Term
global burden of disease
-5 preventable causes of child deaths |
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Definition
undernutrition
ischemic HD and CVD
infxn: Bacteria & Rickettsia (54%), viral (25%)
pneumonia, diarrhea, malaria, measles, perinatal/neonatal (prematurity, neonatal infxns) |
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Term
| emerging infectious diseases |
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Definition
MRSA
SARS
Dengue fever: a recent increase in incidence |
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Term
|
Definition
disability-adjusted life year, time based measure that adds the years of life lost to premature mortality with the years lived with illness and disability
used to measure premature mortality and disease morbidity
uniformity for health info in different parts of the world |
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Term
| effects of greenhouse gases & global warming on health |
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Definition
CVD, cerebrovascular, respiratory diseases
gastroenteritis and infectious disease epidemics (contamination)
vector-borne infectious diseases (West Nile, hantavirus pulmonary syndrome)
malnutrition |
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Term
Xenobiotics
-characteristics
-metabolism |
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Definition
lipophilic, penetrate membranes by diffusion, and transported by lipoproteins in blood
phase I: hydrolysis, oxidation, or reduction
-most imp: CYP, catalyze rxns that either detoxify or activate into active compounds that cause cellular injury
phase II make them water-soluble: glucuronidation, sulfation, methylation, conjugation -> readily excreted
both types may produce ROS |
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Term
Cytochrome P450 enzyme system
-purpose of drug metabolism?
-where do you find CYP?
-potential toxic byproduct? |
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Definition
The basic purpose of drug metabolism in the body is to make drugs more water soluble and thus more readily excreted in the urine or bile.
One common way of metabolizing drugs involves the alteration of functional groups on the parent molecule (e.g., oxidation) via the cytochrome P450 enzymes.
These enzymes are most predominant in the liver (ER, microsomes) but can also be found in the intestines, lungs and other organs.
may produce ROS |
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Term
| Acetominophen metabolism & toxicity |
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Definition
95% -
detox by phase II enzymes
excretion in urine as glucuronate or sulfate conjugates
no toxicity
5% -
CYP2E1
NAPQ
-> conjugation with GSH, no toxicity
OR
-> protein adducts, lipid peroxidation
--> liver failure, hepatocyte necrosis |
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Term
Ozone pollutant; effects in:
-healthy people
-athletes, outdoor workers
-asthmatics |
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Definition
d/c lung function, i/c airway reactivity, lung inflammation
d/c exercise capacity
i/c hospitalizations |
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Term
Nitrogen dioxide, effects in:
-health adults
-asthmatics
-children |
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Definition
i/c airway reactivity
d/c lung function
i/c respiratory infxns |
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Term
Sulfur dioxide, effects:
-health adults
-people with chronic lung disease
-asthmatics |
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Definition
i/c respiratory symptoms
i/c mortality
i/c hospitalization
d/c lung function |
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Term
Acid aerosols, effects in:
-health adults
-children
-asthmatics |
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Definition
altered mucociliary clearance
i/c respiratory infxns
d/c lung function
i/c hospitalizations |
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Term
Particulates, effects in:
children
people with chronic lung or heart disease
asthmatics |
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Definition
i/c respiratory infxn
d/c lung function
excess mortality
i/c attacks |
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Term
CO poisoning
-describe the gas
-effects on O2 curve
-skin changes
-CNS changes, CV changes |
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Definition
odorless, colorless, byproduct of combustion
worse with low atm pressure, i/c rain & humidity
CO binds Hb -> COHb
250x stronger than O2 and Hb
left shifts in O2 dissociation curve
*hypoxemia*
"cherry red," bright pink lividity
asphyxia, cell hypoxia
white matter demyelination
liquefactive necrosis in the brain
hypotension
myocardial depression |
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Term
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Definition
sealants, furnishings, perm press
old homes - resins
burning, tingling in ENT
chest tightness, wheezing
acute hypersensitivity (esp asthmatics)
toxicity to cilia
mucosal irritation |
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Term
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Definition
#2 cause of lung cancer (squamous cell carcinoma)
decay of radium (uranium)
high-energy alpha particles
underground miners
i/c risk to smokers 10-20x |
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Term
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Definition
eye and/or nasopharyngeal irritation
rhinitis or nasal congestion
inability to concentrate
general malaise-complaints
commonality of symptoms
no symptoms when occupants leave the building
humidity makes it worse
low levels of pollutants work synergistically |
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Term
Lead poisoning
-what kind of anemia do you get?
-kids (what test would you do?)
-adults
-sources of lead in the environment
-how do you measure lead poisoning (blood, urine)
-histologically, what would you see in the peripheral blood? the BM? |
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Definition
microcytic, hypochromic anemia (lead inhibits d-ALA dehydratase, ferrocheletase)- when poisoning is severe
i/c SI, d/c TIBC
low levels: intellect, behavior, organizational skills
impaired remodeling of calcified cartilage in epiphyses -> i/c radiodensity ("lead lines")
encephalopathy
lead lines in epiphysis and gums
Zinc protoporphyrin (will be high)
blood
CNS toxicity
peripheral motor nerve demyelination
lead colic
renal tubular acidosis
renal failure
gingivodental lead lines
lead paint, lead plumbing, and lead gasoline
batteries, spray painting, tin cans, car radiators
Blood - protoporphyrin IX
Urine - d-ALA
Blood - basophilic stippling
BM - ringed sideroblasts |
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Term
Mercury poisoning
-clinical manifestations
-problems
-environmental sources |
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Definition
"Mad Hatter" - tremor, gingivitis, bizarre behavior
-neurotoxicity
-nephrotoxicity
contaminated fish, dental amalgams |
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Term
Acute arsenic poisoning
Chronic arsenic poisoning |
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Definition
hemorrhage gastroenteritis
CNS manifestations (paresthesias, numbness, pain)
risk for squamous cell carcinoma of skin and lung
skin changes
abdominal pain
peripheral neuropathy |
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Term
Cadmium poisoning
-symptoms
-occupational hazards |
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Definition
COPD (necrosis of alveolar macrophages)
lung carcinoma
renal tubular damage, renal disease
osteoporosis and osteomalacia - calcium loss
mining, electroplating, production of nickel-cadmium batteries, food exposure |
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Term
Human Diseases Associated with Occupational Exposures
CV system |
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Definition
Heart disease:
Carbon monoxide
lead solvents
cobalt
cadmium |
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Term
Human Diseases Associated with Occupational Exposures
Respiratory system
Lung cancer
COPD
hypersensitivity
irritation
fibrosis
no significant disease |
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Definition
Lung cancer: radon, asbestos, silica, arsenic
COPD: cadmium
Hypersensitivity: beryllium
Irritation: formaldehyde
Fibrosis: Silica, asbestos
NSD: anthracosis (carbon) |
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Term
Benzene
-associated cancer?
-hematologic problems with chronic exposure?
-two major diseases can result from benzene toxicity
-occupational hazards? |
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Definition
leukemia (AML)
anemia, leukopenia, thrombocytopenia, pancytopenia
damage the DNA of pluripotent stem cells
aplastic anemia
AML
rubber workers |
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Term
Human Diseases Associated with Occupational Exposures
GI - liver angiosarcoma |
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Definition
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Term
nervous sytem
peripheral neuropathies, ataxic gait
CNS depression |
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Definition
peripheral neuropathies, ataxic gait: Solvents, acrylamide, methyl chloride, mercury, lead, arsenic, DDT
CNS depression: Chlordane, mercury |
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Term
Human Diseases Associated with Occupational Exposures
Urinary system
toxicity
bladder cancer |
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Definition
toxicity: mercury, lead, glycol esthers, solvents
bladder cancer: naphthylamines, 4-aminobiphenyl, benzidine, rubber |
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Term
Human Diseases Associated with Occupational Exposures
Repro
Male infertility
Female infertility/stillbirths |
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Definition
Male infertility: Lead, phthalate plasticizers, cadmium
Female infertility/stillbirths: Lead, mercury |
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Term
Human Diseases Associated with Occupational Exposures
Repro
Male infertility
Female infertility/stillbirths |
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Definition
Male infertility: Lead, phthalate plasticizers, cadmium
Female infertility/stillbirths: Lead, mercury |
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Term
Human Diseases Associated with Occupational Exposures
Skin
Folliculitis & acneiform dermatosis
Cancer |
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Definition
Folliculitis & acneiform dermatosis: dioxins
Cancer: UV radiation |
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Term
pneumoconiosis
-associated dusts?
-respiratory symptoms
-what other disease is it associated with? |
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Definition
chronic, neoplastic lung diseases caused by inhalation of mineral dusts
-coal dust
-silica
-asbestos
-beryllium
interstitial; pulmonary fibrosis
calcified parietal pleura
associated with mesothelioma
*honeycomb lung - fibrosis* |
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Term
Organic solvents
-disease risk? |
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Definition
chloroform, carbon tetrachloride, benzene
AML |
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Term
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Definition
fossil fuel combustion
lung, bladder cancer |
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Term
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Definition
DDT, PCBs, dioxin
endocrine disruptors, anti-estrogenic/anti-androgenic |
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Term
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Definition
folliculitis, chloracne, hyperpigmentation
President of Ukraine |
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Term
List the carcinogens and noxious chemical in tobacco smoke
most common diseases caused by smoking?
complications for pregnancy?
dangers of 2nd hand? |
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Definition
carbon monoxide, arsenic, formaldehyde, tar, and nicotine
emphysema, chronic bronchitis, COPD, lung cancer, atherosclerosis, MI, cancers of the lip, mouth, pharynx, esophagus, pancreas, bladder, kidney, cervix
-squamous and small cell carc of the lung, not adenocarcinoma
spontaneous abortion
lung cancer, coronary atherosclerosis, MI, i/c levels of cotinine in the blood |
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Term
Ethanol metabolism
The effects of the products of ethanol metabolism |
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Definition
ADH - rate-limiting!! -- cytosol
catalase - 5% -- peroxisome
CYP2E1 - oxidation -- ER/microsome
ALDH - metabolizes acetaldehyde -- mitochondria
Induction of CYP i/c the tolerance for alcohol
Acetaldehyde: oral cancers, acute alcohol effects; ppl with low ALDH can't drink
Increase in the NADPH/NAD ratio: NAD is req'd for fatty acid ox in the liver, def is main cause of fatty liver; also lactic acidosis
Production of ROS: lipid peroxidation of cell membranes |
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Term
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Definition
mainly CNS, hepatic steatosis, acute gastritis and ulceration
disordered behavior, respiratory arrest
hepatitis & cirrhosis, portal HTN, hepatocellular carcinoma
gastritis, ulcers, esophageal varices
thiamine def: peripheral neuropathies, Wernicke-Korsakoff syndrome, cerebral atrophy, cerebellar degen, optic neuropathy
alcoholic cardiomyopathy, HTN
acute and chronic pancreatitis
FAS
cancer: oral cavity, esophagus, liver, breasts
malnutrition |
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Term
Adverse effects of HRT
Risks of OCs |
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Definition
i/c breast cancer risk
i/c risk of venous thromboembolism
Thromboembolism
CVD (higher in smokers)
Endometrial, ovarian cancers
*Hepatic adenoma* |
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Term
| Adverse effects of anabolic steroids |
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Definition
inhibits LH, FSH
i/c estrogens
stunted growth, acne, gynecomastia, testicular atrophy, facial hair, menstrual changes
hepatic cholestasis |
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Term
| adverse effects of acetaminophen |
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Definition
conversion to free radicals in the liver, liver and kidney damage
when taken in larger doses unconj NAPQI accumulates and causes hepatocelluar injury leading to centrilobular necrosis and liver failure
-covalent binding to hepatic proteins
-depletion of GSH |
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Term
acute aspirin toxicity/overdose
chronic aspirin toxicity |
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Definition
confusion, respiratory acidosis and metabolic acidosis
alkalosis followed by metabolic acidosis, enhances the formation of non-ionized forms of salicylates, diffuse into brain, nausea, coma
tinnitus, acute erosive gastritis and upper GI bleeding, impaired platelet function due to reduced platelet aggregation |
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Term
| adverse effects of cocaine |
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Definition
euphoria, seizures, cardiac arrhythmias, perforated nasal septum, and sudden death
fetal hypoxia, spontaneous abortion |
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Term
adverse effects of heroin
prenatal effects |
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Definition
cardiopulmonary arrest and sudden death due to overdose; pulmonary foreign body granulomas, infections and pulmonary edema; infections of skin, heart valves, and liver
endocarditis
kidney disease
sudden death
baby born addicted to heroin |
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Term
List and define (giving appropriate examples of physical injuries) the following
Contusion
Abrasion
Laceration
Incised wound
Puncture wound, penetrating and perforating |
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Definition
bruise, blunt object, extravasation of blood
scraping/rubbing, removal of superficial skin layer (epidermis)
tear, blunt object, intact bridging BV and jagged, irregular edges, facial fractures
inflicted by a sharp instrument, bridging BV are severed
long, narrow instrument, penetrating (no exit) or perforating (exit wound) |
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Term
Thermal Injury
First-degree
Second-degree
Third-degree
what can make the prognosis worse?
the clinical significant of a burn injury depends on 4 factors: |
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Definition
First-degree
Painful, partial-thickness burns (e.g., sunburn)
Heal without scarring
Second-degree
Painful, partial-thickness burns
Damage to entire epidermis
Blister formation / Usually heal without scarring
Third-degree
Painless full-thickness burns
Extensive necrosis of epidermis and adnexa
Scarring is inevitable.
Inhalation injury
Depth of the burns
Percentage of body surface involved
Internal injuries caused by the inhalation of hot and toxic fumes
Promptness and efficacy of therapy, especially fluid and electrolyte management and prevention or control of wound infections |
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Term
Effects of hyperthermia
-3 |
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Definition
Heat cramps
Painful, involuntary spasmodic contractions of muscle
Due to deficiency of sodium, potassium, and fluids in muscle fibers
May occur in individuals sweating profusely without proper fluid replacement
Heat exhaustion
Significant volume depletion (salt and water depletion) with or without increase in body temperature
Major heat syndrome: heat stroke
> 40° C (>104° F), anhidrosis (absence of sweating), impaired consciousness |
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Term
Hypothermia
-pathogenesis
-clinical findings |
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Definition
Frostbite
Pathogenesis
Localized tissue injury caused by direct damage (ice crystallization in cells)
Indirect damage (vasoconstriction, thrombosis)
Clinical findings
Loss of pain sensation or burning/tingling sensation
Discoloration of the skin; waxy appearance; cold to the touch
Left untreated, skin gradually darkens (becomes completely black) and blisters
vasoconstriction and increased viscosity of the blood in the local area cause ischemic injury |
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Term
Electrical injury
-AC vs DC
-resistance
-what's the most dangerous route for a current to travel? |
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Definition
AC-tetanic contractions
DC-single shot
Wet skin decreases resistance, which increases current.
Dry skin increases resistance, which decreases current.
Path: current moving from the left arm to the right leg
Most dangerous route, because it affects the heart
Death results from cardiorespiratory arrest |
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Term
List the tissues/cells that are the most radiosensitive
List the tissue/cells that are least radiosensitive
cancers caused by radiation?
-most frequent? |
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Definition
high mitotic index
lymphoid tissue, BM, GI mucosa, germinal tissue
bone, brain, muscle, skin
*AML*
Hodgkin's lymphoma
Papillary carcinoma of the thyroid |
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Term
Non-ionizing radiation
precursor for cancer?
associated cancers |
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Definition
UVB
actinic (solar) keratosis
basal cell carc: most common UVB cancer
squamous cell carc
malignant melanoma |
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Term
|
Definition
Asbestosis - calcified plaques
Mesothelioma - carcinoma that forms along the PLEURA of the lungs |
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Term
| *How does tobacco cause its harmful effects?* |
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Definition
hydrocarbons, tar, benzopyrene, and nitrosames are carcinogens
CYP and phase II enzymes produce some intermediates that are electrophillic and form DNA adducts
*they cause mutations in oncogenes and tumor suppressor genes such as KRAS and p53 respectively* |
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Term
| *what's the most dangerous sequelae to an electrical burn?* |
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Definition
V fib
left arm to right leg
can cause other heart arrythmias as well |
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