Oxidative Stress
Causes (3)?
CAUSES:
- Infections
- Sulfa drugs
- Fava beans
Superoxide Free Radical Damage
Seen In (6)?
SEEN IN:
- Acetaminophen overdose
- Fe overload (Hemochromatosis)
- Reperfusion Injury
- Retinopathy of Prematurity
- Blindness
- Bronchopulmonary Dysplasia
Osmotic Damage
Causes (2), Seen In (Epi), Conseq (3)?
CAUSES:
- Intracel accum of Sorbitol (ie sorbitol dehydrogenase def)
- High bl Galactose
SEEN IN: Chronic Hyperglycemia
CONSEQ:
- Cataracts
- Retinopathy
- Peripheral Neuropathy
Aniline Dyes
Conseq?
CONSEQ:
- Renal TCC
(Aniline = industrial precursor to polyurethane)
Arsenic Exposure
Conseq (2)?
CONSEQ:
- Hemangiosarcoma (vascular tumor) of Liver
- Squamous Cell Carcinoma
Arsenic Toxicity
Mech, Pres (3)?
MECH = Inhib of Lipoic acid (cofactor in Pyruvate Dehydrogenase complex).
PRES:
- Garlic breath
- Vomiting
- Rice-Water stools
Thorotrast (ThO2) Exposure
Conseq?
CONSEQ:
- Hemangiosarcoma (vascular tumor) of Liver
Vinyl Chloride Exposure
Conseq?
CONSEQ:
- Hemangiosarcoma (vascular tumor) of Liver
Ethylene Glycol Poisoning
Conseq?
CONSEQ:
- Ca Oxalate kidney stones
Lead Poisoning
Cause (CLUE), Mech (2), Pres (“LEAD”), Micro Finding?
CAUSE:
- High risk in “old house with chipped paint”
MECH:
- Lead inhibits ALA-dehydratase + ferrochelatase ->↓Heme syn
->↑Protoporphyrin
- Lead inhibits rRNA degradation -> Aggregates of rRNA in RBCs ->
Basophilic Stippling
PRES:
- Lead Lines on gingivae (Burton’s Lines) + on epiphyses of long bones
- Encephalopathy + Erythrocyte basophilic stippling
- Abdominal Colic
- Drops- wrist + foot
FINDING:
- Basophilic stippling
Iron Poisoning
** A leading cause of death from tox in children **
Mech, Pres (3 Acute, 2 Chronic), RX (2)?
MECH:
PEROXIDATION of memb lipids -> Cell death.
PRES: THINK: GI
- Acute:
- Lethargy
- Nausea + Vomiting
- Gastric Bleeding - Chronic:
- Metab Acidosis
- Scarring -> GI Obstruction
RX:
- Chelation
- Dialysis
Smoking
Mech of Conseq, Conseq (6)?
Arteriolar Calcification ->↓arteriole dilation ->↓bl flow thr arterioles.
=>↑Diastolic P
=>↑MAP
CONSEQ:
- Htn
- Variant / Prinzmetal Angina
- Buerger’s Dz
- Pancreatic Adenocarcinoma
- Abruptio Placentae
- Periductal Mastitis
Alcoholism
Path (2), Conseq (7)?
PATH:
- Excess NADH -> Shunting of Oxaloacetate to Malate
- ↑syn of HDL
CONSEQ:
- Dilated / Congestive Cardiomyopathy
- Microcytic Sideroblastic Anemia
- Macrocytic Megaloblastic (Folate def) or Non-Megaloblastic Anemia
- Cirrhosis
- Pancreatitis
- Osteonecrosis
- Gynecomastia
Cocaine
Conseq (5)?
CONSEQ:
- Dilated / Congestive Cardiomyopathy
- Coronary vasospasm
- Sudden Cardiac Death
- Variant / Prinzmetal Angina
- Abruptio Placentae
IV Drug Abuse
Conseq (2)?
CONSEQ:
- Bacterial Endocarditis of Tricuspid valve
- Adult T-Cell Lymphoma (NHL)
Systemic Amyloidosis
Pres (5), Findings?
PRES:
- Restrictive Cardiomyopathy
- Arrhythmia
- Nephrotic Sx
- Hepatosplenomegaly
- Malabsorption
FINDINGS:
- Tongue enlarged
