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140 Cards in this Set
- Front
- Back
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environmental disease including what personal habits
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smoking, alcohol and drug abuse
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exposure responsible for the most morbidity and mortality
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tabacoo products
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cigarette smoking is a major risk factor for what
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emphysema, chronic bronchitis, and lung cancer
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cigarette smoking is also a risk factor for what
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atherosclerosis, CAD and PAD
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what is most hazardous form of tabacco
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cigarette smoking
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smoking increases the risk of what types of cancer other than lung cancer
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lip, oral cavity, larynx, esophagus, urinary bladder, pancreas, and kidney
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what are the risk of smoking while pregnant
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low birth weight, prematurity, increased risk of spontaneous abortions
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how many cigarettes does it take for fetal hypoxia
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as few as ten
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pack years
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number of cigarettes smoked daily and number of years smoked
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what carcinogens are in cigarette smoke
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chemical and metal carcinogens, arsenic, nickel, cadmium, and chromium
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what is pathogenesis of smoking
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delivered via various routes and then act on distant target organs and cause a variety of systemic diseases
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when does increased risk of lung and laryngeal cancer begin to decline after smoking is stopped
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1-2yrs
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smokers always have what
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increased risk of cancer
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passive smoke leads a an increased risk to what
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lung cancer, ischemic heart disease, and acute myocardial infarction
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maternal smoking increases the risk of what
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sudden infant death syndrome
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children of smokers have increased risk for what
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respiratory and ear infections
exacerbation of asthma |
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what is pneumoconioses
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disease caused by inhalation of any aerosol
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what is the development of pneumoconioses dependent on
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amount of dust retained in lung and airways, size shape and buoyancy of particles, solubility and physiochemical reactivity, additional effects
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what is the cause of coal workers pneumoconiosis
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coal dust
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what is the spectum of findings with coal workers pneumoconiosis
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anthracosis, simple CWP, complicated CWP
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anthracosis
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pigment accumulates without perceptible cellular reaction
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simple CWP
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accumulation of macrophages with little or no pulmonary dysfunction
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complicated CWP
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extensive fibrosis, lung function compromised
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what is PMF
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progressive massive fibrosis the confluent fibrosing reaction in the lung that can be a complication of any pneumoconioses
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what percent of simple CWP will progress to complicated CWP
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<10%
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what is morphology of simple CWP
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coal macules 1-2mm
coal nodules |
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what is morphology of complicated CWP
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background of simple CWP
blackened scars >2cm, up to 10cm multiple |
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caplan syndrome
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coexistence of RA with a pneumoconiosis leading to the development of distinctive nodular pulmonary lesions
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simple CWP and mild forms of complicated CWP fail to do what
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demonstrate abnormalities of lung function
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what develops in a minority of cases with CWP
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PMF
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what are the clinical signs and symptoms of PMF
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increased pulmonary dysfunction, pulmonary hypertension, Cor Pulmonale
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silicosis
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inhalation of crystalline silicon dioxide
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what is most chronic occupational diseae in the world
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silicosis
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what occupations are at high risk for silicosis
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sandblasters and mine workers
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when does silicosis develop
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after decades of exposure
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what is pathophysiology of silicosis
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after inhalation particles interact with epithelial cells and pulmonary macrophages initate injury and cause fibrosis, macrophages rls mediators
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what is early morphology of silicosis
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tiny discrete nodules in upper zones of the lung
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what is the morphology of silicosis as it progresses
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nodules may coalesce into hard collagenous scars, these may undergo cavitation, calcification may be present
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when is silicosis usually detected
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on routine chest radiograph on an asymptomatic worker
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when do patients with silicosis begin to have shortness of breath
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not until PMF is present late in it course
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silicosis has no clear association with what
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development of lung cancer
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what dictates whether or not disease occurs from asbestos
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concentration, size, shape, and solubility
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what are the two distinct forms of asbestos
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serpentine and amphibole
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which form of asbestos is more pathologic
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amphibole
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amphibole exposure has been linked to what
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mesothelioma
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what is the pathogenicity of amphiboles linked to
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aerodynamic and solubility properties
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asbestos can be what
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botha tumor initiator and promoter
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asbestos pathogenesis depends on what
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interaction of fiber with macrophages
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where does injury from asbestos intially begin
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bifurcation of small airways and ducts
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what do asbestos bodies look like
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golden brown, fusiform or beaded rods with translucent center
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what is an asbestos body that is not identified
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ferruginous body
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where does fibrosis begin with asbestos
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around respiratory bronchioles and alveolar ducts
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what are pleural plaques from asbestos
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circumscribed plaques of dense collagen
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where does mesothelioma from asbestos exposure develop
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from either visceral or the parietal pleura
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there is increased incidence of what among people with heavy exposure to asbestos
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malignant mesothelioma
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there is a long what with malignant mesothelioma from asbestos exposure
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long latent period between exposure and development of the tumor
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mesothelioma is usually associated with what
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extensive pleural effusion
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what are the two cells types in mesothelioma
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mesenchymal stromal cells and epithelial like cells
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mesenchymal cells in mesothelioma resemble what
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fibrosarcomas
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epithelial like cells in mesothelioma resembles what
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adenocarcinoma
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asbestosis is usually indistinguisable from what
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any other diffuse interstitial lung disease
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what is usually first manifestation of asbestosis
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dyspnea 10-20 yrs after exposure
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asbestosis may progress to what
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congestive heart failure, cor pulmonale and death
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what are the two types of drug and chemical injury
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exaggeration and unpredictable
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what does acetaminophen cause when taken in large amounts
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hepatic necrosis
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what is toxicity of acetaminophen attributed to
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formation of a toxic metabolite by hepatocytes
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what is the toxic does of acetabminophen
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15-25 grams
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what is fatal dose of aspirin in adults and children
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adults 10-30g
kids 2-4g |
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what is pathogenesis of aspirin overdose
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starts with respiratory alkalosis and is followed by metabolic acidosis which is fatal
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when does chronic aspirin toxicity develop
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people who take 3gm or more daily
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what are signs and symptoms of chronic aspirin toxicity
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headache, dizziness, tinnitus, difficulty hearing, mental confusion, drowsiness, nausea, vomiting, and diarrhea
CNS may include coma and convulsions |
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most widely abused drug in world
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ethyl alcohol
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what are acute effects of alcholism
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CNS depressant
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what is affected in CNS by alcohol
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inhibitory neurons first, cortical, and medullary
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what are signs of chronic alcohol abuse
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cardiomyopathy, wernicke syndrome, and acute gastritis
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10g of ethanol in what
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12 oz of beer
4 oz of wine 1.5 oz of 80 proof liquor |
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amount of alcohol for impairment
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20-30 mg/dl
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amount of alcohol for legally intoxicated
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80-100mg/dl
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amount of alcohol for narcosis
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200-250mg/dl
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amount of alcohol for coma and fatal respiratory arrest
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300-400mg/dl
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what is onset of lead posioning
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insidius
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where is lead absorbed at
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GI and lungs
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absorption of lead is greater in what populations
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children
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what enhances the absorption of lead
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Ca, Iron, or zinc deficiency
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where is lead taken up in children
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bone and developing teeth
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what are the CNS signs of lead poisining in adults and children
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adults=headache, memory loss
child=encephalopathy, mental deteroration |
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what does lead cause in the blood
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anemia: microcytic, hypochromic, basophilic stippling
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what is an important indicator of lead in blood
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elevated blood levels of zinc protoporphyrin
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what are lead effects on GI
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colic and anorexia
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what are lead effects on kidneys
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damage to proximal tubules, diffuse interstitial fibrosis, gout, and renal failure
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what are lead effects on children
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intellectual impairment, behavioral abnormalities, learning deficits
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what are the types of mechanical injuries soft tissue
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abrasion, contusion, laceration, incised wound, gunshot wound
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abrasion
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tearing way of the superficaial layers of the skin caused by blunt trauma
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contusion
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hemorrhage and edema in the skin, soft tissue, or viscera caused by blunt trauma no disruption of continuity of surface
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laceration
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rough edged split or tear in the skin, soft tissue, or viscera caused by blunt trauma
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incised wound
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smooth edged cut in the skin soft tissue or viscera caused by sharp trauma
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what ways does chilling or freezing of cells cause injury
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direct or indirect
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what are direct effects of chilling or freezing
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physical dislocations within cells and high slat concentration incident to crystallization of the intra and extra cellular water
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what are the indirect effects of chilling or freezing
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caused by circulatory changes
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what is trench foot
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slow chilling causing vascoconstriction and paralysis of vasomotor control increased permeability and edema
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what is frostbite
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sudden sharp changes in temp cause vasoconstriction and localized hyperviscosity, ischemic changes, infarction and edema upon warming
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what things facilitate hypothermia
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high humidity in cold, wet clothing and ingestion of alcohol
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when is consciousness loss due to loss of body heat
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90 degrees F
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what happens after loss of consciousness with hypothermia
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bradycardia and atrial fibrillation
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what is the diving reflex associated with hypothermia
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slowing of metabolic processes
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what is the treatment of hypothermia
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controlled internal warming, GI Lavage, peritoneal dialysis, blood transfusion
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what are the effects of hypothermia
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ischemic brain, heart, kidney, and liver damage
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what is severity of burn related to
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% of total body involved, depth of surface involvement, possible presence of internal injuries from inhaled hot gases or fumes, promptness of therapy
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partial thickness burn
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preservation of some part of skin
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full thickness burn
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total destruction of skin and skin appendages
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when are burns grave and potentially fatal
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when it involves 50% of body surface
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what is a serious complication of burns
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infection
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what is severity of internal thermal injury related to
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depth of inhalation
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what are types of internal thermal injury
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oral cavity burns, laryngeal, tracheobronchial
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heat cramps
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loss of electrolytes through sweating
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heat exhaustion
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failure of cardiovascular system to compensate for hypovolemia due to water depletion
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heat stroke
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failure of thremoregulatory system, cessation of sweating, increased core temperature
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what is grave prognostic sign of heat stroke
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rectal temp of 106 degree F
50% mortality |
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what factors influence severity of electrical injuries
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currents magnitude, duration, path, and resistance of intervening tissue
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electrical signals can disrupt what
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nerve impulses and cardiac
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electrical injuries can cause what markings
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burns marking entry and exit
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what are the types of radiation
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alpha, beta, gamma, X-ray
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what are direct effects of radiation
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direct hits on target atoms like DNA which can cause breaks in strands and without repair mutations
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what are indirect effects of radiation
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radiolysis of cellular water formation of hot free radicals
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which cells are more radiosensitive
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rapidly dividing cells, cells in G2
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which doses are more lethal
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single dose of external radiation admin to whole body
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what are acute effects of radiation
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overt necrosis, subcellura damage, genetically damaged cells may become malignant
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what are effects of radiation on skin
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desquamation and atrophy, hyper and hypopigmentation, damage to blood vessels, impaired healing, ulceration and increases susceptability to infection
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what are effects of radiation on hematopoietic and lymphoid systems
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bone marrow decrease in cellularity
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what initial effect of radiation on blood vessels
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inflammatory reaction which may accompany necrosis of endothelial cells
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what are later effects of radiation on blood vessels
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subintimal fibrosis, fibrosis of muscle wall, degeneration of elastic lamina, narrowing of lumen
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what are effects of radiation on gonads
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sterility
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what are effects of radiation on lungs
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acute injury and chronic radiation pneumonitis, dyspnea, chronic cough, diminished lung function
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what are effects on GI of radiation
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esophagitis, gasteritis, enteritis, colitis, and proctitis, exfoliation of mucosa
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what are effects on heart of radiation
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damage to heart and pericardium
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what are effects on kidneys ane urinary bladder of radiation
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acute necrosis of epithelium
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what are effects on CNS
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focal necrosis and demylination in brain and damage to small blood vessels in spinal cord leading to necrosis, demylination, and paraplegia
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what are effects of radiation on eyes
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cataracts, retinal and ciliary arteris
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what is dose for acute radiation sickness
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LD50 those exposed to 250-400 rad in 60 days
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what are clinical syndromes of radiation
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subclinical, hematopoietic, gastrointestinal, central nervous system
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