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117 Cards in this Set
- Front
- Back
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In Lipophilic Toxicant Metabolism - in what phase does hydrolysis, reduction, and oxidation take place
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phase 1
a primary metabolite (reactive electrophilic) is produced. e.g oxygen free radicals |
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In lipophilic toxicant metabolism the primary metabolit may undergo a phase II reaction which involves
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confugation with endogneous substrate yielding a secondary metabolite
e.g glucuronidation, sulfation, methylation, conjugation |
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benzoapyrene metabolism in lung, skin tumors involves what PHASE I reaction
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cytochrome P450-dependent monooxigenase system
other E.g of Phase 1 1. flavin-containing monooxygenase system involving nicotine in the liver 2. peroxidase-dependent cooxidation of 2-napthylamine and the link to bladder cancer |
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napthylamine's second metabolite which is excreted in urine and linked to bladder cancer has under gone
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glucuronidaiton
(Phase II reaction) another example: is glutathione conjugation leading to vinyl chloride (secondary metabolite) leading to angiosarcoma of the liver |
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Minamata disease
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named after minimata Bay - mercury fish were allowed to be caught and consumed
Mercury under went a phase II biomethylation and bioaccumulated |
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Toxic effects depend on what five things
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1. Genetic variations in enzyme acitivity
2. predominant pathway 3. nutritional/hormonal status 4. exognenoug substances 5. repair pathways |
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the acute nicotine effects are via
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catecholamines
increase HR, BP, CBF, contractiligy, CO mobilization of free fatty acids, addiction |
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what effect does tobacco have on the fetus
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fetal hypoxia
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why might tobacco cause acute respiratory tract infections
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ciliatoxins and irritants
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what effects does ethanol have on the CNS
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it acutely depresses
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what are the chronic effects of ethanol
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systemic effects, vitamin deficiencies
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what is the blood alcohol content which may cause ataxia
drowsiness stupor death |
ataxia 100mg/dL
drowsiness 200 stupor 300 death 500 |
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what is the elimination rate for ethanol
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9 gm ETOH per hour
10% in urine, seat, breath, 90% metabolized to acetaldehyde |
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tolerance to alcohold due to the induction of
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cytochrome p450 CYP2E1
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why might asian populations might have a distinct reaction to ethanol
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reduced activity of aldehyde dehydrogenase
women have lower levels of alcohol dehydrogenase |
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what are the 4 main mechanisms for the development of a fatty liver due to consumption of alcohol
note: this fatty liver is acute, asymptomatic, and reversible |
1. increased catabolism peripheral fat
2. increased NADH for lipid synthesis 3. Decreased fatty acid oxidation in Mitochondria 4. decreased transport lipoproteins from liver (microtubule dysfunction) |
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in acute alcoholic hepatitis what are three pathological characteristics
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1. necrosis
2. PMNs 3. Mallory's hyaline acute alcoholi hepatitis is symtpomatic and reversible |
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5 mechanisms of direct toxicity in acute alcoholic hepatitis
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1. glutathione depletion
2. mitochondrial injury 3. altered methionine metabolism 4. cytokine release from Kupffer cells 5. Hypoxia |
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10% to 15% of alcoholics develop cirrhosis of the liver what are some symtoms
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path: hard, shrunken liver
pt may be weak, wasted, ascites, GI bleed, coma |
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Wernicke syndrome
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due to alcohol via thiamine deficiency. ataxia, cognition, opthalmoplegia, nystagmus
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Korsakoff syndrome
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due to alcoholism
via toxicity and thiamine deficiency memory loss |
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protective effects of alcohol
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increased HDL
decreased platelet aggregation |
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effects of alcohol on cardiovascular system - negative
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hypertension due to catecholamine release
dilated cardiomyopathy |
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most common preventable cause of Mental retardation
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fetal alcohol syndrome
growth retardation, microcephly |
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barbiturates and benzodiazepines are what kind of drugs
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sedative hypnotics
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aphtamines are toxic to what kind of neurons
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serotonin
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what are some symtoms of acute intoxication with amphtamines
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sweating, tremors, restlessness, confusion, delirium, convulsions, coma death
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alkaloid extracted from leaves of erythroxylon coca
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cocain
crack cocaine is a freebase cocaine |
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chronic abuse of cocain leads to
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insomnia, anxiety, paranoia, hallucinations
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what happens with an overdose of cocain
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seizures, cardiac arrhythmias, respiratory arrest
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what is cocainse's mechanism
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blocks reuptake of dopamine, serotonin, catecholamines in presynaptic terminals
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when cocaine blocks the reuptake of dopamine - the resulting symptoms are
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eurphoria, paranoia, hyperthermia
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when cocaine blocks the reuptake of NE causing NE to bind the adrenergic receptor more the resulting symptoms are
(name 3) |
hypertension, caridac arrhythmia, myocaridal infarct, cerebral hemorrhage and infarct
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why does cocain accelerate atheroslcerosis
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1. enhanced platelet ativation/ aggregation
2. increased PAI 3. increased endothelial permability |
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heroin, codeine, morphine are what kind of drugs
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opioid narcotics
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the side effects of these types of drugs are anxiolytic, sedation, mood changes, nausea, and respiratory depression
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opioid narcotics
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an overdose on opioid narcotics results in what
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convulsions, cardiorespiratory arrest, death
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these drugs may lead to infection (IVDA)
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opioid narcotics
skin, subcutaneous, heart valves (staph aureus), liver (viral hepatitis), lungs |
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most common preventable cause of Mental retardation
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fetal alcohol syndrome
growth retardation, microcephly |
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barbiturates and benzodiazepines are what kind of drugs
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sedative hypnotics
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aphtamines are toxic to what kind of neurons
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serotonin
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what are some symtoms of acute intoxication with amphtamines
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sweating, tremors, restlessness, confusion, delirium, convulsions, coma death
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alkaloid extracted from leaves of erythroxylon coca
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cocain
crack cocaine is a freebase cocaine |
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chronic abuse of cocain leads to
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insomnia, anxiety, paranoia, hallucinations
overdose: seizures, cardiac arrhythmias, respiratory arrest |
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what is cocainse's mechanism
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blocks reuptake of dopamine, serotonin, catecholamines in presynaptic terminals leading to eurphoria, paranoia, and hyperthermia
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why does cocain accelerate atheroslcerosis
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1. enhanced platelet ativation/ aggregation
2. increased PAI 3. increased endothelial permability |
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heroin, codeine, morphine are what kind of drugs
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opioid narcotics
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the side effects of these types of drugs are anxiolytic, sedation, mood changes, nausea, and respiratory depression
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opioid narcotics
drugs may also lead to infection - skin, subcutaneous, heart valves (staph, liver (liver hepatitis, lung etc.. |
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an overdose on opioid narcotics results in what
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convulsions, cardiorespiratory arrest, death
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PCP and LSD are examples of what kind of drugs
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chemical hallucinogens
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Marijuana is an example of what kind of drug
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natural hallucinogen
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marijuana's active ingredient is
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THC
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chronic use of marijuana may induce
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lung damage (not a carcinogenic)
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5% of all drugs are metabolized by
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CYP1A2
and 12% of caucasians have variants with reduced activity |
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oral contraceptives/ HRT have increased risk of
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stroke
MI (smokers over 35) thrombosis/PE breast cancer (HRT) endometiral cancer (HRT |
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ADR
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Adverse Drug reactions
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for what cancer is OCP protective
(contraceptives) |
endometrail and ovarian
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what is the therapeutic dose of acetaminophen
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.5 gm
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at what does dose acetaminophen yield hepatic necrosis
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15-25gm
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what is the acute toxic dose of aspirin
what does it cause |
2-4 gm kids / 10-30 gm adults
respiratory alkalosis then metabolic acidosis |
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the chronic toxicity of this drug leads to acute erosive gastritis, petechiae, renal papillary necrosis
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aspirin
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what is the dose of aspirin that may cause chronic toxicity
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3+ gm per day
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why does aspirin cause petechiae
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COS inhibition
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radioactive decay product of uranium emits radiation associated w/ lung cancer
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radon
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colorless odorless gas w/ 200x affinity for Hb
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carbon monoxide
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absorption of lead is enhaced by
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calcium/iron, and zince deficiency
greater in children (80-85% in bone and teeth, 5-10% in blood, rest in soft tissue) |
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how does lead lead to hypochromic anemia
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via the inhibition of iron incorporation into heme
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how does lead affect CNs
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inverse correlation between IQ and blood lead level
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how does lead affect Gi tract and kidneys
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lead colic and renal failure
inhibits membrane associate enzymes |
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lead impairs the production of what vitamin
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active vitamin D
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how does lead influence reproduction
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infertility, delayed puberty, fetal toxicity
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organophosphates (type of insecticide irreversibly inhibit
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cholineresterases
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carbamates
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reversibly inhibit cholineesterase
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agent orange is
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a dioxin (TCDD) and herbicide
which is carcinogenic an teratogenic, and immunotsuppressive |
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aflatoxin B1 a mycotoxin has been linked to
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liver cancer
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the phytotoxin cycasin has been linked to A
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ALS
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saxitoxin is a natural toxin linked to
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paralytic shellfish poisoning
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body surface area burned effects outcome how
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20% BSA = shock
over 50% = death |
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BSA re burns refers to
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Body surface area
head = 9% neck = 1 arm = 9 each trunk = 18 each side leg = 18 |
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1st degree burn means
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partial thickness burn through epidermis only
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2nd degree burn
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partial thickness through epidermis and superficial dermis
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full thickness burns (3rd and 4th degree characteristics?
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dry, white, or charred
toatl destruction of epidermis and dermis |
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20% BSA burned leads to
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increased local intersitial osmotic pressure and increased vascular permeability
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inhalation injury due to smoke may be delayed how long
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24 -48 hours
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how does 40% BSA affect metabolic rate
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doubles metabolic rate and
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why might you get heat cramps
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voluntary muscles cramps do to electrolyte imbalance do to exertional sweating
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what are the three steps on your way to hyperthermia
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1. heat cramps
2. heat exhuastion - (prostraiton and collapse do to hypovolemia do to water depletion do to seating w/ inadequate fuid replaement - normal core temp 3. heat stroke |
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three groups of people at risk for heat strokes
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1. elderly
2. military recruits, 3. athletes at risk |
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50% mortality if temp is above
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106
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loss of thermoregulation and hypothermia aggreavated by
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humidity and ethanol (cutaneous vasodilation)
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at what temp do you see systemic efects of hypothermia
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below 90F
LOC, bradycardia, AFib |
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what is a direct local effect of hypothermia on
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crystallizatoin of water w/ increased salt
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what is an indirect local effect of hypothermia
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vasoconstriction and permeability (edema, and ischemia)
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the resistance to electrical injury is inversely proportional to
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water content
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Low voltage causes
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ventricular fibrillation
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high voltage causes
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paralysis of medullary centers, asystole
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HAPE and HACE stand for what
they occur as high altitude above 4000 m |
HAPE pulmonary edema
HACE high altitude cerebral edema |
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CAGE, "bends", chokes, stagers, caissons disease of the bone are all due to
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rapid decompression - barotrauma / decompression sickness
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two forms of protein energy malnutrition
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somatic: skeletal muscle depleted - marasmus
visceral: organs and liver - depleted in kwashiorkor |
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what diagnostic test could you use to asses visceral protein energy stores
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serum protein analysis
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secondary protein energy malnutrition includes what two categories
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1. malabsorption: impaired utiliazation or excess losses
2. chronically ill patiens with depletion of fat and muscle, edema |
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syndrome X has what symptoms
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abdominal abesity
insulin resistance incread TAG Decreased HDL Hypertension Coronary artery disease |
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cytokine secreted by adipocytes
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Leptin
crosses BBB and binds leptin receptor. inhibits anabolic circuits and triggers catabolic circuits. reduces food intake and promotes energy expenditure. elevated blood levels (low CSF levels) in most obese persons |
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a mutation in POMC and PC1 (4) cause what
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obesity
they are leptin receptors. autsomal recessive, rare. hyperphagia, childood onset massive obesity |
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a leptin receptor common (5 to 8%) of obese persons which leads to the inabilit to stimulate energy consumption
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melanocotin receptor
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essential for the formation of second order leptin neurons
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SIM1 transcription factor
mutation in obese persons? |
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prevents diverticulosis
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dietary fiber
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diet which limits MI
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fruits, veggies, limited meat and processed foods
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reverses preneoplastic lesions
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retinoic acid
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how does a high fiber diet protect from cancer
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1. decrease transit time
2. certain fibers bind carcinogens |
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non-neoplastic lung reaction to inhalation of mineral dusts in the workplace
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pneumoconioses -
now includes reacations to organic and inorganica particulates, fumes, and vapors |
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what size particle of dust is most harmful in causing pneumoconioses
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1 to 5 microm
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most prevalent chronic occupational disease in the world
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silicosis
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what is silicosis
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inhaled silica which is engulfed by marcophages and triggers an inflammatory response
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what is the disease spectrum f silicosis
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slowly progressing disease w/ upper zone nodules progresin to coalescend scars to progressive massive fibrosis
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fibers which may cause asbestos related disease
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serpentine fibers (most common and less pathogenic)
amphibole fibers (more pathogenic) |
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how does asbestos stimulate pulmonary fibrosis
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the fibers are ingested by phagocytes and they timulate fibrosis
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