Robbins ch 7 Flashcards Preview

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Flashcards in Robbins ch 7 Deck (81):
1

what aspects of climate change causes increases in CV, cerebrovascular, and respiratory dz

heat waves & pollution

2

contaminated/disrupted water supplies (flood, heavy rain, environmental disaster) increase the the incidence of ….

gastroenteritis, cholera, other food/water-borne infectious dz

3

inc temperature, crop failures and other extreme weather cause an increase in what type of dz

vector borne infectious dz (b/c inc vector numbers)

4

Increased temperatures can destroy crops. what is the effect of this and where is it most likely to occur?

Malnutrition, tropical regions

5

which countries yield the heaviest burden of climate change

developing countries

6

what defines a poison

everything can be a poison at the right dose

7

What is a xenobiotic

an exogenous chemical in the environment

8

What are phase I reactions

hydrolysis, oxidation, or reduction

9

What are phase II reactions

conjugation

10

What is CCl4 converted to in the body and what does it cause

converted to trichloromethyl free radical and causes fatty change in the liver (THINK DRY CLEANER)

11

What chemical from cigarette smoke can be metabolized into a DNA binding molecule

Benzo[a]pyrene

12

which 6 chemicals produce smog

SO2, CO, O3, NO2, Pb, particulate matter

13

What is released by burning coal and oil

sulfur dioxide, particles, & acid aerosols

14

what is the main cause of morbidity and mortality when burning coal and oil

the particles

15

How is CO produced

incomplete oxidation during burning

16

what are 4 characteristics of CO

non-irritating, colorless, odorless, tasteless

17

What are 3 things you should think of when you hear CO

working in tunnels, underground garages, or suicide

18

which has a higher affinity for Hb: CO or O2? and by how much

CO has 200X more affinity to Hb than O2

19

What happens to the blood gases when you have CO tox

dec O2 sat; arterial partial pressure of O2 stays the same

20

what is the progression of CO tox

hypoxia-->eventual death
20-30% of Hb saturated w/ CO = systemic hypoxia
60-70% of Hb saturated w/ CO = comma and death

21

what regions of the brain are most susceptible to damage of long term CO exposure

basal ganglia and striatum

22

Cherry-red discoloration of skin and mucus membranes

Acute CO tox

23

if death by CO happens slowly what would you see on autopsy

slightly edematous brain w/punctate hemorrhages, hypoxia induced neuronal changes … (these are aspects of systemic hypoxia)

24

What is the most common pollutant

Tobacco smoke

25

what does wood smoke lead to

lung infections (b/c of carcinogenic polycyclic hydrocarbons)

26

Uranium miners

radon

27

how can Radon predispose to cancer

only if you are a smoker. it normally does not pose a cancer risk

28

what do bioaerosols predispose to

microbial infections (legionella, viruses, allergen) b/c they contain the bugs

29

What are the 4 MC environmental pollutants (metals)

Pb, Hg, As, Cd

30

places you can get lead poisoning from

paint, gas, mines, foundries, batteries, spray paint
Kids: eating paint off walls, soil contamination

31

How long is the half life of Pb

LONG 20-30 yrs

32

Who absorbs more lead kids or adults?

Kids

33

Where is most of the lead taken up in the body

bone/teeth

34

effects of lead in adults

peripheral neuropathy (stops w/ stopping exposure)

35

effects of lead in kids

CNS effects (low IQ, hyperactivity, poor organization skills)

36

effects of lead in kids are reversible or irreversible

irreversible

37

hyper pigmentation lines in gums/plain film

Lead poisoning

38

which organ can be effected by Pb other than the brain

Kidney, damages proximal tubule when excreted

39

How does Pb cause tox (2)

-binds -SH groups and interferes w/ 2 enzymes in Heme synth --> ANEMIA
-inhibits Na/K ATPase --> hemolysis

40

microcytic hypochromic anemia w/ basophilic stipling in RBCs

Lead poisoning

41

increased RBC free protoporphyrin

lead poisoning

42

inc Zn-protoporphyrin

lead poisoning

43

first gets wrist drop then develops foot drop

lead poisoning

44

extremely severe poorly localized abdominal pain (GI colic) can be seen w/

lead poisoning

45

tremor, gingivitis, bizarre behavior

Hg poisoning

46

what ares sources of mercury

fish, dental amalgams, gold mining

47

cerebral palsy, deafness, blindnes

minamata dz (mercury poisoning)

48

where is arsenic found

soil, water, wood preservatives, herbicides, mining, smelting

49

anyone in bangladesh chile or china drinking water

arsenic poisoning

50

How does arsenic cause tox

interferes w/ oxidative phosphorylation

51

chronic exposure of arsenic predisposes to what cancers

BCC & SqCC of skin on palms and soles
lung cancer

52

severe GI, CV, CNS problems that lead to death

acute arsenic tox

53

where do you find cadmium

nickel-cadmium batteries, but MC is food

54

obstructive lung dz, renal tox, skeletal abnormalities, inc Ca in urine

acute cadmium tox

55

osteoporosis, osteomalacia, renal dz

Itai-itai (cadmium poisoning)

56

Rice fields in japan

cadmium poisoning

57

when you see bone and kidney problems think….

cadmium poisoning

58

dizziness, confusion ---> possible coma

organic solvents (chloroform, CCl4, paint removers)

59

Rubber workers .. what do they get and from what

leukemia (marrow aplasia & AML) from the benzene & 1,3-butadiene

60

polycyclic hydrocarbons come from what and cause what

from combustion of coal/gas, also in tar and soot --> lung and bladder cancer

61

name 4 pesticides

DDT, lindane, aldrin, dieldrin

62

name 2 non-pesticides

PCBs, dioxin

63

What does acute DDT poisoning cause

Neuro tox

64

what is DDT used for

Malaria prevention (kills the mosquitos)

65

what can dioxins and PCBs cause

skin disorders like folliculitis and acne (maybe som liver and CNS involvement)

66

BPA is found in

food and plastic (bottles)

67

What are the effects of BPA exposure in adults and kids

Adults --> heart dz
Kids --> endocrine defects

68

vinyl chloride leads to

angiosarcoma of liver

69

Remember all the pneumoconiosis???

coal dust, silica, asbestos, beryllium

70

MC exogenous cause of cancer?

tobacco smoke

71

3 MC dz caused by smoking

emphysema, COPD, lung cancer

72

what are the direct effects of cig smoke

inflammation and increased mucus production

73

how does cig smoke produce emphysema

inc WBC => inc elastase prod -> emphysema

74

does smoking increase the risk of other cancer risks

yes it has a multiplicative effect on other exposures w/ predisposing risk

75

why is atherosclerosis and MI increased in smokers

inc platelet aggregation, dec myocardial O2 supply, inc O2 demand, dec threshold for arrhythmias (VFib)

76

what kind of risk is associated when smoking is combined w/ HTN and high cholesterol; multiplicative, additive, or no risk

multiplicative

77

what other cancers other than lung are associated w/ smoking

laryngeal, esophageal, pancratic, bladder, oral

78

Smoking and EtOH use predisposes to

oral, laryngeal, and esophageal cancer (multiplicative effect)

79

smoking during pregnancy leads to

spontaneous abortion, IUGR, and preterm birth

80

Kids living w/ smoker (2nd hand)

respiratory illness, asthma

81

how do you estimate 2nd hand smoke exposure

cotine levels in blood