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93 Cards in this Set

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HgCl2
proximal renal tubule necrosis
2napthylamine
conjugated to glucuronate, excreted in urine
causes bladder cancer
acetaldehyde
tumor promoter
hydrogen cyanide
cilia toxin
smoking and pregnancy
low birth weight (SGA)
prematurity
inc. spont. abortion
inc. complications at delivery
genetic polymorphisms in ___ cause delayed alcohol metabolism in asians
ALDEHYDE dehydrogenase

(acetaldehyde builds up and makes them sick!)
hard, shrunken liver with nodules of regenerating hepatocytes surrounded by dense bands of collagen?
alcoholic cirrhosis!
2 ways ethanol causes acute depressive effects
1. altered membrane fluidity
2. altered signal transduction
ataxia
disturbed cognition
ophthalmoplegia
nystagmus
Wernicke's syndrome
chronic etoh effect on CV system?
dilated cardiomyopathy
alcohol and pregnancy?
fetal alcohol syndrome
1. microcephaly
2. facial dysmorphism
3. brain, cardiovascular, and GU malformation
retinal ganglion cells targetted
methanol
calcium oxalate obstruction of renal tubules
ethylene glycol - concrete in your kidney tubules
seizures
cardiac arrhythmias
respiratory arrest
acute cocaine overdose
insomnia
anxiety
paranoia
hallucinations
hypertension
strokes
sudden death
chronic cocaine abuse
oral contraceptives and thromboembolism
increase the risk
oral contraceptives and cardiovascular disease
no increase in healthy nonsmoking women under 45

increase CV disease risk in smoking women over 35
hepatic adenoma
benign tumor
incidence increased by birth control
birth control and breast, ovarian, cervical, and endometrial cancer
inc cervical
protects against ovarian and endometrial
no increase in breast
hormone replacement therapy and endometrial carcinoma
increases the risk, but adding progesterone dulls this increase
hormone replacement therapy and breast cancer
increases the risk
hormone replacement therapy and cardiovascular disease
increases the risk
hormone replacement therapy and cholcystitis
increases the risk (biliary stasis?)
acetominophen toxicity
run out of GSH
NAPQI forms
hepatic necrosis and liver failure
give acetylcysteine
aspirin overdose
respiratory alkalosis followed by metabolic acidosis that can be fatal
chronic aspirin toxicity
salicylism

tinnitis
headache (the irony!)
dizziness
confusion

acute erosive gastritis
aspirin + phenacetin
**
potentially fatal renal papillary necrosis
benzene
Benzeme
and BONE MARROW!!!!!!


bone marrow toxicity
aplastic anemia
acute leukemia
chloroform and carbon tetrachloride
CNS depression (chloroform formerly used as anesthetic)
liver toxicity
kidney toxicity
vinyl chloride
* angiosarcoma of the liver
rubber workers
1,3 butadiene
leukemia
moa of lead posioning
inhibits 2 enzymes in producing hemoglobin and leads to hypochromic anemia

competes with calcium for storage in bone

leads to red cell hemolysis, renal damage, and hyperentsion

also effects the CNS!
metal causing headache, dizziness, and memory deficits in adults

also abdominal pain and anorexia
lead!
metal causing encephalopathy, cerebral edema, and mental deterioration in kids

intellectual impairment
behavioral abnormalities
learning deficits
lead
amanita phalloides causes death by ___
hepatic dysfunction
ciguatoxin and sagitoxin come from ____
dinoflagellates in fish, snails, and mollusks
aflatoxin B1 causes
hepatocellular carcinoma

peanuts, corn, and other grain
aspergillus
africa
what is a Rad?
dose of radiation that produces absorbtion of 100 ergs of energy per gram of tissue
what is a Gray
dose of radiation that produces absorption of 1 Joule of energy per kilogram of tissue
1 Gray = 100 rads
what is a Rem?
dose of radiation that produces a biological effect equivalent to 1 Rad of X rays or gamma rays
which is more lethal: a single dose of radiation administered to the whole body or regional administration with shielding?
the single dose to the whole body is more lethal!
delayed carcinogenic effect of ionizing radiation may be due to ____
induced genetic instability where mutations persist and accumulate
What is acute radiation syndrome?
acute radiation sickness has 4 syndromes.

in order of increasing severity
1. subclinical
2. hematopoietic
3. GI
4. CNS
effects of radiation therapy?
transient fatigue, vomitting, and anorexia
effects of radiation in 4 phases of development:
1. preimplantation
2. 1st 9 weeks
3. 9-37 weeks
4. childhood
preimpl - lethal to embryo before implantation
probs with organogenesis
CNS and repro system abnormalities
cessation of bone growth and maturation. CNS dev also disturbed
delayed radiation effect on:
1. blood vessels
2. skin
3. heart
4. lungs
5. kidneys and urinary bladder
6. GI
7. eyes
8. CNS
1. subintimal and medial FIBROSIS, degeneration of ELASTIC LAMINA, and lumenal NARROWING
2. radiation dermatitis - epidermis becomes atrophic
dermis becomes fibrotic
subcut vessels weaken
3. heart damage, esp in chest radiotherapy
4. fibrosis (delayed radiation pneumonitis)
5. fibrosis, vascular damage, hyalinization of glomeruli
bladder - necrosis of epithelium, submucosal fibrosis, contracture, bleeding, ulceration
6. every GI problem imaginable
7. cataracts
8. transverse myelitis - necrosis, demyelination, and paraplegia of spinal cord
caisson disease
embolic occlusion of vascular supply to bone, particularly the head of femur and humerus - aseptic necrosis of femoral head, etc

this occurs days after decompression sickness
albumin levels in marasmus
near normal!
immune deficiency in marasmus or kwashiorkor?
both! concurrent infections
why does fatty liver occur in kwashiorkor?
decreased synthesis of lipoproteins. increased breakdown of "visceral" protein compartment
vitamin which potentiates the differentiation of mucus secreting cells?
vitamin A
xerosis?
dryness of the conjunctivae (seen in vitamin A deficiency)
bitot spots?
corneal opacities seen in the xerophthalmia in vitamin A deficiency. they can become ulcers
keratomalacia?
seen in vitamin A deficiency
=destruction of the cornea
vitamin deficiency which causes metaplasia of epithelial surfaces?
vitamin A
levels of Ca and PO4 in vitamin D deficiency
Ca normal
PO4 is low!!!

pay attention!!!!!!!!!!!!!!!!!!
why is bone mineralization in vitamin D deficiency impaired?
insufficient phosphate!!!!!@#@@##
in ricketss, overgrowth or undergrowth of epithelial cartilage?
overgrowth! not mineralized properly b/c of insufficient phosphate
infant with frontal bossing and a squared head?
vitamin D deficiency (ricketts!)
rachitic rosary
BEADLIKE prominences seen at costochondral junction in children with rickets. from deposition of osteoid insufficently minearlized cartilage

seen with pigeon breast deformity (protruding sternum)
absent tendon reflexes, ataxia, dysarthria, loss of proprioception, loss of pain sensation due to what vitamin deficiency?
vitamin E deficiency - spinocerebellar degeneration

caused by degeneration of axons
antibiotics can decrease synthesis of ___
vitamin K by normal flora
bleeding diathesis caused by what vitamin deficiency?
vitamin K
3 major syndromes of thiamine deficiency
dry beriberi - peripheral nerve
wet beriberi - heart - peripheral vasodilation, 4 chambered dilation of heart, high output cardiac failure
wernike-korsakoff syndrome
footdrop, wristdrop, sensory changes caused by what vitamin deficiency
thiamine - dry beriberi
peripheral vasodilation, high output cardiac failure, flabby dilated heart caused by what vitamin deficiency
wet beriberi - thiamine
angular cheilosis
glossitis
greasy, scaling dermatitis
corneal opacities

seen in what vitamin deficiency
riboflavin

(alcoholics, people with cancer)

cheilosis, glossitis, and dermatitis seen in both B6 and riboflavin
dermatitis
diarrhea
dementia
death
pellagria (niacin deficiency)
neuronal degeneration, atrophy of GI epithelium, rash on sunexposed areas caused by what vitamin deficiency
niacin deficiency (pellagra)
isoniazid can cause what vitamin defiency
secondary vitamin B6 (pyridoxine) deficiency
cheilosis, glossitis, dermatitis, peripheral neuropathy caused by?
vitamin B6 (pyridoxine)
cheilosis, glossitis, and dermatitis seen in both B6 and riboflavin


riboflavin needed to activate pyridoxine, so they are in the same pathway
skeletal changes caused by which vitamin deficiency
vitamin C - scurvy - causes decreased deposition of osteoid

vitamin D - rickets/ osteomalacia - causes dep of osteoid on undermineralized matrix
folate deficiency + vitamin B12 deficiency is linked to ______
COLON CANCER
folate + B12 def.
acrodermatitis enteropathica
rash around eyes, nose, mouth, anus, distal extremities

seen in Zinc deficiency
Keshan disease
congestive cardiomyopathy caused by selenium deficiency in china. seen in women and young children

selenium in GSH peroxidase
growth retardation and diminished reproductive capacity caused by which vitamin deficiency?
zinc
also causes acrodermatitis enteropathica - rash around eyes, nose, mouth, and anus
hypersomnolence, polycythemia, and rightsided heart failure
Pickwickian syndrome or hypoventilation syndrome in obese people
a morbidly obese woman has an increased chance of getting what kind of cancer?
endometrial carcinoma

linked with obesity
2naphthyline is converted to a carcinogen by ____
peroxidase dependent cooxidation
isoniazid blocks the action of which vitamin
isoniazid is a B6 antagonist

pts need supplemental b6 with their rx for tb
what is a unique feature of pyridoxine deficiency?
peripheral neurophathy! (q)
_____ poisoning could lead to elevated ALT and AST levels with hyperbilirubinemia
acetominophen
silicon increases chance of lung cancer. lung disease
severe restrictive lung disease
why does chronic cocaine use cause heart attacks?
it is a powerful vasoconstrictor. it can also increase the process of atherosclerosis.

amphetamines can cause cardiac arrhythmias
basophilic stippling of RBC's
LEAD POISIONING
LEAD LEAD LEAD LEAD
interferses with hemoglobin synthesis
elevated in lead poisoning, anemia of chronic disease, and iron deficiency anemia
zinc protoforin
selenium deficiency can cause __ and __
myopathy
cardiomyopathy
what vitamin deficiency could cause poor wound healing, hemorrhage, and rash in an older person who eats weirdly?
vitamin C
which is worse for the heart, AC or DC?
AC!!
how can primary biliary cirrhosis cause fractures?
it interferes with fat absorption which interferes with vitamin D absorption which is needed for bone health.

vitamin d absorption can also be impaired by chronic cholestatic lvier disease, biliary tract disease, and pacreatic disease
inhalation of hot gases from a fire can result in death from ___ without ever being burned
pulmonary edema
how does cocaine cause spontaneous abortion?
vasoconstriction in placenta!
when can oral contraceptives increase incidence of cardiovascular disease?
35+
smoking