Exam 2 - Environmental Diseases

Question 1

What are environmental diseases?

Answer 1

injuries or disorders caused by chemical or physical agents

Question 2

What is occupational medicine?

Answer 2

field focusing on workplace related injuries from chemical or physical agents

Question 3

How much more do work related injuries occur than home injuries?

Answer 3

2 times more

Question 4

What US agencies are involved in regulating environmental hazards?

Answer 4

Environmental Protection Agency
Food and Drug Administration
Occupational and Safety Health Administration
Consumer Products Safety Commission

Question 5

What are the categories of environmental diseases?

Answer 5

air pollution
industrial exposures
tobacco smoke
chemical agents
physical agents
electrical injury
radiation injury
nutritional diseases

Question 6

What subsections of chemical agents that cause environmental disease are there?

Answer 6

general
therapeutic
nontherapeutic

Question 7

How do general chemical injuries occur?

Answer 7

inhalation, ingestion, injection or absorption through the skin

Question 8

What percentage of chemical exposures are oral intake?

Answer 8

73%

Question 9

What percentage of chemical exposures are in children less than 6 yrs old?

Answer 9

61%

Question 10

What are the most common household chemical agents?

Answer 10

cleaning agents
analgesics (pain reliever)
cosmetics
plants or cold preparations

Question 11

What factors affect chemical injuries?

Answer 11

Concentration
Liberation
Absorption
Distribution
Metabolism
Excretion

“CLADME”

Question 12

True or False:

2% of chemical injuries are adverse events

Answer 12

True

Question 13

What percentage of therapeutic agent injuries are adverse drug reactions?

Answer 13

7-8% are ADRs

10% of these are fatal

Question 14

When does anaphylaxis occur?

Answer 14

with any medication, but often associated with antibiotics (PCN)

Question 15

True or False:

The more potent a drug, the less likely it will cause an adverse reaction.

Answer 15

False: the more potent a drug the more likely an ADR.

Question 16

What are other examples of ADRs?

Answer 16

anti-cancer drugs
aspirin
acetaminophen
Exogenous Estrogens & Oral Contraceptives (OCP)

Question 17

What is the fatal amount of aspirin when ingested?

Answer 17

2-4 grams (kids)

10-30 grams (adults)

Question 18

What is the mechanism for aspirin injury?

Answer 18

respiratory alkalosis (acute)
metabolic acidosis (acute)
Chronic ingestion: headaches, dizziness, ringing ears, drowsiness, mental status changes, gastritis, GI bleeding, nausea, vomiting 
Can lead to seizures and coma

Question 19

How much acetaminophen is ingested for overdose?

Answer 19

15-20 grams

Question 20

How quickly can liver toxicity occur from an acetaminophen overdose?

Answer 20

several hours to days

Question 21

What are symptoms of acetaminophen overdose?

Answer 21

Early: nonspecific, nausea, vomiting, diarrhea
Later: jaundice, shock (liver failure process)
heart, kidney damage

Question 22

What are the risks of long term HRT (hormone replacement therapy), like estrogen?

Answer 22

increased risk of breast cancer
strokes
blood clots

Question 23

Why are exogenous estrogens and oral contraceptives used?

Answer 23

postmenopausal syndrome
osteoporosis
contraceptive

Question 24

With such a risk in long term use of exogenous estrogens, why would you continue to use it?

Answer 24

short term therapy outweighs the risk

Question 25

What are risks of using oral contraceptives?

Answer 25

``` blood clots hypertension hepatic adenoma (benign liver tumor) cholecystitis increase risk of breast cancer ```

Question 26

What are the benefits of oral contraceptives?

Answer 26

contraception protective effect for endometrial ovarian cancer protection

Question 27

Examples of nontherapeutic agents

Answer 27

``` lead carbon monoxide cleaning agents cyanide ethylene glycol organophosphates (pesticides) mercury, plants (mushrooms) petroleum and PCBs ```

Question 28

Where is lead found?

Answer 28

``` urban air soil water food house dust gasoline batteries old paints ```

Question 29

Why is lead so poisonous to the body?

Answer 29

it has a high affinity for enzymes involved in hemoglobin synthesis. blocks iron it also competes with calcium in teeth and in bone remodeling effects neurological abilities

Question 30

What do patients develop if they have lead poisoning and it affects the hemoglobin synthesis?

Answer 30

microcytic hypochromic anemia

Question 31

What happens when lead toxicity occurs in the CNS?

Answer 31

mild sensory, motor, cognitive and psychologic deficits reduced IQ learning disabilities peripheral neuropathies

Question 32

What occurs intraorally if a patient has lead poisoning?

Answer 32

gingival hyperpigmentation (kids)

Question 33

If you are looking at an x-ray of the arm, how would you be able to tell if a patient had lead poisoning?

Answer 33

Lead lines. bone becomes hyperdense

Question 34

What does lead poisoning look like in the GI tract?

Answer 34

severe, colicky pain

Question 35

Name 2 diseases that can occur with the renal system if lead poisoning occurs.

Answer 35

interstitial fibrosis renal failure (Lead is toxic to the renal tubules)

Question 36

Who is responsible for monitoring lead exposures?

Answer 36

It is a public health responsibility

Question 37

What is the maximum blood level of lead?

Answer 37

5 ug/dL

Question 38

How do you treat lead poisoning?

Answer 38

chelation therapy (45 ug/dL) and other supportive measures

Question 39

What are the 7 classes of drug abuse?

Answer 39

``` sedative hypnotics CNS stimulants opioids cannabinoids hallucinogens inhalants nonprescription drugs ```

Question 40

Describe sedative hypnotics

Answer 40

alcohol, barbiturates, benzodiazepines

Question 41

Describe/name CNS stimulants.

Answer 41

cocaine, amphetamines, weight loss products

Question 42

Describe/name opioids.

Answer 42

heroin, morphine, methadone, codeine, fentanyl

Question 43

Name cannabinoids

Answer 43

marijuana

Question 44

Name/describe hallucinogens.

Answer 44

LSD, mescaline, phencyclidine (PCP), ketamine

Question 45

Describe some inhalants

Answer 45

glues, toluene, paint thinner, gasoline, amyl nitrate, nitrous oxide

Question 46

Describe nonprescription drugs of abuse.

Answer 46

atropine, scopolamine, antihistamines, weak analgesics.

Question 47

When did cocaine arise and what was it used for?

Answer 47

19th century | used to cure everything from exhaustion to depression

Question 48

What are club drugs?

Answer 48

substances that have become popular in dance clubs, bars, raves, trances.

Question 49

What is considered a club drug?

Answer 49

anything: methamphetamines (MDMA/ecstacy), hallucinogens, CNS depressants, benzodiazepeines

Question 50

What is a side effect of MDMAs (ecstacy)?

Answer 50

bruxism

Question 51

What are some environmental physical agents?

Answer 51

mechanical injury thermal injury radiation injury nutritional diseases

Question 52

What are the different mechanical injuries one can have?

Answer 52

abrasion contusion laceration

Question 53

Define abrasion.

Answer 53

wound produced by scraping/rubbing | removal of superficial skin layer

Question 54

Define contusion

Answer 54

bruise; caused by blunted object.

Question 55

Describe laceration

Answer 55

tear in tissue | usually irregular edges

Question 56

What is normal temperature for the body to operate?

Answer 56

89-106 degrees F | 31-41 degrees C

Question 57

What is hyperthermia?

Answer 57

high body temp/burns | 5000 deaths/yr in US

Question 58

What is hypothermia?

Answer 58

prolonged exposure to low temps, body temp drops

Question 59

What factors affect clinical significance of burns?

Answer 59

1. percentage of total body surface involved 2. depth of the burn 3. possible internal injuries from inhalation of hot gases and fumes 4. the age of the pt 5. how fast & well it is treated.

Question 60

What percentage of the body is involved in burns to be considered often fatal?

Answer 60

50%

Question 61

When does shock occur when someone has burns?

Answer 61

20% or more of the body is burned

Question 62

What occurs when a person goes into shock from burns?

Answer 62

1. massive fluid shift causing hypovolemic shock 2. sepsis/infections like Pseudomonas spp., Candida 3. electrolyte/nutritional imbalances