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Occupational Health > Mentals > Flashcards

Mentals Flashcards

0
Q

Wrist drop, lead colic, lead line and basophilic stippling are manifestation of inorganic lead poisoning or organic lead poisoning?

A

Inorganic lead toxicity

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1
Q

Lead poisoning has been associated with motor neuropathy or sensory neuropathy ?

A

Moto neuropathy, with slow motor nerve conduction, wrist drop may occur

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2
Q

Symptoms of severe toxicity including delusions, hallucinations, hyperactivity, and loud shouting and laughing, are manifestations of inorganic lead or organic lead poisoning?

A

Organic lead such as tetraethyl lead toxicity are related to CNS irritability

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3
Q

Methyl mercury poisoning can lead to?

A
  1. Fulminant chemical pneumonitis
  2. Fetal toxicity
  3. Speech disturbances

(F.F.S)

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4
Q

Nickel compound can cause ?

A
  1. Contact dermatitis
  2. Adult respiratory distress syndrome
  3. Lung cancer

(C.A.L)

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5
Q

Agent that causes Upper airway irritation and green tongue?

A

Vanadium

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6
Q

4 mentals that cause peripheral neuropathies are ?

A

Lead (motor >sensory)
Arsenic (painful, sensory>motor )
Mercury （+ tremor )
Thallium

LAM Tea

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7
Q

Lead T1/2?

A

Red cell: 60-90 days

Bones: years

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8
Q

Lead’a biochemical effects?

A

Enzyme inhibition
Delta-aminolevulinic dehydratase (ALA-D)
Ferrochelatase
Coproporphyrinogen oxidase
Pyrimidine-5-nucleotidase
Enzyme stimulation
Delta-aminolevulinic acid synthetase (ALA-S)

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9
Q

Lead mainly excreted through?

A

Mainly kidney, small amount through stool

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10
Q

Biological effects of lead in the blood?

A 
Increased:
   ALA
   FEP (Free erythrocyte protoporphyrin)
   ZPP (zinc protoporphyrin ) - Fe++ not inserted into porphyrin ring
Basophilic stippling in RBC's
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11
Q

Lead biomonitoring?

A 
Whole Blood lead level
ZPP
CBC & smear
Serum creatinine 
Urinalysis
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12
Q

Distinguish between iron deficiency and lead poisoning ?

A

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

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13
Q

Situations that can have increased ZPP/FEP ?

A

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

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14
Q

Lead poisoning Sx?

A

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
Fanconi syndrome
Infertility, low birth weight

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15
Q

Health effects of Chromium?

A 
Immune system sensitized
Chrome holes (painless skin ulcers)
Nasal septal perforation
Lung cancer
Pulmonary irritant
Renal tubular acidosis
Hepatic necrosis
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16
Q

Septic ulcer, what could be the causes?

A

Cocaine use

Chromium

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17
Q

Heath effects of Arsenic (elemental)

A 
Cancer: skin, lung, bladder
Cardiomyopathy 
Hepatic necrosis
Renal failure
Peripheral vascular changes
Peripheral neuropathy - sensory, painful
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18
Q

Heath effect of Arsine Gas?

A

Garlic odor
AsH3-interaction of arsenic with acids

Made & used in electronic indrustry

Massive intravascular hemolysis
Hemoturia, renal failure
Jaundice, abd pain
Tx: supportive, exchange transfusion

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19
Q

Best indicator of recent As (arsenic) exposure) is?

A

Urine As

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20
Q

Sx of Chronic As (Arsenic ) intoxication?

A

Hyper pigmentation
Keratosis /hyper keratosis of palms and soles - Blackfoot disease
Mee’s line on nail
Painful neuropathy

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21
Q

At what year lead was banned from paint?

A

1976

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22
Q

What year lead was banned from gasoline?

A

1990

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23
Q

Why lead poisoning increase ZPP?

A

Lead inhibit enzyme ferrochelatase

24
Q

Lead T1/2 in the bone?

A

> 25 years in the bone in chronic lead exposure.

25
Q

Indication of recent or long term lead exposure with kappa x-Ray fluorescence study?

A

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)

26
Q

OSHA lead standards?

A

PEL: 50mcg/m3
Action level: air concentration 30mcg/m3

When air level > action level for >30days/year:
   Surveillance program
   Initial medical evaluation including:
      BLL
      ZPP
27
Q

BLL in General industry, Medical removal at?

A 
BLL= or>50 mcg/dL on repeated teat(mean of 3) or
BLL= or >60 mcg/dL once
28
Q

BLL for Medical removal in construction workers?

A

BLL= or>50mcg/dL

29
Q

Follow up after removal from work with high BLL?

A

Repeat BLL in 2 wks:

when BLL40mcg/dL, medical evaluation q2mos until 2 measurement are<40mcg/dL

30
Q

Tx of Cadmium acute poisoning?

A

Chelation with EDTA

BAL is contraindicated

31
Q

What agent is associated with Garlic odor?

A

Tellurium
Phosphorus
Selenium
Arsenic

The garlic odor is very hard “To P.A.S”

32
Q

Visual and auditory hallucinations are classically found in which mental?

A

Manganese neurotoxicity

33
Q

Which mental is associated with stomatitis, gingivitis, tremor, and behavior change?

A

Elementary mercury causes “Mad Hatter Syndrome “

34
Q

Chronic exposure to organic mercury (Methyl Hg) can produce CNS disfunction associated with Sx of ?

A

Tremor, paresthesias, dysarthria, ataxia, decreased visual field, deafness, and mental disfunction

35
Q

Metal fume fever is associated with exposure to?

A

Zinc oxide

Metal fume fever is an acute, self-limiting syndrome characterized by flu-like symptoms

36
Q

chromium VI associated with ? Cancer?

A

Lung cancer

Skin cancer

37
Q

Types of mercury?

A
  1. Elementary Hg (metallic ‘quicksilver’)
  2. Inorganic (chlorides HgCl2, oxides)
    • found in disinfectants
  3. Organic (methyl- or dimethyl mercury)
    • mostly in fish from contaminated ocean and fresh water
    • Minamata bay
38
Q

Tremor, gingivitis, tremor, and behavioral changes, AKA erethism in the “ Mad Hatter Syndrome” is seeing in

A

Elemental mercury chronic intoxication

39
Q

Bloody emesis and diarrhea due to GI mucosal necrosis, stomatitis, ATN, what poisoning ?

A

Inorganic mercury (chloride or oxides of Hg)

40
Q

Bioaccumulate, GI absorbes 100%, lipid soluble, crosses BBB, placenta and excreted in breast milk
CNS: numbness, ataxia, tremor, construction of visual field, hearing loss, rigidity, spasticity, what agent?

A

Organic mercury

41
Q

Minamata Bay and organic mercury toxicity

A

Japan 1940s -1960s by by eating tunna etc fish
At least 30 cases of prenatal lay exposed infants
- cerebral palsy like Sx
- microencephaly, mental retardation, seizures
- nephrotic syndrome

42
Q

Heath effects of cadmium?

A 
Anosmia
Lung cancer
Metal fume fever
Prostate and testicular cancer
Renal tubular damage
   -wasting calcium, causes osteomalacia - Itai Itai (weak and deformed Bone, spinal and leg bone pain)
Yellow gum lines
43
Q

Phossy jaw, bone necrosis, which chemical ?

A

Phosphorus

44
Q

Skin and lung granulomas after chronic exposure, risk of lung cancer, which mental?

A

Beryllium toxicity

45
Q

Cause type IV (delayed or cell- mediated hypersensitivity) reaction
Screening test: specific lymphocyte transformation test (LTT), which mental?

A

Beryllium

Beryllium - specific lymphocyte transformation test for screen of worked: may not develop disease if +, buy beats job reassignment

46
Q

Painful erosive ulcer, nasal septal erosion and perforation, what metal ?

A

Chromium

47
Q

Hard metal disease, what metal?

A

Cobalt, causes pulmonary fibrosis, giant-cell pneumonitis

48
Q

Causes asthma, # 1 mental allergen in general population, which mental?

A

Nickel
Allergic disorder caused by Nickel is permanent. Removed/avoid contact is the best Tx.
Nickel carbonyl Ni(CO)4 formed in the refining Ni, causes diffused interstitial pneumonitis.

49
Q

Asthma, rhinitis, urticaria, type I (IgE) sensitizer, what metal?

A

Platinum

50
Q 
Garlic odor, sweat
Inhalation irritant
Hair loss
Nail discoloration 
Tooth decay

What metal?

A

Selenium

51
Q

Inhalation irritant
ARF
Argyria - irreversible blue- grey skin discoloration

Which metal?

A

Silver

52
Q

Tx of Metal Fume Fever?

A

Caused by zinc

Tx: EDTA, BAL

53
Q

2nd leading cause of lung cancer?

A

Radon

Uranium ~> radium ~> radon~> lung cancer

54
Q

ARF
Hemolytic anemia
Rhabdomyolysis
Myocarditis

What metal?

A

Uranium

55
Q

The only metal that can cause Fanconi syndrome after chronic exposure

A

Cadmium

56
Q

Garlic breath odor

A
  1. Arsenic
  2. Phosphorus
  3. Selenium
  4. Tellurium
57
Q

Metal that can cause nasal septum perforation?

A

Chromium

Nickel

Occupational Health (69 decks)

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