Activity 7

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Chapter 7: Environmental and Nutritional

Pathology
Objectives:
1. To identify the most common environmental factors that may cause
disease in individuals.
2. To identify how said environmental pathogens cause disease and
the long term consequences of exposure to these agents
3. To identify the most common nutritional deficiencies or excesses
and how they cause disease in the body
Discussion:
Environmental injury includes both physical and chemical injury. The
former includes injury from mechanical, thermal, electrical and radiation
sources. Mechanical injury includes abrasions or superficial tearing of
epidermal cells, laceration, a jagged tear often with stretching of the
underlying tissue, or punctures,, a deep tubular wound, deeper than it is
wide. It also includes incisions which are clean cuts made by a sharp object
and contusions or bruises caused by disruption of small blood vessels. This
may result into bleeding within body cavities, embolism of bone marrow
arising from fractures of bone, or secondary infections. In severe cases, there
may be ruptured viscera or even renal failure. Injury to the head may cause
brain damage , laceration or contusion. Contusions involve damage to the
point of impact (coup injury) and to the side opposite the site of impact
(contrecoup injury)
Injuries to the chest may cause fractures, hemothorax, or
pneumothorax. Injury to the abdomen, on the other hand, may cause rupture
of certain abdominal viscera, particularly the solid organs like the liver and
the spleen.
Burns may be categorized as first or second degree which are both
collectively known as partial degree burns. Third degree burns are also
known as full-thickness burns while fourth degree burns are also known as
extended burns. First degree burns are characterized by hyperemia without
significant epidermal damage. A sunburn is an example of this. A second
degree burn, on the other hand, is destruction of epidermis with slight
damage to the underlying dermis. They typically heal without additional
intervention. A third degree burn meanwhile is characterized by damage to
the epidermis, dermis, and the underlying dermal appendages and typically
require skin grafting. Finally, extension of the burns to the underlying bone is
called a fourth degree burn. Complications include inhalation of toxic fumes,
hypovolemia, curling ulcers and infections.
Freezing causes cell death due to the formation of intracellular ice
crystals, intravascular thrombosis or localized gangrene. Electrical injury, on
the other hand, causes respiratory or cardiac arrest due to arrhythmias.
Radiation injury causes sunburn and may often be associated with
premalignant cutaneous lesions (actinic keratosis). This can lead to basal cell
carcinomas and melanomas.
The most common cause of chemical injury in human s is chronic
alcoholism. This may result in alcoholic hepatitis and acute and chronic
pancreatitis. It may also result in gastritis and may predispose one to oral,
pharyngeal, laryngeal, esophageal and gastric carcinoma. In some cases, it
may result in a dilated cardiomyopathy.
Common environmental causes of chemical injury includes carbon
monoxide, methanol, lead, and cyanide. Methyl alcohol is converted to
formaldehyde and formic acid resulting to transient metabolic acidosis. This
causes damage to the retina and the optic nerve resulting in blindness.
Carbon monoxide has a higher affinity to hemoglobin than oxygen.
This results in hypoxic injury leading to death of neurons with resultant brain
injury. It causes a cherry red color of the skin, blood, viscera and muscles.
1. Differentiate a concussion from an contusion
2. What is contusio cordis? Explain the pathophysiology.

3. What organism is a burn patient most predisposed to?
4. Why is neutralization of acid burns with alkali not recommended?
5. Between acid and alkali burns, which one is more damaging and why?
6. How does cyanide cause damage? Explain the mechanism behind the damage.
7. How does one get lead toxicity and explain the mechanism that leads
to the damage.
8. What is alcoholic hepatitis?
9. Differentiate marasmus from kwashiorkor

10. What is Minamata disease?
Case 12:
Patient A.T. Is a 5-year old toddler who was brought to the pediatrician
for severe developmental delay. He is still unable to form complex sentences
and can only speak in one or two words at any given time. He walks with a
waddle and is unable to walk unassisted. The patient has been living with his
grandmother since he was two weeks old in an old ramshackle house. An
inspection of the site reveals cracked paint on the walls and ceilings.
1. What could be a likely reason for the developmental delay?
2. What is the mechanism for causing disease?
3. What are the physical manifestations of a person with this disease?

4. What is the Fenton Reaction, and how does it cause cellular damage?

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Chapter 7: Environmental and Nutritional

1. Differentiate a concussion from an contusion

2. What is contusio cordis? Explain the pathophysiology.

4. Why is neutralization of acid burns with alkali not recommended?

8. What is alcoholic hepatitis?

9. Differentiate marasmus from kwashiorkor

1. What could be a likely reason for the developmental delay?

2. What is the mechanism for causing disease?

3. What are the physical manifestations of a person with this disease?

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