Metal Toxicity (Krasowski)

Question 1

the major application of this mineral is in metal alloys, including orthopedic implants, and it is obtained in the diet as vitamin B12

Answer 1

cobalt

Question 2

deficiency of this mineral is rare but toxicity may occur in populations that are occupationally exposed (welding) and in premature infants receiving feeding via parenteral administration; late stages resemble Parkinson’s disease

Answer 2

manganese

Question 4

the organic version this metal is much more dangerous than the inorganic form, and is found in top predator seafood

Answer 4

mercury

Question 5

toxic metal found in drinking water that displays high affinity for binding to keratin and inhibits gluconeogenesis

Answer 5

arsenic

Question 6

mineral that is found in many foods, highly prevalent in grains, and is used in fertilizers and fungicidal sprays

Answer 6

copper

Question 6

mineral found in soil and is a component of glutathione peroxidase, and at toxic levels can cause “garlic breath” and hair loss

Answer 6

selenium

Question 7

An autosomal recessive disorder, resulting from a defect in the metal ion transporter ATP7B, in which copper accumulates in and damages the liver, destryoing hepatocytes and spilling into the rest of the body

Answer 7

Wilson’s disease

Question 7

mineral that is used in steel and other alloys, is derived from grain, soy and leafy vegetables, and is important for some enzyme activity (e.g., dismutase, pyruvate carboxylase)

Answer 7

manganese

Question 8

metal that is a waste product from burning coal and has no known biological role; toxicity is not easily treated

Answer 8

thallium

Question 9

Which of these is NOT a characteristic of Wilson’s disease? A. resembles viral hepatitis B. brittle, kinky hair C. neuropsychiatric manifestations D. kayser-fleisher rings E. low serum copper

Answer 9

B. Brittle kinky hair is characteristic of Menke’s disease.

Question 10

A rare X-linked recessive disorder involving the copper transporter ATP7A that results in low levels of copper in the brain, growth failure, deterioration of nervous system, skeletal abnormalities and brittle, kinky, colorless hair

Answer 10

Menkes disease (aka, copper transport disease, aka kinky hair disease). This is difficult to treat - copper supplements may benefit

Question 11

therapeutic applications of this metal include a highly toxic treatment for “sleeping sickness” and refractory promyelocytic leukemia, with the metal chelator dimercaprol

Answer 11

arsenic

Question 12

Which of the following regarding chelation therapy is TRUE?

A. Chelation therapy is most effective for treating long term exposure to toxic metals

B. Metal chelators are generally easily tolerated, which is one reason why they are therapeutically beneficial even at low levels of metal toxicity

C. Penicillamine, like isoniazid (TB medication) and hydralazine (anti-hypertensive), causes lupus-like effects

D. Only oral preparations of chelation therapy iare available for the treatment of lead poisoning

E. Succimer is highly effective in treating copper and zinc toxicity

Answer 12

C

Question 13

found in batteries and having no known biological role, this metal denatures proteins and does not respond to chelation therapy

Answer 13

cadmium

Question 14

Name 2 treatments that are effective for Wilson’s disease.

Answer 14

copper chelators (trientine)

zinc (reduces copper absorption)

Question 15

this mineral is an important component of many enzymes (e.g., cytochrome c oxidase, dopamine β-hydroxylase, tyrosinase, lysyl oxidase) and is measured in the lab as ceruloplasmin, a binding protein that transports it from liver; deficiency and toxicity are both rare

Answer 15

copper

Question 17

selenium deficiency may lead to this condition, characterized by cardiomyopathy and skeletal muscle weakness

Answer 17

Kashin-Beck disease

Question 18

chelation therapy with oral succimer (long term) and dimercaprol are treatments associated with which metal toxicity at >45 μg/dL?

Answer 18

lead

Question 19

mineral found in red meat, fish, wheat germ and bran, and in deficiency may lead to growth restriction, increased risk of infections, diarrhea, and altered cognition

Answer 19

zinc

Question 20

too much absorption of this metal causes anemia, which causes more absorption, and may lead to toxicity characterized by abdominal pain or colic in children

Answer 20

lead. long term exposure has been linked with cognitive impairment

Question 21

this mineral does not tend to be associated with toxicity, and is rarely deficient due to a public health initiative that took place in the 50s and 60s, but it may cause mottling of teeth enamel in excess use

Answer 21

fluoride

Question 22

essential mineral found in (low levels) fruit and has biological significance in the actions of insulin receptors

Answer 22

chromium

Question 23

toxicity associated with this metal results in neurologic (‘Mad Hatter’) disease and irreversible pulmonary fibrosis

Answer 23

mercury

Question 24

mineral that is deficient in acrodermatitis enteropathica, a rare autosomal disorder characterized by dermatatitis around natural orifices and hair loss

Answer 24

zinc