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Mechanisms of DiseaseMechanisms of DiseaseEnvironmental/NutritioEnvironmental/Nutritional/ Diseases of Infancy nal/ Diseases of Infancy and Childhoodand ChildhoodJune 17, 2003June 17, 2003
Stephen L. Putthoff, D.O., FCAPStephen L. Putthoff, D.O., FCAP
Chairman, Department of Chairman, Department of Pathology and AnatomyPathology and Anatomy
a. bad
b. really, seriously bad
c. really, really bad
d. very, very bad
e. the worst
1. How bad is cigarette smoking for you?
Table 10-3, pg. 409 Table 10-4, pg. 409
How much do you How much do you drink?drink? Do you have an alcohol problem? Do you have an alcohol problem?
It might be useful if you reflected It might be useful if you reflected upon itupon it
Do you have any friends who Do you have any friends who youyou thinkthink have, or may have a have, or may have a predilection for alcohol abuse – predilection for alcohol abuse – but they seem oblivious?but they seem oblivious?
a. 0.1./ 0.7
b. 0.08/0.75
c. 0.20/0.3
d. 0.15/0.35
e. 0.1/0.5
in Texas? How "high" can serum alcohol go before lethality?2. What's the legal limit for a serum alcohol level while driving
a. fatty metamorphosis of the liver
b. hepatic cirrhosis
c. acute alcoholic hepatitis
d. gastritis
e. pancreatitis
ab. CNS effects
alcohol abuse?3. What changes to you tend to see in the body with chronic
Table and images, p. 411
a. CNS depressants
b. CNS stimulants
c. narcotics
d. hallucinogens
4. Which of the following are common drugs of abuse?
p413
a. hypertension
b. cardiac arrythmia
c. myocardial infarct
d. cerebral hemorrhages/infarcts
e. hyperthermia
a PNS effect?5. Which of the following is a CNS effect of cocaine vs.
a. breast
b. endometrial
c. cervical
d. ovarian
e. thromboembolism
ab. hypertension
ac. ASCVD
ad. hepatic adenoma
estrogen therapy?6. Which cancers and/or complications are associated with
Common OTC agentsCommon OTC agents
Acetaminophen Acetaminophen
AspirinAspirin
PollutionPollution
OutdoorOutdoor
IndoorIndoor
Industrial exposuresIndustrial exposures
Volatile organicsVolatile organics Halogenated hydrocarbonsHalogenated hydrocarbons Plastics, rubber and polymersPlastics, rubber and polymers MetalsMetals
– Table 20-12, pg. 421Table 20-12, pg. 421
Table 10-11, p 419
Effects of leadEffects of lead
Clinical manifestations?Clinical manifestations?
PesticidesPesticides
DDTDDT DiazanonDiazanon MalathionMalathion NicotineNicotine ArsenicArsenic ParaquatParaquat
WarfarinWarfarin StrychnineStrychnine
Natural Toxins
Radiation Injury
UV irradiation
Physical Environment
Wounding = E x 1/T x 1/A x k
abrasion
laceration
contusion
gunshot wounds
characteristics, range, etc.
entries
exits
Physical Injury [cont’d]Physical Injury [cont’d]
Thermal injuries
burns
hyperthermia
hypothermia
Electrical injuries
Atmospheric pressure injury
Food and NutritionFood and Nutrition
Nutritional deficienciesNutritional deficiencies Protein-energy malnutritionProtein-energy malnutrition
Kwashiorkor Marasmus
Table 10-20, pg. 438
Protein Energy Malnutrition
a. normal serum albumin
b. edema
c. hepatomegaly
d. hair "changes"
e. thin extremities
than marasmus?7. Which of the following is more characteristic of kwashiorkor
Vitamin deficienciesVitamin deficiencies Fat solubleFat soluble
Water solubleWater soluble
Table 10-21, pg. 440Deficiency states vs. toxicity
Vit. AVit. A vs. vs. Vit. CVit. C vs vs Vit. Vit. DD A: Fig. 10-23, pg. 442A: Fig. 10-23, pg. 442
– Eye; xerophthalmia, etc.Eye; xerophthalmia, etc. D: Fig. 10-24, pg. 443D: Fig. 10-24, pg. 443
– rickets, osteomalaciarickets, osteomalacia C: Fig. 10-30, pg. 451C: Fig. 10-30, pg. 451
– scurvyscurvy
Others: beriberi, chelitis, pellagra, macrocytic anemia,acrodermatitis enteropathica,
a. insulin
b. leptin
c. parathormone
d. thyroglobulin
e. serotonin
expenditure?the hypothalamus centers that control appetite and energy
8. In terms of obesity, how do adipocytes communicate with
DietDiet
High protein/low carbohydrateHigh protein/low carbohydrate Low proteinLow protein High carbohydrateHigh carbohydrate
Basic principle: Basic principle: eat less, exercise eat less, exercise moremore
Chemoprevention of Chemoprevention of cancercancer ????????????
Diseases of Infancy and Diseases of Infancy and ChildhoodChildhood
Congenital Congenital malformationsmalformations
Perinatal Perinatal infectionsinfections
RDS-newbornRDS-newborn ErythroblastosisErythroblastosis
fetalisfetalis
PKUPKU GalactosemiaGalactosemia Cystic fibrosisCystic fibrosis SIDSSIDS NeuroblastomaNeuroblastoma Wilms tumorWilms tumor
a. Type I pneumocytes
b. alveolar macrophages
c. alveolar surfactites
d. Type II pneumocytes
e. "dust cells"
ab. interstitial myofibroblasts
ac. mast cells
deficiency of a substance(s) secreted by:9. In RDS of the newborn, the primary defect involves
a. chloride, sodium and water
b. the action/movement of the above in the same fashion with both ducts and airways
c. a gene on chromosome 17 (band q31-32)
d. primarily, gastrointestinal disease
e. secondary infection(s) with anaerobes
ab. alginate
ac. autosomal dominant transmission
the common mechanism involves:10. In the most common lethal genetic disease of Caucasians,
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