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Environmental Medicine > Final > Flashcards

Final Flashcards

1
Q

What does VOC stand for?

A

Volatile organic compound

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2
Q

How can we be exposed to VOC’s

A

Ingestion, inhalation, dermal

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3
Q

What are the main systems affected by VOC’s

A

Heme, nervous, immune

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4
Q

Benzene too can cause what path?

A

Leukemia

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5
Q

Component of teflon?

A

PTFE

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6
Q

What is the water soluble toxic substance the prevents access to lower rest tracts?

A

Formaldehyde

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7
Q

This VOC is 25x more reactive than benzene and is a huffing agent

A

Toluene

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8
Q

VOC in dry cleaning

A

Tetrachloroethylene - PERC

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9
Q

VOC is the precursor to medication and in oral anesthetics like carmen and chloraseptic

A

Phenol

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10
Q

MC VOC that is potentially hazardous to people working in hist labs

A

Xylene

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11
Q

Source of new car smell

A

Vinyl chloride and PVC

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12
Q

Main ingredient in mothballs

A

Napthalene

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13
Q

Major component of tar from charred/grilled foods

A

Benzo a pyrene

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14
Q

PAH

A

Polyvinyl aromatic hydrocarbon

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15
Q

MC concern that can develop from asbestos?

A

Mesothelioma

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16
Q

Safest plastics

A

2 and 4

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17
Q

Used in plasticizers and are concerning due to leeching abilities

A

Phthalate

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18
Q

Substance in packaging material and metal can coating

A

BPA

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19
Q

Species of black mold

A

Staphybotrys chartarum

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20
Q

Major severe health effects of vinyl chloride exposure from off-gassing/leaching

A

Hepatic angiosarcoma

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21
Q

6 criteria of pollutants

A 
Ground level ozone
Particulate matter
CO
NO
Sulf diox
Pb
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22
Q

Xenobiotic

A

Substance thats foreign to the body

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23
Q

3 routes of excretion

A

urine, bile, breath

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24
Q

3 routes of absorption

A

Ingestion, inhalation, derm

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25
Q

Predominant CYP in liver

A

3A4

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26
Q

Fasting and biotransformation

A

Not a good idea because it requires energy that has to be spared in fasting state at the expense of gluconeogensis

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27
Q

Limits set by EPA about pesticides in food

A

MRL - max residue limit

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28
Q

Heavy metal is common in organic form in shellfish and test in weak immune system people

A

Arsenic

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29
Q

2 pollutant that combine to form ground level ozone

A

NO and VOC

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30
Q

Cause of acid rain

A

Self dioxin and NO

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31
Q

Immune response assoc with eosinophils and atopy

A

Th2

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32
Q

Many toxic exposures can cause hypersen, AI, or suppression of immune function

A

True

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33
Q

2 metal exposures that can lead to inability to kill candida

A

Hg

Pb

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34
Q

Primary component of smog

A

Ground level ozone

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35
Q

Main health effect of CO poisoning

A

RBC pick up CO slower than O2 which cause tissue necrosis and cell death

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36
Q

Particulate matter size is most concerning because of ability to penetrate organs

A

0.1 microns

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37
Q

Form of Hg that accumulates in fish and is concerning in humans

A

Methylmercury

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38
Q

What type of pesticide is DDT

A

organochlorine

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39
Q

Methylglobinemia is a serious result of exposure to what

A

Nitrate fertilizers

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40
Q

Bioaccumulation is define as what

A

Accrual of toxic chemicals in tissues or a particular organism

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41
Q

First female MD in US

A

Elizabeth Blackwell

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42
Q

What is sick building syndrome

A

Sxs of illness when in a building but without specific known cause

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43
Q

What is sick building illness

A

illness from a building with identifiable causes

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44
Q

Main chemical in brazilian blow outs

A

Formaldehyde

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45
Q

Maternal occupation at increased risk for cleft palate in their kids

A

Preschool teachers

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46
Q

Components of natural gas

A

Fossil fuels and hydrocarbons

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47
Q

Health effects of natural gas

A

Hematologic changes with high exposure to hydrogen sulfide

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48
Q

Major SE of natural gas exposure

A

Hematologic changes

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49
Q

Exposure risk for broken fluorescent bulb

A

Hg

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50
Q

Common chemical in fabric softeners

A

Phthalates

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51
Q

Agent added to vaccines to promote immune response

A

Al

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52
Q

OSHA

A

occupational safety and health admin

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53
Q

MSDS

A

material safety data sheet

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54
Q

4th review

A

study reporting human exposure to env chemicals and is updated regularly

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55
Q

Found in forest fires, volcanoes, crude oil, exhaust, and cigs

A

Benzene

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56
Q

Found in paint thinners and added to gasoline and adhesives

A

Toluene

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57
Q

In histology labs, coal, petroleum, wood tar

A

Xylene

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58
Q

Main effect of xylene

A

CNS depression

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59
Q

White, volatile crystalline solid produced from petroleum

A

Phenol

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60
Q

Used in plywood, construction, automative, and appliances. Precursor of plastics

A

Phenol

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61
Q

Adhesive glues and dyes, pressed wood products, carpets, and particle board, wrinkle free clothing

A

Formaldehyde

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62
Q

Health effects of formaldehyde

A

URI and mucus membrane sxs

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63
Q

What is acroosteolysis and what can cause it

A

Dissolution of terminal phalanges and SI joints - caused by PVC and vinyl chloride

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64
Q

Combustion of carbon based fuels and contains multiple benzene rings

A

PAH

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65
Q

2 forms of PAH

A

Low molecular weight with 2-3 rings: naphthalene

High molec weight with 3+ rings:
Benzo a pyrene

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66
Q

From charred, grilled foods, and tar

A

PAH - benzo a pyrene - high molec weight

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67
Q

Most carcinogenic component of tobacco smoke

A

PAH - benzo

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68
Q

1st carcinogen to be discovered

A

Benzo a pyrene

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69
Q

Metabolite found in 2nd and 3rd hand smoke

A

Continine

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70
Q

Found in electrical, heat, sound, brakes, clutch, and tiles

A

Asbestos

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71
Q

3 main health effects of asbestos toxicity

A

Asbestosis
Lung CA
Mesothelioma

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72
Q

Semi safe plastics

A

1, 5

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73
Q

Unsafe plastics

A

3, 6, 7

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74
Q

Is PVC plastic safe?

A

No, made from 3

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75
Q

Is IV tubing and IV bags safe?

A

No, made from PVC –> 3

76
Q

Health risk of PVC

A

Cardio and nervous diseases are increased

77
Q

What are plasticizers

A

Phthalates that leech easily

78
Q

Health effects of phthalates

A

Endocrine disruption

79
Q

Acute exposure sxs of polystyrene

A

Mucous membrane and resp irritation

80
Q

Chronic exposure sxs of polystyrene

A

NV, fatigue, cognitive loss, neural tox, renal and hep path, affect Fe absorp

81
Q

What are BPA’s and how are they used

A

Found in food packaging and metal can coating

82
Q

SE of BPA

A

Endocrine disruptor

Xenoestrogenic

83
Q

What is AQI

A

Air quality index, developed by EPA to indicate pollutant air quality

84
Q

What is the safe size of particulate matter and why

A

PM10 microns or greater because it can’t get into lungs

85
Q

What is the concerning size of particulate matter

A

0.1 micron and less because it can travel through blood and into organs

86
Q

Components of acid rain

A

Sulfur and NO

87
Q

Component of smog

A 
Ground level O3
NO
VOC
Self diox 
Particulate matter
88
Q

How is ground level O3 created

A

Chem rxn between oxides and VOC in presence of sunlight

89
Q

Main cause of acid rain

A

Sulfur dioxide

90
Q

Main cause of haze

A

Particulate matter - PM2.5

91
Q

What form of pesticide is organochlorine

A

organochlorine

92
Q

2 classes of acetylcholinesterases

A

organophosphates

Carbamates

93
Q

What type of acetylcholinesterase was used as a nerve gas in WW2

A

organophosphates - banned in 1970’s

94
Q

How do fertilizers affect our health

A

Contains nitrates that alter Fe in Hb from ferrous state to ferri state
Then forms methemoglobin which can’t carry O2

95
Q

What is LD50

A

Median lethal dose that will cause 50% death in a test group
Lower the LD50 the higher the toxicity

96
Q

What are some common mechanisms of heavy metal tox

A 
enzyme inhib
Disruption of membranes and transport
Disturb mitochondria
decreased neural function
Bind sulfa groups on protein which causes misfolding
97
Q

Where is Pb commonly found

A

Duse, soil, paint

98
Q

Who is at greatest risk of Pb poisoning

A

Kids, preggos

99
Q

Where is Pb MC found in environment

A

Pre 1978 houses

100
Q

What jobs contain Pb

A

Smelting, mining, auto repair, plumbing, military

101
Q

What hobbies contain Pb

A

Painting, stained glass, pottery, shooting

102
Q

What products today still contain Pb

A

Computers, ceramics, pewter, jewelry, auto batteries

103
Q

What are sxs of Pb tox

A

Usu asx
Decreased learning, IQ, impaired speech and hearing, body pains, fatigue, HA, tremor, weight loss, constipation, paralysis, seizures

104
Q

Best test to screen for Pb tox

A

Blood

105
Q

Acceptable levels of Pb for adults and kids

A

Adults: <20 mcg/dl
Kids: <5

106
Q

Imagining for Pb tox

A

And shows Pb based items if swallowed

Long bones show Pb lines

107
Q

3 types of Hg

A

Elemental, organic, inorganic

108
Q

2 types organic Hg

A

Methyl and ethyl

109
Q

Where is methyHg found?

A

Fish from bioaccumulation

110
Q

Where is ethylHg found?

A

Preservatives, vaccines

111
Q

Where is inorganic Hg found

A

Batteries, disinfectants, skin creams

112
Q

Where is elemental Hg found

A

Thermometers, barometers, dental amalgams, smelting, fossil fuels, mining

113
Q

Health risks of Hg exposure

A

Neurotic and teratogenic

114
Q

Difference between bioaccumulation and biomagnification

A

Bioaccumulation - substance builds up

Biomagnification - eating animal that as accumulated substance

115
Q

Where is Cd found

A

battery manufacturing, pigmentation, coating, plastic stabilizers
MOSTLY IN CIG SMOKE INHALATION

116
Q

Where does Cd accumulate

A

Liver and kidneys

117
Q

Health effects of Cd

A

Fe def, kidney damage, lung CA

118
Q

Why is chelation of Cd concerning

A

Because it needs to be excreted and further damage of kidneys is possible

119
Q

Where is As found

A

Medicine, cosmetics, paint pigments, wood preservatives

120
Q

Best test for acute heavy metal exposure

A

Blood

121
Q

Why is hair testing not good

A

Can have falsely high level because hair heavy metals won’t reabsorb into body and because hair is vulnerable

Good for methylHg

122
Q

What is depuration?

A

Process of freeing impurities from body

123
Q

What is detoxification

A

Process of making toxic substances more water soluble

124
Q

What is a xenobiotic

A

Chem compound that is foreign to the body

125
Q

What is nasal fatigue

A

Ability to stay in area that originally irritates the nose but after time isn’t detected

126
Q

3 types of absorption at cellular level

A

Simple diffusion
Passage through pores
Transport systems

127
Q

Major storage sites in the body

A

Adipose, bones, liver, kidneys

128
Q

2 major barriers for within humans

A

Placental, BBB

129
Q

Routes of excretion

A

Urinary, biliary, pulm

130
Q

Endocrine disruptor

A

Chemical that interferes with boys endocrine system causing adverse reactions

131
Q

Xenoestrogen

A

Type of endocrine disrupt that imitates estrogen

132
Q

Phytoestrogen

A

Xenoestrogen from plant

133
Q

What are the problems with research surrounding xenoestrogens

A

Mostly done on animals not humans and half lives differ

134
Q

What pt pop is best for stool testing

A

Kids

135
Q

What in order is the best chelators of Hg

A 
Hg 2+
Ag 2+
CH3Hg+
Cu2+
Pb2+
Zn2+
136
Q

Method of admin for chelation

A

IV

137
Q

Why avoid seafood for 7 days before challenge testing

A

To prevent falsely elevated As or Hg

138
Q

Best method for acetylcholinesterase testing

A

Whole blood and plasma

139
Q

Theory behind hydrotherapy for Tx of heavy metals

A

Increases bile dumping for excretion

140
Q

Why is low temp sauna beneficial for detoc

A

Increases lipolysis and can increase excretion of heavy metals stored in adipose tissue

141
Q

Supplements increase glutathione

A

NAC

142
Q

MC supportive supp for heavy metal exposure and dosages

A

Vit C: 6-12g/day
Fiber
Se: 2 mcg/day
Zn: 30mg BID-TID

143
Q

Diagnostic criteria for MCS

A
  1. sxs reproducible with repeat exposure
  2. condition has persisted for sig period of time
  3. low levels of exposure result in manifestations of syndrome
  4. sxs improve when triggering chemicals are removed
  5. responses often occur to multiple chemically unrelated substances
  6. sxs involve multiple organ systems
144
Q

Abused as an inhalent

A

Toluene

145
Q

Can penetrate the most clothing

A

Xylene

146
Q

Major sources of air pollution

A

power plants, refineries, transpo

147
Q

Found in pipes, insulation, siding, and shower curtains

A

PVC

148
Q

What is HCA

A

Heterocyclic amines from grilling foods

149
Q

Some prevention strategies to protect against PAH

A

Stop smoking and limit grilled meats, brassica, antiox, marinade in acidic bases

150
Q

What plastic number is transvaginal mesh and diapers

A

Polypropylene 5

151
Q

Minor sources of air pollution

A

Nail salons, dry cleaners, auto shops

152
Q

What are CFC’s and their common use

A

Chlorofluorocarbons and found in refrigerations, solvents, and foam blowing agents

153
Q

What does it mean when soil pesticides bioaccumulate

A

1 organism and refer to assume of the toxic chem in tissue of particular organism

154
Q

What does it mean when soil pesticides biomagnify

A

Whole food chain and the look at its effects at increase concern of toxic chem the jogger and animal is on the food chain

155
Q

What soil pesticide was removed dt biomaginifcation effects

A

Organochlorine pesticide (DDT)

156
Q

What are 2 classes of AchE inhibitors in soul

A

Organophosphates (more toxic) and carbamates

157
Q

Soil AchE inhibitors resulted in what

A

Excessively high Ach levels

158
Q

How does Hg get through BBB

A

Not fat soluble this transported into brain by building to sulfhydryl group on AA cystein

159
Q

Why is NAC use controversial in detox

A

Cysteine increase means more can get through BBB because methylHg binds to it to pass through BBB

160
Q

Pb poisoning results on blood

A

Microcytic hypochromic anemia with basophilic stippling

161
Q

Ref range for blood Hg

A

Whole blood <5ug/L

162
Q

What has increased absorption when there is Fe def

A

Cd

163
Q

How does Cd contribute to osteomalacia and osteoporosis

A

Increased urinary excretion of Ca and P and decreased hydroxylation of Vit D metabolites

164
Q

Where is As best absorbed in the body

A

GI tract - SI

165
Q

What is the main ida of biotransformation

A

Conversion of lipid soluble xenobiotic into polar water soluble for excretion

166
Q

Are heavy metals inducers or inhibitors

A

inhibitor

167
Q

Trauma

A

Inhibitor

168
Q

Obesity

A

Inhibitor

169
Q

Circadian clock of glutathione

A

6pm - GSH cycles between oxidation and cycled back by glutathione reductase. If a heavy metal is present then replenishment can’t occur which leads to GSH def

170
Q

TH1 vs TH2

A

1: syn IL2, IFNgam, MO. Following infection by bac and virus

2: IL4,5,10
After GI nematodes - EOS

171
Q

How do toxins cause immune deficits

A

Hypersens rxn and AI

172
Q

DES, dioxin, and DDT can cause atrophy and death of what glandular cells

A

Thymus

173
Q

PCB exposure may make people more prone to what

A

Increase allergic response

174
Q

PAH exposure has decreased activity in what

A

Splenic and thymic

175
Q

Pb and Hg decreases ability to kill what

A

Candid

176
Q

What supplement may be protective of immune function and Cd exposure

A

Se

177
Q

What is the main problem with reproductive problems in offspring

A

DES

178
Q

½ life of genistein and daidzein

A

5-6 hours

179
Q

½ life of PBC and DDT

A

bioaccumulate and store in fat and released into serum daily

180
Q

What affects female fertility the most

A

PAH, chemo, solvents, BPA, particulate matter

181
Q

What affects male fertility the most

A

Organophosphates and heavy metals

182
Q

What toxin affects the thyroid

A

PCB - bind to thyroxine

183
Q

What test must you do before doing any specialty testing

A

CBC, CMP, lipid, complete UA, HCG, G6PD, TB

184
Q

Most accurate test for body burden of heavy metals

A

None

185
Q

What is DMPS best for, IV or oral and common SE

A

Hg
IV is best
SE more than DMSA, crappy feeling and exhausted, N, dizzy, rash

186
Q

What is DMSA best for and common SE

A

Pb
Oral
GI dysfunct, rash, DEF of essential elements

187
Q

What is EDTA best for and common SE

A

Pb
IV
Hypotension, hypoglycemia, hypoCa

Environmental Medicine (1 decks)

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