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113 Cards in this Set
- Front
- Back
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What is Groud level ozone
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it refers to ozone in the troposhere and is harmful
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How is ground level ozone formed
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it is formed by a chemical reaction b/w oxides of nitrogen and volatile organic compounds in the presence of sunlight and hot wheather
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Ground level ozone is the primary constituet of ....
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smog
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whats the pathophys of ground level ozone
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it damages Epi cells lining the Res. tract. and also damages type 1 alveolar cells
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what are the chemical manifestations of groundlevel ozone
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1. Coughing, and pain when taking a deep breath
2. Wheezing and breathing difficulties 3. Aggravation of asthma and increased susceptibilty to respiratory ilness 4. Permanant Lung Damage |
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How is CO formed
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it is formed by incomplete combustion of carbon
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56% of all CO emissons worldwide come from
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Motor vehicle ehaust... other causes include
Cigarrette smoking Residental wood burning forest fires |
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the highest levels of CO in outdoor air occur during....
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it occurs during the colder months. when inversions conditions are more frequent. aslo the air pollution becomes trapped near the gound becomes of the warm air.
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CO binds to..
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Hb.200 greater affinty
Cytochrome oxidase |
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CO leads to
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hypoxia at 20-30%
at 60-70% lead to unconsis and death. |
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What happens during Chonic CO poisning
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due to low level but peritent amount of CO
it is caused by widespread ischemic changes in CNS in the BG and LENTICUALR NUCLIE |
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What happens duirng Acute CO
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due to accidental exposure on suicide attempts
CHERRY RE COLOR IN SKIN AND MUCOUS MEMBRANDE BRAIN EDEMA AND PUNCTATE HEMORRHAGE, NERUONAL DEATH |
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CO LEVEL
.1-.9% |
NORMAL
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Carboxyhb levels correlate with acute Co poisinng
10-30 % |
INCREASING HAche and dyspnea
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Carbosyhb levels correlate with acute Co poisning
40-50 |
SEVER HA AND TACHYCARDIA
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carboxyhemoglobin levels correlate with acute CO poisning
60-70% |
COMA SEIZURES.. OFTEN FATAL
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CarboxHb levels correlate to CO toxciity
80% |
RAPILY FATAL
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Sulfur oxides are formed when..
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they are formed when fuel contaiing sulfur is burned, or when gasoline is extracted from oil... or metals extracted from ore.
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when SO2 dissloves in vapor what does it form
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it forms sulfurinc acid.. it then interacts other gasses to from sulfate
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greater thatn 65% of SO2 released to air comes from what
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electirc utilites..especially those that burn coal.
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What problems does SO2 cause
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respiratory problems...
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WHat are nitrogen oxides
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a group of highly reactive gases... usually colorless and odorless..but NO2 seen as a reddish brown layer over many urban areas
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how are nitrogen oxides formed
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when fuel is burned at high temperatures as in a combustion process
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what are the primary manmade sources of NOx
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are motor vehicles, electric utilities
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N oxides can help produce...
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ground level ozone
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N oxides can react with ammonina and form
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nitric acid,... and it can damage lung tissue and casu or worsen res. dis such as ephymesema and brochititis
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Nitrogen can react with other substances in the air and form
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acid rain.
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major source of lead emmissoins
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motor vehicles but now are near lead smelters... waste incenerators.... lead-acid battery manufectors
dont forget flanking lead paint...old building |
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most human exposure to lead occur by
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Ingestion (children) and Inhalation.
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Why are children are at a greater risk for leadt toxciity....
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b/c children absorb >50% fo lead from contamnated foods while adults absorb 15%
2. they also have a more permable BBB.. more suceptable to brain damage. |
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when the lead is absorbed where does it go...
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Bone 85%...1/2 life :20-30 yrs aslo in developing teeth
2. 5-10% remain in blood 1/2life 28-36 days |
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Why do women with prior lead exposrue and significant bone ead levels have a greater chance of exposing the fetus and infant to lead
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b/c lead may be releasd from bones duirng times of Ca stress... suc as pregancny and lactation.
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Pregnant women with elevated blood lead levels main hae an increased chance of ..
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1. Preterm labor
2. Spot. abortion or still birth 3. LBW infant 4. impaired brain development in the fetus... |
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Lead competes with what and binds to what in the bone
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Ca... PO4
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lead binds to what type of enzymes
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those containtng sulfhydrl groups... such as those that invovled in heme synthe
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when lead inhibits Na and K dependent cell adenosin triPO4s what type of anmeia does it cause
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hemolytic anemia... remembr lead aslo inhibts enzymes containg sulfhydryl groups such as those involved in heme syntheis and that can cause mychocytic anemia
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what type of anemia develops when it inhibths sulfhydr. using enzymes
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microcytic hypochromic anema... see this in lead poisining
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with increasing dose what are the clinical manfestations of lead toxiciity
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1. decreased learning and
memory and hyperactivity 2. fatigue, irritbable.. palor 3. Ab. pain vomiting.. constipation 4. paralysis, encephalopthy, death |
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what is the most usfull screnning and diagnositc test for recent or ongoing lead exposure
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venous blood lead concentration (BLC)
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BLC <10
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no action req.
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BLC 10-19
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It a venous blood lead concetration. its a usefull screening nd diagnostic test for ongoing lead exposure.
Re test in 3 months x2, if persienty elevated follow the 20-44 lead exposure |
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BLC 20-44
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retest monthly
perform clinical evaul provide lead education |
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BLC 45-69
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perform clinical evaul and manage with chelators witin 48 hurs
retest montholy |
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BLC >70
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its a medical emergence
hospitlzie and begin immediate chelation therapy pr |
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what are some of the chealing agents for lead
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Ca disodium edetate
dimercaprol d-penicillamine succimer |
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mercury exists in what 3forms
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(metallic quick silver
inorganic mercury (salts) organic ...methylmerucury |
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methymercury comes from what type of food
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fish... shellfish, and animals that eat fish
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all forms of merucury cause what type of symptoms
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1. neuromuscualr signs
2. renal failure |
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Elemen. Mercury...it specifcally cause
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inhalation.. respiratory failure
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inorganic mercury causes...
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Skin rashes
Emotinal changes Mem. Loss and Congnitve Distu Muscle Weakness |
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why is methymercury so toxic
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b/c it is very lipophilic
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Arsenic interferes with what
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mito. oxidative phosporlation
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acute Arsenic toxcitity signs and symptoms
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GI,
Cardio CNS |
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Chronic Arsenic toxciity
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skin hyperpig. hyperkeratosis
sq. cell and basal cell carin lung carn. |
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cadmium casues
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Obsturctive lung dx
Renal tubular damage osteoporiss osteomalcia |
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benzene causes
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aplastic anema
AML |
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polycyclic hydrocarbons
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very potent carcinogen... in cig.
oral cavity larnx and lung p53? |
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organochlorines
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antiestrogenic
antiandrogenic |
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vinyl choloride.. and industrial or agriculture exposure
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hepatic angiosarcoma
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what is the most common eogenous cause of huma cancer and most preventable cause of death
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tobacco
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what is responsible for 90 % of lung cancers
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cigarette smoke... it also multiples the carcinogenic potential of ethanol and / uranium cancer
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what are the componets of cigar. smoke
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polycylci hydrocargons (beznene)
Naphthylamine nitroso polonium-210 arsenic nicel, chromium |
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Napthylamine
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urinary bladder cancer
one of the carcinogens found in cigarettes |
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nitroso
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Cancer of esophagus, pancreus, oral cavity
one of the carcinogens in ciggarettes |
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polonium 210
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Cancer in the oral cavity laryns LUNG
it is one of the carcinogen in ciagrettes |
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ARSENIC..chronic exposure to this toxin can cause
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cancer of skin and lung
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nickel chromium
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cancer of nasas sinuses
one of the carcinogens in cigarette smoke. |
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smokeless tobacco is an important cause of
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oral carcinoma
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smoking can
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1. increase platlet adhesion
2.decrease myocardial oxygen supply.. as result of res. dx 3. increase oxygen demand 4. trigger arrythima |
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is smoking is a riskfactor for development of atheroscleroiss and acute mocardial infaction
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yes
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maternal smoking increases the risk of
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1. Spot. abortion
2. placental abrubtion 3. premature rupture of membranes 4. placenta previa 5. LBW 6. Prematurity. |
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the only way to prevent second hand smoke
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is the eliminate active smoking competly.
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what is the most common drug of abuse
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ethanol
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whats heavy drinking
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drinking more than 2 drinks per day on average for men or more that noe drink per day on average for women
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what is binge drnking
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drinking more that 4 drinks during a single occasion for men or more that 3 drinks dring a single occaseion for women
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breath ethanol is proportionoal to what
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blood ethanol lvel
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what is the definition of drunk.
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80 mg/dl of ethanol in the blood is the legal definition of drunk
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what 3 enzymes metabolize ethanol... which is oxidized to acetaldehyde.
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1. alchol deydrogenase (major)
2 microsmoal cytochrome P-450.. this is important at high blood ethanol levels 3. peroxisomal catalase (minor) |
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Whats the mech. for mito. actealdyde dehydrogenase
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acetaldehyde is oxidized to acetic acid...
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why do they say they have empty calories when driking beer.
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when ethanol is oxidized by alcohol dehydrogenase requres the conversion NAD to NADH. and it is the increased ratio to NADH to NAD inibits fatty acid oxidation and promotes fatty acid synthesiss... leading to hepatic steatosis or fatty liver... also this inhibits oxidation of lactate to pyruvate ( producing metabolic aciosis)
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oxidation by cytochrome p450 produces
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ROS that cause membrane injury by lipid peroxidation
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Ciliatoxins (hydrogen cyanide
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one of the constituents of cig SMOKE THAT affects res. heath.... it impairs tracheobronchial clearacne
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One of the things you see in CIG SMOKE
respiratory irritants (NO2 and formaldeyhede) |
one of the constituents affect res. health... it induce sumbucosal gland hypertrophy., increase in goblet cells
and chronic bronchitis |
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Smokers are prone to (in terms of the respiratory system)
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1. Acute res tract infectoin
2. acute and chronic sinusitis 3. chronic obstructive airway dx 4. Chronic bronchiits (centriacinar emphysema) |
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Smoking can
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1. increse platelet adhesion and aggregation
2. decrease myocardial oxyen supply as a result of respiratory dx 3. increase cardiac oxygen demand 4. trigger cardiac arrhythmia |
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smoking is a rskf factor for develoment of
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atherosclerosism, and acute MI and stroke
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maternal smoking increases the risk of
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Spontaneous abortions
• Acute placental abruption • Premature rupture of membranes • Placenta previa • Prematurity • Low birth weight infants |
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Ethanolo may release what from intestinal bacteria
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endotoxin.. the latter produces from cell injury by stimulating RES cells to release cytokines such as tumor necrosis factor.
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Methano toxciity is caused by
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Inebriation, vomiting, blurring of vision (“as if looking
through a snowstorm”), metabolic acidosis, anion and osmolar gaps |
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ethelyene glycol
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Inebriation, acute renal failure, oxalate and glycolate in
urine, metabolic acidosis, anion and osmolar gaps |
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Isopropyl alcohol
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Inebriation, fruity odor in breath, osmolar gap
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Acute ethanol toxciity causes
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hepatic statosis
gastritis and gastric ulceration. cns depression that may lead to respiratry arrest |
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Chronic ethanol toxcity can casue
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o Alcoholic fatty liver disease
o Gastrointestinal bleeding (gastritis, ulcers, varices) o Malnutrition and vitamin deficiencies (thiamine deficiency) o Congestive cardiomyopathy o Acute and chronic pancreatitis o Increased risk of oral, esophageal, hepatic, and breast cancers |
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Fetal alcohol syndrome
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• Growth retardation and developmental defects
o Craniofacial dysmorphism: microcephaly, short palpebral fissures, smooth philtrum o Brain malformations: holoprosencephaly o Cardiovascular defects: atrial septal defect o Genitourinary malformations o 0.2 to 1.5 per 1,000 live births |
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the most common tpe of preventable mentla retardatin in the us is
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FAS
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in regards to alchol and preg.
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There is no known safe amount of alcohol to
drink while pregnant and there also does not appear to be a safe time to drink during pregnancy (CDC |
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what are te risks nof HRT
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it increase the risk of
ovarian ca/breatcancer endometrial cancer.. although this is reduced if given progestins, it increased the risk of venous thromboembolism (DVT, PE, and stroke) |
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Oral Contracetpties
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increase the risk of Venous thromboembolism
increase risk of atherosclerotic cardio dx in women smoker older than 35 yrs increased rsik of heaptic ademoms with prolonges use increased risk of cerveral cnaer.. no increase in risk of breast cancer decreased risk of endo and ovarian cancers... |
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95 % of Acetamnophen is ..
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conjugated in liver with glucuronide or sulfate
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5 % of Aceaminophen is ...
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converted to NAPQI.. via cytochorme p450 enxyme...
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at toxic does of ACPN
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thats 12- 15 grams... NAPQI accumulates i the liver and prouces CENTRILOBAR (ZONE 3 NECROSIS).. BY COVALENT BINDING TO HEPATIC PROTEINS AND DEPLETION OF REDUCED GLUTAHIONE
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glutahione can be repleted by
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inve N-acetylcysteine
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Acute overdose of Aspirin cna lead to
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res. alkalosis folowied by metabolic acidosis that may be fatal
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in chronic toxicity of asprin the clinica manfestations that you see are
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HA
Tinnitus Hearing diffculty Confusion drowsy N/v GI bleedin blood diathesis analgesic nephropathy |
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Reyes syndrome you see
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acute encephl. microvesical
hepatic failure high mortality after adminstraion of asprin ton child mito. dysfxn. |
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What are the acute affects of Coocaine
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Cardioeffects
>>>sympathometic. blocks the reuptake of DA in the CNS and epi and NE reuptake in the peripheral nerve >>> disrupts ion transport in myocardium >>>> taky HTN Perpheral an coronary VC CNS effects >>> hyperpyrexia seziures |
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what are the chronic effects of coccaine abuse
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nasal septal performatoin in snorters
decreaed pulmanory diffusing capacity insmoke inhaliers dilated cardio. |
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Maternal cocaine abuse affects the fetus...
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spontaneous abortions, placental abruptoion
fetal hypoxia and brain damange |
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what are the features of nonionzing radiation.
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o Long wavelengths, low frequencies
o Electric power, radio waves, microwaves, infrared light, visible light, ultraviolet light o Produce vibration and rotation of atoms |
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Ionzing radiation
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o Short wavelengths, high frequencies
o Electromagnetic - X-rays, gamma rays, cosmic rays o Particulate - alpha and beta particles |
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acute effects of Ionizing radiatoin
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Acute Effects..
1. Direct injury or via fomration of free radicals 2. DNA-protein and DNA-DNA cross links, degradation of bases, cleavage of suar-phosphate bonds, DNA breaks 3. Activation of TF and corresponding genes invovled in cell cycle arrest, DNA repair, apoptosis |
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What are the chronic effects of ionzing radiation
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1. Vascualr injury-ischemia-fibrosis
2. chronic ulcers and strictures 3. Poor wound healing 4. Cataracts 5. infertility |
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Carcinogenesis of ionizing radiation
o Persistent DNA lesions o Epigenetic mechanisms (CpG methylation, telomere shortening) o All leukemias except for chronic lymphocytic leukemia o Carcinomas and sarcomas |
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