Pathology - Lecture 6 & 7

Front 1

mortality attributed to environmental and occupational pathology

Back 1

Pneumoconioses - 100%
Cancer -10%
CVS disease - 10%
Resp disease - 10%
CNS disease - 3%
renal disease - 3%

Front 2

mechanism of toxicity

Back 2

1. exposure
2. absorption at portals of entry
3. toxic metabolites
4. distribution to body
5. interaction w/ proteins, DNA, RNA, receptors
6. toxic effects

Front 3

What are the toxic effects of xenobiotics?

Back 3

genetic, carcinogenic, reproductive and immunotoxicity

Front 4

What 6 air pollutants does EPA monitor?

Back 4

1. sulfur dioxide
2. carbon monoxide
3. ozone
4. nitrogen dioxide
5. lead
6. particulate matter

CLONS PM
(Carbon dioxide, lead, ozone, nitrogen dioxide, sulfur dioxide, particulate matter)

Front 5

ozone

Back 5

- formed from nitrogen oxides
- ozone + particulate matter = smog
- free radicals from ozone --> toxicity --> injure epithelial cells of RT

Front 6

radon (indoor air pollution)

Back 6

radioactive gas widely present in soil and homes

Front 7

effects of indoor air pollution

Back 7

1. chronic bronchitis and asthma
2. pneumoconioses
3. cancer (squamous cell carcinoma)

Front 8

pneumoconioses

Back 8

due to inhalation of various dusts

Front 9

anthracosis

Back 9

accumulation of carbon dust in lungs --> emphysema esp. in smokers

Front 10

silicosis

Back 10

silica dust (sand blasters, glass workers, miners, metal grinders, cement workers)

Front 11

complications a/w silica

Back 11

- pulmonary fibrosis
- gradual reduction in lung capacity
- increase risk of tuberculosis

Front 12

Caplan syndrome

Back 12

silicosis + rheumatoid arthritis
- acute exposure to large quantities of silica
- exudative pneumonitis w/ resp failure & death w/in 1-2 yrs

Front 13

coal worker's pneumoconiosis (CWP)

--progression of complications which lead to cor pulmonale

Back 13

progressive massive fibrosis --> black lung disease --> emphysema --> pulmonary HTN --> RV hypertrophy --> cor pulmonale

Front 14

Asbestosis can cause what serious complication

Back 14

- mesotheliomas

Front 15

smoking
- causes what cancers
- what complications
- how many premature deaths/yr

Back 15

- oral and laryngeal
- CAD, lung ca, COPD
- > 40,000/yr

Front 16

smoking increases the risk of what acute, fatal cardiovascular episode

Back 16

sudden cardiac death

Front 17

fetal tobacco syndrome

Back 17

- causes low birth weight and inflicts lasting harm on children (physical/developmental/cognitive skills impairment)

Front 18

Mallory-Weiss Syndrome

Back 18

tears at esophago-gastric junction, may cause severe hemorrhage

Front 19

Wernicke Encephalopathy

Back 19

mental confusion, ataxia, polyneuropathy (B1 deficiency), disturbed cognition, ophthalmoplegia

Front 20

Korsakoff Syndrome

Back 20

retrograde amnesia and confabulatory symptoms

Front 21

Fetal alcohol syndrome

Back 21

infants born to mothers who consume alcohol during pregnancy. AbnL include growth/mental retardation, microcephaly, facial dysmorphology, neurologic dysfunction and other congenital anomalies

Front 22

Drug abuse

Back 22

endocarditis (R side tricuspid valve)

Front 23

arsenic

Back 23

chronic toxicity due to exposure in fruit sprays, weed killers, industrial compounds. Pigmentation, maliase, paralysis
- inc. incidence of live and lung cancer

Front 24

mercury

Back 24

acute poisoning, contaminated fish, grain
- renal acute tubular necrosis, cerebral edema

Front 25

lead

Back 25

exposure to paint spraying, batteries, highway work, and lead in paints chief source of toxicity for children

Front 26

ASA overdose

Back 26

v, hypokalemia, acidosis, bleeding, coma

Front 27

reye syndrome

Back 27

ASA in usual doses, in children w/ viral illness, causing rashes, jaundice, severe anaphylaxis, coma

Front 28

high radiosensitivity

Back 28

bone marrow
lymphoid system
hair follicles
germ cells
epithelium (e.g. GIT)
lung

Front 29

acute radiation sickness

Back 29

hair loss
n/v/d
infxn
bleeding tendency
anemia

Front 30

moderate radiosensitivity

Back 30

body tissues such as CT
blood vessels
breast
bladder
brain

Front 31

low radiosensitivity

Back 31

organs/tissues such as:
kidney
liver
pancreas
muscle
bone
nerve

Front 32

high radiosensitivity (tumor cell types)

Back 32

germ cell tumors
lymphomas
leukemia

Front 33

moderate radiosensitivity (tumor cell types)

Back 33

carcinoma:
skin
cervix
breast
lung
esophagus
pancreas
bladder
neuroblastoma

Front 34

low radiosensitivity (tumor cell types)

Back 34

gliomas
sarcomas
melanoma
renal cell carcinoma

Front 35

primary malnutrition

Back 35

due to lack of food
- not common in US

Front 36

secondary malnutrition

Back 36

adequate diet but defective absorption or metabolism of food or severe food restriction as in anorexia nervosa
- common in US & w/ drug addiction

Front 37

main causes of 2ndary malnutrition

Back 37

1. abnL eating habits - drugs, anorexia nervosa
2. impaired ingestion - oropharyngeal ds, myasthenia gravis
3. defective absorption
4. impaired metabolism
5. increased metabolic requirements

Front 38

Protein energy malnutrition

Back 38

seen in infants and children in underdeveloped countries

Front 39

Kwashiorkor

Back 39

severe malnutrition seen in children
Africa
protuberant abd due to ascites

Front 40

Marasmus

Back 40

extreme wasting and emaciation
seen in 1st years of life
skin and bones

Front 41

2 forms of severe PEM in young children:

Back 41

Kwashiorkor
Marasmus

Front 42

% of obese adults in US

Back 42

30%

Front 43

fat accumulation in body measured by:

Back 43

1. BMI
2. waist-hip ratio
3. skin fold measurements

Front 44

BMI:
1. nL
2. overweight
3. obese

Back 44

1. 25 kg/m^2
2. 25-29.9 kg/m^2
3. >= 30 kg/m^2

Front 45

obesity related diseases

Back 45

Diabetes
HTN
VAD
-- being to increase w/ BMI > 25

Front 46

central obesity

Back 46

a/w higher risk for obesity related diseases than excess deposition of fat diffusely in subQ tissue

Front 47

body weight is maintained in narrow rang by:

Back 47

LIPOSTAT

Front 48

LIPOSTAT consists of:
1. afferent
2. efferent
3. effector

Back 48

1. signals from Leptin and Insulin
2. hypothalamus
3. NE and NPY from hypothalamus regulte FI and EE

Front 49

FI > EE =>
FI < EE =>

Back 49

increase fat
decrease fat

Front 50

abundance of stored energy in adipose tissue, leptin and insulin cause:
1. activation of
2. inhibition of
3. net effect

Back 50

1. catabolic pathway (inc EE; dec FI)
2. anabolic pathway (inc FI; dec EE)
3. reduce FI, promote EE

Front 51

etiology of obesity (genetic)

Back 51

- leptin gene mutation
- subtle alterations resulting in obesity
- **dysfunction of leptin system**
- abnL of hypothalamic pathways

Front 52

Pickwickian syndrome

Back 52

a/w hypersomnolence and R-sided heart failure; hypoventilation

Front 53

hypervitaminosis A and D results from

Back 53

increase dietary intake

Front 54

hypervitaminosis A
-sxs

Back 54

alopecia
periosteal new bone formation
hepatic injury
portal HTN
ascites

Front 55

Hypervitaminosis D
- sxs

Back 55

hypercalcemia
renal stones

Front 56

vit K:
- fnxn in body
- deficiency results in

Back 56

- essential for blood clotting (factors II, VII, IX, X)
- bleeding

Front 57

vit B1 (thiamine) deficiency
- can cause
- seen in

Back 57

- beriberi
- alcoholics

Front 58

dry vs. wet beriberi

Back 58

dry: involves nervous system
wet: cardiac ds w/ failure may predominate; marked by cardiac dilatation w/ all 4 chambers enlarged, pallor and flabby myocardium

Front 59

Niacin (nicotinic acid)
- deficiency can cause
- clinical manifestations

Back 59

- pellagra
- 3 D's: dermatitis, diarrhea, dementia

Front 60

Vit B12 def. causes

Back 60

1. lack of gastric intrinsic factor that is required by B12 absorption (absent in pts w/ gastric atrophy or after sx)
2. inadequ dietary intake
3. infestation w/ fish tapeworm

Front 61

clinical manifestations of vit b12 def

Back 61

- pernicious anemia - megaloblastic anemia (RBC maturation impaired)
- **subacute combined degeneration of spinal cord: degen of both lat and dorsal columns (**both sensory & motor affected)