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80 Cards in this Set

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What are the major air pollutants?
Ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, and lead particulates
T/F Pollutant particles in the air larger than 10um are more dangerous than smaller ones
False, the smaller ones get further down into the respiratory passages where they get phagocytosed by macrophages.
What is the radioactive gas derived from uranium in soil?
Radon. It has been implicated in lung cancer etiology
What industrial pollutant would cause irritation of mucosa of airways?
Fumes of formaldehyde or ammonia
What industrial pollutants would cause lung cancer?
Asbestos, volatalized nickel, arsenic, or chromium.
What industrial pollutants would cause leukemia?
Prolonged exposure to benzene or uranium
Which industrial organic pollutants most commonly cause injuries?
Chloroform and carbon tetrachloride found in degreasing agents and paint removers. Also PCHs released from burning fossil fuels
What organic compounds used in production of plastics can cause cancer?
Vinyl chloride monomers used in polyvinyl resins can cause angiosarcoma of the liver
What is the most dangerous particle size of mineral dust or other solid particulates?
1 to 5um, bigger or smaller than that doesn't cause much problem
T/F Coal dust causes problems at lower concentrations than silica, asbestos, and beryllium
False, it is relatively inert and has to be present in large quantities to cause disease
What is the most dangerous place in the lung for a small particle to end up?
Alveolar duct bifurcations where they can be endocytosed by macrophages.
What causes lung pathology in people that inhale small particulate matter?
Macrophages endocytose the particles and realease chemotactic factors that bring in inflammatory cells which release damaging mediators.
T/F Tobacco smoke worsens the effect of inhaled mineral dust, especially with asbestos
True
What is pneumoconioses?
Lung disease that results from inhalation of coal, silica, or asbestos
What type of coal mining has been associated with higher risk of pneumoconioses?
Anthracite mining, as opposed to bituminous coal
What is pulmonary anthracosis?
The most innocuous coal-induced pulmonary lesion. Result of macrophages endulfing carbon pigment and accumulating in lung lymphatics and CT
What distinguishes CWP from silica and asbestos exposures?
Coal dust doesn't increase susceptibility to tuberculosis and doesn't cause lung carcinoma like asbestos
What is the most common mineral implicated in silicosis?
Quartz
What is the histologic appearance of lung tissue in acute silicosis?
Interstitial inflammation and accumulation of proteinaceous fluid rich in surfactants within alveolar spaces
What type of silicosis results in formation of fibrotic nodules in the lung?
Chronic silicosis resulting from inhalation of crystalline silica over prolonged period of time
What is conglomerate silicosis?
Progression of chronic silicosis until nodules coalesce and lung parenchyma is destroyed
Which environmental pulmonary disease is associated with increased susceptibility to tuberculosis?
Silicosis
T/F Silica particles can be carcinogenic
True, this is thought to be mediated by silicas ability to induce reactive oxygen species in the lung
What are the 2 different types of asbestos?
Serpentine chyrsotile, which is most widely used, and amiphiboles which is less used but induces mesothelioma
T/F Asbestos probably functions as both a tumor initiator and a promoter
True
How can you distinguish idiopathic pulmonary fibrosis from that caused by asbestos?
Presence of asbestos bodies that are formed when macrophages attempt to phagocytose asbestos fibers
T/F In contrast to CWP and silicosis, asbestosis begins in the upper lobes of the lung and progresses down
False, asbestosis begins in lower lobes and subpleurally and progresses to middle and upper lobes
When would you find pleural plaques and how would you find them?
THey can be found via chest x-ray and are the most common manifestations of asbestos exposure. They are plaques of dense collagen often containing calcium
What 2 cancers commonly develop in asbestos workers?
Bronchogenic carcinomas and malignant mesotheliomas. 5 fold increase for former, 1000 fold increase for latter.
T/F Concomitant cigarette smoking increases risk of bronchogenic carcinoma but not mesothelioma in asbestos workers
True
As asbestosis progresses what secondary heart problems can arise?
Cor pulmonale and congestive heart failure
Who is at risk for berryliosis?
Aerospace and nuclear workers
Heavy exposure to dusts or fumes of metallic beryllium can lead to what condition?
Acute pneumonitis. Light exposure may lead to pulmonary granulomatous lesions similar to sarcoidosis
How does beryllium induce T-cell mediated immunity in some individuals?
It can act as a hapten by binding to proteins and rendering them immunogenic for CD4+ helper T cells
What is the result of T-cell activation in berryliosis?
Formation of non-caseating granulomas in lungs and hilar nodes
What condition can result from leukocyte production of elastase in the lungs of smokers?
Emphysema, where the lungs lose their elasticity
T/F Almost one third of all heart attacks are attributed to cigarette smoking
True
What two types of immune response can penicillin induce?
Type 1 or 2 hypersensitivity. (IgE mediated anaphylactic response, or IgG mediated hemolytic anemia)
What are two leading causes of death in postmenopausal women?
Myocardial infarction and stroke
T/F Estrogens elevate LDL and reduce HDL
False, it the opposite. Estrogen has a protective effect against atherosclerosis
Is it better for women to start estrogen replacement at onset of menopause or later on?
40-50% decrease in risk of ischemic heart disease in women who begin at onset of menopause
When does use of oral contraceptives casue major increase in breat cancer risk?
When woman has BRCA1 or BRCA2 gene mutation and family hx of breast cancer
What type of cancer are oral contraceptives most associated with generally?
Cervical cancer, usually correlated with duration of use
T/F Oral contraceptives protect against endometrial and ovarian cancers
True
What damage can be caused by high doese of acetaminophen?
Hepatic necrosis, but it would have to be a huuuge dose for this to happen, like 15-25g taken at one time
What are the symptoms of lead poisoning?
Abdominal pain, fatigue, headache. In kids it can go unsuspected until there is a catastrophic encephalopathic crisis leading to seizures or retardation
What are the oral manifestations of lead poisoning?
Gingival lead line. Black line that appears at the junction of the free gingival margin
Where is most of absorbed lead deposited?
In developing teeth and bone.
What radiographic evidence would exist in lead poisoned child?
Deposition of lead in growth plates, causing radiopaque lead line on x-ray
What effect does lead have on blood?
It interferes with enzymes involved in heme synthesis. Iron isn't incorporated into heme and you get hypochromic anemia
What peripheral neural effects can lead poisoning have?
Peripheral neuropathy of commonly used muscles. Leads to wristdrop and footdrop
What oral symptoms are caused by lead poisoning?
Hypersalivation, and dysthesia, numbness, tingling, or burning of tongue or lips
What would you suspect when you see a cherry-red color of skin and mucous membranes?
Acute carbon monoxide poisoning
How is CO poisoning detected?
By presence of significant levels of carboxyhemoglobin in blood
What is the byproduct of alcohol metabolism that causes acidosis?
Excess build-up of NADH
What peripheral neural effects can lead poisoning have?
Peripheral neuropathy of commonly used muscles. Leads to wristdrop and footdrop
What oral symptoms are caused by lead poisoning?
Hypersalivation, and dysthesia, numbness, tingling, or burning of tongue or lips
What would you suspect when you see a cherry-red color of skin and mucous membranes?
Acute carbon monoxide poisoning
How is CO poisoning detected?
By presence of significant levels of carboxyhemoglobin in blood
What is the byproduct of alcohol metabolism that causes acidosis?
Excess build-up of NADH
What peripheral neural effects can lead poisoning have?
Peripheral neuropathy of commonly used muscles. Leads to wristdrop and footdrop
What oral symptoms are caused by lead poisoning?
Hypersalivation, and dysthesia, numbness, tingling, or burning of tongue or lips
What would you suspect when you see a cherry-red color of skin and mucous membranes?
Acute carbon monoxide poisoning
How is CO poisoning detected?
By presence of significant levels of carboxyhemoglobin in blood
What is the byproduct of alcohol metabolism that causes acidosis?
Excess build-up of NADH
T/F Large doses of cocaine are required in order to induce cardiac event
False, even small normal doses could cause this in a first time user
How does cocaine effect the nervous system?
By inhibiting reuptake of dopamine and norepi, which leads to excess stimulation
How do the lethal effects of cocaine and heroin differ?
Cocaine kills you by MI and heroin kills you by resp depression
What is the most common infection among addicted persons?
Viral hepatitis acquired by sharing dirty needles
What are two beneficial effects of THC?
Decrease in intraocular pressure in glaucoma and ease of nausea secondary to cancer chemo
How do lacerations and incisions differ?
Lacerations are due to blunt object and have intact bridging blood vessels and jagged, irregular edges.
What are the gross characteristics of a full-thickness burn?
White or charred and dry skin. Will not hurt do to destruction of nerve endings.
What are the characteristics of a partial-thickness burn?
Pink or mottled skin with blisters. This will be painful because nerve endings are still intact
What are the histologic characteristics of burned tissue?
It exhibits coagulative necrosis
How do gasses such as chlorine cause burns?
By reacting with water to form acids or alkalis in the airways that lead to inflammation and tissue destruction
What is the leading cause of death in burn victims?
Organ system failure resulting from burn sepsis secondary to bacterial infection
What is the most common bacterial infection in burn victims?
Pseudomonas aeruginosa
What are the most common sequelae in burn victims secondary to infection?
Renal failure and/or acute respiratory distress syndrome.
What is the biggest dependent factor in severity of electrical injury?
Amperage and path of current within the body
What happens when alternating current passes through a person?
It induces tetanic muscle spasms