Multi-Systems: Environmental Exposures Flashcards
1
Q
Definition of Poison
A
- A quantitative concept strictly dependent on Dosage
- “all substances are poisons; the right dosage differentiates a poison from a remedy”
2
Q
Definition of Xenobiotics
A
- Exogenous chemicals in the environment in air, water, food, and soil that may be absorbed into the body through inhalation, ingestion, and skin contact
3
Q
(6) Air Pollutants Monitored by EPA
A
- Sulfur dioxide
- Carbon monoxide
- Ozone
- Nitrogen dioxide
- Lead
- Particulate matter
4
Q
Effects of Ozone
A
- Decreased Lung function
- Increased Airway reactivity
- Lung Inflammation
- Decreased Exercise capacity
- Increased Hospitalizations
5
Q
Effects of Nitrogen Dioxide
A
- Increased Airway reactivity
- Decreased Lung function
- Increased Respiratory Infections
6
Q
Effects of Sulfur Dioxide
A
- Increased Respiratory symptoms
- Increased Mortality
- Increased Hospitilizations
- Decreased Lung functions
7
Q
Effects of Acid Aerosols
A
- Altered Mucociliary clearance
- Increased Respiratory infections
- Decreased Lung function
- Increased Hospitalizations
8
Q
Effects of Particulates
A
- Increased Respiratory Infections
- Decreased Lung function
- Excess Mortality
- Increased Attacks
9
Q
Effects of Carbon Monoxide (CO)
A
- CO kills by inducing CNS depression (insidiously and unaware)
- Hemoglobin has a 200-fold Greater affinity for CO than Oxygen
- Carboxyhemoglobin cannot carry O2
- Systemic hypoxia (20 - 30%)
- Unconciousness / Death (60 - 70%)
- Acute Poisoning is marked by a Characteristic Generalized Cherry-red color of the Skin and Mucous membranes
- Brain: slightly edematous, with Punctate Hemorrhages and hypoxia-induced neuronal changes
10
Q
Top Indoor Air Polluters
A
- Tobacco Smooke (1st)
- CO
- Nitrogen dioxide
- Asbestos
11
Q
Lead Poisoning
A
- Binds to Sulfhydryl Groups in Proteins
- Interferes w/ Calcium Metabolism
- -> Hematologic, Skeletal, Neurologic, GI, Renal Toxicity
- House paints and Gasoline
- Mining, Foundries, Batteries, and Spray Painting
- Intellectual capacity, Behavioral problems (Hyperactivity and Poor orginizational skills)
- Decreased IQ, Hearing, Growth, Impaired peripheral nerve function, Fetal effects by Transplacental transfer
12
Q
Lead Absorption in Children and Adults?
A
- < 15% Adults - peripheral neuropathis
- > 50% Children - Higher intestinal absorption –> Higher susceptibility to Brain damage due to increased permeable BBB –> inhibition of neurotransmitters due to disruption of Calcium Homeostasis.
13
Q
How does Lead interfere with Cartilage and Bone?
A
- Lead interferes w/ the normal remodeling of cartilage and Primary bone Trabeculae in the Epiphysis in Children
- This Increased Bone density detected as Radiodense “Lead Lines” (Gums –> Hyperpigmentation)
- Inhibits Fracture healing by increasing Chondrogenesis and Delaying Cartilage mineralization
14
Q
How does Lead effect RBCs?
A
- Lead inhibits the activity of (2) enzymes involved in Heme synthesis
- Aminolevulinic acid dehydratase
- Ferrochelatase –> catalyzes the incorporation of Fe into Protoporphyrin
- -> inhibition causes rise in Protoporphyrin lvls
- -> Microcytic Hypochromic anemia stemming from Hemoglobin synthesis
15
Q
Mercury
A
- Binds to Sulfhydryl groups in certain Proteins w/ High affinity –> Damage to CNS and Kidneys
- Tremor
- Gingivitis
- Bizarre Behaviour (Mad Hatter)
- Contaminated Fish (methyl mercury)
- Dental amalgams (metallic mercury)
- Lipid solubility accumulation in Brain
- Intracellular glutathione –> Sulfhydryl donor (protective)
16
Q
Arsenic
A
- Arsenic salts interfere w/ metabolism
- -> GI, Nervous system, Skin, Heart
- Tx for Acute Promyelocytic Leukemia
- Interference w/ Mitochondrial oxidative Phosphorylation
- -> replace the Phosphates in Adenosine Triphosphate
- Neurologic effects - 2 to 8 weeks - sensorimotor neuropathy, paresthesias, numbness, pain
- Skin changes - Hyperpigmentation and Hyperkeratosis
- Development of Cancers (Lung, Bladder, Skin)
- Arsenic induced skin tumors - multiple, palms and soles
- Non-malignant respiratory disease (exposed water)
17
Q
Cadmium
A
- Toxic to the Kidneys and Lungs
- Increased production of Reactive Oxygen species
- Mining, Electroplating, Production of Nickel-cadmium batteries
- Food is the most important source of Cadmium exposure
- ZIP8 transporter uptake (normally zinc)
- Obstructive Lung Disease - alveolar epithelial cell necrosis
- Renal Tubular damage –> End-Stage Renal Disease
- Skeletal abnormalities
18
Q
- Carbon monoxide
- Lead
- Solvents
- Cobalt
- Cadmium
A
Cardiovascular System - Heart Disease
19
Q
- Isopropyl alcohol
- Wood dust
A
Respiratory - Nasal Cancer
20
Q
- Radon
- Asbestos
- Silica
- Bis(chloromethyl)ether
- Nickel
- Arsenic
- Chromium
- Mustard gas
- Uranium
A
Respiratory - Lung Cancer
21
Q
- Grain dust
- Coal dust
- Cadmium
A
Respiratory - Chornic Obstructive Lund Disease
22
Q
- Beryllium
- Isocyanates
A
Respiratory - Hypersensitivity
23
Q
- Ammonia
- Sulfur Oxides
- Formaldehyde
A
Respiratory - Irritation
24
Q
- Silica
- Asbestos
- Cobalt
A
Respiratory - Fibrosis
25
* Solvents
* Acrylamide
* Methyl Chloride
* Mercury
* Lead
* Arsenic
* DDT
Nervous - **Peripheral Neuropathies**
26
* Chlordane
* Toluene
* Acrylamide
* Mercury
Nervous - **Ataxic Gait**
27
* Alcohols
* Ketones
* Aldehydes
* Solvents
Nervous - **Central Nervous System Depression**
28
* Ultraviolet Radiation
Nervous - **Cataracts**
29
* Mercury
* Lead
* Glycol ethers
* Solvents
Urinary - **Renal Toxicity**
30
* Nahthylamines
* 4-aminobiphenyl
* Benzidine
* Rubber products
Urinary - **Bladder Cancer**
31
* Lead
* Phthalate plasticizers
* Cadmium
Reproduction - **Male Infertility**
32
* Lead
* Mercury
Reproduction - **Female Infertility / Stillbirths**
33
* Mercury
* Polychlorinated biphenyls
Reproduction - **Teratogenesis**
34
* Benzene
Hematopoietic System - **Leukemia**
35
* Polychlorinated biphenyls
* Dioxins
* Herbicides
Skin - **Folliculitis and Acneiform Dermatosis**
36
* Ultraviolet Radiation to Skin
Skin - **Cancer**
37
* Vinyl Chloride
Gastrointestinal tract - **Liver Angiosarcoma**
