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PATH2220 > W5 > Flashcards

W5 Flashcards

1
Q

what are the environmental causes of disease

A

chemical (air pollution, heavy metals and occupational exposures), drugs (tobacco, ETOH and therapeutic drugs), physical agents (trauma, thermal injuries, temperature, radiation (UV, ionising) and nutritional deficiencies

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2
Q

what are the bradford hill considerations

A

1.strength of association
2.consistency of the observation (reproducibility)
3.specificity to a disease 4.temporality (cause before disease) 5.gradient (dose-response) 6.plausibility (biology)
7. coherence
(with natural history of disease) 8.experimentation (with significance) 9.analogy (similar known causes)

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3
Q

what is the asbestos pathogenesis

A

–direct interaction
(• surface charge adsorb proteins, DNA, RNA)
–reactive oxygen species
(• macrophages attempt digest, catalysed by surface iron)
–chronic inflammation

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4
Q

what are some asbestos related diseases

A

fibrosis (asbestosis)-long term/ high intensity exposure and mesothelioma (rare, high rates in Australia, particularly in WA), incidence rising. and adenocarcinoma (massive risk increase with smoking, lower lobe predilection). and pleural plaques that are benign

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5
Q

describe lead as a toxic chemical agent (acute)

A

• GIT pain (colic)
• demyelination neuropathy
(weakness)

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6
Q

describe lead as a toxic chemical agent (chronic)

A
  • decreased IQ
  • renal dysfunction
  • anaemia
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7
Q

what is particulate matter

A

soot

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8
Q

what does particulate matter do

A

cause irritation/inflammation of eyes, throat, lungs, asthma, myocardial ischaemia

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9
Q

what are some ambient environment chemicals we need to worry about

A

ozone, sulfur dioxide, nitrogen dioxide

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10
Q

what are some indoor air pollution chemicals we need to worry about

A

carbon monoxide (from incomplete combustion of carbon sources)

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11
Q

what should we worry about UV radiation

A

non-ionising but can alter chemical bonds. causes sunburn (cell death due to induction of apoptosis) and collagen damage

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12
Q

what are some physical agents that can cause disease

A

burns, trauma, electrocution, hyperthermia and hypothermia

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13
Q

what can hyperthermia do

A

– core 41-42° causes confusion, cardiac and respiratory dysfunction
– vasodilation, oedema, clotting, acidosis

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14
Q

what can hypothermia cause

A 
– core 35° causes confusion, loss of shiver response
– diuresis
– cardiac
arrhythmia
– pulmonary
oedema
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15
Q

what does an overdose in paracetamol do

A

overwhelms liver antioxidant glutathione

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16
Q

when is the highest incidence of mesothelioma going to be

A

2018 (expected)

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17
Q

where do mesothelioma mostly affect

A

lung and mediastinal structures

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18
Q

what gives it away that an adenocarcinoma may be caused by asbestos

A

predication of the lower lobe

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19
Q

what is asbestos composed of

A

hydrous magnesium silicate

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20
Q

what are the most dangerous fibres in asbestos

A

crocidolite then amosite followed by chrysotile.

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21
Q

what is one of the major factors that make the crocidolite fiber so dangerous

A

the shape of it, it is long and narrow and allows it to penetrate into the deeper parts of the lung

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22
Q

describe the pathology of mesothelioma

A

causes a thickening of the pleura (or other mesothelial lined surface). In the early stages this produces small nodules mainly on the parietal pleura. This then turns into nodules that increase in size and the parietal and visceral pleura thicken and fuse.

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23
Q

what do the tumour cells look like in malignant mesothelioma

A

can be epothelioid or sarcomatoid or both

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24
Q

how does an intake of lead affect the body

A

competitor with calcium for bone and teeth. it has a longer half life than calcium.

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25
Q

who has a greater chance of being affected out of children and adults of lead poisoning

A

children

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26
Q

what is the treatment for acute lead poisoning

A

Plasmapheresis (every few weeks for years because the lead leaches out of the bones).

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27
Q

what is the histological appearance of steatosis

A

large vacuoles (reversible)

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28
Q

what does the increased core body temperature do to your body

A

denaturation of the cell proteins (causes by the shape changing) and disfunction of the neurotransmitters

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29
Q

what is radiobiology

A

the study of the effects of ionising radiation on biological tissues

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30
Q

what are the four different uses of radiation

A

industry, medicine, agriculture and security

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31
Q

what is radiation

A

Electromagnetic radiation or sub atomic particles and involves the transfer of energy through space and matter….

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32
Q

what is ionising radiation

A

can liberate electrons, can break chemical bonds (cause direct molecular damage or through indirect by radicalising water and the radicals from water attack other molecules)

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33
Q

what are the different types of radiation and what is the most penetrating

A

alpha, beta, gamma and neutrons

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34
Q

what device typically measure radiation and how does it work

A

dosimetry device- gas in a tube and when radiation hits it, it ionises the molecules and they are then attracted to cathodes and anodes

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35
Q

what is the unit for radiation activity

A

becquerels (number of particles/photons emitted per second

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36
Q

what is the absorbed dose

A

energy deposited per kilo

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37
Q

what is the equivalent dose

A

absorbed dose X radiation factor

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38
Q

what is the effective dose

A

equivalent dose X tissue factor

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39
Q

what is the tissue factor

A

the factor of the tissue (i.e. different tissues have the potential to turn bad due to radiation because of the sensitivity and the amount of times it replicates)

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40
Q

what is the three different steps of radiobiology

A

physical interactions, chemical interactions and biological phase

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41
Q

what type of radiation can cause double strand DNA breaks

A

alpha

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42
Q

what stage of the cell cycle are double strand breaks usually occur and can be fixed by sister chromatids

A

G1

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43
Q

what stage of the cell cycle sit he most dangerous for a double strand break to occur

A

during the S phase.

44
Q

what can little radiation do to you

A

can promote up regulation of cellular repair mechanisms. can be good for you

45
Q

what are the strongest carcinogens

A

polycyclic aromatic hydrocarbons, nitrosamines, aromatic amines

46
Q

what happens to certain genes in tobacco-induced cancer

A

inactivation of tumour suppressor genes and actuation of oncogenes

47
Q

what defines cancer cells in a histology slice

A

large nuclei because of the genetic structures being read out at a high rate

48
Q

what are some other thing that smoking is associated with

A

– glucose intolerance

– low serum HDLc

49
Q

what is chronic bronchitis

A
  • cough and sputum most days for at least 3 months in at least two years
  • in half of heavy smokers
  • symptoms decrease within 1-2 months of cessation
50
Q

what is the pathogenesis of COPD

A 
oxidative stress
– higher levels of H2O2 in breath
• protease-antiprotease imbalance
– free radicals in cigarette smoke
– chronic inflammation
• neutrophil elastase
• matrix metalloproteases
– genetic pre-disposition
• AAT deficiency multiplicative effect
51
Q

why does smoking cause preterm births

A

contractile sensitivity increases due to the toxins of the smoking and UTI

52
Q

where was blue asbestos mined in WA

A

at wittenoom

53
Q

what is asbestos

A

mineral fibres found world-wide

54
Q

what are the characteristics of asbestos that makes it a useful building tool

A

tensile strength, thermally stable (fire proof), used in various industries as insulator, fire retardant

55
Q

what asbestos is found in wa

A

blue

56
Q

what asbestos is found in SA

A

brown

57
Q

what asbestos is found in quebec

A

white

58
Q

what are the three different types of asbestos

A

commerical amphiboles, non-commercial amphiboles and serpentine

59
Q

what asbestos comes under commercial amphiboles

A

crocidolite and amosite

60
Q

what type of asbestos is crocidolite

A

blue

61
Q

what type of asbestos is amosite

A

brown

62
Q

where is commercial asbestos (crocidolite and amosite) used for and mined

A

mined and used in Australia and south africa

63
Q

what is the most dangerous type of asbestos

A

commercial amphiboles

64
Q

what are the non-commercial amphiboles

A

anthophyllite, actinolite and tremolite. less used and less dangerous

65
Q

what is the only type of serpentine

A

chrysotile (white asbestos)

66
Q

describe serpentine asbestos

A

found and used world wide, significant danger because used widely, prevalent in living environment

67
Q

describe the fibres of white asbestos

A

very long, flexible and curly fibres. Easily eroded, fragmented and shattered by weathering

68
Q

describe the fibers of blue asbestos

A

long, straight and sharp needles. Resists physical and chemical weathering.

69
Q

long, straight and sharp needles. Resists physical and chemical weathering.

A

blue asbestos

70
Q

when was crocidolite mined at wittenoom

A

between the 1950’s and the 1970’s

71
Q

where is felted asbestos (wool) used

A
  • Pipes,furnaces,boilers

* Buildingstructure(beams) • Breakpads

72
Q

what makes • Pipes,furnaces,boilers

• Buildingstructure(beams) • Breakpads

A

felted asbestos (wool)

73
Q

what does Woven asbestos ‘cloth’ make

A
  • Fire proof material, blankets
  • Cinemascreens
  • Electricalwiresanddevices
74
Q

what particles more easily impact the walls of the respiratory tract and get trapped in muscus and then cleared upwards?

A

large, spherical particles

75
Q

what particles will float down to the lower respiratory tract and to the alveoli

A

finer particles

76
Q

what is the structure of chrysotile asbestos fibres

A 
• Long (10-50um) and curled.
• Occur in wide bundles.
• Effective diameter of 1-2 um.
• Effectively trapped and cleared in the
upper airways.
77
Q

what is the structure of amphibole asbestos fibres

A
  • Long straight needles.
  • Occur in small bundles, single crystals.
  • Effective diameter of 0.1-0.3 um.
  • Reach the alveoli…
  • To be ingested by macrophages…
  • And dragged into the alveolar wall…
  • Where they cause damage!
78
Q

describe pulmonary fibrosis from asbestos

A

• Regional scarring of the alveolar lung tissue
around the site of injury.
• The thickened, rigid wall no longer allows gas
exchange and restricts ventilation.
• Scarring localised, scattered, sparing wide areas
of the lung.
• Slow progression, some repair.

79
Q

what does inexorable mean

A

impossible to stop or prevent.

80
Q

describe asbestosis

A

• Widespread fibrosis and scarring of the alveolar
tissue in the presence of asbestos.
• Widespread, generalised to the whole lung.
• Progressive, unrelenting, irreversible.

81
Q

where are pleural plaques

A

parietal pleura

82
Q

what are pleural plaques

A 
• Small thickened patches of the parietal pleura
and diaphragm.
• Multiply, calcify and harden.
• Ulcerate.
• Painful on inhalation, adhere to lung.
• Usually precedes fibrosis.
83
Q

where does pleural fibrosis occur

A

visceral pleura

84
Q

where does respiratory malignancies commonly occur

A

all parts of the airway: • Nose, nasopharynx, throath
• Trachea and main bronchi
• Lower respiratory tract
• Respiratory alveoli

85
Q

describe carcinoma of the airways

A

• Upper airways first attacked as
first involved in clearance
• Bronchoalveolar carcinoma in
the lower airways and alveoli

86
Q

describe malignant mesothelioma

A

• Malignancy of mesothelial layer
around the lungs
• Rare, mostly associated with
asbestos exposure

87
Q

what mesothelial layers does malignant mesothelioma affect

A

Pleura, diaphragm, pericardium, peritoneum

88
Q

what does a malignant mesothelioma replace, then what does it do?

A

the thin elastic pleura, thickened layer of tumour, fibroses and calcified, enclosing the lung in ‘concrete’. Prevents ventilation

89
Q

can surgical resection stop a malignant mesothelioma

A

no, causes metastasis. the only treatment is palliative treatment

90
Q

what is bronchogenic carcinoma

A

malignant neoplasm of the lung arising from the epithelium of the bronchus or bronchiole.

91
Q

what is an asbestos body in the lung

A

An asbestos body shows a core of a single asbestos crystal (fibre) coated with iron-rich protein in beads.

92
Q

what are the two things you must consider when quantifying the exposure to asbestos of an individual

A

how much exposure is there and what type of asbestos is it

93
Q

what is AB

A

asbestos body

94
Q

what is AF

A

asbestos fibre

95
Q

how do you isolate AB from lung tissue

A

• Excise and weigh precisely 2g of lung tissue.
• Digest it in strong alkali (bleach or KOH) at 70C for 3-24h.
• Centrifuge at 15,000rpm for 20m to pellet the mineral component.
• Resuspend sediment (minerals) in a known volume of water.
• Filter a precise aliquot (pore size 3um) to trap the asbestos bodies and larger
fibres.
• Dry the filter and mount on a glass slide for LM, or a stud for SEM.

96
Q

how do isolate asbestos fibres from lung tissue

A
  • Reheat the unused fluid sample at 350C for 3h (with O2 flow).
  • Filter a precise aliquot (pore size 2nm) to trap all asbestos fibres.
  • Dry the filter, mount a portion on a TEM grid or SEM stud.
  • Coat with an ultrathin carbon film to protect the fibres.
97
Q

what way can you expose the core of an asbestos fibre

A

use TEM preparation

98
Q

in a biopsy, how do we identify the various asbestos fibres

A

analyse the atomic structure of the crystal

99
Q

how do you use X-rays to measure the atomic structure of the crystal

A

1- The electron beam transfers its energy to an electron in the sample and excites it to a higher energy shell.
2- The excited electron emits the excess energy in a x- ray photon to return to its ground state.
3- The x-ray photon is unique to the atom of origin.
4- X-rays are detected by supercooled crystal detectors in the EM

100
Q

what is the appendix in humans

A

– Blind ending pouch, abached to caecum – Redundant organ in humans
– Remnant of an enlarged caecal ‘fermenta&on’ chamber seen in many in herbivores which aids in the diges&on of cellulose (vegetable maber)

101
Q

what is appendicitis

A

initial non-specific manifestations and vague central abdominal pain, then localisation of pain to McBruney’s point with local and systemic signs of inflammation.

102
Q

what is the cause of appendicitis

A

obstrcution –> intraluminal pressure –> occlusion of blood and lymphatic flow –> ischaemic injury and down regulated bacterial defences –> inflammation

103
Q

what is c-reactive protein

A

a plasma protein, synthesised by and released from the liver in response to inflammation

104
Q

what is the erythrocyte sedimentation rate

A

rate at which red blood cells sediment in a period of one hour

105
Q

does appendicitis spontaneously resolve

A

no

PATH2220 (14 decks)

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