Term
| why is it so important to be on the watch for environmental and occupational hazards |
|
Definition
preventible
patients will seek advice
may show up in trends in the community |
|
|
Term
| what does the effect of an environmental exposure depend on |
|
Definition
amount,timing, pattern, duration
route (inhaled, absorbed, IV)
half life
storage location |
|
|
Term
| where is dignxin stored, for how long |
|
Definition
|
|
Term
| how long is silicia stored |
|
Definition
|
|
Term
| polycyclic aromatic hydrocarbons: where are they found, who is at risk, what is the side effect |
|
Definition
soot
chimney sweeps
scrotal cancer |
|
|
Term
| vinyl chloride: who is at risk, what is the side effect |
|
Definition
plastic industry
angiosarcoma of the liver |
|
|
Term
| uranium/radon gas: who is at risk, what is the side effect |
|
Definition
miners and some natural areas
lung cancer |
|
|
Term
| B-naphthylamine: who is at risk, what is the side effect |
|
Definition
dye makers, rubber workers
bladder cancer |
|
|
Term
| carbon tetrachloride: who is at risk, what is the side effect |
|
Definition
| dry cleaners, liver and kidney toxicity |
|
|
Term
| organophosphates: who is at risk, what is the side effect |
|
Definition
farmers
irreversible cholinesterase inhibitors |
|
|
Term
| what is the normal breakdown process of alcohol |
|
Definition
ethanol is metabolized by alcohol DH into acetaldehyde which is broken by aldehyde DH into acetic acid
the process makes the byproduce NADH |
|
|
Term
| why are some people unable to handle alcohol as well as others |
|
Definition
many asians have aldehyde DH mutation so they flush after a glass due to acetaldehyde build up
women have alcohol DH levels lower than men so ethanol builds up |
|
|
Term
| how can a habitual drinker be identified (before liver or highly notible damage) |
|
Definition
| cytochrome P450 enzymes in cells will begin helping with breaking dowh ethanol into acetaldehyde |
|
|
Term
| how much alcohol does it take for inebriation and serious effects (name them) in the occasional drinker |
|
Definition
200 mg/dL (6oz)
300-400 mg/dL causes coma, respiratory arrest |
|
|
Term
| how much alcohol does it take for inebriation in habituial drinkers |
|
Definition
|
|
Term
| what changes occur in the liver of a habitual drinker |
|
Definition
fatty change in the liver
acute alcoholic hepatits
alcoholic chirrhosis |
|
|
Term
| how does alcohol cause fatty change in the liver |
|
Definition
excess NADH stimulates lipid synthesis
FA oxidation in mitochondria decreased
acetaldehyde forms adducts with tubulin decreasing lipoprotein transport from liver
peripherial fat catabolism increased |
|
|
Term
| what are signs of acute alcoholic hepatitis |
|
Definition
| fever, liver tenderness, jaundice |
|
|
Term
| how does alcohol cause acute alcoholic hepatitis |
|
Definition
| fat accumulation and alcoholic haylin (mallory bodies) build up, neutrophils surround them and allow for necrosis via ethanol metabolites |
|
|
Term
| where does acute alcoholic hepatitis cause necrosis and fibrosis usually begin |
|
Definition
|
|
Term
| how do ethanol metabolites cause necrosis |
|
Definition
glutathionine depletion
mitochondrial injury
altered metabolism of methionine
cytokine release from Kupuffer cells |
|
|
Term
| what are clinical signs of alcoholic chirrhosis |
|
Definition
| weaness, muscle wasting, acites, GI hemorrhage, coma |
|
|
Term
| what are cellular signs of alcoholic chirrhosis |
|
Definition
perisinusoidal fibrosis: collagen deposition b Ito cells in spaces of disse
depleted liver stores of a-tocopherol
micronodules of regenerating hepatocytes surrounded by bands of collagen |
|
|
Term
| what are two ways habitual alcohol affects the cns |
|
Definition
changes membrane fluidity altering signal transduction causing depressive effect and addiction
thiamine deficiency (due to poor nutrition) |
|
|
Term
| what are 4 general signs of thiamine deficiency |
|
Definition
nerve degeneration
reactive gliosis
cerebellar and peripherial nerve atrophy |
|
|
Term
| what are two diseases caused by thiamine deficiency |
|
Definition
| wernicke and korsakoff syndromes |
|
|
Term
| signs of wernicke syndrome |
|
Definition
ataxia, disturbed cognition, opthalmoplegia, nystagmus
confusion, apathy, disorientation |
|
|
Term
| signs of korsakoff syndrome |
|
Definition
| severe memory loss (retrograde amnesia), inability to acquire new information, confabulation |
|
|
Term
| what are the effects of chronic alcohol on the cardiovascular system |
|
Definition
cardiomyopathy and heart dilation
hypertension, anemia
caputmedusa, esophageal varicies |
|
|
Term
| why does alcohol cause HTN |
|
Definition
| ethanol triggers catecholamine release |
|
|
Term
| why does alcohol cause anemia |
|
Definition
|
|
Term
| what are the effects of moderate alcohol on the cardiovascular system |
|
Definition
| moderate consumption has protect effect (increased HDL, decreased platelet aggregation) |
|
|
Term
| why does alcohol cause venous conditions like caput medusa and esophageal varicies |
|
Definition
| portal vein obstruction via chirrhosis leads to portal vein Htn and increased pressure on venous channel causing dilation of abdominal end esophageal vessels (which can rupture and cause quick death) |
|
|
Term
| affects of chronic alcohol on GI |
|
Definition
acute gastritis
acute and chronic pancreatitis
pancreatic acinar destriction causes malabsorption, vitamin deficiency
GI hemorrhages after chirrhosis |
|
|
Term
| alcohol effect on skeletal muscle |
|
Definition
| toxin: weakness, pain, myoglobulin breakdown |
|
|
Term
| what are the affects of chronic alcohol on the reproductive system |
|
Definition
testicular atrophy
descreased fertility
increased spontaneous abortion
fetal alcohol syndrome |
|
|
Term
| signs of fetal alcohol syndrome |
|
Definition
microcephaly
facial dysmorphology
malformations of brain, cardiovascular, GU |
|
|
Term
| what is the most common preventable illness in the US |
|
Definition
|
|
Term
| why does alcohol cause fetal alcohol syndrome |
|
Definition
| ethanol induces apoptosis of CNS cell precursors |
|
|
Term
| why does alcohol cause cancer |
|
Definition
| acetaldehyde is a tumor promoter |
|
|
Term
| what cancers does ethanol cause |
|
Definition
oral cavity, pharynx, esophagus, liver, breast
hepatocellular carcinoma (synergistic with hep B and C) |
|
|
Term
| why does alcohol cause hepatocellular carcinoma |
|
Definition
| inhibits detoxification of chemical carcinogens |
|
|
Term
|
Definition
methanol
isopropanol
ethylene glycol |
|
|
Term
|
Definition
| solvents, paint remove, methylated spirits |
|
|
Term
| how does methanol cause problems |
|
Definition
| metabolized to formaldehyde by alcohol DH and formic acid which causes metabolic acidosis |
|
|
Term
| signs of methanol poisoning |
|
Definition
nausea, vomiting, abdominal pain, blurred vision (snow storm)
30 mL can cause death
10 mL can cause blindness |
|
|
Term
| how does isopropanol cause damage, where |
|
Definition
| ADH metabolizes to acetone and damages gastric mucosa |
|
|
Term
| what is a lethal dose of ethylene glycol |
|
Definition
|
|
Term
| how is ethylene glycol broken down in the body |
|
Definition
| alcohol DH metabolizes into aldehydes, glycolate, oxalate, and lactate |
|
|
Term
| signs of ethylene glucol toxicity |
|
Definition
| renal failure due to Ca oxylate crystals in tubules (show in urine) |
|
|
Term
| how can you tell if someone has ethylene glycol toxicity |
|
Definition
florescein detectable with UV light, examine oral cavity
Ca oxylate in urine |
|
|
Term
| what is the treatment for all ethanol substitute toxicities, why |
|
Definition
| administer ethanol so alcohol DH is used to break it down and avoids making toxic byproducts of other substancs |
|
|
Term
| what drugs are CNS stimulants |
|
Definition
|
|
Term
| signs of chronic CNS stimulant abuse |
|
Definition
| insomnia, anxiety, paranoia, hallucinations, dilated cardiomyopathy, nasal septum perforation (can be from infection), increases risk of athlerosclerosis!, compounds risk of MI if a smoker |
|
|
Term
| signs of acute CNS stimulant overdose |
|
Definition
| seizure, cardiac arrhythmia, respiratory arrest, increases risk of athlerosclerosis! |
|
|
Term
| what drug is an abused narcotic |
|
Definition
|
|
Term
|
Definition
sedation, mood change, nausea, supression of anxiety
chronic: tolerance, dependance
susceptability to infection |
|
|
Term
| what infections do heroin uses often have |
|
Definition
skin (track marks)
heart valves: especially tricuspid (S. aureus)
liver
lungs |
|
|
Term
| why should you never buy the cheap crap when you get drugs from your dealer |
|
Definition
| because the cheap ones are cut with talcum power which accumulates in lungs, liver, kidney causing granuloma, pulmonary abscess, pulmonary edema, amyloidosis, and focal glomerulosclerosis |
|
|
Term
| what are three hallucinogens |
|
Definition
delta-9-tetrahydrocannabinol (THC)
phencyclidine (PCP)
LSD |
|
|
Term
| side effects or complications of THC |
|
Definition
marijuana smoke carcinogens do not induce cancer but induce lung damage simillar to tobacco
intoxication impairs cognative and motor function |
|
|
Term
|
Definition
| inebiration, disorientation, numbness, mystagmus, coma in high doses |
|
|
Term
|
Definition
| death in high doses, psychic effects, visual illusions |
|
|
Term
| what routes of exposure cause lead poisoning |
|
Definition
|
|
Term
| where does lead go in the body, what problems does it cause there |
|
Definition
mostly bone and teeth where it competes for Ca binding causing lead lines of x-ray
soft tissues or filtered in kidney causing hyperpigmentation (blue) gum tissue |
|
|
Term
| 4 ways lead interferes with the body |
|
Definition
interferes with heme synthesis
interferes with membrane Na/K pumps
competes with Ca in bone
interferes with nerve transmission |
|
|
Term
| what is the consequence of lead interferance with nerve transmission |
|
Definition
| abnormal brain development |
|
|
Term
| what is the consequence of lead interfering with Na/K pumps |
|
Definition
| shortens RBC survival causing hemolytic anemia |
|
|
Term
| how does lead interfere with heme synthesis, what is the clinical result |
|
Definition
has affunity for sulfhydryl groups
accumulates in mitochondria forming ringed sideroblasts and blocks ferliochetlase which normally incorporates Fe into heme causing Fe overload in the marrow and sideroblastic anemia |
|
|
Term
| what diseases cause sideroblastic anemia |
|
Definition
lead poisoning
thiamine deficiency |
|
|
Term
| what are the carcinogens in tobacco smoke, which is most potent |
|
Definition
| tar, polycyclic aromatic hydrocarbons, benzopyrene (most potent), nitrosamine |
|
|
Term
| how does benzopyrene cause carcinogenesis |
|
Definition
| intercolates between DNA strands causing mutation |
|
|
Term
| what does nicotine cause to happen in the body |
|
Definition
gangloside stimulation and depression
tumor promotion |
|
|
Term
| what parts of smoke cause cillia toxicity and irritation |
|
Definition
| formaldehyde, oxides of nutrogen |
|
|
Term
| what are the pulmonary signs in a smoker |
|
Definition
irritants cause inflammation and increased mucous production
recruitment of leukocytes to lung
carcinogenic constituents
chronic bronchitis and emphysema |
|
|
Term
| what are cardiovascular signs in a smoker |
|
Definition
decreased myocardial oxygen supply
MI
systemic athlerosclerosis |
|
|
Term
| what cancers are caused by smoking |
|
Definition
| lung, larynx, trachea, esophageal, pancreas, bladder |
|
|
Term
|
Definition
|
|
Term
|
Definition
increases risk of spontaneous abortion and preterm birth
intrauterine growth retardation causes low birth weight |
|
|
Term
| effects of secondary hand smoke |
|
Definition
increased asthma and respiratory illness in kids
1.3x rosk of lung cancer |
|
|
Term
| what are 4 sources of outdoor airpollution and what polutants for each |
|
Definition
fossil fuel combustion: CO, hydrocarbons, NO2, particulates
photochemical reactions: ozone
power plants: SO2 and particulates
waste incerinators/smelters: acid aerosols, metals, mercury vapor, organic compounds |
|
|
Term
| how does SO2 pollution caus eproblems |
|
Definition
| H+ and sulfites cause local irritations |
|
|
Term
| how does ozone cause problems |
|
Definition
| cough, chest discomfort, lung inflammation, asthmatics very sensitive |
|
|
Term
| how does NO2 cause problems |
|
Definition
| dissolves in airway making nitric and nitrous acids |
|
|
Term
| wht are 4 indoor air polluters and their sources |
|
Definition
wood smoke
formaldehyde: textiles, pressed wood, furinature
bioaerosols: contaminated heating and cooling
radon: natural decay product emit a raiation (uranium rocks breaks to radium which breaks to radon gas) |
|
|
Term
| how does radon gas (a-radiation) effect the body |
|
Definition
|
|
Term
| give an example of a bioserosol and the complications |
|
Definition
legionella pneumo in heating and cooling of public buildings
allergens cause allergic rhinitis and exacerbate asthma |
|
|
Term
| what does formeldahyde pollution do to the body |
|
Definition
acute eye irritation
exacerbate asthma |
|
|
Term
| what does wood smoke pollution do to the body |
|
Definition
| increase respiratory infections |
|
|
Term
| where does CO come from, how is it detected |
|
Definition
combustion, cigarette smoke
difficult detection: odorless and colorless, O2 meter may think its O2 |
|
|
Term
| how does CO cause problems |
|
Definition
competes with O2 dor Hb binding with 200x inc in affinity causing hypoxia
inhibits cytochrome oxidaze in ETC |
|
|
Term
| low levels of CO: signs, how much |
|
Definition
2-4 ppm
reduced exercise capacity |
|
|
Term
| high levels of CO: signs, how much |
|
Definition
>9 ppm
headache, dizzy, loss of motion control
cherry red skin, mucosa, blood (due to carboxyHb) |
|
|
Term
|
Definition
|
|
Term
| pathogenic effet of chloroform (Carbon tetrachloride) |
|
Definition
| CNS depression, liver necrosis |
|
|
Term
|
Definition
| block ctochrme oxidadae causing rapid death due to hypoxia |
|
|
Term
| signs of low dose mercury exposure |
|
Definition
| intention tremor, memory loss, gingivitis, skin rash, nephrotic syndrome |
|
|
Term
| what are petroleum distillates |
|
Definition
| kerosine, benzene, gasoline |
|
|
Term
| what as signs of petroleum distillate toxicity |
|
Definition
| respiratory depression, GI inflammation, pneumonitis |
|
|
Term
| signs of polychlorinated biphenyl toxicity |
|
Definition
| insidious development o chloracne, vsual loss, impotence |
|
|
Term
| signs of organophosphate toxocity and MOA |
|
Definition
neurotoxicity via acetylcholinesterase inhibition: muscle weakness, cardiac arrhythmia, resporatory depression
inhibits RBC or plasma cholinesterase |
|
|
Term
| route of organophosphate exposure |
|
Definition
|
|
Term
|
Definition
| used in manufacturing, degresing, dry cleaning, paint remover, aerosol |
|
|
Term
| general signs of acute exposure of volitile compound |
|
Definition
| headache, dizzy, liver / kidney toxicity |
|
|
Term
| general signs of chronic low exposure to volatile compound |
|
Definition
carcinogenesis
reproductive effects |
|
|
Term
| methylene chloride: location, route of exposure |
|
Definition
paint removes, aerosol, gasolene, mineral oil, turpentine
lungs |
|
|
Term
|
Definition
| metabolized by CP450 into CO2 and CO |
|
|
Term
| methylene chloride signs of toxicity |
|
Definition
CNS depression, dizzy, incoordination
contact dermatitis: usually from kerosine |
|
|
Term
| where are polycyclic aromatic hydrocarbons made |
|
Definition
| combustion of fossil fuels, high temp, processing of coal and oil, iron and steel foundries, cigarettes |
|
|
Term
| route of exposure of polycyclic aromatic hydrocarbons |
|
Definition
|
|
Term
| hazards of polycyclic aromatic hydrocarbons |
|
Definition
|
|
Term
| organochlorines: soources, route of exposure |
|
Definition
| insecticides, environment, bioaccumulatre |
|
|
Term
| organochlorines: storagein body, hazards |
|
Definition
fat, human milk
estrogenic |
|
|
Term
| what is an example of a organochlorine and the hazards |
|
Definition
| DDT: reproductive defects in birds, none in humans but suspected |
|
|
Term
| carbamates: MOA of toxocity, effect |
|
Definition
reversible inhibitor of cholineserase
neurotoxicity |
|
|
Term
| carbamate example and effect |
|
Definition
sevin (carbaryl)
poisons mititoc spindle (mutagen and teratogen) |
|
|
Term
| where is dioxin found, how is it made |
|
Definition
| herbacide, agent organge, paper pulp + chlorine incerination |
|
|
Term
| signs of acute dioxin toxicity |
|
Definition
chloracne
fetotoxicity
immunotoxicity
leukemia, lymphoma, sarcoma |
|
|
Term
| signs of chronic dioxin exposure |
|
Definition
induces CP450
increases estrogen metabolism
decreased thyroxine |
|
|
Term
| signs of rodenticide toxicity |
|
Definition
| induces strychnine causing respiratory failure and warfarin causing hemorrhage |
|
|
Term
| what emits non-ionizing radiation, what are the characteristics |
|
Definition
long wavelength, low frequency
electric power, radio waves, microwaves, infrared, UV light |
|
|
Term
| effects of non-ionizing radiation |
|
Definition
vibration and rotation of atoms
only cause cancer at very high levels |
|
|
Term
| what emits ionizing radiation, what are the chacacteristics |
|
Definition
short wavelength, high frequency electromagnetic waves or particles
x-ray, gamma ray, cosmic ray |
|
|
Term
| effects of ionizing radiation |
|
Definition
| ionize molecules and eject electrons |
|
|
Term
| two major health effects of UV radiation |
|
Definition
premature aging of skin
skin cancer |
|
|
Term
| why is skin cancer rates increasein |
|
Definition
| ozone depletion by CFCs increase UVB and UVC |
|
|
Term
| how does UVB and UVA cancer damage |
|
Definition
|
|
Term
| 7 changes induces by UV radiation |
|
Definition
solar elastosis (wrinkling)
injury to langerhans and keratinocytes
damage DNA
pigmentation changes
edema
erythema
acute inflammation |
|
|
Term
|
Definition
histamine release from dermal mast cells
arachidonic acid metabolites
pro-inflammatiory cytokines (IL-1) |
|
|
Term
| which UV causes pigmentation change, how |
|
Definition
UVA oxidizes melanin
increases menalocytes
elongation and extension of dendtiric processes
transfer of melanin to keritanocytes |
|
|
Term
|
Definition
| pyrimidine dimers, DNA breaks, DNA proteins cross link inducing mutations (usually in p53) |
|
|
Term
| how does UV damage langerhans and keritanocytes |
|
Definition
induces apoptosis (thymidine dimers detected)
RAS signaling activated |
|
|
Term
| how does UV cause solar elastosis |
|
Definition
degeneration of elastin and collagen causes increased expression of elastin and MMP degradtion of collagen and indroduction of TIMP
generates ROS |
|
|
Term
| what does ionizing radiation to do the body |
|
Definition
cells in G2 (esp rapidly dividing ones) are pushed into mitosis
produces ROS increasing cell injury |
|
|
Term
| how is the severity of ionizing radiation determined |
|
Definition
single high dose is worse than fractioned
whole body is worse than partial |
|
|
Term
| how much ionizing radiation is needed to cause cancer |
|
Definition
|
|
Term
| causes of acute radiation syndrome |
|
Definition
had whole body radiation
dose dependant
radiation therapy |
|
|
Term
| subclinical radiation syndrome: exposure amount, symptoms, prognosis |
|
Definition
<200 rad
mild nause and vomiting, lymphocytes <1500
100% survival |
|
|
Term
| hematopietic radiation syndrome: exposure amount, symptoms, prognosis |
|
Definition
200-600 rad
intermitent nausea and vomiting
petechiae, hrmorrhage, neutrophil and platelet depression (peaks 2 wek), lymphocytes <1000 uL
infection, may need marrow transplant |
|
|
Term
| GI radiation syndrome: exposure amount, symptoms, prognosis |
|
Definition
600-1000 rad
nausea, vomiting, diarrhea
hemorrhage and infection in 1-3 wks
neutrophil and platelet depression severe
<500 uL lymphocytes
shock and death in 10-14 days even with replacement therapy |
|
|
Term
| CNS radiation syndrome: exposure amount, symptoms, prognosis |
|
Definition
>1000 rad
intractivle nausea, vomiting
confusion, somnolence convlsions,
coma in 15 min - 3h
lymphocytes absent
death in 14-36h |
|
|
Term
| what are delayed radiation injuries |
|
Definition
infertility
cataracts
fibrosis of skin, GI, GU, vagina |
|
|
Term
| why does radiation cause delayed fibrosis |
|
Definition
| up regulation of chemokines and growth factors involved in fibroblast activation and of chemokines which recruit inflammatory cells |
|
|
Term
| significance of thermal injury depends on |
|
Definition
burn depth
%of surface involved (rule of 9s)
internal injuries from fumes
promptness of care |
|
|
Term
| when do burns become fatal, why |
|
Definition
| >50% of body cause shift in body fluids that cause hypovolemic shock |
|
|
