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,