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59 Cards in this Set

  • Front
  • Back

Types of carbon monoxide poisoning

Acute poisoning


- accidental exposure or suicide attempt


- Cherry red color of the skin and mucous




Chronic poisoning


- Ischemic changes with permanent neuro sequele

Collapse and syncope occur when how many percent of Hemoglobin is converted to carboxyhemoglobin

40 %

lead concentration in blood and its effect

10 ug/ml- Developmental toxicity




40 ug/ml- decreased hemoglobin synthesis




100 ug/ml- encephalopathy, nephropathy, frank anemia, colic




150 ug/ml- death

Lead poisoning effects in BONES



Interfere with bone remodeling of epiphyses in children (Lead lines)

Lead effect in BLOOD

Inhibition of ferrochelatase




Iron lade mitochondria (Ringed sideroblast)




Microcytic hypochromic anemia with mild hemolysis




Basophilic stippling

Lead effect in GI

Sever poorly localized abdominal pain (Lead Colic)

Lead effect in Nervous system

Children:Sensory, motor, intellectual and psych impairments




Adults: Peripheral demyelinating neuropathy (Foot drop and Wristdrop)

Lead effect in Kidneys

1. Proximal tubular damge with lead inclusions


2. Impaired Uric excretion (Saturnine gout)

Treatment of lead poisoning


CHELATING AGENTS:


Acute: EDTA +- Dimercaprol




Out patinet managment: oral SUCCIMER

Mercury poisoning source

Contaminated fish


Dental amalgams


Gold mining


Mercury vapors





The main intracelluar protective mechanism against mercury poisoning

Glutathione

Cause of MINAMATA disease and its clinical manifestation

Methylmercury poisoning




Cerebral palsy, deafness, blindnes, mental retardation

Treatment for Mecury poisoning

Acute inorganic: Oral succimer or IM dimercaprol




Chronic: SUCCIMER or UNITHIOL


-Do not give Dimercaprol

The poison of kings and the kings of poison

Arsenic




Source: pesticides, Agricultural products, burning of coal

Morphology of arsenic poisoning

Milk and rose complexion


Hyperkeratosis


diarrhea


transverse bands in nails (Mee's Line


Convulsion

Cancers associated with arsenic poisoning

SCCA of the skin, Liver angiosarcoma, Lung cancer

Most commmon exogenous cause of human cancers and most preventable cuase of human death

TOBACCO

The most wildly used and abused agent throughout the world

Alchohol

Alcohol Metabolism

Biotransformed to acetaldehyde by acetaldehyde dehydrogenase increasing NADH/NAD ratio




At high level


- Microsomal ethanol-oxidizing system

Morphology of alcoholism

Acute alcoholism:


- Fatty change (Hepatic steatosis)




Chronic Alcoholism


- Alcoholic hepatitis and cirrhosis


-thiamine deficiency


-dilated cardiomyopathy


-hpn


-CHD


-Acute and chronic pancreatitis

Superficial excoriation of the epidermis

Abrasion

Blunt force injury to blood vessels with subsequent of blood into tissue

Contusion (Bruise)

Sharp Margins with severed bridging blood vessels

Incision

Jagged tear with intact bridging blood vessels, nerves and connective tissue

Laceration

When instrument pierces the tissue

Penetrating wound

When it traverses a tissue creating an exit wound

Perforation

Thermal Injury: Burns

Superficial:


- Confined within the epidermis




Partial thickness burns:


- Dermis




Full Thickness burns


- Subcutaneous tissue, may include muscle

Morphology of burns

Full Thickness:


-White or charred and dry


-anesthetic




Partial:


Pink or mottled with blisters


Coagulative necrosis

Burn complications

ARDS


Infection- Pseudomonas


Gastric ulcer- Curlings


Squamous cell carcinoma ( Marjolin Ulcer)

Result from loss of electrolytes via sweating

Heat cramps

Most common hyperthermic syndrome


-result from failure of Cardiovascular system to compensate for hypovolemia

Heat exhaustion




- sudden onset, prostration and collapse

Thermoregulatory mechanism fail leading to multi organ dysfunction

Heat stroke

Affected in malignant hyperthermia?

Nitrosylation of ryanodine receptor type 1 (RYR1)

common cause of malignant hyperthermia?


Drug of choice?

Succinyl Choline and Halothane



Dantrolene


MOA of halothane

Facilitate GABA-mediated inhibition, Block NMDA and ACH-N receptors

Succinylcholine

Depolarizing neuromuscular blocker


- Agonist of Ach-N receptors causing initial twitch then persistent depolarization

Types of current

AC more dangerous than DC


- AC= tetanic contraction


-DC= Single shock

Types of radiation

Non-ionizing


- Not sufficient enought to displace electron bound atom




Ionizing


- Sufficient energy to remove bound electros

Tissue susceptibility to radiation

Most sensitive ( Lymphoid tissue)


- other sensitive bone marrow, GI, Germinal tissue




Least Sensitive (Bone)


- others skin, muscle, brain

Radiation injury causes

Cytoplasmic swelling


Mitochodrial distortion


Degeneration of ER


FIBROSIS and VASCULAR CHANGE

Definition of Marasmus

Weight falls to 60 % of normal


Deficiency of all nutrients


Better prognosis than kwasiorkor

Clinical findings in marasmus

Emaciation, Loss of muscle, growth retardation, Immune deficiency, but Normal ALBUMIN




Broomstick extremities


Bone marrow hypoplasia

Kwasiorkor definition

Protein depribation is greater than reduction in calories




Most common form of Protein-energy malnut




associated with Generalized or dependent edema

Clinical finding in Kwasiorkor

Skin lesions (Flaky paint appearance)


Hair changes (Flag sign)


Enlarged, fatty liver (Dec Apo B-100)


Loss of villi and microvilli in SB


Bone marrow hypoplasia


Cerebral atrophy


Thymic and lymphoid atrophy



Features of Anorexia nervosa

self induced starvation, resulting in marked weight loss




Highest death rate of any psychitric disorder

Features of bulimia Nervosa

BInges on food and then induces vomiting




more common than anorexia




Sever dental caries


Erosion of tooth enamel (perimolysis)


Swollen salivary gland


Russells sign


- calluses on back of hands due to repeated traum from incissors

Vitamin A Function

Maintaining normal vision


Differentiation of specialized epi cells


- esp.. Mucus secreting cells


Enhance immunity

Effects of deficiency to Vit A

Nyctalopia (First signs of deficiency)


Xeropthalmia


Bitot spots (Buildup of keratin)


Keratomalacia


Squamous metaplasia


blindess


renal calculi

Effects of Toxicity in vit A

Papilledema


Pseudotumor cerebri


- Idiopathic cranial hypertension


Seizure


Hepatitis


Bone pain

Effects of vitamin D deficiency

Pathologic fracture


Bow leg (Genu varum)


Tetani


Craniotabes


Rachitic rosary


Pigeon Breast Deformity



Effects of Vit C deficiency

SCURVY:


Perifollicular hemorrhage


hemarthrosis


bleeding gums


loosened teeth


glossitis


poor wound healing

Softened occipital bone with elastic recoil

Craniotabes

Overgrowth of cartilage at costochondral junction

Rachitic rosary

Inward bending of weakend metaphysel areas of rib

Pectus carinatum

Bowing of legs (outward)

Genu varum

Adult disease caused by Vit D deficiency

Osteomalacia

Effect of zinc deficiency

Acrodermatitis eneropathica


Anorexia


diarrhae growth retardation


depressed wound healing

Effect of selenium def

Congestive Cardiomyopathym (keshan disease)

Copper deficiency

Muscle weakness


neuro defects


abnormal collagen cross linking