

head and neck - 9%
trunk front and back each - 18%
arms - 9% (hands 1%)
legs each - 18%
perineum - 1%

16

What are four important factors regarding burns on a patient

depth of the burn (full or partial thickness)
potential for internal injuries from inhalation of fumes or hot gasses
age of the patient
speed and quality of treatment

17

What percentage of BSA burned leads to a grave prognosis

>50%

18

Shock is common when what percentage of BSA is burned

>30-40%

19

When BSA burned reaches shock levels, what three things can occur

massive fluid shift causing hypovolemic shock
sepsis/infections
other problems like electrolyte and nutritional imbalance

20

Internal thermal injuries like inhalation can cause what two things to occur

damages to the URT and LRT
acute respiratory distress syndrome (ARDS)

21

What are three variances of hyperthermia

heat cramps
heat exhaustion
heat stroke

22

What occurs during a heat stroke

elevation of body temperature above 40℃ causes regulatory mechanisms to fail; perisperhal vasodilation results in pooling and decrease blood volume leading to ischemic and necrosing tissues - DIC

23

What occurs during hypothermia

bradycardia
atrial fibrillation
loss of consciousness
cell damage due to crystallization of water

24

What are the two forms of radiation injuries

electromagnetic waves; x and gamma rays
high energy neutrons and charged particles; alpha and beta particles and protons

25

Radiation interacts with atoms and molecules by what

excitation and ionization

26

In which ways does radiation interact with biological systems

directly on DNA; causing mutations
indirectly causing the production of free radicals

27

What can be the result of radiation injury to the cell

may be reversible, induce apoptosis or mitotic arrest
nuclear abnormalities or DNA strand breaks
cytoplasm is affected via swelling, membrane changes, and mito/ER changes

28

What is the level of radiation that occupational exposures should not exceed

20mSv/year
a single oral find has 0.005mSv

29

What happens over time to the skin exposed to radiation damage

erythema at 2-3 days
edema at 2-3 weeks
blistering/desquamification at 4-6 weeks
atrophy/fibrosis/neoplasia at months/years/decades

30

How does radiation affect the lymphocytes

decreases levels over hours, but they rebound in weeks/months

31

How does radiation affect the lymph nodes and spleen

shrinks in size

32

How does radiation affect the PMNs

decrease in levels over 1-2 weeks, but levels rebound in 2-3 months
patients are susceptible to infection at this time!

33

These cellular components also decrease due to radiation, and take a longer time to rebound

erythrocytes and platelets

34

How does radiation affect the gonads

both sexes are sensitive to radiation - sterility

35

How does radiation affect the lungs

sensitive due to the rich vascularity; pulmonary congestion and edema; ARDS

36

How does radiation affect the GI tract

very sensitive; ulcers, strictures (narrowing) and later possible carcinomas

37

How does radiation affect the blood vessels

endothelial cell injury then fibrosis and narrowing

38

What is the lethal range of radiation

2Sv, at 7Sv, death is certain without medical care

39

What are the fatal acute radiation syndromes and level os Svs

hematopoietic; 2-10Sv
gastrointestional; 10-20 Sv
cerebral; >50Sv

40

What occurs during the hematopoietic radiation syndrome

decrease WBCs
hair loss
infections
sepsis and bleeding
death 2-6 weeks

41

What occurs during the gastrointestinal radiation syndrome

vomiting
bloody diarrhea
shock
sepsis
death 5-14 days

42

What occurs during the cerebral radiation syndrome

listlessness
drowsiness
seizures
coma
death 1-4 hours

43

What is the difference between primary and secondary malnutrition

primary - diet is deficient
secondary - diet is fine, there is a problem with absorption, etc.

44

This protein compartment is found in the skeletal muscle and you can assess the loss of this compartment by measuring skin fold thickness

somatic protein compartment

45

This protein compartment is mainly found in the liver and you can assess this compartment by measuring serum proteins

visceral protein compartment

46

In this disorder, there is a deficiency of caloric intake

marasmus

47

What does marasmus cause in the body

growth retardation
loss of muscle mass
the body catabolized proteins as a source of energy, depleting the somatic compartment
extremities appear emaciated
head looks too large

48

What are some manifestations of marasmus in the body

anemia
vitamin deficiencies
immune deficiency, especially T cells - infections are coming (thrush)
bradycardia
low body temperature

49

In this disorder, there is a greater deficiency of protein that total calories; common form of PEM found in africa

kwashiorkor

50

What does kwashiorkor cause in the body

depletion of the visceral protein compartment leading to a loss of vascular oncotic pressure (and low serum proteins) leading to fluid retention and edema

51

What are some manifestations of kwashiorkor

skin changes; hyper pigmentation, desquamation, hypo pigmentation
hair changes
fatty liver
vitamine and immune deficiencies

52

Which is worse, marasmus or kwashiorkor

kwashiorkor

53

Why may it be difficult to diagnose kwashiorkor

the weight is between 60-80% of normal, but is misleading due to the edema

54

This is a form of PEM found in cancer patients, most likely due to loss of appetite and increase catabolism (cytokine mediated)

cachexia

55

What are the three biologically active forms in vitamin A

retinol
retinal
retinoic acid

56

Where is over 90% of vitamin A stored

in the liver

57

What are the three functions of vitamin A

maintain normal vision in reduced light
augments differentiation of specialized epithelial cells (mucus secreting)
enhance immunity to infections

58

True or False
Vitamin A deficiency is common worldwide

True

59

What are the ocular changes of a vitamin A deficiency

impaired night vision (early)
dry eyes leading to corneal damage
total blindness

60

What are the non-ocular changes associated with a vitamin A deficiency

squamous metaplasia of the respiratory and urinary tracts; increase infections and stones
impaired immunity - measles, pneumonia, infectious diarrhea

61

What are some symptoms of vitamin toxicity

nausea and vomitting
blurred vision
hair loss
dry skin

62

What results from a vitamin C deficiency

scurvy; found in the elderly, alcoholics, pirates, dialysis patients

63

What is the function of vitamin C

formation and stabilization of collagen
conversion of tyrosine to catecholamines
role as an antioxidant

64

Scurvy is a disease of what

impaired collagen synthesis; the weakened collagen cannot support capillaries or venues therefore causing hemorrhage (especially in the skin and gingival mucosa)
poor wound healing

65

What symptoms are common with scurvy

gingival bleeding
swelling
periodontal infections

66

What are some symptoms of vitamin C toxicity

enhancement of iron absorption
acidic urine - stone formation
rebound scurvy if suddenly stop taking large amounts