chronic conditions leading to natural disease radiation injury pollutants nutritional diseases

Chronic Conditions Leading to Natural Disease• Radiation injury• Pollutants• Nutritional diseases

Radiation

• Non-ionizing electromagnetic waves– Radio waves, microwaves, ultraviolet waves

• Ionizing electromagnetic waves– X-rays– Gamma rays

• High energy particles– Alpha particles (He nucleus, Rn)– Beta particles (e-)

Radiation

• Factors influencing radiation absorption– Energy– Mass and charge– Radiodensity of tissue

• Mechanisms of action (point or frame shift)– Direct damage to DNA– Indirect damage by formation of O radicals

(depends on [O2] and richness of blood supply)

Radiation

Biological doses measured in rads1 rad of radiation delivers 100 ergs of energy per

gram of target tissue

Radiation

Whole body irradiation• Acute Radiation sickness• Chronic Carcinogenesis

Russia• No warning• Contaminated milk

consumed by children• 28 workers died of

radiation poisoning• 6000 cases thyroid

carcinoma, 15 fatal

Japan• Warning• Milk destroyed; foods

being screened• 5 workers died (cause

unstated)• ?

Radiation

Why is 2000 rads lethal, but we treat patients with 5000 rads without killing them?

Radiation

Biologic effects• Dose per unit time critical

– Higher dose yields greater effect– Lower dose allows time for cellular DNA repair

• Radiosensitivity of cells– Most sensitive in G2 and mitosis

– Less sensitive in G0 and non-dividing cells

Radiation

Histologic appearance of irradiated tissue• Cytoplasmic swelling, vacuolization• Nuclear swelling, pleomorphism

Radiation

• Microvasculature (constriction, necrosis)• GI tract (N&V, C&D, scarring)• Lungs (ARDS, scarring)• CNS (progressive deficits, pleomorphism)• Hematopoietic (pancytopenia, leukemia)• Gonads (germ cell destruction, both sexes)

Pollutants

• IndustrialDust and gases

• PersonalMedications, tobacco, alcohol

Pollutants

Pneumoconiosis – disease caused by dust in lungs and reaction of lungs to dust

Development depends upon• Amount of dust retained in lungs• Size and shape of particles (~10 μm)• Solubility and physiochemical reactivity

Pollutants

Pneumoconioses• Silicosis (tunneling, sand blasting)• Coal worker’s pneumoconiosis (mining)• Asbestosis (exposure to buildings)

– Fibrous plaques– Bronchogenic carcinoma– Mesothelioma

Pollutants

Tobacco– Emphysema (10-15%)– Carcinoma (10%)– Accelerates atherosclerosis

Pollutants

Alcohol– Acute accidental deaths (overdose, MVAs)– Chronic cirrhosis, nutritional deficits

Nutritional disease

• Caused by– Ignorance and poverty– Alcoholism– Illness (malignancies, HIV, Crohn’s, anorexia)

• Malnutrition– Marasmus– Kwashiorkor– Anorexia nervosa

Nutritional disease

Vitamin deficiencies• Vitamin A• Vitamin D• Vitamin C• Vitamin B1

• Vitamin B3

• Vitamin B12

Mineral deficiencies• Iron• Iodine

W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders CompanySlide 10.29

W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders CompanySlide 10.30

W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders CompanySlide 10.31

W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders CompanySlide 10.33

W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders CompanySlide 10.32

W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders CompanySlide 10.36

W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders CompanySlide 10.37

Nutritional disease

Vitamin deficiencies• Vitamin A• Vitamin D• Vitamin C• Vitamin B1

• Vitamin B3

• Vitamin B12

Mineral deficiencies• Iron• Iodine

Forensic Pathology

• Medical subspecialty concerned with – Identification of remains– Cause of death– Manner of death

Violent Injuries

• Blunt Force• Sharp Force• Gunshot Wounds• Asphyxia• Burns• Electrocution• Drug Abuse

Drug Abuse

• Alcohol and Tobacco

• Cocaine• Amphetamines• Opiates