TRACE ELEMENTS CCHM Flashcards by Queenie Mae

Trace Elements Methods and Instrumentation

Atomic Absorption Spectrometer (AAS)
Atomic Emission Spectrometer (AES)
Graphite Furnace Atomic Absorption Spectroscopy (GFAAS)
Inductively coupled Plasma Atomic Emission Spectroscopy (ICP-AES)
Inductively couples plasma Mass Spectrometry (ICP-MS)

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Crystalline silver white ductile metal
Most abundant metal
Oxygen, silicon & fluorine
Aluminum containing minerals
Good conductivity of heat & Electricity

ALUMINUM

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Aluminum
Health effects & toxicity

Toxicity is not well understood
Encephalopathy
Osteomalacia or aplastic bone disease
Proximal myopathy
Increased risk of infection
Microcytic anemia

Increased left ventricular mass & decreased myocardial function
Renal insufficiencies
Anemia
Bone disease
Progressive dementia
Impaired neurologic Development

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Aluminum Laboratory

ICP MS
GFAAS

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In aluminum, Urine and serum levels are useful in _____, ______ and _____

determining toxic exposures, monitoring exposure overtime, and monitoring chelation therapy

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Metallic & non metallic properties
Earth’s crust (1.5 2.0 mg/kg)
Food (25 50 ug/d)
Anthropogenic sources

ARSENIC

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Arsenic
Health effects & toxicity

Nausea, emesis, abdominal pain, rice water diarrhea
Pancytopenia, anemia, & basophilic stippling
ECG changes
Encephalopathy & neuropathy
Renal insufficiency & renal failure
Hepatic systems
Mees Lines”, hyperkeratosis, hyperpigmentati on, & alopecia

Cirrhosis & hepatomegaly
Hypertension & PVD
CNS neuropathy & tremor
Squamous cell, hepatocellular, skin, bladder, lung, & renal carcinomas
“Black foot disease”

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Arsenic Laboratory

ICP MS
GFAAS
HG AAS

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____is desired, a separation method is employed either online or off line prior to metal analysis

Arsenic speciation

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Soft, bluish white metal which is easily cut with a knife
Burning of fossil fuels such as coal and oil & incineration of municipal waste materials

CADMIUM

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Toxicity is believed to be a result of ____, ____, ____, ____, ____,____
___ can be used as a chelating agent in cadmium poisoning

“Protein Cd” adducts
Severe nausea, vomiting, and abdominal pain
Renal dysfunction
Nasal epithelial damage and lung damage similar to emphysema

EDTA

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Laboratory Cadmium

GFAAS & ICP MS
ICP AES

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In ____, Urinary excretion is about ___ in the RBC
____ of the body burden per 24 hours.

Cadmium
70%
0.001% and 0.01%

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Greek word “___”
Rubies red & emeralds green
21 st most abundant element in the earth’s crust
Stainless steel

chromium
chroma

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Chromium Health effects:

Enhances insulin action
Metabolism of glucose, fat, & cholesterol
Adequate daily intake of chromium (50 200ug/d)

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Chromium Deficiency

Insulin resistance
Impaired glucose tolerance
Hyperlipidemia
Glucose intolerance, glycosuria, hypercholesterolemia, decreased longevity, decrease in sperm counts, and impaired fertility

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Chromium Toxicity
Powerful oxidizing agent

Cr(6+)

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In chromium, ___ At physiological pH

CrO42+

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Toxicity of Chromium

It similarity to essential phosphate & sulfate anions
Skin ulcer, renal & hepatic necrosis
Severe dermatitis & skin ulcers
Allergic dermatitis with eczema

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protein complex in chromium

Cr (3+)

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Chromium Toxicity

Airway irritant, airway obstruction, & possibly lung cancer
Lung, kidneys, liver, skin, & immune system
Transient renal effects
Elevated urinary B 2 Microglobulin (an indicator of renal tubular damage)

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Chromium Laboratory

GFAAS
NAA
ICP MS

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In chromium, ___, ___, and ___ do not indicate the total body status of the individual, whereas ___may be useful for metabolic studies

Plasma, serum, and urine
urine levels

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Relatively soft yet tough metal
Electrical & heat conducting
Forms___,____ and ______
Cu(0), Cu(1+), Cu(2+), Cu(3+)
Cofactor of several metalloenzymes
Heme synthesis
Cellular respiration
Collagen synthesis

Copper
alloys w/ zinc, tin, & nickel

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Copper Health effects:

Ceruloplasmin, cytochrome C oxidase, superoxide dismutase, tyrosinase, metallothionein, dopamine hydroxylase, lysyl oxidase, clotting factor V and unknown enzyme that cross links keratin in hair

Copper Deficiency

Premature infants Severe diffuse diseases of small bowel, lymphosarcoma, & scleroderma Malnutrition, malabsorption, chronic diarrhea, hyperalimentation, & prolonged feeding with low copper, total milk diets Neutropenia & hypochromic anemia in early stages Osteoporosis & various bone and joint abnormalities Decreased pigmentation of the skin and general pallor Hypotonia, apnea, and psychomotor Retardation Coronary heart disease “Menkes Disease”

This invariably fatal, progressive brain, disease characterized by peculiar hair, called kinky or steely, and retardation of growth.

“Menkes Disease”

Progressive mental deterioration, coarse feces, disturbance of muscle tone, seizures, and episodes of severe hypothermia.

“Menkes Disease”

Interferes with absorption of ____ and ___ is an irritant to epithelia & mucus membranes. Hepatic & renal damage with hemolysis. induced ___ has characteristic “blue green color” “Wilson’s Disease” Genetically determined disease that usually presents between ages of ___ and ___ years old Neurological disorders, liver dysfunction, and Kayser Fleischer rings in the cornea

Copper Iron and zinc emesis 6 - 40 y/o

Copper lab

Flame aas , icp ms , icp aes , and asv Serum copper & urine copper Direct measurement of free copper & Serum ceruloplasmin

4th most abundant element Most abundant transition metal Classified as a trace element Oxygen transport Participates in ___ Agent in ___ and ____

Iron redox chemistry Agent in redox & electron transfer reactions

Increased in serum Iron:

a.Condition of increased erythrocyte destruction ( haemolytic anemia) b. Decreased blood formation (lead poisoning, pyridoxine deficiency) c. Increased release of iron from the body of stores (release of ferritin in acute hepatic cell necrosis) d. Defective iron storage (pernicious anemia) e. Increased rate of absorption (hemochromatosis and transfusion siderosis)

Decreased in serum Iron:

. Generalized iron deficiency (lack of sufficient dietary iron) b. Inadequate absorption of iron c. Chronic loss of iron as a result of bleeding or nephrosis d. Impared releases of iron from the reticuoendothelial system (infection) e. Malignant f. Rheumatoid arthritis

Increase in TIBC:

a. Iron defificency b. Late pregnancy c. Oral contraceptives d. Viral Hepatitis

Decreased in TIBC:

Chronic infections b. Malignancy c. Iron poisoning d. Nephrosis e. Kwashiorkor f. Thalassemia

___ bound to transferrin Serum or heparinized plasma Oxalate citrate and EDTA Early morning sampling Specimen with visible hemolysis should be avoided

“TOTAL IRON CONTENT” Fe(3+)

amount of iron that could be bound if transferrin and other minor iron binding proteins present in the serum or plasma sample weresaturate

TIBC

called transferrin saturation, is the ratio of serum iron to TIBC. Approximately 20% to 50%, but it varies with age and sex.

“PERCENT SATURATION”

Measured by immunochemical methods such as ___. Iron deficiency Chronic infections & malignancy Iron overload & hemochromatosis

TRANSFERIN nephelometry

Immunochemical methods Iron deficiency anemia Iron overload & hemochromatosis Chronic infections, malignancy, and viral hepatitis

FERRITIN

Fe Laboratory

AAS ICP-ms

Iron quantification in liver is not used for the evaluation of ____ ____ testing has not yet been shown to be clinically useful.

Iron acute iron toxicity hepcidin

Soft, bluish white, highly malleable and ductile Poor conductor of electricity & heat and resistant to corrosion

Lead

>45 μg/dL ___ 60 μg/g ___ IQ declines are seen in children with blood lead levels of 10 μg/dL or more Clumsiness, gait abnormalities, headache, behavioral changes, seizures, &severe cognitive and behavioral problems. Abdominal pain, constipation, and colic.

Lead treshold for acute clinical intervention upper treshold

Lead Laboratory

ICP-MS ICP-AES & GFAAS

The most common specimen type is____ the result of which is commonly referred to as the ____ Elevated lead levels in capillary blood specimens should be confirmed with a venous specimen

lead whole venous blood, blood lead level

“Quicksilver” Heavy, silvery metal Liquid at room temp. & pressure Hg(0), Hg(1+), and Hg(2+). Organic mercury

Mercury

Mercury Health effects & Toxicityy

autism in children Headache, tremor, impaired coordination, abdominalcramps, diarrhea, dermatitis, polyneuropathy, proteinuria, and hepatic dysfunction

Mercury Laboratory

ICP-MS Cold vapor AAS

Mercury is usually determined as total mercury levels in ____ and ___ without regard to chemical form.

blood urine

12thmost abundant element Found in over 250 minerals Constituent of metalloenzymes and as an enzyme activator

MANGANESE

Health effects of Manganese

Arginase, pyruvate carboxylase, and manganese superoxide dismutase. Hydrolases, kinases, decarboxylases, and transferases Many of these activations are not specific to manganese and other metal ions (magnesium, iron, or copper)

Manganese Deficiency

Blood clotting defects, hypocholesterolemia, dermatitis, and elevated serum calcium, phosphorus, and alkaline phosphatase activity Epilepsy, hip abnormalities, joint disease, congenital malformation, heart and bone problems, and stunted growth in children

Toxicity of Manganese

Nausea, vomiting, headache, disorientation, memory loss, anxiety, and compulsive laughing or crying. Resembles Parkinson’s diseasewith akinesia, rigidity, tremors,mask-like faces. locuramanganica(manganese madness)

Manganese lab

ICP-MS GFAAS

___ is used in conjunction with___ to evaluate possible toxicity or deficiency

Urine manganese serum manganese

Hard, silvery white metal Molybdenite, wulfenite, & powellite

MOLYBDENUM

Health effectS of Molybdenum

Xanthine oxidase, aldehyde oxidase, and sulfite oxidase “Molybdopterin” Dietary molybdenum deficiency is rare Molybdenum cofactor deficiency is a recessively inherited error of metabolism Elevated uric acid in blood and an increased incidence of gout

Laboratory of Manganese

ICP-Ms GFAAS Blood levels are less than 60 μg/L

Naturally occurring metalloid Similar to sulfur (chemical & physical) Essential trace elements Major constituent of 40 minerals & minor constituent of 37 others

Selenium

Selenium Health effectS

Glutathione peroxidase (in the form of selenocysteine) Deiodinaseenzymes and thioredoxin reductase

Selenium Deficiency

Cardiomyopathy, skeletal muscle weakness, and osteoarthritis Selenium intakes and the rate of cancer of the large intestine, rectum, prostate, breast, ovary, and lungs and leukemia. “Keshan disease” “Kashin-beck disease”

an endemic osteoarthritis that occurs during adolescent and preadolescent years.

“Kashin-beck disease”

an endemic cardiomyopathy that affects mostly children and women in childbearing age dizziness, malaise, loss of appetite, nausea, chills, abnormal electrocardiograms, cardiogenic shock, cardiac enlargements, and congestive heart failure

“Keshan disease”

Selenium toxicity

Nausea, vomiting, and diarrhea Tachycardia Nails and skin and hair loss, as well as neurologic problems such as unsteady gait or paralysis

Selenium lab

ICP-MS GFAAS Determination of urinary and blood selenium is an useful measure of selenium status.

Bluish-white lustrous metal. Stable in dry air and becomes cover with a white coating when exposed to moisture. Alloys, especially brass (with copper), in galvanizing steel, in die casting, in paints, in skin lotion. Treatment for____

Zinc wilsons disease

zinc deficiency

Growth retardation, slows skeletal maturation, causes testicular atrophy, and reduces taste perception. Old age, pregnancy, lactation, and alcoholism “acrodermatitis enteropathica” adolescent

Health effects of zinc

Oxidoreductases, transferases, hydrolases, leases, isomerases, and lipases. Synthesis and metabolism of DNA & RNA Synthesis and metabolism of proteins Metabolism of glucose and cholesterol, membrane structure maintenance, insulin function, and growth factor affects

First develop a characteristic facial and diaper rash Growth retardation, diarrhea, impaired T-cell immunity, insufficient wound healing, infections, delayed testicular development in adolescence, and early death

“acrodermatitis enteropathica”

Slow growth or weight loss, altered taste, delayed puberty, dwarfism, impaired dark adaptation, alopecia, emotional instability and tremors.

“adolescent”

zinc toxicity

Gastrointestinal symptoms Decrease in heme synthesis Hyperglycemia “zinc fume fever”

Chemically induced pneumonia, severe pulmonary inflammation, fever, hyperpnea, coughing, pains in legs and chest, and vomiting

“zinc fume fever”

zinc Laboratory

FAAS, ICP-AES, ICP-MS

____ in the presence of low ____ usually confirm zinc deficiency. Serum zinc cannot be interpreted as evidence of ____ Zinc concentration in RBCs is approximately ___ that in serum. ___ should be monitored in patients undergoing long-term zinc therapy

Low urine zinc levels serum zinc levels normal zinc stores 10x Copper status

strong yet lightweight metal commonly found in ____

aluminum Al 13 soda cans

highly toxic element commonly used in ___

Arsenic As 33 rat poison

can be found in some paint pigments

Cadmium ca 48

red-colored metal that is good conductor of electricity

Copper Cu 29

Cars from the 1950s and 60s were often decked out with this

Chromium Cr 24

Rusts by itself which is why a lot of element are added to it to make ___

Iron Fe 26 steel

poisonous, people used to drink from it in medieval times

Lead Pb 82

can lead to ___, a toxic state causing hallucinations and violence

Manganese Mn 25 manganism

deadly liquid element that causes damage to NS.

Mercury Hg 80

tough metal used in many types of power tools

Molybdenum Mo 42

when consumed by cows, can cause them to go into blind staggers

Selenium Se 34

corrodes quickly, added to steel to increase longevity

Zinc Zn 30