Flashcards in Mentals Deck (58)
Lead poisoning has been associated with motor neuropathy or sensory neuropathy ?
Moto neuropathy, with slow motor nerve conduction, wrist drop may occur
Wrist drop, lead colic, lead line and basophilic stippling are manifestation of inorganic lead poisoning or organic lead poisoning?
Inorganic lead toxicity
Symptoms of severe toxicity including delusions, hallucinations, hyperactivity, and loud shouting and laughing, are manifestations of inorganic lead or organic lead poisoning?
Organic lead such as tetraethyl lead toxicity are related to CNS irritability
Methyl mercury poisoning can lead to?
1.Fulminant chemical pneumonitis
2. Fetal toxicity
3. Speech disturbances
Nickel compound can cause ?
1. Contact dermatitis
2. Adult respiratory distress syndrome
3. Lung cancer
Agent that causes Upper airway irritation and green tongue?
4 mentals that cause peripheral neuropathies are ?
Lead (motor >sensory)
Arsenic (painful, sensory>motor )
Mercury （+ tremor )
Red cell: 60-90 days
Lead'a biochemical effects?
Delta-aminolevulinic dehydratase (ALA-D)
Delta-aminolevulinic acid synthetase (ALA-S)
Lead mainly excreted through?
Mainly kidney, small amount through stool
Biological effects of lead in the blood?
FEP (Free erythrocyte protoporphyrin)
ZPP (zinc protoporphyrin ) - Fe++ not inserted into porphyrin ring
Basophilic stippling in RBC's
Whole Blood lead level
CBC & smear
Distinguish between iron deficiency and lead poisoning ?
Lead poisoning with increase of both lead and ZPP
Iron deficiency anemia with high ZPP but normal lead level.
ZPP can also increase in old age
Situations that can have increased ZPP/FEP ?
Depends on new RBC synthesis
Except lead poisoning, ZPP/FEP Increase with age and iron deficiency anemia
In lead poisoning, at BLL>35, ZPP /FEP increase as BLL increases
Lead poisoning Sx?
Colic, abd pain, constipation
Motor neuropathy-wrist drop (radial and perineal N.)
Burtonian (blue) gum lines - indicate lead exposure not poisoning
Saturnine gout- urate nephropathy
Infertility, low birth weight
Health effects of Chromium?
Immune system sensitized
Chrome holes (painless skin ulcers)
Nasal septal perforation
Renal tubular acidosis
Septic ulcer, what could be the causes?
Heath effects of Arsenic (elemental)
Cancer: skin, lung, bladder
Peripheral vascular changes
Peripheral neuropathy - sensory, painful
Heath effect of Arsine Gas?
AsH3-interaction of arsenic with acids
Made & used in electronic indrustry
Massive intravascular hemolysis
Hemoturia, renal failure
Jaundice, abd pain
Tx: supportive, exchange transfusion
Best indicator of recent As (arsenic) exposure) is?
Sx of Chronic As (Arsenic ) intoxication?
Keratosis /hyper keratosis of palms and soles - Blackfoot disease
Mee's line on nail
At what year lead was banned from paint?
What year lead was banned from gasoline?
Why lead poisoning increase ZPP?
Lead inhibit enzyme ferrochelatase
Lead T1/2 in the bone?
>25 years in the bone in chronic lead exposure.
Indication of recent or long term lead exposure with kappa x-Ray fluorescence study?
Trabecular bone, eg. In patella, reflects relatively recent lead(Pb) exposure (T1/2 - years)
Cortical bone, eg. Tibia, reflects long term exposure (T1/2 - decades)
OSHA lead standards?
Action level: air concentration 30mcg/m3
When air level > action level for >30days/year:
Initial medical evaluation including:
BLL in General industry, Medical removal at?
BLL= or>50 mcg/dL on repeated teat(mean of 3) or
BLL= or >60 mcg/dL once
BLL for Medical removal in construction workers?