Path Week 8: Enviromental And Nutritional Diseases

Front 1

What 3 diseases account for the most deaths associated with smoking

Back 1

Lung cancer, cardiovascular disease, and chronic respiratory disease.

Front 2

Lung problems caused by smoking

Back 2

Emphysema, chronic bronchitis, COPD, and lung cancer.

Front 3

Mechs of how smoking effects lungs

Back 3

1) Direct irritant of mucosa leading to bronchitis
2) Cilia toxins in smoke impair tracheobronchial clearance
3) Recruits leukocytes to lung which increase elastase production and general injury leading to emphysema.
4) Tars and Polycyclic hydrocarbons, carcinogenic metals, acetylaldehyde, and phenols are all carcinogens in smoke. Cause cancers of lung, bronchus, lip, tongue, buccal mucosa, larynx, esophagus adenocarcinoma of kidney, pancreas, and squamous carcinoma of cervix.
5) Smoking acts with other exposures synergistically to increase cancer risk.

Front 4

Heart problems caused by smoking

Back 4

Ischemic heart disease (atherosclerosis and MI)

Front 5

Mechs of how smoking effects heart

Back 5

1) Plattlette adhesion and aggregation is increased
2) Decreased myocardial o2 supply due to lung disease and carbon monoxide induced hypoxia
3) Decreased threshold for ventricular fibrillation and arrhythmia.

Front 6

Fetal Tobacco Syndrome

Back 6

Fetal exposure results in low birth weights, prematurity, spontaneous abortions, premature rupture of fetal membrane, premature rupture of placenta, and SIDS

Front 7

What are examples of occupations with lead exposure

Back 7

Handling batteries, ammunition, spraypaint, and radiator repair workers.

Front 8

Effect of lead on skeleton

Back 8

Lead competes with calcium in bones, can impair remodeling of bone in kids causing lead lines. Have an increased radiodensity on Xray. Accumulation also leads to longer recovery time for fractures. Halflife in bone is 30 years.

Front 9

Effect of lead on bone marrow

Back 9

Get anemia due to incorporation into hemoglobin. Develop hypochromic (lighter in color due to less hemoglobin) microcytic anemia with basophilic strippliing of RBCs. Will see elevated zinc protopophyrin in cells.

Front 10

Effects of Lead on nervous system

Back 10

Children get reduced IQ, iriitibility, ataxia, clumsiness, hyperactivity, seizures and coma. Maternal exposure can effect fetus. Adults get peripheral demylinating motor neuropathy leading to footdrop, headache, and memory deficits (most common prob).

Front 11

Leads effect on kidneys

Back 11

Proximal tubule epithelial cells become damaged with intranuclear inclusions. Lead intoxication can cause aminoaciduria, glycosuria, and hyperphosphaturia (aka fanconi syndrome)

Front 12

Carbon Monoxide poisoning

Back 12

Much higher affinity for hemoglobin than O2, not only reducing O2 content but also making hemoglobin hold onto O2 tighter. Causes increased redness of the skin and brain. Brain also gets necrosis of globus pallidus.

Front 13

What do burn victims ultimately die from

Back 13

Shock, Sepsis, and Resp Insufficiency

Front 14

What determines the severity of a Burn

Back 14

Depth, surface area affected, internal injury from inhalation of toxins, and promptness of therapy. Burns on over 50% of body are potentially fatal.

Front 15

First Degree Burn

Back 15

Epidermal involvement only. Ex. mild sunburn

Front 16

Second degree burn

Back 16

Involves epidermis and superficial dermis. Skin is pink and mottled amd has blisters.

Front 17

3rd and 4th degree burns.

Back 17

Destruction of epidermis, dermis, and loss of appendages. Skin is white, charred, and anesthetic.

Front 18

Pathology of burns

Back 18

Coagulative necrosis with inflammation. Burned skin weeps plasma, fluid and protein shifts into the interstitial compartment leading to hypovulemic shock. and edema.

Front 19

2 forms of ionizing radiation

Back 19

High frequency short wavelength: X and gama rays
High Energy particles like neutrons, protons, deutrons, mesons, and alpha and beta particles.

Front 20

Effect of radiation on DNA

Back 20

Most important target of radiation. Can be damaged directly or indirectly by oxygen radicals derived from water. Cause pyrimidine dimers, cross links, strand breaks and rearrangements.

Front 21

Radiation levels and the organ systems they affect in acute radiation syndrome

Back 21

200-600 rem - Hematopoetic system. Destruction of lymphocytes in circulating blood and tissues, pancytopenia.
600-1000 rem - GI probs. NVD, hemmorrhage, emaciation.
>1000 rem - CNS. NV, confusion, listlessness, convulsions, coma.

Front 22

What is the clinical level for malnourished

Back 22

Child with weight less than 80% normal.

Front 23

Primary Marasmus

Back 23

Protein malnutrition in children due to an overall lack of caloric intake. Less than 60% of normal weight. Growth retardation, loss of fat and muscle, depletion of Somatic protein. Look emanciated, have anemia, have t cell deficiency.

Front 24

Secondary Marasmus

Back 24

Protein malnutrition occuring during chronic illness like cancer. Weight loss, muscle wasting, loss of subQ fat. Cachectic wasting is due to loss of appetite, elevated BMR, and production of IL-1, TNF, and IL-6.

Front 25

Kwashiorkor

Back 25

Protein malnutrition due to low protein more than total caloric loss. 60-80% of normal weight. Loss of Visceral protein. Get hypoalbuminemia and edema. Flakey paint skin discoloration, hair color loss, and enlarged, fatty liver due to reduced synthesis of carrier proteins. More severe than marasmus b/c they break down fat less efficiently.

Front 26

What BMI is considered Obese?

Back 26

>30kg/m2

Front 27

Central Obesity

Back 27

Fat accumulates in trunk and abdomen. More dangerous.

Front 28

7 diseases associated with obesity

Back 28

1) Hypertension
2) Type 2 diabetes
3) Coronary artery disease
4) Liver/biliary disease
5) Hypoventilation disease
6) Osteoarthritis
7) Cancer

Front 29

What aspect of obesity leads to increased risk of coronary artery disease.

Back 29

Abnormal lipids. Low HDL cholesterol and hypertrigyseridemia

Front 30

What liver/biliary diseases are associated with obesity

Back 30

Cholelithiasis - Increased total body cholesterol, increased turnover and billiary excretion predispose to cholesterol stones.
NASH may progress to fibrosis.

Front 31

Pickwickian Syndrome

Back 31

Hypoventilation syndrome associated with obesity. Causes hypersomnolence (excessive sleepiness), apnea, polyctythemia and right sided heart failure.

Front 32

What aspects of obesity cause an increase in cancer occurrence.

Back 32

Hyperinsulinemia, insulin resistance, and increased IGF-1.

Front 33

Cancers more common in obese men and women

Back 33

Men: Adenocarcinoma of esophagus, thyroid, colon, and kidney cancer.
Women: Adenocarcinoma of esophagus, edometrial, gall bladder, and kidney cancer.