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Questions and Answers
What percentage of absorbed lead remains in the blood after exposure?
What percentage of absorbed lead remains in the blood after exposure?
- 50-60%
- 15-20%
- 5-10% (correct)
- 80-85%
Which of the following conditions is linked to chronic arsenic exposure?
Which of the following conditions is linked to chronic arsenic exposure?
- Radiodense deposits in epiphyses
- Microcytic hypochromic anemia
- Basophilic stippling
- Hyperpigmentation and hyperkeratosis (correct)
Which symptom is NOT characteristic of lead poisoning?
Which symptom is NOT characteristic of lead poisoning?
- Abdominal pain
- Encephalopathy
- Memory loss
- Cerebral palsy (correct)
Which pathologic feature is associated with lead poisoning in the blood?
Which pathologic feature is associated with lead poisoning in the blood?
What primary disease results from fetal exposure to mercury?
What primary disease results from fetal exposure to mercury?
At which blood alcohol level is a person likely to experience slurred speech and poor judgment?
At which blood alcohol level is a person likely to experience slurred speech and poor judgment?
Which of the following statements about blood alcohol levels and their effects is accurate?
Which of the following statements about blood alcohol levels and their effects is accurate?
Which process is primarily responsible for metabolizing ethanol in the body?
Which process is primarily responsible for metabolizing ethanol in the body?
What is the consequence of prolonged high blood alcohol levels on cognitive functions?
What is the consequence of prolonged high blood alcohol levels on cognitive functions?
What blood alcohol concentration is often categorized as light coma and depressed vital signs?
What blood alcohol concentration is often categorized as light coma and depressed vital signs?
Which of the following is most likely a result of acute ethanol consumption at high levels?
Which of the following is most likely a result of acute ethanol consumption at high levels?
What condition can result from the oxidation of ethanol to acetaldehyde?
What condition can result from the oxidation of ethanol to acetaldehyde?
What effect does a blood alcohol level of 80 mg/dL generally have on motor performance?
What effect does a blood alcohol level of 80 mg/dL generally have on motor performance?
What biochemical change primarily leads to fatty change in the liver due to alcohol consumption?
What biochemical change primarily leads to fatty change in the liver due to alcohol consumption?
Which syndrome is primarily associated with thiamine (Vit B1) deficiency due to alcohol abuse?
Which syndrome is primarily associated with thiamine (Vit B1) deficiency due to alcohol abuse?
What is a major consequence of acetaldehyde formation in individuals abusing alcohol?
What is a major consequence of acetaldehyde formation in individuals abusing alcohol?
Which organ system is NOT typically affected by ethanol toxicity?
Which organ system is NOT typically affected by ethanol toxicity?
In the chronic consumption of alcohol, which of the following is a primary mechanism of alcoholic liver disease?
In the chronic consumption of alcohol, which of the following is a primary mechanism of alcoholic liver disease?
Which nutritional deficiency is strongly associated with Korsakoff syndrome in chronic alcoholics?
Which nutritional deficiency is strongly associated with Korsakoff syndrome in chronic alcoholics?
What is a typical lesion in the nervous system caused by chronic alcohol consumption?
What is a typical lesion in the nervous system caused by chronic alcohol consumption?
What condition may result from the toxic effects of alcohol on the gastrointestinal tract?
What condition may result from the toxic effects of alcohol on the gastrointestinal tract?
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Study Notes
Alcohol Metabolism and Effects
- Alcohol dehydrogenase (ADH) oxidation occurs in the cytosol.
- Cytochrome P-450 system, particularly CYP2E1 isoform, is located in the endoplasmic reticulum (ER).
- Catalase is found in peroxisomes, aiding in alcohol oxidation.
- Aldehyde dehydrogenase (ALDH) oxidizes acetaldehyde in mitochondria.
Alcohol and the Liver
- Fatty change affects over 90% of chronic alcohol drinkers, leading to fatty liver.
- Alcoholic hepatitis occurs in 10-15% of alcoholics.
- Alcoholic cirrhosis is a severe liver disease due to prolonged alcohol intake.
Biochemical Effects of Fatty Change
- Increased catabolism of fat in peripheral tissues and elevated delivery of free fatty acids to the liver.
- An excess of NADH stimulates lipid biosynthesis.
- Mitochondrial fatty acid oxidation is reduced.
- Acetaldehyde binds to tubulin, impairing microtubule function and reducing lipoprotein transport from the liver.
Alcoholism-Related Syndromes
- Wernicke syndrome arises from thiamine (Vitamin B1) deficiency.
- Korsakoff syndrome features memory loss and confabulation.
- Cerebellar degeneration and peripheral neuropathy can also be attributed to thiamine deficiency.
Mechanisms of Disease from Ethanol Abuse
- Liver Lesions: Fatty change, acute hepatitis, and cirrhosis caused by toxicity.
- Nervous System: Wernicke syndrome (thiamine deficiency), Korsakoff syndrome (toxic effects), cerebellar degeneration (nutritional deficiency), and peripheral neuropathy (thiamine deficiency).
- Cardiovascular System: Alcohol can lead to cardiomyopathy and hypertension due to toxicity.
- Gastrointestinal Tract: Alcohol causes gastritis and pancreatitis through toxic effects.
- Skeletal Muscle: Rhabdomyolysis is also induced by toxicity.
- Reproductive System: Alcohol consumption can lead to testicular atrophy.
Effects of Blood Alcohol Levels
- Blood alcohol level of 20 mg/dL results in decreased inhibitions and mild intoxication.
- At 80 mg/dL, complex cognitive functions and motor performance decrease markedly.
- A level of 200 mg/dL shows slurred speech, motor incoordination, irritability, and poor judgment.
- At 300 mg/dL, light coma may occur alongside depressed vital signs.
- A blood level of 400 mg/dL can result in death.
Lead Toxicity
- Common sources include lead-contaminated air, food, old house paints, soil, and gasoline.
- 80-85% of absorbed lead accumulates in bone and developing teeth.
- Blood shows microcytic hypochromic anemia and basophilic stippling as pathologic features.
- Nervous system effects include memory loss and encephalopathy.
- Gastrointestinal symptoms include abdominal pain, while kidney effects present as chronic tubulointerstitial disease.
Mercury Exposure
- Minamata disease is a severe outcome of mercury exposure, leading to cerebral palsy, deafness, blindness, and significant CNS defects during fetal development.
Arsenic Toxicity
- Acute exposure results in central nervous system damage, often progressing to death by disrupting mitochondrial oxidative phosphorylation.
- Chronic exposure leads to skin hyperpigmentation and hyperkeratosis.
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